Posts Tagged ‘Family Therapy’

Enhancing Performance in Sports, Intellectual Activities, and Everyday Life Ronald A. Havens & Catherine Walters

Estimated reading time: 15 minutes, 25 seconds.

Our purpose in this chapter is to describe a hypnotic technique we use to help our clients enhance their performance in almost any enterprise. Our approach remains fairly constant no matter what area of life a person wishes to improve. Whether a client wants to lower his or her golf score, become a better salesperson, develop new interpersonal skills, or simply feel better emotionally, we conduct our sessions in essentially the same manner.

ENHANCING FUTURE PERFORMANCE

After an initial diagnostic interview to determine why the person is there and what he or she wants to accomplish, we use hypnosis to clarify the thoughts, sensations, emotions, and behaviors that individual associates with the desired outcome. During this trance session, the client is instructed to imagine how it will feel to accomplish the desired goal and to examine all of the elements of this imagined situation, including the events that led up to it. This utilization of the individual’s own prior experiential learnings and understandings to establish the treatment outcome ensures that the particular objectives, personality, and background of that person are taken into account and that the prescribed changes truly suit the activity under consideration.

On the other hand, the client’s reservoir of experiential learnings and understandings is not the only possible source of guidance at this point. Relevant information from the professional literature also may be incorporated into the hypnotic suggestion process if necessary. For example, an ever-growing body of research consistently shows that success in virtually every endeavor, including everyday life, depends on an optimistic attitude and a positive sense of self-efficacy (e.g., Taylor, 1989; Maddi & Kosaba, 1984). Accordingly, we routinely include suggestions regarding these attitudes as the person develops the imagined experience of a successful outcome.

We also routinely include suggestions designed to promote a condition of highly focused attention.  Obviously, one must focus one’s attention on an activity to perform it with any degree of success. What is less obvious, and less widely known, is that a particular state of highly focused attention is commonly associated with exceptional performances in virtually any area. For example, Gallwey (1974) taught tennis and golf players to enter into a state of “relaxed concentration” to improve their game. Lozanov (1978) found that students could learn a foreign language more efficiently in a similar state that he called “concert  pseudopassiveness,” and Gilligan (1987) attributed the “controlled spontaneity” frequently observed in the performances of professional musicians, athletes, and psychotherapists to this condition of absorbed attention. Zeig (1985) described the way in which Milton Erickson reportedly predicted the winners of a track meet. He would choose those who were “concentrating and focusing.” Race car drivers refer to this state as “streaming” and athletes in general talk about being “on” or “in the zone.” Given the similarity of this experience to the absorbed attention typical of a hypnotic state, it is natural and useful to incorporate a description of it as a desirable outcome of therapy for most clients.

Furthermore, individual activities, such as target shooting, require a narrow internal focus of attention for peak performance (Maxeiner, 1987), whereas team sports demand a more diffuse and external focus (Nettleton, 1986). When such information is available for the pursuit being considered, it is added to the client’s own understandings via the suggestions we offer regarding the goal state.

The specific steps involved in this intervention are as follows:

Conduct a trance induction or any other procedure designed to stabilize and redirect the client’s attention inward. Ideally, the person will be in a receptive, passively observant frame of mind before the therapist proceeds to the next Explain to the person that in the same way that it is possible to remember and relive a past experience, it also is possible to use imagination to “remember” an event that has not yet happened. Quickly add that the person can, for example,  “remember”  what it will feel like when the person realizes that he or she accomplished whatever it was that brought the  person  to  you  in  the first place. Indicate that the client already knows how it will feel to do so and suggest that they he or she pay attention to those feelings and sensations now. While he or she is locating and becoming familiar with how it feels to succeed, suggestions for different aspects of the experience can be provided, such as a sense of satisfaction, well being, or excitement. After the client begins to identify and experience the emotions and sensations associated with accomplishing the desired goal, the experience is expanded and clarified, one sensory pathway at a time. Details about that future situation are gradually filled in by asking the person to pay attention to physical sensations, sounds, and sights. Eventually the person is asked to take cognizance of where he or she is, who else is there, what the date is, and so on. As the person vividly imagines being in that future situation, happy and satisfied with a successful outcome, he or she is asked to “remember” the actual experience of succeeding. This step can be omitted if the goal is a change in emotional or psychological state, because it is often difficult to identify exactly when such changes occur, but if the objective is enhanced performance of some specific mental or physical activity, then it is a useful part of the process. The client  has  an  opportunity  to  “experience” (and thus rehearse) how it feels to perform in a successful  manner, and the therapist has an opportunity  to  include  suggestions for particular actions or states of mind that  are  known  to  enhance performance in that endeavor. For example, this is an appropriate time to suggest  that  the client  “remember”  how it  felt to be effortlessly focused and undistracted,  to  be sure of  himself or herself and yet amazed by his or her own abilities. This alsois an appropriate time to suggest that the client examine things about the situation that seemed to make it easier to perform so well, that is, to become aware of any changes in attitude or approach that apparently helped to create a positive outcome. The next step is to ask the client to remember, from that future vantage point, some of the significant events that  took  place along the path leading from now, sitting in your office, to the desired result. These events are  mentally  “reviewed”  to  “remind” the person about what led to  the hoped-for  end  product  and  to set the stage for their eventual  occurrence,  but there  is no  need for the events to be reviewed in sequential order, nor is it necessary for the client to understand how those happenings  contributed to that conclusion.  In fact, it is best if the client views them as a selection of unrelated events that simply pop into the mind. Throughout the entire process, the client is encouraged to wait for different aspects of the experience simply to emerge or appear and not to create them on purpose. Even if what springs to mind does not make sense or seem relevant, as is often the case, the person is asked to observe passively and allow things to unfold in whatever manner they do without interfering  or  attempting  to alter them. Finally, as the trance and the session are brought to a close, the client is told to forget about the things that have occurred and to allow the unconscious mind to assume responsibility for turning these imagined events into Although some clients are able consciously and intentionally to follow their own “unconscious” advice, others tend to alter matters in a way that merely perpetuates previous patterns of action and reaction. Thus, whenever possible, it is desirable to elicit amnesia for these experiences and to offer a posthypnotic suggestion for their eventual accomplishment in a seemingly spontaneous manner. When this suggestion is successful, clients engage in the activities that lead to the desired outcome without realizing that there is a method to it. Looking back on it, they typically report, “One thing just led to another.”Although we would love to take credit for inventing this approach, the basic rationale and structure of the technique presented here were derived directly from the work of Milton Erickson.

ERICKSON’S APPROACH

In our book on Hypnotherapy for Health, Harmony, and Peak Performance (Walters & Havens, 1993), we point out that Erickson was less concerned with what people were doing wrong in the present than with getting them to do things right in the future. He encouraged the development of attitudes and behaviors that would eventually result in successful adjustment and emotional well-being. He elicited the positive attitudes, states of mind, and behaviors that he knew would allow his clients to accomplish their goals, whether those goals involved enhanced athletic performance, academic performance, or performance in everyday life. Erickson concentrated on what people could do, and he devised an impressive array of techniques to help them build better futures for themselves. He used direct and indirect hypnotic suggestions, implications, metaphorical anecdotes, and straightforward behavioral assignments to get people to begin thinking and behaving in healthier, more productive ways. The approach outlined here is based on one of these many techniques, a technique Erickson called “pseudo-orientation in time” (Erickson, 1954).

Because Erickson usually devised a unique therapeutic intervention to suit the needs and personality of each unique person, it may seem some­ what presumptuous to reduce his approach to one specific strategy to be used with a broad range of problems. Nonetheless, we believe that it is appropriate to do so. Few practitioners can emulate Erickson’s creativity or wisdom and, luckily, most of the time it is not necessary to do so. We propose that it is possible, instead, to use his pseudo-orientation-in-time technique with virtually every client because it is the one intervention that captures the underlying essence of Erickson’s seemingly endless list of strategies. By concentrating on one particularly powerful Ericksonian hypnotherapeutic approach, it is possible to condense his insights and genius into a manageable procedure.

Pseudo-orientation in time is one of the few techniques Erickson used with more than one patient, and it is the only one of his techniques that seems to be useful for almost any presenting problem. In his original publication on the topic, Erickson (1954) described his use of this technique with five very different patients, all of whom enjoyed successful outcomes. Each patient eventually engaged in the activity he or she had foreseen in the age-progression visualizations, and each did so with no recognition that he or she was following his or her own self-generated prescription for success.

In another publication (Erickson & Rossi, 1977), Erickson even described using this approach on himself to prepare for the unpleasant situations he realized he would eventually encounter as a physician. He projected himself into an imagined future, figured out how to cope with the unfairness and unpleasantness of the events he was likely to face in his practice, and emerged from his reverie ready to continue with his career. Given the nature of that career, it is safe to conclude that his intervention worked.

Like most of Erickson’s interventions, the pseudo-orientation-in-time approach focuses the client and the therapist fully and solely on the future. In addition, because it is centered around the client’s self-generated imagined experience of accomplishing the desired objective, this technique relies heavily on the client’s own “unconscious” learnings and observations to define both the goal state and the steps required to arrive at that goal. Once the desired future and the steps to that future are identified, then the client is instructed to forget about it and to allow this outcome to unfold automatically or “unconsciously.” No other strategy seems to capture the essence of Erickson’s approach more directly or completely, and no other approach seems to be more consistently successful.

CASE EXAMPLE

Jason, a 17-year-old member of a local high-school track team, consulted our office to improve his performance in the 1,600-meter race. His coach suggested that he seek professional help because he repeatedly lost races that, theoretically, he should have won. During practices, his lap times were consistently fast. During actual competition, however, he was unable to maintain a fast pace throughout a race.  He started and finished fast, but always faded during the middle laps and lost too much ground to catch up and win. As Jason described it, he was always fired up during the first third of the race, discouraged and  ready  to  quit during the middle third, and then would become angry and try to  do his best  again  for the final third of the way.

The intervention in this case was quite simple and brief. Following an induction process, Jason was asked to imagine himself talking to his coach after winning an upcoming race. He was able to do this with little trouble, and he was also able to offer a verbatim account of his conversation with the coach about that race. He was then asked to remember what was different about the  way he had thought  about the various parts  of the race and to tell his unconscious to make sure that  these  new thoughts arose during the next track  meet.  Finally, he was told to wake up without remembering much, if any, of the session. He left with a promise to return the following week and report what happened.

Jason later said that he had won his next race, although he did not know why. As he described it, he was really fired up during the first half of the race, and by the second half was getting angry and determined, just as he always did. It was immediately obvious that he had stopped split­ ting the race into thirds. He had solved the problem of becoming discouraged and tired during the middle third of the race by simply eliminating it from his thoughts. Interestingly, this was exactly what he had said to his coach during his imagined winning experience.

SUMMARY AND CONCLUSIONS

Peak performance in any field is a function of multiple variables, including attitudes, emotions, innate talents, and practice. People who succeed have a clear idea of an attainable goal. They also know what they must do to accomplish that goal, and they have the willingness or desire to do it. Finally, they have optimistic expectations that they can and will reach their objective; they trust themselves and know how to get out of their own way. The techniques presented here are designed to provide these ingredients of peak performance to those who want and/or need them.

Hypnotic trance allows people to establish attainable goals. During trance conscious concerns, inhibitions, misunderstandings, fantasies, or wishful thinking do not interfere with the construction of a viable outcome. People are able to review the potential disadvantages or advantages of various goals and actions in a detached and careful fashion. The end product springs into awareness before it can be censored or modified by ordinary conscious considerations. Consequently, the imagined future is almost invariably compatible with the person’s needs and capacities.

This also is the case when trance is used to envision a series of actions or events that will lead to that imagined outcome. When conscious biases are bypassed, the end product is a set of activities, insights, or decisions that are quite appropriate for that individual and that lead almost inexorably to the desired outcome. Hypnotherapists merely help people discover what they already knew about their own abilities and potentials but were unable or unwilling to acknowledge.

People seek help from professionals because they want something different, something better, to occur. They want to change their thoughts, their feelings, their actions, and their lives, but those changes will take place only after they can envision them as happening in the future. Our vision of the future is a road map, a program, a guiding principle that modifies our present actions in ways that lead us toward that envisioned outcome. To explain his technique of pseudo-orientation in time, Erickson (1954) said, “Deeds are the offspring of hope and expectancy” (p. 261). When we expect more of the same, that is what our deeds create. But when we can imagine a better future so clearly that it actually seems possible, then we begin to think and behave in ways that lead us there.

Many different techniques can be used to attain enhanced performance, but few are as straightforward or as likely to meet the unique needs and capacities of each individual as the approach presented here. If you want to help others respond in ways that promote a better future, why not follow Erickson’s lead? Imagine the changes your clients will experience, first in their imaginations, then in their lives. Once you have envisioned such outcomes, you will find this approach hard to resist.

Points to Remember

Focus on what will make things go right in the future. Not on what made things go wrong in the past. Remember that people need to know where they are going in order to get there.  Help them develop a clear picture of a successful outcome. Always assume that the client knows at some level what goals and strategies are most appropriate and useful, but also remember to mention relevant information from the research. Encourage the client to enter imagined future situations by thinking about how it will feel to succeed rather than about what to do. After the client has a clear picture of a successful outcome and re­ views the events that led to to it, suggest that the unconscious mind can now accomplish these things and that the conscious mind can forget all about them.

References

Erickson, M. H. (1954). Pseudo-orientation in time as a hypnotherapeutic procedure. journal of Clinical and Experimental Hypnosis, 2, 261-283.

Erickson, M. H., & Rossi, E. (1977). Autohypnotic experiences of Milton H. Erick­ son. American Journal of Clinical Hypnosis, 20, 36-54.

Gallwey, W. T. (1974). 1beginner game of tennis. New York: Random House.

Gilligan, S. (1987). Therapeutic trances: The cooperation principle in Ericksonian hypno­therapy. New York: Brunner/Mazel.

Lozanov, G. (1978). Suggestology and outlines of suggestability. New York: Gordon & Breach.

Maddi, S., & Kosaba, S. (1984). The hardy executive: Health under stress. Homewood, IL: Dow Jones-Erwin.

Maxeiner, J. (1987). Concentration and distribution of attention in sport. International Journal of Sports Psychology, 18, 247-255.

Nettleton, B. (1986). Flexibility of attention and elite athletes’ performance in “fast­ ball games.” Perceptual and Motor Skills, 63, 991-994.

Taylor, S. E. (1989). Positive illusions. New York: Basic Books.

Walters, C., & Havens, R. A. (1993). Hypnotherapy for health, harmony, and peak performance: Expanding the goals of psychotherapy. New York: Brunner/Mazel.

Zeig, J. (1985). Experiencing Erickson: An introduction to the man and his work. New York: Brunner/Mazel.

 

Clinical Depression Following the Death of a Parent By Ron Soderquist, PhD, MFT

A fellow church member whose husband died 10 years ago called out of concern for her 30-year-old daughter, Amy, who had never gotten over the loss of her father. The woman said, “I think Amy’s depression is affecting her health and her marriage.”

“Haggard” would not be too strong a word to describe Amy when she entered my office. She looked much older than her years. Tears began flowing down her face even before she sat down. The visual evidence of depression was so dramatic, I could understand why her mother reported that it was taking its toll.

As Amy told her sad story, it was obvious that she had told it many times before in the last decade. She began: “I was in training as a student nurse in the local hospital where my father had had heart surgery. One day he came in for a post-surgery check up. I was in the midst of my normal nursing duties when all at once I heard alarms. Staff were rushing around. A nurse said she heard a patient had collapsed and died, and it might have been due to a nursing error. Then, a fellow student nurse came in, put her arms around me and told me it was my father who had died. My first thought was, ‘I should have done something to save him.’ I berated myself for not doing something. Ever since then there has been a voice in my head saying, ‘You could have saved his life.’ I can’t stop thinking about him dying and the funeral and that I could’ve done something.”

I asked her if it was like a movie running in her mind. Amy agreed that a movie of her Dad’s death played over and over in her head. I began by acknowledging her grief. “First, Amy,” I began, “I am so sorry for your loss—a deep tragic loss. And when we have an intense experience like yours, the brain often makes a movie like the one you have been looking at over and over. It’s like the brain gets stuck on that movie.”

“Yes, that’s me,” she replied. “My brain got stuck on that awful moment when I was told my father had died.”

“I wonder if before your tragic loss if you had happy experiences with your father, perhaps family activities or special times with him.”

“Oh yes, I have many beautiful family memories, and also, my father and I used to play tennis together. we had a special warm relationship.”

“I wonder, when you close your eyes, if you could turn on some of those sweet memories, and as you visualize your father, ask him if it would be all right with him now, after 10 years of grieving, for you to switch channels in your brain; if it’s okay if you switch to the Happy Memories channel. And because your father was a Christian, would it be all right to imagine him in heaven smiling when he sees you remembering those happy times? Perhaps you can see him smiling and nodding his head about as you switch to this channel.”

“I can see him saying he wants me to enjoy our happy memories,” Amy said. “And he wants me to enjoy my dear family instead of obsessing about his death.” Then, she added with deep feeling, “I didn’t know I had a choice.”

“Yes, what a relief to discover you have a choice. Just imagine you have a remote control in your hand and you switch to the Happy Memories channel. That’s right, along with a deep relaxing breathing, switch to the memories he would like you to share with your children, his grandchildren.” With a sigh of relief Amy did that easily. We practiced tuning into the Happy Memories channel for a while until she felt relaxed and confident doing it.

The following week, Amy called to report she no longer felt depressed, and, in fact, was now enjoying showing photos of her father and sharing happy memories with her children. It’s been three years now since our session, and the Happy Memories channel is still “on the air.”

Commentary

By Eric Greenleaf, PhD

Ron Soderquist shows us the simple elegance of human relationship – the basis of all psychotherapy, and the heart of Dr Erickson’s hypnotic approaches to helping people. Soderquist listens with compassion to Amy’s story of suffering. Then, thinking like a competent hypnotherapist, he helps her to dissociate – to tune into the Happy Memoirs channel with“sweet memories,” rather than re-experiencing abject grief in a sad movie that plays in a loop.

Utilizing both her love for her father and his heavenly presence in her experience, Soderquist elicits Amy’s realization that she actually has a choice. She can continue to grieve, or she can switch to the Happy Memories channel. The goal of eliciting positive memories over traumatic ones is helping the client recognize that there is a choice. Amy’s grief and torment over her father’s death could be replaced with memories of all the happy times she once shared with him. Soderquist’s ability to transform Amy’s grief was beautiful, brief, direct, and compassionate.

Business as Usual by Carl Hammerschlag, M.D.

A middle-aged man came to see me under pressure from his wife. She had told him she would leave if he didn’t make some life changes. Both husband and wife expressed that their marriage was very important to them, but it was clear to us all that their marriage was near collapse. He told me he did not know what the problem was even though his wife had complained about his commitment to his work for many years. He acknowledged that he was highly committed to his work, but said it was important to them both and that he was very successful. He wasn’t completely aware, nor was he in agreement, that his business interfered on other levels of their lives.

His wife described the man’s work as his mistress and his only interest and hobby. He didn’t even take vacations without sleeping with his telephone by his side. At, and away from, home, where he wasn’t talking business he was reading financial magazines. He was not interested in his wife’s activities and was unwilling to converse about things of interest to her. They had virtually no social life as a couple.

When he arrived at my office the first time, his cell phone was clipped to his belt. He explained he was waiting for an important call. When it rang, he interrupted our session to talk at length on the phone. When I asked him if he thought the information that he was going to get from the phone was more important than what he might learn in my office, he replied without hesitation, that it was business and therefore very important.

I told him that if he couldn’t pay attention here in my office, it was clear to me he would not remain married. I asked him to turn the phone off. Reluctantly, he did so.

During the course of therapy, he agreed to follow my directions regarding an important intervention that I told them, could save their marriage. I prescribed what I knew would be an ordeal for him. He agreed to go on vacation with his wife to a place without a telephone or fax machine close by. He also agreed to let me provide all his reading material. I gave him a sealed package which I had already prepared.

His wife later reported that when they arrived at their destination, he opened the package and cursed, threw it against the wall and stormed out of the room. Inside the package was only one book. When he opened it, he discovered there were only blank pages and a pen. On the inside cover, I had written, “Dear John. Fill this book with whatever makes sense to you at the moment. You can choose to write in dialogue or in simple prose but you must write in this book every day. I ask that you to come to this task with openness and truth, and to tell the truth of your experiences at that moment.”

He cursed, threw the book against the wall and stormed out. His wife picked up the book and read my note. When he returned, and continued to rail on, she said, “Why not write this down?” She pointed out that writing about how angry he felt might be useful for him and would certainly provide a topic for later sessions. Her words struck a key with him.

Later in the vacation, he found an interesting stone that was covered with lichen. He knew lichen was an organism formed by a combination of fungus and algae growing as a unit on a solid surface. Picking up the stone, he inserted it into a hollow he created in the pages and began to write around it. “Everything grows connected to something other than itself.”

He began to describe himself as the lichen feeding from the impersonal rock of business. He recognized he wanted to find another way to thrive. This moment of insight became the beginning of productive therapeutic expansions and of rebuilding the marriage between two committed people.

I chose this somewhat ambiguous but potentially powerful intervention because of what I learned from Erickson and other medicine men I have known. They taught me that the most important knowledge is that derived from life experience not from theories or equations. If you can help people look again at their present experiences and at themselves with different perspectives, they can create new directions. The process of psychotherapy is to find creative ways through which you make the invisible visible.

Discussion by Ricky Pipkin, Ph.D.

Hammerschlag had a client typically considered difficult–a reluctant participant in therapy wanting a specific outcome without realizing that a generalized change must be made to reach that outcome. Additionally, this man was clearly successful in many areas of his life and accustomed to making fact-based business decisions. It often is easier to factor out emotional content and disregard the importance of feelings and, in business, it often is more efficient. However, this couple was highly motivated to keep their marriage which provided needed leverage.

The problem in the marriage was not a “business” one–it was that the wife felt discounted and unimportant. Hammerschlag’s problem was two­fold. First he had to capture the client’s attention; second, he had to make him understand that feelings and intangibles are important to a well-rounded life. As well as to relationships.

Directly confronting the inappropriate use of John’s cell phone during session and telling him that, what he learned in session could save the marriage was a business-like approach to a multi-level symptom. He used language that John was used to and could understand. John’s willingness to continue participating in therapy without using his phone created an implicit contract.

The sessions before the important intervention of the vacation were preparation for John to expand his own perceptions. Every act of insight, of expansion, is the result of the prepared mind and some serendipitous moment. Finding a rock with lichen, knowing what lichen was, provided John a metaphor of his own making. He recognized that even a lowly lichen is a union of different things, joined together to create a different and more complex organism. The needs of each part must be nurtured.

The simple moment of finding the lichen-covered rock and following, in his own way, Hammerschlag’s instructions, provided ways to understand himself differently. These changes were necessary in order for him to have what he really wanted-­the continuation of his marriage. This would not have occurred had not Hammerschlag first gotten John’s attention by using the techniques and language of business. Then, during the vacation, John was given only one concrete outlet for his thoughts and energies–self-examination in writing “the truth of his experiences of the moment.”

Erickson had a gift for creating and telling stories that patients could hear. He taught us all to look at our own blind spots and how to reach beyond them. Hammerschlag provided that for John by setting the stage for him to tell his own story about his own blind spots and to understand how to reach beyond them by the seemingly simple ambiguous and open assignment of writing on the blank pages , ”with openness and truth.”

Obviously, there was careful preparation so that John would be willing to go on vacation with no phone, fax or business reading materials. Hammerschlag’s success also demonstrates the value of using the client’s own language and world. The implicit contract between Hammerschlag and John insured that the directions would be followed even though, as business, John could implement them in his own way.

Good therapy often appears much simpler than it actually is.