Fine C G, Berkowitz A S
Am J Clin Hypn. 2001 Jan-Apr;43(3-4):275-90. doi: 10.1080/00029157.2001.10404282.
Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress disorder, is currently recognized as a treatable condition. It is considered the paradigmatic dissociative condition and carries with it extreme posttraumatic symptomatology. Therapists skilled in the treatment of DID are typically fluent in the uses of hypnosis for stabilization, affect management, building a safe place and grounding to name of few. EMDR, which has come to the forefront of clinical awareness in the last ten years, seems aptly suited for the treatment of trauma, but can be destabilizing. This paper proposes a protocol, called Wreathing Protocol, for the imbricated use of EMDR and hypnosis in the treatment of not only DID (though this will be the primary focus of the paper), but also Dissociative Disorder Not Otherwise Specified (DDNOS) and chronic Posttraumatic Stress Disorder (PTSD). This protocol is useful to advanced clinicians skilled in both modalities independently. The sequential steps of the Wreathing Protocol will be described and illustrated by a clinical vignette on DID. The clinical implications of the use of the Wreathing Protocol will be discussed in DID as well as the chronic post traumatic spectrum.
分离性身份障碍（DID）是一种慢性起病于童年期的创伤后应激障碍，目前被认为是一种可治疗的疾病。它被视为典型的分离性疾病，并伴有极端的创伤后症状。擅长治疗DID的治疗师通常熟练运用催眠来实现稳定状态、情绪管理、构建安全空间以及进行扎根等（仅列举少数方面）。眼动脱敏再处理疗法（EMDR）在过去十年中已成为临床关注的焦点，似乎非常适合治疗创伤，但也可能导致病情不稳定。本文提出了一种名为“环绕疗法方案”的流程，用于将EMDR和催眠交织运用，不仅治疗DID（尽管这将是本文的主要重点），还用于治疗未特定指明的分离性障碍（DDNOS）和慢性创伤后应激障碍（PTSD）。该方案对同时精通这两种疗法的资深临床医生有用。“环绕疗法方案”的连续步骤将通过一个关于DID的临床案例进行描述和说明。还将在DID以及慢性创伤后谱系中讨论使用“环绕疗法方案”的临床意义。
