Freud's Rejection of Hypnosis: Perspectives Old and New:Part III of III-Toward Healing the Rift: Enriching Both Hypnosis and Psychoanalysis.

As Freud developed his own ideas, he abandoned the use of hypnosis. This change led to more than a century of disengagement between hypnosis and psychoanalysis, characterized, with notable exceptions, by mutual avoidance, dismissiveness, and incomplete appreciation of each by the other. Earlier communications challenged the foundations of Freud's rationales and their perpetuation.

Freud's Rejection of Hypnosis, Part I: The Genesis of a Rift.

Modern psychoanalysis begins with Sigmund Freud's study of hypnosis and the treatment of the grand hysterics of the fin de siècle. In the process of developing his own paradigm, Freud came to reject the use of hypnosis and turned his attention away from the severe hysterias. These decisions began what has become, notwithstanding noteworthy exceptions, over a century of estrangement and disengagement between the fields of hypnosis and psychoanalysis.

Freud's Rejection of Hypnosis, Part II: The Perpetuation of a Rift.

Freud's rejection of hypnosis gave rise to a rift between clinical hypnosis and psychoanalysis that has endured for over a century. A review of Freud's rationales (Kluft, 2018a/this issue) demonstrates that while some stemmed from what he considered advances, others appear strongly influenced by his promoting the superiority of his "psycho-analysis" at the expense of hypnosis. Mainstream psychoanalysis continues to endorse the perpetuation of rationales Freud asserted nearly a century ago, and an oral lore of related supportive statements.

Reconsidering Hypnosis and Psychoanalysis: Toward Creating a Context for Understanding.

Sigmund Freud developed what became psychoanalysis in the context of his experiences with hypnosis and the treatment of the grand hysterics of his era, conditions largely classified among the dissociative disorders in contemporary systems of diagnosis. He rapidly constructed understandings of the human mind and human distress that replaced the concept of dissociation and a model of pathology that was passive (associated with reduced psychic cohesion), with the paradigm of an active defensive process he termed repression, and an understanding that psychological discomfort was the outcome of intrapsychic conflict. In short order Freud repudiated hypnosis, initiating the schisms that subsequently separated the study and practice of hypnosis from the study and practice of psychoanalysis.

Weaponized sex: defensive pseudo-erotic aggression in the service of safety.

Problematic sexual behaviors are frequently encountered in the treatment of patients suffering Dissociative Identity Disorder and related forms of dissociative disorders. These may include unfortunate patterns of ready acquiescence or submission to overtly or potentially aggressive or sexual approaches/encounters, subtle and/or overt seductive signaling and behaviors, and even overt sexually provocative patterns of verbalizations and actions. This paper discusses the possibility that in some instances, sexual behavior has become weaponized; that is, deployed in circumstances under which assertiveness and/or aggression or other self-protective measures might be expected, probably because such behaviors were not within the range of the possible or were not understood as potentially successful for some victims of trauma.

Perspectives on Pathways to Induction: Confronting Unexpected Challenges.

In clinical practice, the process of induction may prove more complex and nuanced than its presentation in workshop training would suggest. The relatively straightforward cognitive and instrumental educational domains address defining the concept of induction and instructing workshop participants about how inductions can be performed. However, in work with patients, factors relevant to the attitudinal domain of education become increasingly salient and speak to the importance of how the person inducing hypnosis relates to the person in whom hypnosis is to be induced and how that person goes about crafting a constructive rather than formulaic approach to the induction of hypnosis for a unique individual.

The Wounded Self in Trauma Treatment.

The potential role of hypnosis in the treatment of trauma is both venerable and underappreciated. This article underscores the importance of the wounded-self concept by proposing a Kohutian perspective complimentary to the cognitively-driven model of Alladin (2014a, 2014b) discussed elsewhere in this issue. It explores selected topics that demonstrate (1) the importance of considering the wounds to the sense of self experienced by trauma victims and their implications for individualization of treatment in planning a psychotherapy; (2) the possibility of enhancing access to memories using shame alleviating techniques with minimal suggestive properties; (3) the use of hypnosis to facilitate less disruptive processing of traumatic materials; and (4) the importance of hypnosis in enhancing the safety of the trauma patient between sessions.

Approaches to difficulties in realerting subjects from hypnosis.

Recent studies have demonstrated the importance of identifying and addressing failures of realerting or dehypnosis. In parallel with the exploration of the adverse consequences of hypnosis in workshop settings, a number of techniques for effecting realerting subjects from hypnosis were collected. Some of these techniques are well-known, some were developed by applying techniques developed for other purposes to the task of realerting, and some were developed by the author when other known techniques proved unsuccessful or were rejected by subjects requiring dehypnosis.

Enhancing workshop safety: learning from colleagues' adverse experiences (part II--structure/policy).

Findings summarized in Part I demonstrated that more adverse events occur during hypnosis workshops than had been previously appreciated. 93% went unnoticed and unreported during those workshops. Shortcomings in dehypnosis/realerting preceded most adverse events.

Enhancing workshop safety: learning from colleagues' adverse experiences (part I--structure/content).

Recent studies demonstrate that unwanted responses to hypnosis during training workshops are not uncommon, and usually are covert (Kluft, 2012). Adverse events usually occurred subsequent to inadequate realerting from previous experiences of hypnosis. Inadequate realerting almost invariably was associated with unsuccessful permissive instructions for dehypnosis.

Issues in the detection of those suffering adverse effects in hypnosis training workshops.

Enhancing safety in hypnosis workshops is an issue of significant concern in the progress and promulgation of hypnosis as a facilitator of treatment. In general, hypnosis is a safe modality, but occasional adverse effects are encountered in its use in clinical, research, and professional workshop settings. To develop and implement modifications designed to reduce the number and/or severity of such unfortunate incidents in workshop settings, it is necessary to establish an awareness of the nature and implications of these adverse events.

The older female patient with a complex chronic dissociative disorder.

Dissociative disorders are rarely considered in the diagnostic assessment of older women, despite the fact that the existence, appearance and characteristics of certain dissociative disorders in older populations has been known and described since the 1980s. This communication reviews the core phenomena of Dissociative Identity Disorder and related forms of Dissociative Disorder Not Otherwise Specified, the natural history of their phenomena from youth to old age, and describes common presentations of Dissociative Disorders in older women. It also reviews the treatment of complex chronic dissociative disorders and discusses alternative approaches to their psychotherapy in the older female patient.