In 1837, a report which may well be the first record of a successful treatment of multiple personality disorder (MPD) described a cure by hypnotherapy. Over the course of time the use of hypnosis in the therapy of MPD has waxed and waned.
In recent years most clinicians who have taken a serious interest in the investigation and treatment of MPD have found that can make valuable contributions toward efforts to help these patients achieve symptomatic relief, integration, and character change. Allison, Braun, Brende, Caul, and Kluft are among those who have written about such interventions, and described their effects. Braun has offered a tentative and preliminary description of the neurophysiological changes which accompany this process: Kluft has described the stability of treatment results.
Despite this, the use of hypnosis with these patients has been, and remains, controversial. Over the years, many prominent individuals have stated or implied that hypnosis can create multiple personality. Several other figures echo these cautions, and some investigators have used hypnosis to produce phenomena which have been described as multiple personality.
In response to those opposing the use of hypnosis, Allison states; "I consider hypnosis a method by which one can open the Pandora's box in which the personalities already reside. I do not believe that such hypnotic procedures create the personalities anymore than the radiologist creates lung cancer when he takes the first x-rays of the chest." He goes on to urge the use of hypnosis in both the diagnosis and treatment of multiple personality. Braun supports this view in his article. "Hypnosis for Multiple Personality" and offers arguments to refute the concept that hypnosis creates multiple personality. Working independently, Kluft, in an award-winning article, strongly challenges the ideas that hypnosis creates multiple personality and is contraindicated in its treatment. Elsewhere, he reports statistics on a large series of cases (many of whom had treatment including hypnoses), and advances testable criteria for fusion (integration).
Kluft and Braun found that reports of the experimental creation of multiple personalities with hypnosis were rather overstated. Experimenters have created phenomena seen in association with and analogous to multiple personality, but did not create a case of clinical multiple personality. Harriman produced automatic writing and some role playing, but not full personalities. Kampman and Hirvenoja asked highly hypnotizable subjects to "...go back to an age preceding your birth, you are someone else, somewhere else." The resulting behaviors were taken to be alternate personalities. However, to be a personality, an ego state must have a range of emotion, consistent behavior, and a separate life history. Kluft and Braun show that none of the authors criticizing the use of hypnosis with multiple personality produced phenomena which met these criteria. It is widely known that ego state phenomena short of MPD can be evoked with or without hypnoses. A form of therapy has been developed to capitalize on this. Allison, Caul, Braun, and Kluft all concluded use of hypnosis in the diagnosis and treatment of multiple personality. All emphasize the need to proceed with care. Their work describes the use of hypnosis for symptom relief, ego building, anxiety reduction, and the building of rapport. It can be used as well for diagnosis (by facilitating the switching process). In the treatment it can aid in history-gathering. Creating co-consciousness, and achieving integration. After integration it has a role in dealing with stress and enhancing copying skills.
General Issues Concerning Hypnosis
Allison, Caul, Braun, Bliss, and Kluft have reported that multiple personalities are good hypnotic subjects. One can take advantage of this to expedite both diagnosis and treatment. Access to the several personalities can be facilitated. After inducing trance, one can teach the patient to respond to cue words (called "key words" by Caul) so that future inductions can be achieved more rapidly.
In determining whether or not to use hypnosis, it is recommended that it not be undertaken unless the clinician has specific therapeutic objectives in mind and can anticipate the possible outcomes of the intervention. If the results are as expected, one is likely to be on the right track. If not, one must clarify one's understanding before proceeding. Poorly planned hypnosis can cloud issues.
When hypnosis is employed, the therapist must formally "remove" the trance before the session ends, and reserve enough time to process the sessions and help reorient the patient to the current time and place. In emerging from trance, a sense of disorientation is common. This is accentuated in MPD, because the trance experience is akin to their switching process. Patients may complain of a "hangover" effect if a trance has not been removed properly.