Posts Tagged ‘Pyschologist’
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 are 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.
His behavior changed dramatically. He became rude and unreliable; his ability to practice surgery became noticeably and severely compromised. There were even several episodes where he collapsed during surgery. He was relieved from all duties at the hospital. His wife left him and returned to her parents’ home where she thought of divorcing him.
He came to my clinic and decided to use hypnosis as part of therapy. After a deep hypnotic trance was induced, I suggested he recall his happy, confident days before the beginning of his doctoral thesis. The recall and re-experiencing of these good times were confirmed by finger signaling.
Using age progression, he was asked to imagine a scene in the future where he was freed from his addiction and felt happy and confident both mentally and physically. These feelings were tied to the feelings he had as a student before he was addicted. He was asked to see the people close to him, his parents, his wife and the staff of the hospital, being so pleased for him and filled with trust for him as they had been in the past. I suggested that he imagine such scenes as vividly as possible.
As a post-hypnotic suggestion, I told him that the experience he had in the hypnotic trance would be firmly fixed in his unconscious mind. It would positively influence his daily activities without conscious awareness. Then the trance was ended.
The next week, he said he had stopped taking the pills. He said he was feeling some confidence and happiness. There were two more sessions using the same principles of building a productive future on productive behaviors and responses in the past.
It is now 25 years since these three sessions. He has had no further problems with drug dependency. He is working actively at the hospital where he did his doctoral thesis, and has replaced his father, who retired, as director.
The work described here is a successful example of what I have called the “in advance rewarding method.” This technique aims to develop the patient’s inner strengths toward a possible and positive future. I developed treatment in this case without knowing about Erickson’s work in pseudo-orientation in time.Discussion
by Betty Alice Erickson M.S., L.P.C. Dallas, Texas
Dr. Takaishi’s patient did not seem to require the added complexities of a physical detoxification, and he was not initially enthusiastic about treatment. Using the man’s previous experiences as a successful and competent person, Takaishi used trance to guide the man into a realization that his future could have those same components. In 1934, Erickson wrote that the hypnotist “must implant his suggestions in the vast aggregate of mental reactions and patterns accumulated throughout the subject’s lifetime.” Takaishi did just that.
Regression in a hypnotic state helps a patient reestablish patterns of behavior “uninfluenced by subsequently acquired” behaviors (Erickson, 1937). And again, Takaishi did just that.
Good therapy allows the patient to access and build upon personal strengths and resources in productive ways. It is the therapist’s job to structure psychotherapy so the patient is in a position where those currently inaccessible abilities and resources become usable once again.
This patient clearly had the ability to succeed and accomplish his goals. Imagining a future, in a trance state, where goals already have been met and the warm glow of success is felt, can give patients deep-seated feelings of accomplishment and pride. Structuring this future as a post-hypnotic suggestion that didn’t have to enter conscious thinking allowed the patient to reap the benefits of the therapy without having to ascribe the cause to the therapist’s suggestions.
One of the most intriguing aspects of Erickson’s work is its timelessness. Six decades ago, when hypnosis was poorly understood and under-used in the psychotherapeutic world, he was writing about the principles that Takaishi employed in his work 35 years later. These techniques are as applicable and powerful today as they were when Erickson first wrote about them and when Takaishi used them. Takaishi did good therapy, with creativity and intelligence.
The opportunity to reexamine effectiveness after twenty-five years is rare. The absence of a relapse speaks for the effectiveness and the appropriateness of the therapy used. With his discovery that Erickson had written about this same technique years previously, Takaishi can now compare and enhance his own abilities just as students of the “modern” arms of psychotherapy, of brief, cognitive, narrative, and solution-focused, can compare and enhance their own understandings by studying Erickson’s original works.
Erickson rarely claimed credit for “inventing” a technique. He understood that the tenets of human behavior have been known and studied for centuries. Part of his gift to the psychotherapeutic world was his ability to encapsulate commonalties in productive methodologies and to write about and teach them in understandable and replicable ways.
Erickson, M. H. (1934). “A brief survey of hypnotism.” Medical Record, 140, 609-613.
Erickson, M. H. (1937). Development of apparent unconsciousness during hypnotic reliving of a traumatic experience. Archives of Neurology and Psychiatry, 38, 1282-1288.
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.
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 hand. Grasp the client’s hand in a normal handshake. Slow the handshake down by pacing and leading the client’s hand during the clasp. Shift the touch and pressure, slowly releasing the handshake. Slowly release the hand from the handshake; slide hand away. 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 levitation. Direct the client therapeutically, thus utilizing the outcome. 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 Pressure. 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 handshake.
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 operator. 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.
From Newsletter Vol 36. No.1