By Maria Escalante Cortina MA.
Estimated Reading Time: 4 minutes, 4 seconds
It was September 2001. Diego, a young boy, told his mom that he was not hungry because his tummy was full. All of a sudden, he doubled over in pain. Upon medical examination, they discovered Diego had a five-pound tumor beside his stomach. The tumor was a Rabdomiosarcoma, an aggressive, fast-growing form of sarcoma.
Diego’s life changed dramatically. No more school, no friends. Lots of new words to learn: cancer, biopsies, chemotherapy, catheters, radiotherapy, metastasis cells, surgery, etc. Diego was confused, angry, sad, worried, and very scared.
As soon as chemotherapy began, Diego’s pain increased dramatically and nausea became a big problem. Neither drugs nor painkillers were working even at high doses. It seemed appropriate to find out whether or not hypnosis could help him feel better.
When somebody has cancer, it is important that in addition to medical treatments such as chemotherapy and radiotherapy, the person also gets emotional support to increase his quality of life as much as possible. As an Ericksonian psychotherapist I believed Diego still needed to turn his head to the good things he had. He needed hope. He needed to smile, even in the midst of an ordeal.
When someone undergoes this intense kind of cancer treatment, it is quite common that the person loses control. Nurses bathe them, feed them, and give them shots. Everyone exerts control except the client.
Diego was aware of his tumor; he was in pain and could not see his friends. There was much suffering, yet he was a child, and children play and enjoy life.
In order to help Diego, I decided to integrate Ericksonian and play therapy.
During my first visit I introduced him to “Pancho,” a very nice Teddy bear who needed his help. I knew he liked stuffed animals; I thought this might be good. I told Diego that Pancho had a strong pain in his tummy and he knew Diego could help him. The aim of this, was to redirect Diego’s attention elsewhere so he would not be so focused on his own symptoms. Diego also put some band-aids on Pancho’s tummy to help him feel better.
In order to help him maintain a feeling of control over the cancer, I utilized a technique that was developed by Michael White (Freeman J., Epston D., and Lobovits, 1997), where the child traps the problem (symptom) inside a box in order to gain control over it. I was amazed, at Diego’s immediate response after I introduced the idea of this box to him. He told me that he wanted to keep “la bola” (the ball) in there. This was the way he had named the tumor. He made “the ball” using brown modeling wax. As an Ericksonian I remembered one of Erickson’s basic principles, Utilization. All this could be utilized and I gave him a task assignment for the following week. He would make sure that the ball stayed well kept in the box at night. I had an idea in mind, keeping the tumor in the box might be a metaphor for isolating the malignant tissue from the rest of the body in order to prevent metastasis.
He liked “Pikachu,” one of Pókemon cartoon’s main characters who can throw beams at his foes when it is attacked. Here again the concept of utilization came to mind. Pikachu could be a friendly metaphor that resembled radiotherapy. This friend (I gave him one as a present) would help take care of the box while throwing beams at anything that might try to escape.
During the day, he could play with the ball and “maybe” he might also take a little piece of it every day and keep it somewhere else. Once he had enough “little pieces” he would be able to make something nice with them. (He made a dog, his favorite pet.)
When this was happening, he also was getting chemotherapy. Doctors were surprised at how fast the tumor had shrunk.
I realized he was a very good hypnotic subject: he was intensely focused when I talked to him. I used other techniques during his treatment including visualization and glove anesthesia for pain management.
One of the last times we met, during a session where I was using a future rehearsal technique he opened his eyes and told me: “I have just seen myself as a football champion.”
From that point he got a lot better.
Blood tests showed that cancer had finally been controlled.
Shortly after, his parents decided to leave Mexico City and moved to a smaller, less polluted town. I hear from them every now and then.
Diego still wants to play football. He has kept his dreams, just as Erickson would have done.
I will always remember my little friend, his eyes, his toys, and of course his big smile.
Freeman Jennifer, Epston David, and Lobovits Dean. Playful Approaches to Serious Problems. 1997. Norton & Company. New York and London.
This excerpt has been extracted from Volume 25, Issue No. 1 of The Milton H. Erickson Foundation Newsletter.
Tags: case study, Erickson Foundation, Family Therapy, hypnosis, LAMFT, LCSW, LICSW, LMFT, LMHC, Meaning, Metaphor, Milton H. Erickson, Pain, Psychologist, psychology, psychotherapy, PsyD, story, therapy, Utilization