By Cari Jean Williams, Ph.D., L.P.C.
Estimated reading time: 4 minutes, 57 seconds.
Selena is a precocious five-year old girl who could not stop sucking her fingers. Her teeth were beginning to protrude. Because she still believes in Santa Claus and the Tooth Fairy, I was positive that she would be very susceptible to hypnosis.
I asked Selena to “move to the magic chair where kids stop sucking their fingers .” Then , at my request, she named each finger. She responded with, “Bunny Rabbit,” “Robin” and other similar titles. I directed her to ask each finger if it liked being sucked. She said, “No.” Then , I asked her to find out what her fingers would rather do instead. After some conversation with her fingers, she told me they would rather play dolls, jump rope and do puzzles.
l suggested, “Let’s see how we can give those fingers more time to play.” With proper ceremony, I showed Selena my “magic wand.” I then asked her to “… think of a magic word that will keep you from sucking your fingers.” With delight, she squealed , “Poof!”
Next, I asked Selena to put each finger in her mouth. “But,” I cautioned her, “before you put your fingers in your mouth, say ‘Poof!’ And I will wave my magic wand.” We repeated this pleasant little ritual with each finger.
Then, I told her she could do that all by herself after she left my office.
The following week, Selena and her mother reported that Selena did not suck her fingers all week except for one short moment as Selena was leaving my office. The mother then mentioned, almost in passing, that she would ask me to help Selena overcome her bedwetting, but she knew Selena was not yet ready to stop that behavior. I began to talk to Selena, reinforcing the previous week’s process, but it seemed not to have any energy left in it. Then I told Selena, “I don’t want you to stop wetting the bed yet. But you will be ready very soon. So let’s do some things for when you are ready. OK? Can we do the same magic for the part of you that wets the bed?”
Selena agreed. I told her I would wave my magic wand and asked her what she would do. She replied that she “would dive, like this.” She stood and did a full body dive onto the couch. As she hit the couch she said, “POOF!”
Selena did several more dives on the couch and then progressed to crawling all over the floor saying she “was swimming like in the Olympics.” I gave her an “Olympic medal ” (a sticker) and told her that the medal was for “all the dry ‘Pull Ups’ you will have now.” A week later, I phoned the mother for a “follow-up.” She reported Selena had not sucked her fingers since the day of our first session and had not wet the bed since our second.
by William Keydel, M.A.
Magical … and fun. This wonderful case illustrates three principles which are at the heart of Ericksonian psychotherapy. First and foremost is the acceptance and honoring of the client’s way of viewing the world. Dr. Williams begins by utilizing the preschooler’s belief in magic to set the stage for change. She deepens Selena’s natural imagery by asking her to name her fingers and creating the imaginary friends so common to children’s play. It is then these friends of Selena’s unconscious who provide motivation for change with reasons meaningful to the child and not even necessary for Williams to know. Williams also evokes Selena’s natural energy and excitement by allowing her to come up with the magical words and acts that would extinguish unwanted behaviors. In these ways, Williams has entered Selena’s world to stimulate change from within.
The second principle which stands out is the interruption of existing patterns through strategic interventions. The beauty of Erickson’s work stemmed from his ability to see the individual’s patterns and his creative responses to those patterns generating change with a minimal amount of effort. By having Selena say, “Poof!” as she put each finger up to her mouth , Williams introduced a change in the old pattern. Then this became a new pattern, reinforced by practice with each finger, and further reinforced by the excitement of creating magic on her own. In this case, it’s easy to imagine that Selena experienced no effort as the strategic intervention created its own reward. Similarly, Selena’s patterns for approaching bedtime were changed with her full-body dives which naturally utilized the playful energy of a child.
The third principle to be honored in William’s handling of the case, is the willingness to let go of theories and “treatment plans” and respond to the client. As Erickson is quoted by Gindhart, “Too many psychotherapists try to plan what they will do instead of waiting to see what the stimulus they receive is, and then letting their unconscious mind respond to that stimulus” (p. 120). While reinforcement is generally good work, Williams responded to her client’s “energy ” and appropriately moved on. Throughout her work with Selena, Williams demonstrates the elegance of responding to her client and thereby allowing Selena, in a general way, to structure therapy in accordance with her needs.
I could have focused on Williams’ effective use of permissive therapy and embedded commands; or my focus could have fallen on the value of using a naturalistic trance to avoid the awkwardness a formal trance induction is likely to have on a child. But, as Richard Dimond points out in “Trials and Tribulations of Becoming an Ericksonian Psychotherapist,” (Zeig, 1985), Ericksonian psychotherapy requires more than learning Erickson’s techniques. There are fundamental principles about entering in and trusting the unconscious system of the child across from us.
Dimond, R. (1985). “Trials and Tribulations of Becoming an Ericksonian Psychotherapist.” In Zeig (Ed.), Ericksonian Psychotherapy, Vol. 1: Structures. NY: Brunner/Mazel
Gindhart, L. (1985). “Hypnotic Psychotherapy.” In J. Zeig (Ed.), Ericksonian Psychotherapy, Vol. 1: Structures. NY: Brunner/ Mazel