Peebles Mary J
a Private Practice , Bethesda , MD.
Am J Clin Hypn. 2018 Jan;60(3):239-261. doi: 10.1080/00029157.2018.1400811.
Over 50 years of empirical data demonstrate unequivocally that psychotherapy can cause harm as well as good. Two therapist factors increasing harm risk are inadequate assessment of patients' vulnerabilities and certain attitudes/affects. Adding hypnosis as a technique within psychotherapy heightens risk for harm because: (a) trance can unexpectedly expose patient vulnerabilities (through loosening reality orientation, lessening structure, generating unfamiliar sensations and perceptions, and intensifying access to interior information such as emotions and imagery); and (b) trance can unexpectedly increase porousness to therapist's attitudes/affects (through heightening mental receptivity to the internal states of others). A century of clinical data from psychoanalysis offers guidance for protecting against such risks. Concepts of structure, interiority, and countertransference are explicated and translated into practical clinical suggestions for harm prevention.
五十多年的实证数据明确表明，心理治疗既能带来益处，也可能造成伤害。增加伤害风险的两个治疗师因素是对患者脆弱性的评估不足以及某些态度/情感。在心理治疗中加入催眠技术会增加伤害风险，原因如下：(a) 恍惚状态可能意外地暴露患者的脆弱性（通过放松现实定向、减少结构、产生不熟悉的感觉和知觉，以及增强对情绪和意象等内部信息的获取）；(b) 恍惚状态可能意外地增加对治疗师态度/情感的通透性（通过增强对他人内部状态的心理接受性）。来自精神分析的一个世纪的临床数据为防范此类风险提供了指导。阐述了结构、内在性和反移情的概念，并将其转化为预防伤害的实际临床建议。
