Posts Tagged ‘Pain’

By Steve Andreas Estimated Running Time: 6 minutes, 21 seconds 

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!”

When Erickson worked with an alcoholic, he would often say, “Bring a full, unopened bottle of alcohol with you to the next session.” The implication was, “Don’t drink,” and the deeper implication was that the client can control his drinking.

In working with couples, Erickson would often say to one of them, “I want to hear your side of the story. One implication is: “I also want to hear the other side of the story.” But, because of the word “story,” the further implication is a distinction between the “story” and real story. Virginia Satir made the same kind of distinction by saying to a family member, “I want you to tell me how you see the problem,” implying that there were other views.

Erickson would frequently say to a client, “I want you to withhold any information that you don’t want to share with me.” “Withhold” is not necessarily permanent; you can withhold for a while, and then you can yield. But the implication is: “Don’t pay attention to all the stuff you’re going to tell me; pay attention to the stuff you want to withhold.” So, clients would tell him many sensitive things, and most likely by the end of the session, would think, “Well, I told him all that other stuff, I may as well tell him this too.”

Erickson was in session with a woman right before she was scheduled for a risky surgery and she had doubts if she would be okay. He gradually led the discussion around cooking and asked about her favorite recipes. When she would mention something, he would say, “Oh, you know, I’ve always wanted a good recipe for that. Would you give it to me?” Of course, she couldn’t give it to him in that session because she was due to have surgery, so he’d say, “Oh, that’s all right, you can bring it in when we have our next session,” implying that the surgery would be successful.

I went to see Erickson in 1979, about a year before he died. In the middle of the day, seemingly out of nowhere, I heard him say, “Marry an ugly woman and she’ll always be grateful.” I thought to myself, ‘What an awful sexist thing to say!’ At the time, I was with a woman who I — and many others — thought was quite beautiful. The implied message is: “Marry a beautiful woman and she won’t always be grateful.” I didn’t understand that consciously until after the woman and I were married.

Erickson once worked with a woman he called, “Inhibited Ann.” Shortly before bedtime, she’d start gasping and choking, which interfered with her having sex with her husband. In order to be physical with him, the woman insisted that the lights be out so that she could undress in the bathroom, put on a long robe, and then, covered head to toe, she’d come into the bedroom in the dark and get into bed with her husband. After finding out that Ann loved to dance, Erickson said, “You know, you could dance into the bedroom in the nude.” And then said, “We don’t want to give him heart failure,” implying, “We do want to give him something else.” Then, later in the session, Erickson said, “You really could dance into the bedroom in the nude. You’d be in the dark with all the lights out, so your husband can’t see anything, and he’d never know.” So Ann took his suggestion, danced in the nude in the dark, and then crawled into bed feeling like a schoolgirl, giggling about doing something so daring. Giggling implied not gasping, and not gasping implied availability for sex.

On another occasion, Erickson worked with a professor of music who fainted whenever he tried to go on stage to give a piano performance. He told Erickson he was going to be fired from the university if he didn’t perform. So Erickson said, “Okay, ahead of time, put down towels of different colors all the way from the backstage up to the piano. Then, as you walk onstage, decide which one you’re going to faint on.” Involving the professor in a decision process implied that he would not be attending to whatever thoughts made him faint in the past. Since fainting is elicited unconsciously, the implication is he won’t faint at all. And since you have to faint where you are, not somewhere else, thinking about fainting there implies not fainting here.

This same intervention saved Erickson’s life once. When he was working in a mental hospital, he walked into an elevator and per regulation, locked the door behind him before realizing that there was a murderous psychopath in the corner, who said, “I’m going to kill you.” As Erickson always did, he first paced what the psychopath said, and then replied, “Oh, okay, you’re going to kill me…” as he put the key in the elevator door to unlock it, “and the only question is, ‘Where do you think the best place would be for you to slaughter me?’” Erickson opened the elevator door, pointed down the hall and said, “Would over there be best?” The psychopath looked out into the hall as Erickson calmly walked out of the elevator, saying, “Or, maybe over there in that chair would be better. But then again, over there might be best.” Erickson continued walking down the hall toward the nurse’s station, and to safety. Since there is nowhere he can be slaughtered, he distracted the psychopath from killing him where he stood.

Learning about implication is similar to opening another set of eyes and ears; seeing and hearing in a whole new dimension. It’s spooky the things you can become sensitive to, particularly nonverbal implication. I believe that Erickson’s unparalleled ability to “read” people was largely due to his ability to notice and use implication.

In earlier issues of the Newsletter I have written more extensively about both verbal and nonverbal implication. (Vol. 23, No. 1; Vol. 24, No. 1; Vol. 24, No.2)

*Edited from a dialogue between Jeff Zeig and Steve Andreas “Experiential Approaches: The Power of Implication” at the 2014 Brief Therapy Conference. BT14-D02

 

This excerpt has been extracted from Volume 35, Issue No. 2 of The Milton H. Erickson Foundation Newsletter. 

By Joel Samuels, MD Estimated Reading Time: 3 minutes, 26 seconds 

Stone carving transformed my life of chronic pain, depression, and drug dependency into a life of renewed vitality with the ability to work, dance, and feel whole again.

After 25 years of working as an emergency room physician, I underwent several back surgeries, which resulted in many hours of physical therapy and treatments with never-ending pain and limited mobility; my life was reduced to bed rest and hot baths. So, I pursued several treatment options, including tapping into my creativity as a way of healing chronic pain.

I began by carving small hand size pieces of alabaster and marble while lying in a zero-gravity chair, and I instantly fell in love with sculpting stone. Later, I was able to carve while standing, which provided the opportunity to work on larger pieces. To my amazement, time seemed to melt away while I was engrossed in this process; my physical and mental attention deepening and widening. It was as if I had entered a spacious room, leaving the back pain outside. Something magically healing occurred in me when I entered the world of the stone carving, while at the same time, I remained in the present, discovering the shapes and lines embedded in the rock. Focused attention on carving became a meditation, complete with mindfulness of the body in motion. Previously, I discovered that distracting myself was minimally effective in relieving pain. In contrast, stone carving was highly effective. The repetitive movements of chiseling, filing, and sanding the stone were a perfect setting for mantra recitation and training the mind. I was learning to stay in the present while remaining open in this vast new room of creativity. Stone carving transformed time. Hours felt like minutes, while my body pain was in the distance, as if on the back burner. When the stone would crack and pieces would fall away, it opened me to another opportunity to use creativity and literally go with the flow. As my dear friend and source of sculpting inspiration, Shiffi Menaker-Schreiberr used to say, “The stone is the guru [teacher].” I also found that the process of carving trumped the outcome. This idea became paramount in healing. Stone carving became my medicine.

I hope my story and art will be beneficial to others. A thank you to all my doctors, healers, teachers, and friends (too numerous to name) and to my partner Ellen Vogel whose support and love made this possible. Also, special thanks to Anam Thubten Rinpoche, Darlene Cohen, and Shiffi (mentioned earlier), who were invaluable inspirations and helped guide me along the path.

Commentary

By Eric Greenleaf, PhD

“When you have a difficult problem, make an interesting design out of it.” – Milton H. Erickson, MD

Dr. Erickson employed all manner of creative devices to respond to his own physical pain, and to a patient’s emotional pain in life. He tried countervailing his own pain with distraction, like when he would press his chin into the top of a chair, and when he hallucinated that the colorful hooked rug in his office was spiraling into the air. He would also have detailed discussions with Mrs. Erickson in the middle of the night about the pain sensation in his feet. He used the conversation and detailing of the pain as a distraction until his wife would gently remind him that she and the rest of the family needed their sleep.

To reduce the emotional pain of a woodcarver’s low self-esteem, Dr. Erickson borrowed one of the patient’s ironwood carvings overnight and returned it the next day with bruised fingers and a replica of the carving that he had made. He did this to experientially show the patient the value of his (the patient’s) work.

Dr. Samuels, an experienced physician, and healer discovered a way to respond to his own crippling pain in a way his patients would recognize. He did this by putting his thoughtful, calm demeanor to work through his eyes and his hands, as he slowly changed stone to art. As was once said, “Architecture is frozen music.”

Note: Those interested in viewing Dr. Samuel’s stunning sculptural work, please see: http://mrdrjoel.tumblr.com/

For imaginative approaches to healing, using visual arts, movement, and trance, see www.miltonherickson.com.

 

This excerpt has been extracted from Volume 39, Issue No. 3 of The Milton H. Erickson Foundation Newsletter. 

By Carrie Rehak, PhD Estimated reading time: 3 minutes, 24 seconds.

I did not know what time it was when I came downstairs to finish our winter display — images and symbols communicating the holiday season, as observed and celebrated by various sacred traditions in anticipation of the coming of light. All I knew was that it was cold and dark outside, and I was ready to head home.

Just as I was hanging one of the last ornaments, I caught a glimpse of her in the corner of my eye — a student of mine, who I knew had an extremely long commute. And, I also knew she had cancer, as she asked our community to remember her in our prayers at a service she could not attend last year.

“It’s beautiful,” she said, referring to our twinkling display.

“It really is,” I agreed. “A student worker put it up. I just came down to hang these last few pieces.”

I asked how she was doing.

She pointed to an area under her left arm, saying, “I am in a lot of pain — scar tissue. It’s unbearable.” She said the pain was so distracting she was uncertain if she would be able to finish her program.

I asked what time she had to be at class. She had an hour. I asked if she would like to take 15 minutes for a meditation that might help with the pain. She agreed, even though she just finished a nearly two-hour drive.

We found an empty classroom. I adjusted the lighting so that it was neither too dark nor too bright.

I invited her to get comfortable in her chair, and then listened as she described her pain.

“Does it have a color?” I asked.

“Yes,” she said, “it’s red, fiery red. Like flames.”

I asked if she had a place of health or strength — physical, mental, or emotional.

She said she was emotionally strong.

I asked what that place of strength looked like. She said it was blue.

“Light blue or dark blue?” “It is sapphire, she replied.

“Sapphire blue….Does it have a shape?” “No,” she said, “it’s like water.” I asked if she could bring it to her place of pain.

Then I queried, “Is the water cool?”

“It’s getting warm,” she answered. “It’s putting the pain out.” “How is it feeling now?” I asked, after a long pause.

“The pain is gone. It feels tender.” “Does it want anything?” I inquired. “It wants ointment,” she said.

“OK. Can we apply some ointment, so it’s just right?” “Yes,” she said, “I am applying it now and it feels good.”

“Take as much time as you need,” I said. “I am covering it with gauze now,” she said.

“That’s right,” I said. “It will protect it, while allowing it to breathe and the tissue can stretch.”

“It feels good,” she said, dreamily, after another long pause. Then, opening her eyes widely, she said, “It’s cool!”

“It’s cool?”

“Yes!” she said, “the area — it’s cool! And what we just did — it’s cool!” “Yeah, it is cool,” I agreed.

When I got home, I called my mom who is in severe pain after a terrible fall that resulted in a broken hand and fractured knee. By the time we got off the phone, she said she could no longer feel the pain — pain that had made it nearly impossible for her to sleep.

But, that’s a story for another time.

Commentary By Eric Greenleaf, PhD

Student work is often more impactful and immediate than other work. It carries authority because it is relational, not technical. And it is also fresh, taking the essence of teaching to heart. Carrie Rehak, a student of mine who is studying Ericksonian approaches, has years of experience in spiritual direction and pastoral care. This example of her work with imagery was spontaneous and effective, and utilized the spirit of a class exercise we had done, called “A Pain Map.” This consists of drawing one’s physical and emotional pains on the outline of a body; drawing one’s strengths and resources on a second map; and, in trance, placing a particular strength on a pain and then taking note of what happens. In, Carrie’s example, the exercise is focused, empathic, and succinct.