Imaginative forms of psychotherapy in the treatment of patients with childhood traumas

The psychodynamics of patients with severe personality disorders, eating disorders, or ''hysterical'' symptoms are increasingly understood as ways of coping with traumatic experiences in childhood or adolescence such as abuse or violence. Dissociation with induced depersonalisation, derealisation, and personification of objects as only good or only bad is the central coping mechanism during and after a traumatic experience. Unassimilated memories of traumata have a retraumatizing effect and call for defence through eating disorders, substance abuse, self-harming behaviour, or social acting-out. Against this psychodynamic background we describe a method of trauma-therapy which uses experiences of hypnotherapy and of Guided affective Imagery. In the preparatory phase a secure inner space and contact to inner helpers are established in the imagination using a resource-oriented approach. The actual trauma-therapy consists of a gradual leading-up to the traumatic scenes through consistent, minimally retraumatizing confrontation, followed by consolation and the ability to let go. In the final phase there is a return to resource-oriented creativity and concrete life planning.