Posts Tagged ‘LICSW’
Estimated reading time: 3 minutes, 46 seconds.
An athletically built young man in his mid-20s, neatly attired in a business suit, consulted me to deal with “rage issues,” “depression,” and a desire to get to the “root” of his relationship with his mother. He told me that he had been raised by a single mother who was alternately extremely dependent upon him, and then physically and emotionally absent. They had suffered poverty when he was a child, and he was determined to continue to rise financially in the world as an adult.
Recently, his last two therapists, both women, had dismissed him because he had refused to enter a drug rehabilitation program as a condition of therapy. He thought that he might be a “borderline alcoholic” because of his daily use of alcohol, marijuana, and opioid pills, which left him “faded,” but still able to work in a high-pressure, high-stakes business environment. → Read more
An admonition from William Alanson White, M.D., then Superintendent of St. Elizabeth’s Hospital, was given to this writer early in his psychiatric career, and a year or so later he was again given the same admonition by Adolf Meyer,
M.D. Both strongly advised the writer never to refuse to consult with a patient. A single interview graciously granted during which the patient’s story was listened to attentively, while not especially remunerative, had often permitted them to encounter many unusual instances of psychopathology and to achieve, in many cases, astonishingly effective results. These results had sometimes proved to be far better than the doctors had considered possible at the time of the interview, even if long-term therapy could have been instituted. They likened such instances to the processes of behavior wherein “love at first sight” has drastically and positively altered the lives of various individuals. One such historical example was the schoolteacher who thought it wrong for an adult man making his living as a tailor (Andrew Johnson) to be so uneducated. The events that unfolded began with teaching and led to love, marriage, a law degree, a judgeship, and eventually the presidency of the United States. → Read more
A 28-year-old male physician, who had done well in medical school in Japan, began working on a doctoral thesis at the surgery department of a national university that was not his alma mater. He also was working at the hospital where his father was a staff physician.
He started having difficulties with his doctoral thesis. As a consequence, he began to suffer from severe insomnia. He decided to treat his own insomnia by taking prescription sleeping pills (methaqualone), a type which is no longer manufactured in Japan because of their severe side effects. Soon, the young physician became dependent on these pills as well as tolerant of them. He increased the dosage and finally began taking them during the day as well. → Read more
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. → Read more
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. → Read more
Milton H. Erickson & Ernest L. RossiEstimated reading time: 4 minutes, 54 seconds.
THERAPEUTIC BINDS AND DOUBLE BINDS
The concept of the double bind has been used in many ways. We use the terms “bind” and “double bind” in a very special and limited sense to describe forms of suggestion that offer patients the possibility of structuring their behavior in a therapeutic direction. A bind offers a free choice of two or more comparable alternatives-that is, whichever choice is made leads behavior in a desired direction. Therapeutic binds are tactful presentations of the possible alternate forms of constructive behavior that are available to the patient in a given situation. The patient is given a free, voluntary choice between them; the patient usually feels bound, however, to accept one alternative. → Read more
When children paint the sun, they often draw a circle with rays coming out. You’ve all seen that; you probably did it yourself when you were young. A year or so later, a child might paint the sun partly behind clouds. Several years later, they might paint rays coming out from the clouds, but the sun is not visible — what a friend of mine calls a “God sunset.” Even subtler is to paint only the scattered reflection of sunlight on water. An accomplished artist doesn’t paint the sun at all but suggests where the sun is by painting a tree with a little more light on one side than the other, and a subtle shadow to indicate the sun’s location. I think that’s a good metaphor for implication: indicating something without ever explicitly stating it. One of my favorite quotes is: “The larger the island of knowledge, the longer the shoreline of wonder.” (Ralph W. Sockman) Knowledge and wonder are stated; the ocean of ignorance is implied.
On the first page of the first volume of Conversations with Milton H. Erickson, (in which the word “implication” appears about every third page) Jay Haley says, “I have a whole week, so I suspect I can learn all about psychotherapy in that time. I wouldn’t expect that anywhere else but here.” Erickson laughs and says, “Well, we can have our dreams.” That’s a polite way of implying, “You are wildly optimistic!” → Read more
“From 0 to 10, with 10 being high, how would you rate your current level of distress?” With his rating, the client is asked to keep the most distressing picture of his presenting event or memory in mind; then, to identify where the feeling lodges in his body; and lastly, to identify his associated negative cognitions that go with the problem–such as “I’m helpless,” or “It’s my fault.” Continuing with his images, feelings, and thoughts, he is kept grounded in the present through the clinician’s interactions with him. The eye movement stimulation (or possibly an alternate form, auditory or tactile, of left-right lateral stimulation) is then introduced. He is intermittently asked for his rating of his distress on a scale of 0-10–the Subjective Unit of Disturbance Scale (SUDS) while he is processing the trauma, until the point when his memories have lost their disturbing power. This recursive procedure is maintained until he has desensitized his difficult memories and until positive self-cognitions have replaced his negative self-cognitions. When his negative images are dissipated, he is asked to rate the believability of his alternative positive cognitions on a scale of 1(completely untrue) to 7(completely true)–the Validity of Cognition Scale (VOC). From having spoken of his negative cognitions initially, he now speaks of what he would rather believe about himself, his positive cognitions. → Read more
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. → Read more
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. → Read more