Ben was referred to me by a local hospital for treatment of Rapid Eye Movement (REM) behavioral disorder. Due to aging, a part of his brain had degenerated, resulting in loss of muscular control during REM sleep. Both Ben and his wife were fearful that because he had wild body movements while sleeping, he would inadvertently kick or hit her, or that he would injure himself. After nearly 50 years of marriage and sharing a bed, Ben’s wife had resorted to sleeping in the guest room.
Ben was a lively and interesting 70-year old, who had recently retired from his job in a factory where he worked as a master toolmaker. He was looking forward to enjoying his retirement. Ben had a keen sense of history and a strong interest in Native American culture, and he read many books on the subject. We enjoyed talking about this because I share the interest. Ben longed to visit ancient Native American sites and national parks and he purchased a Winnebago for this purpose. He said he was ready to go, but the extremely narrow single bed he would have to bring along, and his symptoms of the REM disorder, made him hesitant about traveling.
For his entire life, Ben had used his hands and mind to produce tools, so it was understandable that he was looking for a simple, concrete solution to his problem. The fact that he felt his disorder was beyond his control, upset and embarrassed him. His mechanical engineering training and tactile problem-solving skills that served him well in his professional life, gave him the air of someone reluctant to consider hypnosis as a tool for achieving wellness.
Matching, pacing, and leading are the cornerstones of good hypnosis. Because of my conversations with Ben about Native Americans, in which I spoke of “trance healing ceremonies” and their similarity to modern day hypnosis, he gradually became open to using hypnosis to help with his REM symptoms.
As part of my early hypnotic training with Steven Heller, I learned of Erickson’s technique for creating an unconscious generative suggestion for a patient. Erickson demonstrated this therapeutic intervention in a case he called “The February Man.” In trance, he created a positive male character for his female patient who had an emotionally impoverished childhood. This character who appeared in her dreams, valued her by leaving encouraging notes and bringing gifts on her birthday and holidays, which helped her to developmentally progress. (Interestingly, for the past 44 years, Erickson has appeared in my dreams, sometimes offering me helpful advice.)
I decided that with Ben I could create a post-hypnotic suggestion that would happen during his sleep cycle, which would interrupt the REM pattern and disrupt the threatening behavior. There are many references in experimental hypnosis literature that show the success of this type of suggestion. I also had success, as Ben would wake up briefly before flailing, and then fall peacefully back asleep.
There’s a Three Stooges sketch where Curley, Moe, and Larry are in one bed. Larry begins to snore, and Moe hits him and says, “Wake up and go to sleep.” Larry wakes up briefly, and then falls back to sleep. Then Curley begins to snore and a frustrated Moe hits him and says, “Wake up and go to sleep.” Curley is groggy and falls back to sleep, and Moe just smiles. However, like most Stooge antics, it soon turns chaotic. Curley and Larry begin to snore and Moe goes from one to the other slapping and shouting, “Wake up and go to sleep!” In my next session with Ben, I discussed the idea of a generative suggestion and the Three Stooges episode. He remembered it well, and we were both had a good laugh. I suggested to Ben that we put Moe in his unconscious dream world to wake him up right before any sleep behavioral disorders occurred, and he agreed.
The next week Ben and his wife came to his session together and reported that his violent sleep behavior had not happened the prior week, and then asked me if it would be alright if they attempted to sleep together. I said yes.
I continued to see Ben throughout that summer as he and his wife worked together on getting ready for their road trip. I repeated the induction with Ben each week, and his wife called me several times to say that they were sleeping peacefully together. After the couple left on their adventure out West, I had Ben check in with me every week for five weeks. In his words, “We followed the blueprints, installed the boilerplate, and the new circuitry was working well.”Commentary By Eric Greenleaf, PhD
In a letter, Dr. Erickson once wrote, “Concerning my views about dreams, I can state quite simply that they are the substance that paves the way to the goals of achievement. Such goals are reached more rapidly if a dreamboat is available.” (Seminars of MHE #1, 1962) David Norton’s keen understanding of the blueprints of hypnotic suggestion and his workmanlike installation of the boilerplate, allowed the new circuits to hum, and the dreamboat to sail on. The contrast of the Stooges’ hilarious lack of workmanship with Ben’s own careful and effective craftsmanship was speedily effective, but was only hinted at through laughter. Like all expert craftsmanship, David’s work with this patient might look easy, but it was dreamily inspired.
Edgar, a child of five, is the oldest son of a marriage that has lived with great economic and family pressures. The mother began going to therapy two years ago for her distress because of her pregnancy. She left treatment. A short while later, she asked for an emergency appointment. She told me by phone that she had just gotten Edgar out of the hospital, and he did not want to return home because she was afraid of his father who, in an attack of fury and impatience, had hit him against the wall, fracturing his cranium.
I met with the whole family in therapy because that permitted me to under- stand the family situation, to perceive their emotions and to explore their resources. Once I have an idea of the family structure and the context in which the problem occurred, I can tell a story (or build a story together with the children) that represents the problem and different solutions. In an abuse situation, it is necessary to censure actions, not the persons implicated, trying to see them as parents who make mistakes. In this case I constructed the story because the child was immobile in a chair, not wanting to look at anyone, much less participate.
I told them a story about a lion cub and its family. Mommy lion went out to work and to look for food, while Daddy lion stayed to guard his territory and did- n’t like to be disturbed. The lion cub really wanted to go hunting. He wanted to go out to explore. He saw the older lions roar and fight and he was dying to do it too. He wanted someone to play with him, but when Mommy arrived, she wanted to do anything but play. She was tired and wanted him to eat. The little cub began to think he was not interesting or important enough for his mother to play with him.
One day the little cub decided to do as the older lions did. He ran close by his father growling like the older lions, but Daddy lion did not move. The cub growled louder and louder without success. Finally he decided to bite the Daddy lion’s paws and ears to get his attention. He didn’t know that Daddy’s paws had been hurt many years ago. How surprised he was when he bit his daddy and his daddy gave him a shove, throwing him against a rock.
The poor little lion was hurt very badly. At this precise moment, Mommy came back from hunting. Scared, she ran to her cub and started to lick him. She growled very loudly at Daddy lion, more loudly than in other times. Daddy lion also ran to see what had happened to his little son. He hadn’t wanted to hurt his son and he didn’t know why he had let out such a strong blow and why his claws had come out when normally they only came out for attack and defense.
The story continues telling how the little cub had been healed at a special cave, but his little heart still felt very sad and something still hurt inside. All the family went to consult a Leopard therapist that helped the parents and cub to cure their wounds. Leopard told them, “Now is time to heal your wounds, before they become infected.”
While listening to the story, Edgard had drawn a picture of himself that showed the open wound in his head. He drew merthiolate and band aids over the wound and at the end of the session he felt calm about going home. His father talked about his own past psychiatric diagnoses and agreed to visit the psychiatrist again.
They came to three more sessions. Although the problems of the family environment continued, the father’s aggression disappeared and they became closer and more communicative.
The Ericksonian techniques utilized were: story telling, metaphors and reframing through the story.Reference:
Robles, Teresa (1990) A concert for four brain hemispheres in psychotherapy, Alom Editores, México y (1991) Terapia cortada a la medida. Un seminario con Jeffrrey K. Zeig, Alom Editores, México.
Milton H. Erickson was no doubt a master of masters in inducing hypnotic responses for clinical purposes. Dr. Erickson was instrumental in developing a number of indirect hypnotic techniques and strategies, including interpersonal and nonverbal or pantomime tactics (Erickson, 1958, 1964, 1966; Haley, 1967). One fascinating technique that stands out was the “handshake hypnotic induction technique.” The purpose of this article is to outline the key elements and a procedure of the therapeutic hypnotic handshake induction technique.What is a Trance Experience?
Controversies over the nature and definition of trance phenomena often involve the contextualized experienced “state” vs. nonstate. The present authors consider a trance experience as a contextualized state with multiple levels, expressions, and facets. The central aspect includes an intense focusing and sense of detachment (dissociated response). One particular behavior directly associated with the handshake technique is the dissociative cataleptic response.Dissociative Cataleptic Response
Inducing a cataleptic response is the key to the handshake technique. Edgette & Edgette (1995) categorize the handshake technique as a method of inducing hypnotic catalepsy. Catalepsy is the induced immobility of various limbs and/or entire body. Edgette & Edgette (1995 p. 173) define catalepsy as, “…immobility in one or more parts of the body.” Catalepsy has been defined as an involuntary tonicity of the muscles (Kroger, 1977), and a suspension of voluntary movement and condition of well-balanced tonicity (Erickson & Rossi, 1981). Muscles are felt as being in balance and comfortable, neither too tense nor too limp. The client/subject maintains or sustains a suspended state or immobilized position for a long period of time.Handshake Technique Procedure
Therapy involves communication within a change-oriented context in which the therapist engages the client in conversation, forming interactions, which can start with a simple handshake. This handshake can be utilized to facilitate the hypnotic elements in these therapeutic conversations.
Erickson and Rossi & Rossi (1976) describe the handshake technique by starting with a firm hand grasp, then slightly adjusting the operator’s fingers, creating momentary confusion by refocusing the subject’s attention with the different sensations felt, as the operator withdraws their hand. As the operator withdraws their hand, the subject’s habitual framework is interrupted, thus creating a hypnotic touch.
This procedure can be detailed into the following steps:Engage with client or subject. Gaze into the client’s or subject’s eyes (as part of the initial exchange via eye contact). Slowly reach out to shake or grasp the Grasp the client’s hand in a normal Slow the handshake down by pacing and leading the client’s hand during the clasp. Shift the touch and pressure, slowly releasing the Slowly release the hand from the handshake; slide hand Meanwhile, if/or when speaking, use a slow, smooth, monotone relaxing voice. Maintain a gaze, looking into the client’s or subject’s eyes, leaving the client’s hand buoyant, as in arm Direct the client therapeutically, thus utilizing the If necessary, for reorientation, provide suggestions.
A similar process naturally occurs when taking vitals. Carich and Junge (1990) noticed pantomime hypnotic experiences when taking vitals, particularly pulses. By taking a pulse, for longer than required, the subject’s arm can be suspended in mid-air, forming a cataleptic response. This experience is similar to the handshake technique in developing cataleptic responses.Key Elements
There are several key hypnotic elements involved in the technique:Fixation of attention or refocusing the client’s attention by: Eye gazes. Touch and Inducing behavioral suspension or buoyant response (creating a dissociative response). Developing a rhythmic pattern during the process, which includes reduced respiratory rate. Interrupting the subject’s habitual framework, by refocusing one’s attention on different sensations of the
A key point while engaging the subject/client, is that the individual’s internal focus is fixated on some selected stimuli involving the level of pressure of the grip. Slowing down the movement and touch during the clasp can initiate this. Also, during the initial engagement, eye gazes create another source of client fixation. By slowing down the shaking of the subject’s/client’s hand, an arm levitation response is induced or created, thus leaving the hand/arm buoyant and totally immobilized. In some cases, the subject or client may be totally immobilized. Finally, the process entails a rhythmic pattern or integration between the therapist and client. The depth depends upon several factors or conditions:Context of the interaction. Skill and rhythmic pattern of the Level of receptivity and responsiveness of the client.
This is a form of an informal, indirect technique, in which the hypnotic suggestion or induction is delivered through the interaction manifested in the hand- shake.
The authors further recommend discovering nonverbal touch situations in everyday life, whereby one can utilize and help the subject fix and focus attention inwardly.Conclusion
Milton H. Erickson was a brilliant therapist and hypnotist who provided different ways, including the handshake technique, to induce and create trance-like therapeutic experiences. In his handshake technique, he utilized the client’s responses and behavior to further enhance hypnotic responses and therapeutic experiences. He used his ability to notice minimal cues or define moments of responses and receptivity, and he learned to access these movements to facilitate the hypnotic handshake technique.
There are a number of applications of the handshake technique, ranging from enhancing rapport to inducing calming responses to relaxation. Upon inducing hypnotic responses, several paths can be taken. Therapeutic messages can be interspersed in the moment. Other ways include bypassing “resistant” responses, or client goal inhibitory responses, creating a window of client receptivity.References
Carich, M.S. & Junge (1990). Pulse-Rate Rapid Hypnotic Injection. The American Society of Clinical Hypnosis Newsletter, 31 (2), October, p.2.
Edgette, J.H. & Sasson-Edgette, J. (1995) The handbook of Hypnotic Phenomena in Psychotherapy. New York: W.W. Norton, C.C.
Erickson, M. Naturalistic techniques of hypnosis. American Journal of Clinical Hypnosis, 1958, 1, 3-8.
Erickson, M. Pantomime techniques in hypnosis and the implications. American Journal of Clinical Hypnosis, 1964, 7, 65-70. (a)
Erickson, M. The interspersal hypnotic technique for symptom correction and pain control. American Journal of Clinical Hypnosis, 1966, 8, 198-209. (b)
Erickson, M. H., Rossi, E. L., & Rossi, S. I. (1976). Hypnotic Realities: The Induction of Clinical Hypnosis & Forms of Indirect Suggestions. N.Y.: Irving- ton: New York
Erickson, M. H. & Rossi, E.L. (1981). Experiencing hypnosis. NY: Irvington. Haley, J. (Ed.) (1967). Advanced technique of hypnosis and therapy. NY: Grune & Stratton.
Kroger, W. (1977). Clinical & Experimental Hypnosis. Philadelphia, PA.: Lippincott.