In this article, we describe how cognitive hypnotherapy can be used in conjunction with evidence-based practices for the treatment of post-traumatic stress disorder (PTSD). We review cognitive-behavioral interventions for PTSD, including mindfulness and acceptance-based approaches, and contend that (a) empirical support for the use of hypnosis in treating a variety of conditions is considerable; (b) hypnosis is fundamentally a cognitive-behavioral intervention; (c) psychological interventions with a firm footing in cognitive-behavioral therapy (CBT) are well-suited to treat the symptoms of PTSD; and (d) hypnosis can be a useful adjunct to evidence-based cognitive-behavioral approaches, including mindfulness and acceptance-based interventions, for treating PTSD.

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In an undergraduate sample (N = 214), we examined the construct validity of the Clinician Administered Dissociative States Scales (CADSS; Bremner, Krystal, Putnam, Southwick, Marmar, Charney, et al., 1998) in the context of measures of state and trait dissociation, administered in conjunction with measures of depression, state anxiety, and affect. We found evidence for the convergent and discriminant validity of the dissociation measures in terms of correlations among dissociation measures that exceeded the correlations of the dissociation measures with measures of other constructs. Internal consistencies of the dissociation measures exceeded .80. Multiple regression analyses provided further evidence of construct validity in that variance in dissociation scores was largely accounted for by scores on other dissociation measures. Nevertheless, measures of anxiety, affect, and depression accounted for incremental variance in the prediction of dissociation measures and therefore should be included in a comprehensive model of dissociation. Our results strongly support the construct validity of the measures of dissociation.

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We thank Professor Merckelbach for his thoughtful commentary, which raises important questions about the treatment of DID and is replete with interesting observations (e.g., DID may represent a complex mood disorder, DID is a severity marker of a polysymptomatic condition, the need to take symptom exaggeration into account in a complete evaluation of DID). For example, Merckelbach questions whether our patient’s DID symptoms could be an example of “spontaneous developing DID, and thereby provide a falsification of the sociocognitive model,” as he presumed we “went to great lengths to avoid the suggestive shaping of DID symptoms.” Shaping influences on patients may be subtle (e.g., exposure to movies, books, magazine misinformation about DID), and symptoms may appear to arise “spontaneously.” Yet in the case of Ms. M., potentially suggestive influences were less than subtle, if not blatant. Indeed, she was not only an avid consumer of media with trauma-based depictions of multiple personalities, but relatively early in her treatment (before SJL came on board), her previous therapist at some point began to interact with supposedly separate personalities, potentially reifying them and rewarding their manifestation....