Are the guided visualizations safe for persons with a history of traumatic dissociation and a traumatic brain injury?  I introduced a client to the Panic Attack tape and she felt "funny" and dissociated at the end of the session.  We did some grounding exercises to return her into her body, and she was fine, but she is questioning the safety of follow-up work with these tapes.  Thanks for any feedback you can offer!


Great question – a lot of therapists who don’t work regularly with hypnosis or imagery ask it.
Since guided imagery is a form of conscious, purposeful dissociation, it can actually be used to help train a client like this to gain control over her dissociative process.  By practicing with it, she can get a better idea of what it's like to be 'home' inside her body, and what it's like to go AWOL and be someplace else in her mind. By opting to use imagery on a regular basis, starting out with you keeping her company, she can become skillful at realizing when she’s floated out, and can then pull herself back into her body quickly – by doing those grounding exercises you gave her, for instance.  

As you know, it’s much safer for her to be “home” in her body – it’s the ungrounded, floaty, dissociated people who get pegged as prey by predators looking for their next mugging or sexual assault victim.  In that disembodied state, they broadcast with their body language and that spacey look in their eyes, just how easy it would be to figuratively or literally knock them over.  Similarly, they have more auto accidents and accidental injuries while ironing, using an oven or slicing things with a knife.  

But this means she should continue to practice this with you in the office, where she can safely learn to get a handle on this – it won’t be long before she’ll be able to do it on her own and she’ll be far safer and happier for it.  She should be able to tell you when she feels in control.

As I mention in Invisible Heroes, 2 psychologists from Georgia State, Drs. Joen Fagan and Erma Shephard, way back in the 1980’s, amply demonstrated the power of dissociative techniques, such as hypnosis and guided imagery, for helping people who dissociate, even people with the most extreme diagnoses, such as what they used to call at that time Multiple Personality Disorder - now Dissociative Identity Disorder.

I hope this helps.
All best,