Posts Tagged ‘Psychologist’
Edgar, a child of five, is the oldest son of a marriage that has lived with great economic and family pressures. The mother began going to therapy two years ago for her distress because of her pregnancy. She left treatment. A short while later, she asked for an emergency appointment. She told me by phone that she had just gotten Edgar out of the hospital, and he did not want to return home because she was afraid of his father who, in an attack of fury and impatience, had hit him against the wall, fracturing his cranium.
I met with the whole family in therapy because that permitted me to under- stand the family situation, to perceive their emotions and to explore their resources. Once I have an idea of the family structure and the context in which the problem occurred, I can tell a story (or build a story together with the children) that represents the problem and different solutions. In an abuse situation, it is necessary to censure actions, not the persons implicated, trying to see them as parents who make mistakes. In this case I constructed the story because the child was immobile in a chair, not wanting to look at anyone, much less participate.
I told them a story about a lion cub and its family. Mommy lion went out to work and to look for food, while Daddy lion stayed to guard his territory and did- n’t like to be disturbed. The lion cub really wanted to go hunting. He wanted to go out to explore. He saw the older lions roar and fight and he was dying to do it too. He wanted someone to play with him, but when Mommy arrived, she wanted to do anything but play. She was tired and wanted him to eat. The little cub began to think he was not interesting or important enough for his mother to play with him.
One day the little cub decided to do as the older lions did. He ran close by his father growling like the older lions, but Daddy lion did not move. The cub growled louder and louder without success. Finally he decided to bite the Daddy lion’s paws and ears to get his attention. He didn’t know that Daddy’s paws had been hurt many years ago. How surprised he was when he bit his daddy and his daddy gave him a shove, throwing him against a rock.
The poor little lion was hurt very badly. At this precise moment, Mommy came back from hunting. Scared, she ran to her cub and started to lick him. She growled very loudly at Daddy lion, more loudly than in other times. Daddy lion also ran to see what had happened to his little son. He hadn’t wanted to hurt his son and he didn’t know why he had let out such a strong blow and why his claws had come out when normally they only came out for attack and defense.
The story continues telling how the little cub had been healed at a special cave, but his little heart still felt very sad and something still hurt inside. All the family went to consult a Leopard therapist that helped the parents and cub to cure their wounds. Leopard told them, “Now is time to heal your wounds, before they become infected.”
While listening to the story, Edgard had drawn a picture of himself that showed the open wound in his head. He drew merthiolate and band aids over the wound and at the end of the session he felt calm about going home. His father talked about his own past psychiatric diagnoses and agreed to visit the psychiatrist again.
They came to three more sessions. Although the problems of the family environment continued, the father’s aggression disappeared and they became closer and more communicative.
The Ericksonian techniques utilized were: story telling, metaphors and reframing through the story.Reference:
Robles, Teresa (1990) A concert for four brain hemispheres in psychotherapy, Alom Editores, México y (1991) Terapia cortada a la medida. Un seminario con Jeffrrey K. Zeig, Alom Editores, México.
Harold called me because he was concerned about his ten-year-old son, Bob, who was phobic about gravel roads. Bob’s phobia had generalized to the extent that he had become reticent about leaving his home. I told Harold that I would be willing to provide a one-hour consultation, if he would bring his wife, June, and his son.
Bob was the most hyperactive child I have ever seen in my private practice. Based on the phone call, I had no idea that ADHD was part of the constellation. Bob couldn’t stop fidgeting. As he entered my office, he poignantly announced, “I’m the crazy person.” My heart went out to him.
I did not want Bob to assume a negative self-definition. I gave him a difficult wooden puzzle consisting of two pieces that fit together to make a pyramid. Bob struggled but could not solve the puzzle. I told him that I could not solve the puzzle when I first got it. I called the friend who sent me the puzzle and asked, “Where’s the third piece?” There was no third piece.
I took Bob out of the office into the waiting room. I showed him how to solve the two-piece pyramid puzzle. I then instructed him to give the puzzle to his mother and father. Smiling, he strolled back into the office. Then Bob and I watched as his mother and father struggled to put the puzzle together. They could not easily do something that he knew how to do. Now Bob was one-up.
Building on the situation, I said to Bob and his parents, “I’m an expert at helping families solve puzzles.” I wanted to define the solution as existing within the family.
Harold told me how Bob’s problem began. The family was driving on a gravel road when suddenly a mechanical failure caused the car to spin out of control. A very good driver, Harold brought the car to a safe stop, but Grandmother, who was in the back seat with Bob, completely panicked. Then Bob panicked, and
subsequently refused to get into a car. Eventually he refused to be in any place where there was a gravel road. When Bob went on to say that he was afraid of being out of control, Harold had a new insight. He had not previously understood that aspect of his son’s problem.
I remembered a dictum from Gestalt therapy: “If you’re in terror, play out the terrorizer.” If I can get the fearful person to play the part of the fear monger, it may breed a solution. Continuing my redefinition of their familial problem, I said, “Mr. Fear has attacked this family.” I then asked Bob to show me Mr. Fear. Bob went to the far corner of the office and became Mr. Fear, attacking his family.
I knew from experience that analogies can generate a solution, so I inquired, “Tell me, what is Mr. Fear like?” Bob asked me if I watched Power Rangers, which I knew only vaguely. “Mr. Fear is Drilla Monster,” he continued.”Be Drilla Monster and attack your family.” So Bob pantomimed being Drilla Monster attacking his family.
Next, I thought about the Ericksonian principle of eliciting resources. I knew that there must be a resource in this family to deal with Bob’s fears. Since Bob had offered the metaphor of Power Rangers, I asked him, “What power do you have?” “I know karate,” Bob replied. “Show me how you can use karate to fight off Drilla Monster,” I said. Bob successfully fought back the imaginary Drilla Monster, pushing him out of the consulting room.
Next, I explained the therapy. Whenever Mr. Fear, Drilla Monster, attacked the family, they were to stop and convene a meeting of all the Power Rangers who would decide together how to use their powers to defeat Drilla Monster. I then added, “I have two other therapies that I would like you to practice.” Because June seemed exhausted and overwhelmed, I directed the tasks to the father and son. Harold was bright-eyed and seemed to have a lot of energy to devote to Bob. I explained that each morning for a week, Harold and Bob should practice being out of control. Bob would go into the backyard and play being out of control and Harold would coach him about being better at being out of control. Then Harold would act out of control and Bob would coach him about being out of control. My covert design was to turn a problem component into a game. They agreed to the therapy.
Then I offered, “I have an another therapy for Bob. I want you to write your name in my driveway.” I live in Phoenix, Arizona, in the desert. My driveway is made of gravel. I told him that I did not even allow my daughter to write in the gravel, but that I would like him to leave his mark there showing that he had been at my home office. My technique was a symbolic desensitization. Bob would have to slide on my driveway as he shuffled his shoes around to put his name in the gravel. I would have him violate his phobia about gravel. Adequate psychotherapy with a phobia can be achieved when one gets the patient to violate the phobic pattern, even on a symbolic level.
In the one session therapy, I had a series of heuristics that could generate solutions. In this case, the most important heuristic was faith. There were three components of this faith: One, I had faith in my ability to utilize whatever they brought me. Most of my professional contributions in print during the past ten years have been explications of Milton H. Erickson”s utilization method. I have made utilization a center point of my therapy. The second aspect of faith also came from what I learned from Erickson. I had faith in the family. I had faith that they had a resource in their system that would be adequate for solving the problem. The job of the psychotherapy would be to help them access that resource experientially. Finally the third part of this faith was in myself. I knew that I had surmounted similar problems. I also had used methods to cure myself similar to those I prescribed for them. If I could do it, I knew they could, too.
Jeffrey Zeig, PhD will present at the December 2005 Evolution of Psychotherapy Conference, www.evolutionofpsychotherapy.com
Sean was in front of me, looking down at the carpet. “I am afraid that I cannot use my computer anymore. Last night I spent almost four hours downloading all kinds of antivirus software, and when I got up in the morning, I was worried the software could bring more viruses to my computer. I reformatted my computer and worried that I erased my data, which I did not back up.” As an engineer, Sean knew his data was safe, but could not help worrying about it.
As he talked about his worries and fears, I had him describe a typical day, so that I could have a sequence of common events. I also obtained information on his background. He has a loving and academically-oriented Chinese family and he had not experienced major trauma in childhood. Yet, I agreed with him that our world is not a safe one. There are hackers and viruses everywhere. I told him that he was being extremely careful, and that his goal would be to regulate his worry by spending 30 minutes a day worrying about random things.
So he set aside two hours in the morning to worry, two hours in the afternoon, and four hours every night. I asked him if he could find a safe place to visit. He went into trance. His safe place is a quiet lawn with a pond, a bench, and the warmth of the sun. I told him his thoughts would affect his body.
The following week, Sean said he was spending less time worrying about his computer, but more time fretting about his health. He washed his clothes several times a day. The safe place seems to help him calm down. I told him any change is good. I asked him in trance to envision a favorite face; he saw his parents comforting him, assuring him that he is safe. Over the next few sessions he reported that he was sleeping better, no longer washing his clothes repeatedly, and started to go to church to meet people. I encouraged him to walk during his lunch hour. He said that he was talking more to his friends in China and noticed that the worries randomly come and go, about four hours a day. I told him change is good and that things may get worse again before they get better.
By session six, he did not notice the morning worry and used deep breathing and his safe place to handle random worries. I suggested he might want to schedule a time for worry to visit, and to send worry home when the visit is over. I told him that if relapse happens, it is normal, and he said that he invited the worry to come, but his mind was distracted by plans for dinner, taking a walk, and playing video games with friends.
By session eight he happily said, “There is a big improvement.” He traveled with a friend and had a good trip. I initiated a deep trance, just for fun. I asked him to come back every other week and reminded him that a relapse can happen any time. When he reported random worries I said that he was a very responsible per- son and needed his work to be perfect, and that he should take advantage of being perfect and avoid getting caught in too much work.
After 11 sessions, feeling much more relaxed with his life, Sean can handle little worries with deep breathing and a safe place. He decided to discontinue sessions, as he is feeling normal and relaxed, accepting himself as a very detailed and responsible person, and is making travel plans.Commentary by Eric Greenleaf, PhD
Angela Wu demonstrates the best of brief, strategic, MRI-inspired hypnotic psychotherapy. She preempts relapse by predicting it, and reframes anxiety to its other human meaning of responsibility in living among others. Her hypnotic work is straightforward, and rests on her client’s discovery of the characteristics of a safe place and supportive relationships. That both safety and support can be imagined fully in trance, is an elegant counterpoint to the imagined worries that brought her client to her in the first place.Angela Zhe Wu, LMFT
Angela Wu is in private practice at MRI, in Palo Alto, CA, where she provides psychotherapy to individuals, couples, and families of diverse, cultural backgrounds. She speaks English and Mandarin, and is skilled in crisis counseling, family therapy, gestalt, EMDR, hypnotherapy, and art therapy.
– – – – – –Eric Greenleaf, PhD
Eric practices in Albany, CA, and has seen patients for 50 years. He directs the Milton H. Erickson Institute of the Bay Area and teaches internationally. Since 1988, he has studied trance rituals and healing in Bali. Dr. Green- leaf serves on the Board of the New Bridge Foundation, a comprehensive substance abuse treatment center in Berke- ley, CA. Milton H. Erickson, MD, chose Greenleaf to re- ceive the first Milton H. Erickson Award of Scientific Excellence for Writing in Hypnosis from the American Journal of Clinical Hypnosis.