Anxious parents called, each in turn, about their 17 year-old daughter Bev, who for the past six months had obsessively washed her hands three to four hours a day. Both parents reported they had “tried everything.” including counseling and drugs. They were so desperate they were now exploring hypnosis, about which they were skeptical. Somewhat worn down by their forceful skepticism, I said to the anxious mother, “Look, because you are desperate and because you worry that once again you will be throwing money away, I will offer you a complimentary consultation. I will evaluate your daughter’s symptoms and only schedule a therapy session if I believe I can help her.” With this assurance, she made an appointment.
As the family members settled into their chairs at our first meeting, they all appeared relaxed. They communicated with ease, and there were no overtones of hostility. Turning to the girl, I asked about her school and extracurricular activities. She immediately replied, “I have studied piano for many years and enjoy it very much.” I myself play both classical and ragtime piano, so this was a natural opening for building rapport between us.
When I asked about her favorite composer, she quickly said, “Chopin.” Because Chopin is also my favorite, we were now in perfect sync. We agreed we both loved Chopin’s Nocturnes and we both had played most of them. I asked about her favorite and she hummed the melody. I said, “When I practice a nocturne in the evening I often can hear that melody in my head all next day,” and she nodded in agreement. “You can hear that melody right now, can’t you?” I said. She smiled and slipped into a nice little trance. As she did so, I ventured, “Perhaps, when you get the urge to wash your hands, you might enjoy turning on that nocturne instead.” I observed her trance deepen as she considered this, and then she nodded her head and said quietly and confidently, “I can do that.”
After some further rehearsal, and talk about other matters, I concluded the session. I didn’t suggest another session. The mother wondered, “Do we need to make an appointment for Bev?” I looked at Bev as I said, “Perhaps she has already found a solution,” and Bev nodded her head.
A week later the mother called to say Bev was doing fine. I might have held back and scheduled a regular appointment with a fee. But I just couldn’t help myself. It was too much fun just to do it. And while there was no fee, I did get a good story, and the mother soon referred a friend.”Commentary
By Eric Greenleaf, PhD
I immediately liked several aspects of this case and of Ron’s manner with the family and with his young patient. The family’s desperation motivated both Ron to take the case pro bono and the family to agree to let him try therapy with their daughter. Ron bypassed the problem [what Erickson called “drifting rapidly away”] and landed on the keyboard, where his patient could shine as a person and had the resources to address her own solution. Then, as an advanced therapist, he spoke as and of himself: “When I practice a nocturne in the evening I often can hear that melody in my head all next day,” before noting that his patient “can hear that melody right now, can’t you?” Mutual, trance experience can be both more natural and more direct than other hypnotic inductions.
Ron aptly and gently held the mother back from re-establishing the symptom, saying, “Perhaps she has already found a solution,” as indeed, with his help, she had. When the patient is the expert and the therapist is himself, lasting hypnotic therapy can be both brief and effective. I think Dr. Erickson would have been pleased with this case, would he not?”
A private girl’s school nearby my office referred a sophomore named Lana to my practice because of missed classes and academic problems.
Normally when a girl this age comes to a professional for the first time, she pays attention to her appearance. But Lana’s hair was disheveled, her sweat suit looked like it needed a trip to the washing machine, and her sneakers were worn. Her clothing was too big, meant to camouflage her weight. She was definitely not comfortable in her skin. If one looked closer, underneath all this baggage was an attractive, intelligent young lady.
Based on her general appearance I assumed several things: I intuited that Lana was depressed. I asked myself, “Why does she keep her appearance repulsive?” Had someone hurt her in the past; met with abuse or neglect a creative element in her personality? Her repulsive appearance, no doubt, was to keep herself isolated enough to deflect any more harm.
Fortunately, Lana was enthusiastic about hypnosis and wanted to experience it. Hilgard wrote that one of the important components of trance is “original task motivation instruction.” In Ericksonian hypnosis, a key element of therapeutic trance induction is pacing and leading. My procedure was informed by both philosophies.
I began by asking Lana, “What about hypnosis makes you enthusiastic?” Her response was that she had heard wonderful things about hypnosis, and that the experience of trance, in addition to being relaxing, seemed mysterious and exotic. She felt hypnosis helped people to make dramatic changes in short periods of time, like quitting a lifelong habit of smoking in one session. I wholeheartedly agreed. As I mirrored this back to Lana, I repeated the words “relaxing” “mysterious” and “exotic” in pace with each of her exhale breaths. I began to add words suggesting comfort, sleep, and dreamlike feelings.
I also suggested that her unconscious mind probably knew why she was having these current problems. It would be nice if her unconscious gave her a dream during the next few days that would illuminate the source of these problems and offer a solution that would alter the way she looked at this aspect of her past. Her enlightenment would provide a new perspective in how she would see herself in the future. I told her to keep this in the back of her mind.
I finished our trance session by telling Lana a story about how I always made myself go to all of my college classes whether they were interesting or boring, because there might be at least one useful thing from them that I could take away with me.
Two days later, Lana sent me the following email: “During our session, you told me to keep one thing in the back of my mind. Ever since I can remember, I have struggled with my weight. The memory that came to mind during our trance was one of myself at about eight or nine years old at school. A boy I’ve known most of my life was standing next to me and said, “You look like you are pregnant because you are so fat!” Every time I think about my weight struggle, this memory seems to pop into my mind. It was definitely an embarrassing and upsetting moment in my life.
After our session, I felt very sleepy and ended up going to bed quite early. I had a dream that I was standing in my house trying on a prom dress that I had bought with the intention of altering it to fit. I still own the dress, but I never got to wear it to my prom because it didn’t fully zip in the back and the seamstress couldn’t alter it. In the dream, I put the dress on simply to see if it would fit me. At first it would not zip, and then little by little I was showing my mom how it now fit me perfectly! When I woke up this morning, it didn’t immediately occur to me why I had this dream until right before I was leaving my room to go to class.”
A follow-up call to the school’s counseling center a month later revealed that Lana had achieved perfect attendance at her classes and had joined the school swim team. She was finally “fitting in”!
Because Lana had to take a taxi to get to our appointments, I knew I would not see her for more than a few sessions. I would have liked to spend more time discussing relationships, developmental delay issues, and her depression. I decided to use Erickson’s approach of accessing unconscious resources because this has proved successful in my work in the past. Although I anticipated success, receiving Lana’s email was a delight. How’s that for the unconscious as helper!