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 hand. Grasp the client’s hand in a normal handshake. Slow the handshake down by pacing and leading the client’s hand during the clasp. Shift the touch and pressure, slowly releasing the handshake. Slowly release the hand from the handshake; slide hand away. 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 levitation. Direct the client therapeutically, thus utilizing the outcome. 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 Pressure. 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 handshake.
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 operator. 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.
From Newsletter Vol 36. No.1
Harold called me because he was concerned about his ten-year-old son, Bob, who was phobic about gravel roads. Bob’s phobia had generalized to the extent that he had become reticent about leaving his home. I told Harold that I would be willing to provide a one-hour consultation, if he would bring his wife, June, and his son.
Bob was the most hyperactive child I have ever seen in my private practice. Based on the phone call, I had no idea that ADHD was part of the constellation. Bob couldn’t stop fidgeting. As he entered my office, he poignantly announced, “I’m the crazy person.” My heart went out to him.
I did not want Bob to assume a negative self-definition. I gave him a difficult wooden puzzle consisting of two pieces that fit together to make a pyramid. Bob struggled but could not solve the puzzle. I told him that I could not solve the puzzle when I first got it. I called the friend who sent me the puzzle and asked, “Where’s the third piece?” There was no third piece.
I took Bob out of the office into the waiting room. I showed him how to solve the two-piece pyramid puzzle. I then instructed him to give the puzzle to his mother and father. Smiling, he strolled back into the office. Then Bob and I watched as his mother and father struggled to put the puzzle together. They could not easily do something that he knew how to do. Now Bob was one-up.
Building on the situation, I said to Bob and his parents, “I’m an expert at helping families solve puzzles.” I wanted to define the solution as existing within the family.
Harold told me how Bob’s problem began. The family was driving on a gravel road when suddenly a mechanical failure caused the car to spin out of control. A very good driver, Harold brought the car to a safe stop, but Grandmother, who was in the back seat with Bob, completely panicked. Then Bob panicked, and
subsequently refused to get into a car. Eventually he refused to be in any place where there was a gravel road. When Bob went on to say that he was afraid of being out of control, Harold had a new insight. He had not previously understood that aspect of his son’s problem.
I remembered a dictum from Gestalt therapy: “If you’re in terror, play out the terrorizer.” If I can get the fearful person to play the part of the fear monger, it may breed a solution. Continuing my redefinition of their familial problem, I said, “Mr. Fear has attacked this family.” I then asked Bob to show me Mr. Fear. Bob went to the far corner of the office and became Mr. Fear, attacking his family.
I knew from experience that analogies can generate a solution, so I inquired, “Tell me, what is Mr. Fear like?” Bob asked me if I watched Power Rangers, which I knew only vaguely. “Mr. Fear is Drilla Monster,” he continued.”Be Drilla Monster and attack your family.” So Bob pantomimed being Drilla Monster attacking his family.
Next, I thought about the Ericksonian principle of eliciting resources. I knew that there must be a resource in this family to deal with Bob’s fears. Since Bob had offered the metaphor of Power Rangers, I asked him, “What power do you have?” “I know karate,” Bob replied. “Show me how you can use karate to fight off Drilla Monster,” I said. Bob successfully fought back the imaginary Drilla Monster, pushing him out of the consulting room.
Next, I explained the therapy. Whenever Mr. Fear, Drilla Monster, attacked the family, they were to stop and convene a meeting of all the Power Rangers who would decide together how to use their powers to defeat Drilla Monster. I then added, “I have two other therapies that I would like you to practice.” Because June seemed exhausted and overwhelmed, I directed the tasks to the father and son. Harold was bright-eyed and seemed to have a lot of energy to devote to Bob. I explained that each morning for a week, Harold and Bob should practice being out of control. Bob would go into the backyard and play being out of control and Harold would coach him about being better at being out of control. Then Harold would act out of control and Bob would coach him about being out of control. My covert design was to turn a problem component into a game. They agreed to the therapy.
Then I offered, “I have an another therapy for Bob. I want you to write your name in my driveway.” I live in Phoenix, Arizona, in the desert. My driveway is made of gravel. I told him that I did not even allow my daughter to write in the gravel, but that I would like him to leave his mark there showing that he had been at my home office. My technique was a symbolic desensitization. Bob would have to slide on my driveway as he shuffled his shoes around to put his name in the gravel. I would have him violate his phobia about gravel. Adequate psychotherapy with a phobia can be achieved when one gets the patient to violate the phobic pattern, even on a symbolic level.
In the one session therapy, I had a series of heuristics that could generate solutions. In this case, the most important heuristic was faith. There were three components of this faith: One, I had faith in my ability to utilize whatever they brought me. Most of my professional contributions in print during the past ten years have been explications of Milton H. Erickson”s utilization method. I have made utilization a center point of my therapy. The second aspect of faith also came from what I learned from Erickson. I had faith in the family. I had faith that they had a resource in their system that would be adequate for solving the problem. The job of the psychotherapy would be to help them access that resource experientially. Finally the third part of this faith was in myself. I knew that I had surmounted similar problems. I also had used methods to cure myself similar to those I prescribed for them. If I could do it, I knew they could, too.
Jeffrey Zeig, PhD will present at the December 2005 Evolution of Psychotherapy Conference, www.evolutionofpsychotherapy.com