No High Hypnotizability, No Dissociative Disorder

In the mid 1990s, due to an erroneous interpretation of correlational studies of hypnotizability and dissociative symptoms (r = ~.12), the dissociative disorders field and the hypnosis field mistakenly rejected the role of hypnotizability in the dissociative disorders. This mistake occurred despite the fact that DID patients were known to be more hypnotizable than the patients of any other psychiatric or medical diagnosis. This error sent research and understanding of the dissociative disorders down the wrong path for the last quarter-century. During the last 25 years, the dissociative disorders field has focused, almost entirely, on a trauma model of the dissociative disorders. Today, evidence increasingly suggests that high hypnotizability is THE fundamental and necessary cause of the dissociative disorders – not trauma. In the absence of high hypnotizability, no amount of trauma can cause a dissociative disorder. But, when high hypnotizability is present, inescapable pain and discomfort (i.e., “trauma”) MOTIVATE a person to imaginatively distance themselves from the pain -- via high-hypnotizability-enabled, dissociative feats. If carried out repeatedly, these high-hypnotizability-enabled distancing-maneuvers become habitual. They become a reflexively-functioning, procedural learning pattern that we call “a dissociative disorder.”

This sessions was originally presented as a live conference session in April 2023

Target Audience


Learning Objectives

At the conclusion of this session participants will be able to:

  • Describe the high hypnotizability of DID patients
  • List the reasons why correlational studies of unselected clinical or community samples are unable to assess the role of hypnotizability in the dissociative disorders
  • Explain why the trauma model of dissociation is a “gateway drug fallacy.”
  • Explain why trauma can motivate, but cannot cause, the development of a dissociative disorder
  • Explain why the dissociative symptoms of DID are hypnotic feats, rather than posttraumatic symptoms
Course summary
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Presenter: Paul F. Dell, PhD
Presenter Bio: Paul Dell lives in Norfolk, Virginia. He has a PhD in clinical psychology from the University of Texas. Formerly a Professor of Psychiatry and Behavioral Sciences at Eastern Virginia Medical School, Dr. Dell has been in private practice for the last quarter century. Dr. Dell has specialized in the study and treatment of dissociative disorders since 1985. His special interests are the etiology and nature of the dissociative disorders, and their relationship to high hypnotizability. Dr. Dell constructed and developed the Multidimensional Inventory of Dissociation (MID), a self-administered assessment and diagnostic instrument. Twenty-five years ago, he proposed a phenomenological model of dissociation (which is assessed by the MID). For the last 15 years, Dr. Dell has been elaborating an autohypnotic theory of the dissociative disorders that differs substantially from the trauma model. Dr. Dell is a past president of the International Society for the Study of Trauma and Dissociation (ISSTD). He serves on the editorial boards of ISSTD’s Journal of Trauma & Dissociation, and the American Psychological Association’s Psychological Trauma: Theory, Research and Practice. He is co-editor (with John O’Neil) of Dissociation and the Dissociative Disorders: DSM-V and Beyond (2009). Dr. Dell has received ISSTD’s Morton Prince Award for Scientific Achievement (2004), ISSTD’s Pierre Janet Award (2006 and 2019) for the best publication of the year on dissociation, and ISSTD’s Lifetime Achievement Award (2011). The Society for Clinical and Experimental Hypnosis has twice awarded Dr. Dell the Ernest and Josephine Hilgard Award by for the best theoretical paper of the year about hypnosis (2018 and 2019).


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