HYPNOSIS AND TRAUMA

Over the last years, as suggested by scientific literature, the definition of trauma is changing. From the assumption that defined traumas as rare and exceptional events¹ we are shifting to a model in which traumatic events are more frequent than previously imagined². Some studies show that in a wide sample extracted from general population, the percentage of subjects whom, at least once in their lives, found themselves facing a potentially traumatic event (i.e. aggressions, accidents, catastrophic events) ranges from 60% to 90%ibid.. Other sources show that while in most cases being exposed to such kind of events does not lead to long-term consequences, around 25% of subjects exposed to traumas, tend to suffer from repercussions that can become very impairing. Among these there are the Acute Stress Disorder (ASD) and the Post-Traumatic Stress Disorder (PTSD). While the first one describes symptomatic manifestations that appear immediately after the stressful event (typically within 48 hours), the second one is diagnosed if symptoms persist longer than one month. These symptoms include feelings of tension and hyper-arousal, emotional numbing, avoidance of situations that might resemble the stressful event and episodes during which patients vividly re-experience the traumatic event both with nightmares and flashbacks. Flashbacks can be triggered by episodes that in some way recall the trauma and can become very impairing because they make the subject avoid environments that in some cases were part of his everyday life before the onset of the pathology. Since its first modern definitions, hypnosis has been used to treat post-traumatic conditions³ and current research provides evidence of its efficacy. One example comes from a study⁴ in which researchers were interested in verifying whether offering hypnotic sessions to Israeli combat veterans suffering from PTSD could improve the quality of their sleep, often deteriorated by the disorder. While one group was treated with drug therapy and supportive psychotherapy, another one received two additional weekly sessions of hypnosis for two weeks. Results show that, despite both groups improved, the hypnosis group obtained better results in different areas such as sleep quality, ability to concentrate and in the level of sleepiness perceived during the day. Furthermore, despite this wasn’t the researchers’ main focus, these subjects reported improvements also in the frequency and intrusiveness of post-traumatic symptoms (i.e. flashbacks, intrusive thoughts, avoidance behaviors) and in depressive symptoms, which are often present in the treated condition. Another example comes from a study involving victims of civil traumas, stressful events that can happen in urban contexts (i.e. aggressions or car accidents). Building from the evidence that ASD tends to evolve into PTSD in 80% of cases⁵ and that early interventions can reduce this percentage⁶, researchers investigated the potential of hypnosis in the management and resolution of post-traumatic symptoms⁷. They compared three groups: the first one included patients treated with cognitive-behavioral therapy, the second one was treated identically but with the introduction of a hypnosis module and the third one received supportive counseling. Results show that the first two groups obtained better results compared to the third one and that the group who received hypnosis obtained greater improvements in the intrusiveness of flashbacks. Authors comment that in this study hypnosis has been used just to re-experience the traumatic event in order to achieve desensitization. They hypothesize that by using hypnotic techniques more broadly, in order to take into account also other aspects of the patients’ condition, such results could be improved. Another study involved burn patients⁸, a category in which PTSD tends to appear in 45% of cases and in which its symptoms may become chronic. Researchers assigned patients hospitalized for burn care to standard care or to an identical program that included five hypnosis sessions during the course of one week. Results show that patients treated with hypnosis, besides feeling less pain, both caused by burns and medical procedures, reported a reduction in the frequency of flashbacks. Finally it must be remarked that in these kinds of interventions, clinicians often emphasize the importance of a personalized hypnotic treatment tailored on each patient in order to be able to better respond to their specific needs.
 

 

Bibliography  

 

1.	American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: American Psychiatric Association.
2.	Kessler, R., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. (1995). Post-traumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.
3.	Cardeña, E., Maldonado, J., van der Hart, O., & Spiegel, D. (2000). Hypnosis. In E. B. Foa, T. M. Keane, & M. J. Friedman (Eds.), Effective treatments for PTSD (pp. 247–279). New York: Guilford.
4.	Abramowitz, E.G., Barack, Y., Ben-Avi, I., Knobler, H.Y. (2008). Hypnotherapy in the treatment of chronic combat-related PTSD patients suffering from insomnia: A randomized, Zolpidem controlled clinical trial. International Journal of Clinical and Experimental Hypnosis, 56(3); 270-280.
5.	Bryant, R. A. (2003). Early predictors of posttraumatic stress disorder. Biological Psychiatry, 53, 789–795.
6.	Foa, E. B., Hearst-Ikeda, D., & Perry, K. J. (1995). Evaluation of a brief cognitive–behavioral program for the prevention of chronic PTSD in recent assault victims. Journal of Consulting and Clinical Psychology, 63, 948–955.
7.	Bryant, R.A., Moulds, M.L., Guthrie, R.M., Nixon, R.D.V. (2005). The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. Journal of Counseling and Clinical Psychology, 73(2), 334-340.
8.	Shakibaei, F., Ararndi, A.A., GHOLAMREZAEI, A., Samoei, R., Salehi, P. (2008). Hypnotherapy in management of pain and reexperiencing of trauma in burn patients. International Journal of Clinical and Experimental Hypnosis. 56(2); 185-197.