Posts Tagged ‘case study’

By Terry Argast, PhD Estimated Reading Time: 4 minutes, 28 seconds

Rick was a 17- year- old boy who had stuttered since he started to speak. He and his mother came to Arizona from Massachusetts to see Erickson, who said, “I took one look at the mother and Rick and I recognized the ethnic group.” He got a history. The parents were both from a certain community in Lebanon. They came to the United States and married and became citizens. Erickson explained, “Now, in that culture, man is a lot higher than God, and woman is a low lower than low. Now, a man’s children live with him, and as long as they live with him, he is an absolute dictator. And girls are a nuisance. You try to get them married and off your hands because girls and women are fit for only two things–hard work and breeding. And the first child of the marriage should be a boy. If it isn’t a boy the man says, ‘I divorce you,’ three times, and even if his bride brought a million dollars in dowry, her husband confiscates it…Because the first child should be a boy.”

In this case, Rick was the third child with two older sisters. Erickson continued, “Rick was broad-shouldered and sturdy, about 5’10” and his father was 6′ and slender. So Rick was an insult also, not only because he was the third child, but because he didn’t resemble his father.”

Erickson gave Rick a task of working two hours a day in the shop of a Lebanese woman’s florist shop and nursery. Over the phone in the presence of Rick and his mother, Erickson gives the following instructions, “I want you to give him (Rick) the dirtiest, dirtiest work you can…he is not to be paid anything. You don’t have to say anything, just point to the dirty work.”Erickson explained, “..no self-respecting Lebanese…would ever think of working for a woman–it is beneath his dignity. And as for dirty work, that’s only fit for females.”

After seeing Rick for some time, Erickson told the mother to rent Rick a temporary apartment and give him a checking account, then for her to take the first plane back home. The woman said, “I don’t think his father will approve.” To which Erickson replied, “Woman, I never allow anybody to interfere with my patients. Now go and do as I say,” which she did.

Erickson met with Rick and told him, “Rick, I have listened to you carefully. I don’t believe you stutter.

And tomorrow, I want you to bring in two sheets of paper. On the sheets of paper, you will write the numbers of the alphabet from one to ten, and you will write the alphabet. And then you will write a composition on any subject you wish and bring it in tomorrow. And that will prove that you don’t have a stutter.”

This is part of what Rick wrote:

9 8 7 6 5 4 3 2 1 0

z y x w v u t s r q p o n m l k j i h g f e d c b a

Life Histoyr

I fele that theer is anothre rea- son fro my stuttergin, which ew have ton dicussde. I fele, however thta this reanos is onyl a minro one. Yte, you mya feel thta this reanos

did ton contribute ot my stuttergin at lla.

Erickson explained to Rick that, “He came from Lebanese parentage. That is the first part of the family, and they are all right. And he had two sisters who were born before he was and there should be two reversals in that family. But you can’t reverse them.”

Erickson gave Rick the task of reading a book aloud backward from the last word to the first word. “That will give you practice at saying words without communicating…You need practice at saying words.” Then Erickson gave him the assignment of reading a book from the last chapter to the first.

Then  Erickson told  Rick that while he came from a home that was Lebanese, that he was an American. “You are a first-class citizen of America, and your parents are second class…You can respect the Lebanese culture, but it isn’t your culture. Your culture is American.”Erickson’s parting words were, “Now, Rick your therapy is to respect your parent, to know what American culture is for you, for your sisters; and learn to think freely in all directions.” Rick’s speech improvement was rapid and complete.

 

Discussion

Erickson said, “I think any theoretically based psychotherapy is mistaken because each person is different.” Understanding Rick’s personal, family and cultural dilemma provides a springboard for the clinical intervention that has nothing to do with the diagnosis of stuttering. Erickson sees the symptom as symbolic of Rick’s double bind and provides a way out of the bind, which Rick took. Not only did his speech improve, but Rick was able to assert himself with his parents and make his own decision regarding college and a profession. Erickson also gave Rick the assignment of explaining what it meant to be American to his sisters. Erickson said, “I don’t know what the parents think about me, but they have three children to be proud of. You might call it family therapy.”

This case is from A Teaching Seminar with Milton H. Erickson, edited by Jeffrey K. Zeig. (1980) New York: Brunner/Mazel. Pages 121-132.

 

This excerpt has been extracted from Volume 23, Issue No. 1 of The Milton H. Erickson Foundation Newsletter. 

orca

Feb 12

Orca Strait

By Michael F. Hoyt, PhD Estimated Reading Time: 3 minutes, 48 seconds

My wife, Jennifer, is not a big traveler, but she has always wanted to go to Alaska to see the wildlife. So in the summer of 2015, we signed up with National Geographic/Lindblad and went for two wonderful weeks. Jennifer is a hospice nurse, and what makes the story interesting is that for many years if you asked her how someday, she would like to die, her answer was that she would like to be eaten by orcas—those magnificent creatures sometimes called “killer whales,” even though they are actually oceanic dolphins. She had recurring but not frightening dreams of a big orca devouring her—she had talked about it several times. And here I was, signing up to be in a two-person kayak in Alaskan waters teeming with orcas with someone who wants to be eaten alive!

To prepare, we took a one-day kayaking class. For the first week of the trip on the Inside Passage cruise/expedition, our cabin was on a lower level without an outside deck, so we could lie in bed and look out the window and watch pods of orcas swimming alongside the ship. We also frequently went topside to see them. One day, a native guide came aboard. He was a young man who grew up in a village and on the ice, but also went to college for a while in Colorado. He came dressed in his native regalia— beads, bear claw, emblems, etc. He told stories and answered questions. When the orcas and other creatures appeared during the day, we stood on the deck in the brisk air as he sang prayers to them. I introduced myself and my wife, and asked him for any reflections from his tradition, about the meaning of being devoured by an orca. (I also mentioned the Bible story of Jonah and the Whale.) He thought about it, then said the orcas were guardians and protectors (hence, the prayers of thanks and supplication when they appeared), and that if my wife’s dreams were not violent or frightening, he would understand them as positive — to mean being welcomed and protected.

Every day during the week, we got into zodiac boats and kayaks and sometimes hiked on remote islands. We saw moose and bears, caribou and sea lions, salmon and eagles, humpback whales and wolves, but didn’t have any dangerous “close encounters” with orcas.

At the end of the week, we got off the ship and went to Denali National Park for a second week of adventure. The first evening at the lodge deep inside the park, the couple who run the lodge asked each of us in our little group to briefly say something about ourselves by way of introduction. When my turn came, I said, “Hi! I’m Michael. I’m here with my wife, Jennifer. We live in Northern California, near San Francisco. I’m a clinical psychologist, and I retired about two years ago. I’m here to see the wildlife, but I’m really here to watch my wife enjoy herself.”

The next morning in the breakfast room, the woman who runs the lodge came up to our table and asked if she might join us. We welcomed her. When she sat down she said, “Michael, last night you said that you’re a psychologist, right?” I replied, “Well, yes, but I retired two years ago.” And then she said: “Well, I’m hoping that maybe you can help me. I keep having dreams about being eaten by orcas.”

My wife and I looked at each other, dumbfounded. (Hey, you can’t make up stuff like this!!!) Welcome to “The Twilight Zone!” After stammering a bit, we told the woman about Jennifer’s orca dreams. She was astounded. We also told her about our understanding gained from the guide on the boat— she found it reassuring and helpful.

Amazing? I think so. The world sometimes works in mysterious ways.

 

Commentary

By Eric Greenleaf, PhD

Dr. Erickson would have enjoyed and appreciated the serendipitous intersection of old cultures and modern anxieties. The utilization of dream material in this story is contained in loving, helpful, and curiosity-driven human relationships. Erickson-influenced therapy has an eye toward the future – to see what happens next – and a desire that, as Dr. Erickson said, “When you look back, you’d like to see you’ve left a trail of happiness behind you.” The lesson for therapists in this lovely adventure is to guide the ship by connection with others — the waves and stars of our lives – and not by the charts of interpretation.

 

This excerpt has been extracted from Volume 36, Issue No. 1 of The Milton H. Erickson Foundation Newsletter. 

By Marta Campillo, MA

Estimated reading time: 3 minutes, 29 seconds

A concerned father brought his 7- year-old daughter to psychotherapy because she had recently started to have tantrums, was very unhappy and moody, and answered badly when spoken to. She was not sleeping well and she refused to go to school. During the first play therapy session, she told me that before she had always liked school where she sang, laughed, and enjoyed playing with her friends. Now she felt sad and scared. She said, “My father would not love me anymore.” She feared she would no longer be her father’s “princess.” Her brother was born last month and now she felt her family was not the same.

The present story used a metaphor about “The Heart” and it was narrated during that first session. I ask her to close her eyes while she listened to a story.

“I am going to tell you a story that comes from old legends about life. This is a story about how each one of us, in that place where life is created, was given a heart, and life with it.” I asked her to place her hands together, palm to palm, and softly I opened them and told her: “This is your heart: a unique and irreplaceable place in the universe”…living for you, loving you, creating, and enjoying all that you do and want. And as you imagine your heart, you can feel it beating within your hands and can softly place it in your chest. This heart represents your vital essence, that which allows you to live, it creates all the possibilities to learn, to love, to imagine, to be all that you can become, to suffer and overcome hardships, to learn and to create alternatives to improve your life and what you want to be.”

The story continued on, narrating in detail many of the possibilities of that unique journey that is life, using indirect language, “yes sets,” truisms, and presuppositions. It included embedded suggestions about the uniqueness of her life/heart so that she can make her life grow, enjoying it, and she can teach her heart all the good things that she needs to be strong and independent. I emphasized that her heart occupies a unique and irreplaceable place that only can be occupied by her own heart. I also said, “You are the keeper of this heart that is life within you, to care for, to protect it and make it grow.”

The story explains that we are born and continue to grow, and even though we do not remember that moment where we were given life, the strength of the love for life can be felt in everything we enjoy. At the same time, the young girl was asked to imagine all the things she has learned to enjoy and to feel the love generated when discovering relationships with other family members and children, school, play or nature. Also described with indirect language are other steps to take to be able to learn ways of overcoming pain or problems, including embedded suggestions of knowing how to care for our heart, and the joy associated and felt when feeling safe and happy.

The story places the listener as the “Keeper of the Safety of the Heartlife.” It describes the experiences of caring for oneself, the patience and the strength to learn from mistakes, and the kindness to forgive others as part of the richness of the experiences and joy of the heart as life in an inner-self life process which we own by the fact of being alive.

While the child was listening to the story she was asked to imagine, remember, and identify the feelings of life experiences she had had in the past, in which she learned new things, and to enjoy that experience. Before concluding, she was asked to imagine the shape her heart would have, to picture its details in her imagination. Then she opened her eyes and was given the option to draw it or make it with play dough. She chose to draw it.

The next session her father said, “We came to tell you everything is fine, my princess is going to school, sleeping well, and playing and caring for her brother at home.”