Posts Tagged ‘hypnosis’

THE MICRODYNAMICS OF SUGGESTION By Milton H. Erickson & Ernest Rossi

Once Erickson has fixated and focused a patient’s attention with a question or general context of interest (e.g., ideally, the possibility of dealing with the patient’s problem), he then introduces a number of approaches designed to depotentiate conscious sets. By this we do not mean there is a loss of awareness in the sense of going to sleep; we are not confusing trance with the condition of sleep. In trance there is a reduction of the patient’s foci of attention to a few inner realities; consciousness has been fixated and focused to a relatively narrow frame of attention rather than being diffused over a broad area, as in the more typical general reality orientation (Shor, 1959) of our usual everyday awareness. When fixated and focused in such a narrow frame, consciousness is in a state of unstable equilibrium; it can be “depotentiated” by being shifted, transformed, or bypassed with relative ease.

Erickson believes that the purpose of clinical induction is to focus attention inward and to alter some of the individual’s habitual patterns of functioning. Because of the limitations of patients’ habitual frames of reference, their usual everyday consciousness cannot cope with certain inner and/or outer realities, and they recognize that they have a “problem.” Depotentiating patients’ usual everyday consciousness is thus a way of depotentiating facets of their personal limitations; it is a way of deautomatizing (Deikman, 1972) an individual’s habitual modes of functioning so that dissociation and many of its attendant classical hypnotic phenomena (e.g., age regression, amnesia, sensory-perceptual distortions, catalepsies, etc.) are frequently manifest in an entirely spontaneous manner (Erickson and Rossi, I 975). Depotentiating the limitations of the individual’s usual patterns of awareness thus opens up the possibility that new combinations of associations and mental skills may be evolved for creative problem solving within that individual.

Erickson’s approaches to depotentiating conscious sets are so subtle and pervasive in the manner with which they are interwoven with the actual process of induction and suggestion that they are usually unrecognized even when one studies a written transcript of his words. In order to place them in perspective we have outlined the microdynamics of induction and suggestion in Table I as: (I) the Fixation of Attention; (2) Depotentiating Conscious Sets; (3) Unconscious search; (4) Unconscious Processes; and (5) Hypnotic Response. We have also listed a number of Erickson’s approaches to facilitating each stage. Most of these approaches are illustrated in this volume and are discussed in more detail elsewhere (Erickson and Rossi, 1974; Erickson and Rossi, 1975; Haley, I 967; Rossi, 1973). Although we may outline these processes as stages of a sequence in Table I for the purpose of analysis, they usually function as one simultaneous process. Because of this, and in order to distinguish these processes from the broader dynamics of induction and mediating variables previously outlined (Barber and DeMoor, 1972) we designate ours as “microdynamics.” When we succeed in fixating attention, we automatically narrow the focus of attention to the point where one’s usual frames of reference are vulnerable to being depotentiated. At such moments there is an automatic search on the unconscious level for new associations that can restructure a more stable frame of reference through the summation of unconscious processes. There is thus certain arbitrariness to the order and the headings under which we assign some of the approaches Erickson used in Table 1. He could equally well begin with an interesting story or pun as with a shock, surprise, or a formal induction of trance. Once the conditions in the first three columns have been set in motion by the therapist, however, the patient’s own individual unconscious dynamics automatically carries out the processes of the last two columns.

A number of Erickson’s most interesting approaches to facilitate hypnotic response are the hypnotic forms listed in column 3 of table 1. All these approaches are designed to evoke a search on the unconscious level. Allusions, puns, metaphors, implications, and so on are usually not grasped immediately by consciousness. There is a momentary delay before one “gets” a joke, and in part, that is what is funny about it. In that delay period there obviously is a search and processes on an unconscious level (column 4) that finally summate to present a new datum to consciousness so that it gets the joke. All the approaches listed in column 3 are communication devices that initiate a search for new combinations of associations and mental processes that can present consciousness with useful results in everyday life as well as in hypnosis. The hypnotic forms listed in columns 2 and 3 are also the essence of Erickson’s indirect approach to suggestion. The study of these approaches may be regarded as a contribution to the science of pragmatics: the relation between signs and the users of signs (Watzlawick, Beavin, and Jackson, 1967). Erickson relies upon the skillful utilization of such forms of communication, rather than hyper suggestibility per se, to evoke hypnotic behavior.

As noted in Chapter One, it is important to recognize that while Erickson thinks of therapeutic trance as a special state (of reduced foci of attention), he does not believe hyper suggestibility is a necessary characteristic of such trance (Erickson, 1932). That is, just because patients are experiencing trance, it does not mean they are going to accept and act upon the therapist’s direct suggestions. This is a major misconception that accounts for many of the failures of hypnotherapy; it has frustrated and discouraged many clinical workers in the past and may have impeded the scientific exploration of hypnosis in the laboratory. Therapeutic trance is a special state that intensifies the patient-therapist relationship and focuses the patient’s attention on a few inner realities; trance does not ensure the acceptance of suggestions. Erickson depends upon certain communication devices such as those listed in column 3 to evoke, mobilize, and move a patient’s associative processes and mental skills in certain directions to sometimes achieve certain therapeutic goals. He believes that hypnotic suggestion is actually this process of evoking and utilizing a patient’s own mental processes in ways that are outside his usual range of ego control. This utilization theory of hypnotic suggestion can be validated if it is found that other therapists and researchers can also effect more reliable results by carefully utilizing whatever associations and mental skills a particular patient already has that can be mobilized, extended, displaced, or transformed  to achieve specific “hypnotic” phenomena and therapeutic goals.

In the therapeutic trance situation the successful utilization of unconscious processes leads to an autonomous response; patients are surprised to find themselves confronted with a new datum or behavior (column 5). The same situation is in evidence in everyday life, however, whenever attention is fixated with a question or an experience of the amazing, the unusual, or anything that holds a person’s interest. At such moments people experience the common everyday trance; they tend to gaze off (to the right or left, depending upon which cerebral hemisphere is most dominant, (Baken, 1969; Hilgard and Hilgard, 1975) and get that “faraway” or “blank” look; their eyes may actually close, their body tends to become immobile ( a form of catalepsy), certain reflexes (e.g., swallowing, respiration) may be suppressed, and they seem momentarily oblivious to their surroundings until they have completed their inner search on the unconscious level for the new idea, response, or frames of reference that will restabilize their general reality orientation. We hypothesize that in everyday life consciousness is in a continual state of flux between the general reality orientation and the momentary microdynamics of trance as outlined in Table I. The well-trained hypnotherapist is acutely aware of these dynamics and their behavioral manifestations. Trance experience and hypnotherapy are simply the extension and utilization of these normal psychodynamic processes. Altered states of consciousness-wherein attention is fixated and the resulting narrow frame of reference is shattered, shifted, and/or transformed with the help of drugs, sensory deprivation, meditation, biofeed­back, or whatever-follow essentially the same pattern but with varying emphasis on the different stages. We may thus understand Table I as a general paradigm for understanding the genesis and microdynamics of altered states and their effects upon behavior.

This excerpt has been extracted from Hypnotic Realities by Milton H. Erickson and Ernest Rossi’s Collected Works, Chapter 6: Facilitating Hypnotic Learning.

WAKE UP AND GO TO SLEEP By David J. Norton, LPC

Ben was referred to me by a local hospital for treatment of Rapid Eye Movement (REM) behavioral disorder. Due to aging, a part of his brain had degenerated, resulting in loss of muscular control during REM sleep. Both Ben and his wife were fearful that because he had wild body movements while sleeping, he would inadvertently kick or hit her, or that he would injure himself. After nearly 50 years of marriage and sharing a bed, Ben’s wife had resorted to sleeping in the guest room.

Ben was a lively and interesting 70-year old, who had recently retired from his job in a factory where he worked as a master toolmaker. He was looking forward to enjoying his retirement. Ben had a keen sense of history and a strong interest in Native American culture, and he read many books on the subject. We enjoyed talking about this because I share the interest. Ben longed to visit ancient Native American sites and national parks and he purchased a Winnebago for this purpose. He said he was ready to go, but the extremely narrow single bed he would have to bring along, and his symptoms of the REM disorder, made him hesitant about traveling.

For his entire life, Ben had used his hands and mind to produce tools, so it was understandable that he was looking for a simple, concrete solution to his problem. The fact that he felt his disorder was beyond his control, upset and embarrassed him. His mechanical engineering training and tactile problem-solving skills that served him well in his professional life, gave him the air of someone reluctant to consider hypnosis as a tool for achieving wellness.

Matching, pacing, and leading are the cornerstones of good hypnosis. Because of my conversations with Ben about Native Americans, in which I spoke of “trance healing ceremonies” and their similarity to modern day hypnosis, he gradually became open to using hypnosis to help with his REM symptoms.

As part of my early hypnotic training with Steven Heller, I learned of Erickson’s technique for creating an unconscious generative suggestion for a patient. Erickson demonstrated this therapeutic intervention in a case he called “The February Man.” In trance, he created a positive male character for his female patient who had an emotionally impoverished childhood. This character who appeared in her dreams, valued her by leaving encouraging notes and bringing gifts on her birthday and holidays, which helped her to developmentally progress. (Interestingly, for the past 44 years, Erickson has appeared in my dreams, sometimes offering me helpful advice.)

I decided that with Ben I could create a post-hypnotic suggestion that would happen during his sleep cycle, which would interrupt the REM pattern and disrupt the threatening behavior. There are many references in experimental hypnosis literature that show the success of this type of suggestion. I also had success, as Ben would wake up briefly before flailing, and then fall peacefully back asleep.

There’s a Three Stooges sketch where Curley, Moe, and Larry are in one bed. Larry begins to snore, and Moe hits him and says, “Wake up and go to sleep.” Larry wakes up briefly, and then falls back to sleep. Then Curley begins to snore and a frustrated Moe hits him and says, “Wake up and go to sleep.” Curley is groggy and falls back to sleep, and Moe just smiles. However, like most Stooge antics, it soon turns chaotic. Curley and Larry begin to snore and Moe goes from one to the other slapping and shouting, “Wake up and go to sleep!” In my next session with Ben, I discussed the idea of a generative suggestion and the Three Stooges episode. He remembered it well, and we were both had a good laugh. I suggested to Ben that we put Moe in his unconscious dream world to wake him up right before any sleep behavioral disorders occurred, and he agreed.

The next week Ben and his wife came to his session together and reported that his violent sleep behavior had not happened the prior week, and then asked me if it would be alright if they attempted to sleep together. I said yes.

I continued to see Ben throughout that summer as he and his wife worked together on getting ready for their road trip. I repeated the induction with Ben each week, and his wife called me several times to say that they were sleeping peacefully together. After the couple left on their adventure out West, I had Ben check in with me every week for five weeks. In his words, “We followed the blueprints, installed the boilerplate, and the new circuitry was working well.”

Commentary By Eric Greenleaf, PhD

In a letter, Dr. Erickson once wrote, “Concerning my views about dreams, I can state quite simply that they are the substance that paves the way to the goals of achievement. Such goals are reached more rapidly if a dreamboat is available.” (Seminars of MHE #1, 1962) David Norton’s keen understanding of the blueprints of hypnotic suggestion and his workmanlike installation of the boilerplate, allowed the new circuits to hum, and the dreamboat to sail on. The contrast of the Stooges’ hilarious lack of workmanship with Ben’s own careful and effective craftsmanship was speedily effective, but was only hinted at through laughter. Like all expert craftsmanship, David’s work with this patient might look easy, but it was dreamily inspired.

A Brief Review of the Key Hypnotic Elements of Milton H. Erickson’s Handshake Technique By Mark S. Carich, PhD and Mark Becker, MA

Milton H. Erickson was no doubt a master of masters in inducing hypnotic responses for clinical purposes. Dr. Erickson was instrumental in developing a number of indirect hypnotic techniques and strategies, including interpersonal and nonverbal or pantomime tactics (Erickson, 1958, 1964, 1966; Haley, 1967). One fascinating technique that stands out was the “handshake hypnotic induction technique.” The purpose of this article is to outline the key elements and a procedure of the therapeutic hypnotic handshake induction technique.

What is a Trance Experience?

Controversies over the nature and definition of trance phenomena often involve the contextualized experienced “state” vs. nonstate. The present authors consider a trance experience as a contextualized state with multiple levels, expressions, and facets. The central aspect includes an intense focusing and sense of detachment (dissociated response). One particular behavior directly associated with the handshake technique is the dissociative cataleptic response.

Dissociative Cataleptic Response

Inducing a cataleptic response is the key to the handshake technique. Edgette & Edgette (1995) categorize the handshake technique as a method of inducing hypnotic catalepsy. Catalepsy is the induced immobility of various limbs and/or entire body. Edgette & Edgette (1995 p. 173) define catalepsy as, “…immobility in one or more parts of the body.” Catalepsy has been defined as an involuntary tonicity of the muscles (Kroger, 1977), and a suspension of voluntary movement and condition of well-balanced tonicity (Erickson & Rossi, 1981). Muscles are felt as being in balance and comfortable, neither too tense nor too limp. The client/subject maintains or sustains a suspended state or immobilized position for a long period of time.

Handshake Technique Procedure

Therapy involves communication within a change-oriented context in which the therapist engages the client in conversation, forming interactions, which can start with a simple handshake. This handshake can be utilized to facilitate the hypnotic elements in these therapeutic conversations.

Erickson and Rossi & Rossi (1976) describe the handshake technique by starting with a firm hand grasp, then slightly adjusting the operator’s fingers, creating momentary confusion by refocusing the subject’s attention with the different sensations felt, as the operator withdraws their hand. As the operator withdraws their hand, the subject’s habitual framework is interrupted, thus creating a hypnotic touch.

This procedure can be detailed into the following steps:

Engage with client or subject. Gaze into the client’s or subject’s eyes (as part of the initial exchange via eye contact). Slowly reach out to shake or grasp the Grasp the client’s hand in a normal Slow the handshake down by pacing and leading the client’s hand during the clasp. Shift the touch and pressure, slowly releasing the Slowly release the hand from the handshake; slide hand Meanwhile, if/or when speaking, use a slow, smooth, monotone relaxing voice. Maintain a gaze, looking into the client’s or subject’s eyes, leaving the client’s hand buoyant, as in arm Direct the client therapeutically, thus utilizing the If necessary, for reorientation, provide suggestions.

A similar process naturally occurs when taking vitals. Carich and Junge (1990) noticed pantomime hypnotic experiences when taking vitals, particularly pulses. By taking a pulse, for longer than required, the subject’s arm can be suspended in mid-air, forming a cataleptic response. This experience is similar to the handshake technique in developing cataleptic responses.

Key Elements

There are several key hypnotic elements involved in the technique:

Fixation of attention or refocusing the client’s attention by: Eye gazes. Touch and Inducing behavioral suspension or buoyant response (creating a dissociative response). Developing a rhythmic pattern during the process, which includes reduced respiratory rate. Interrupting the subject’s habitual framework, by refocusing one’s attention on different sensations of the

A key point while engaging the subject/client, is that the individual’s internal focus is fixated on some selected stimuli involving the level of pressure of the grip. Slowing down the movement and touch during the clasp can initiate this. Also, during the initial engagement, eye gazes create another source of client fixation. By slowing down the shaking of the subject’s/client’s hand, an arm levitation response is induced or created, thus leaving the hand/arm buoyant and totally immobilized. In some cases, the subject or client may be totally immobilized. Finally, the process entails a rhythmic pattern or integration between the therapist and client. The depth depends upon several factors or conditions:

Context of the interaction. Skill and rhythmic pattern of the Level of receptivity and responsiveness of the client.

This is a form of an informal, indirect technique, in which the hypnotic suggestion or induction is delivered through the interaction manifested in the hand- shake.

The authors further recommend discovering nonverbal touch situations in everyday life, whereby one can utilize and help the subject fix and focus attention inwardly.

Conclusion

Milton H. Erickson was a brilliant therapist and hypnotist who provided different ways, including the handshake technique, to induce and create trance-like therapeutic experiences. In his handshake technique, he utilized the client’s responses and behavior to further enhance hypnotic responses and therapeutic experiences. He used his ability to notice minimal cues or define moments of responses and receptivity, and he learned to access these movements to facilitate the hypnotic handshake technique.

There are a number of applications of the handshake technique, ranging from enhancing rapport to inducing calming responses to relaxation. Upon inducing hypnotic responses, several paths can be taken. Therapeutic messages can be interspersed in the moment. Other ways include bypassing “resistant” responses, or client goal inhibitory responses, creating a window of client receptivity.

References

Carich, M.S. & Junge (1990). Pulse-Rate Rapid Hypnotic Injection. The American Society of Clinical Hypnosis Newsletter, 31 (2), October, p.2.

Edgette, J.H. & Sasson-Edgette, J. (1995) The handbook of Hypnotic Phenomena in Psychotherapy. New York: W.W. Norton, C.C.

Erickson, M. Naturalistic techniques of hypnosis. American Journal of Clinical Hypnosis, 1958, 1, 3-8.

Erickson, M. Pantomime techniques in hypnosis and the implications. American Journal of Clinical Hypnosis, 1964, 7, 65-70. (a)

Erickson, M. The interspersal hypnotic technique for symptom correction and pain control. American Journal of Clinical Hypnosis, 1966, 8, 198-209. (b)

Erickson, M. H., Rossi, E. L., & Rossi, S. I. (1976). Hypnotic Realities: The Induction of Clinical Hypnosis & Forms of Indirect Suggestions. N.Y.: Irving- ton: New York

Erickson, M. H. & Rossi, E.L. (1981). Experiencing hypnosis. NY: Irvington. Haley, J. (Ed.) (1967). Advanced technique of hypnosis and therapy. NY: Grune & Stratton.

Kroger, W. (1977). Clinical & Experimental Hypnosis. Philadelphia, PA.: Lippincott.