Abstract
When Sigmund Freud abandoned the use of hypnosis, minimized the relevance of dissociation and the dissociative disorders, and replaced exogenous trauma with unconscious fantasies as a prime factor in the etiology of psychic distress, he determined the direction of modern psychoanalysis, exerting influences still powerful today. Recent scholarship reveals that many of his stances were questionable, and some were strategic rather than scientific. Contemporary psychoanalytic/psychodynamic psychotherapists treating patients whose phenomenology and issues have long been exiled from psychoanalytic discourse face a dilemma: Should they privilege their paradigms as they understand them, or plunge into areas where the literatures of their preferred models and practices offer little guidance?

One approach to mitigating this dichotomy involves the detailed study of Freud’s personality, personal agendas, and his willingness to overlook unwelcome dichotomies in his own thinking. For example, Freud discontinued using hypnotic inductions, but his own writings indicate that he had used Bernheim’s autohypnotic/autosuggestive methods, continued to seize upon his patients’ moments of spontaneous trance to pursue deeper associations, and embedded suggestion into the core of analytic technique. These are important concerns to bear in mind when the psychoanalytic/psychodynamic therapist works with psychopathogies associated with high hypnotizability, and may be confused by psychoanalytic injunctions against hypnosis, which Freud himself did not follow.

This presentation will begin with a brief overview of how Freud’s personal issues and ambitions contaminated and confused certain aspects of psychoanalytic thinking, and then demonstrate how understanding and bypassing the sequelae of these misadventures makes possible more scientific, trauma-responsive, and dissociation-aware psychoanalytic/psychodynamic treatments of dissociative disorders and complex trauma. The usefulness of several techniques usually associated with hypnosis will be illustrated with vignettes from psychoanalytic/psychodynamic treatments, although these modalities and hypnosis are often depicted as incompatible.

The application of these techniques to history-taking, and stabilization will be reviewed. The traditional interpretive  sequence of confrontation, clarification, interpretation, and working through will be studied in depth as regards dissociation, and the importance of including self psychological concepts in addressing what are clearly dissociative self pathologies will be explained.

The interface of relational and posttraumatic dissociation follows naturally from understanding complex dissociative disorders as self pathologies. A conceptualization of dissociation and a clinical approach to dissociation that embodies relational, hypnotic, and traumatic constructs, together embracing the majority of the dissociative domain, will be outlined. This formulation was inspired by the presenter’s discussion of Cardeña’s (1994) description of the dissociative domain with the late Philip Bromberg (see Kluft, 2022a, 2022b).

The recovery of concepts and techniques long-dissociated from psychoanalysis will provide the psychoanalytic/psychodynamic psychotherapist with useful and powerful tools of known but frequently neglected power. Many have forgotten that the therapeutic results reported by clinicians using psychoanalytic/psychodynamic psychotherapy facilitated with hypnosis (Coons, 1986; Kluft, 1984, 1986), although reported in the 1980s, have yet to be surpassed.

Potential to Distress: Yes
 

This presentation was originally presented as part of a live virtual seminar in November 2023.