The use of altered state methods raises challenging and important issues, but these same issues permeate every interaction between survivors and their therapists. Recently, researchers have criticized these interventions on the grounds that they may create false memories. In this paper, the author places the controversy in the context of a larger issue: the misuse of therapist suggestion, and argues that respect for a client’s experience, rather than procedures, ensures safety in the psychotherapy relationship. It is also argued that some form of altered state methodology, such as imagery, hypnosis, or dramatic enactment is not only beneficial but probably necessary for effective trauma treatment. Ultimately, therapists must work wisely and with self-awareness, or they will not work well. Guided imagery, role-play, dramatic enactment, and similar techniques are widely used by psychotherapists in the treatment of child abuse survivors. These methods invite clients to enter an altered state in which they relax critical judgment and attend closely to internally generated sensory experience. References