Reconsidering the autohypnotic model of the dissociative disorders

ABSTRACT

The dissociative disorders field and the hypnosis field currently reject the autohypnotic model of the dissociative disorders, largely because many correlational studies have shown hypnotizability and dissociation to be minimally related (r = .12). Curiously, it is also widely accepted that dissociative patients are highly hypnotizable. If dissociative patients are highly hypnotizable because only highly hypnotizable individuals can develop a dissociative disorder – as the author proposes – then the methodology of correlational studies of hypnotizability and dissociation in random clinical and community samples would necessarily be constitutively unable to detect, and statistically unable to reflect, that fact. That is, the autohypnotic, dissociative distancing of that small subset of highly hypnotizable individuals who repeatedly encountered intolerable circumstances is statistically lost among the data of (1) the highly hypnotizable subjects who do not dissociate and (2) subjects (of all levels of hypnotizability) who manifest other kinds of dissociation. The author proposes that, when highly hypnotizable individuals repeatedly engage in autohypnotic distancing from intolerable circumstances, they develop an overlearned, highly-motivated, automatized pattern of dissociative self-protection (i.e., a dissociative disorder). The author urges that theorists of hypnosis and the dissociative disorders explicitly include in their theories (a) the trait of high hypnotizability, (b) the phenomena of autohypnosis, and (c) the manifestations of systematized, autohypnotic pathology. Said differently, the author is suggesting that autohypnosis and autohypnotic pathology are unacknowledged nodes in the nomothetic networks of both hypnosis and dissociation.

KEYWORDS:

• Dissociation
• dissociative disorders
• hypnosis
• traumatic stress

Notes

1. Breuer and Freud (1895/1955) each contributed a solo-written chapter to Studies on hysteria. Breuer wrote a chapter titled “Theoretical,” and Freud wrote a chapter titled “The Psychotherapy of Hysteria.” This division of labor allowed them to avoid confronting their massive disagreement about hypnoid states. In his theoretical chapter, Breuer stated that hypnoid states were “the cause and necessary condition of…most…major and complex hysterias” (p. 216). Meanwhile, Freud stated in his own chapter: “I have never in my own experience met with a genuine hypnoid hysteria” (p. 286).

2. A reviewer noted that the analyses of Whalen and Nash (1996) and Putnam and Carlson (1998) are less sophisticated than current meta-analyses. I agree. Nevertheless, these two articles provide a comprehensive review of the empirical studies that assessed the relationship between hypnotizability and dissociativity. Like current meta-analyses, these two articles yielded a summary statistic of that relationship (r = .15 and r = .12). Moreover, they drew the same conclusions that a more sophisticated meta-analysis would draw, and they had the same degree of impact (on the field’s view of the relationship between hypnotizability and dissociativity) that a more sophisticated meta-analysis would produce.

3. The concept of trauma has never been rigorously analyzed and defined. I believe that the reason for this is that trauma is a culture-bound concept that has neither an objective status nor a clear definition. The DSM’s Criterion A for PTSD “claims” that trauma can be defined by a specified set of objective, traumatic events. This is a political claim, not a scientific one (Brewin, Lanius, Novac, Schnyder, & Galea, 2009). A person’s response to a supposedly traumatic event is always determined solely by the person (not by that event – no matter how severe or extreme the event may be). The “traumatic” event merely selects a response from the individual; it can never determine that response. The “structure” of the individual at that moment in time fully determines what his or her response to that event will be (Maturana, 1978; see also Dell, 1985). King Midas, who could turn whatever he touched into gold, is a fairy tale; so is the concept of objective trauma. There are no objective traumatic events that have the ability to “traumatize” a person (à la King Midas’ golden touch).