Elsig Claudia, Schopper Christian, Anthony Marion, Gramigna Ronald, Böker Heinz
Psychiatrische Universitätsklinik Zürich/Schweiz, Switzerland.
Psychiatr Prax. 2002 Mar;29(2):97-100. doi: 10.1055/s-2002-22035.
This paper describes the treatment of a patient with the diagnoses of a borderline personality disorder and posttraumatic stress disorder (DSM-IV and ICD-10) within the setting of a psychiatric ward spezializing in depression. For purposes of controlled re-exposure to the patient's trauma, a hypnotherapeutic method was chosen. A significant reduction of symptoms, in particular the intrusions and the hyperarousal, was observed. Of great importance in the successful outcome of this case is the integration of hypnotherapy into a multi-dimensional treatment concept including group therapy, physical therapy and anxiety-reducing self-management therapy. This approach facilitated the development of trust and security in the patient required for the hypnotherapeutic intervention and minimized the splitting tendencies specific to borderline patients. Further discussion is centered on the difficulties arising in the context of an emergency ward setting with its high intensity atmosphere encompassing the danger of retraumatization of this special group of patients. Finally several aspects of the clinical implications of this method are addressed.
本文描述了在一家专门治疗抑郁症的精神科病房中，对一名被诊断为边缘型人格障碍和创伤后应激障碍（DSM-IV和ICD-10）的患者的治疗情况。为了对患者的创伤进行控制性再暴露，选择了一种催眠治疗方法。观察到症状有显著减轻，尤其是侵入性症状和过度唤醒症状。在这个病例的成功治疗中，将催眠治疗整合到包括团体治疗、物理治疗和减轻焦虑的自我管理治疗在内的多维度治疗概念中非常重要。这种方法促进了患者对催眠治疗干预所需的信任和安全感的建立，并最大限度地减少了边缘型患者特有的分裂倾向。进一步的讨论集中在急诊病房环境中出现的困难，这种环境气氛紧张，存在使这类特殊患者再次受到创伤的危险。最后讨论了该方法临床应用的几个方面。
