Posts Tagged ‘Trance’

Age Progression by Noboru Takaishi, M.D.

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.

References:

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.

A Shift for Victim to Empowerment by Tim Baumgartner, Ph.D. Houston, TX

A 24-year old client who had been in therapy almost continually since her mid-teens presented a long history of sexual abuse and incest. Five years previously, she had been hospitalized for major depression and suicidal concerns.

At that time she reported abusive treatment by her psychiatrist. Complaints involved isolation when she refused medication, verbal insults, and suggestions of memories that she did not have. She reported that the psychiatrist subsequently lost his license.

Prior to seeing me, she was in therapy with another psychiatrist for five years. The client reported feelings of resentment and distress toward this psychiatrist. She reported that he insisted that she had engaged in specific sexual acts with her father. These acts were not consistent with her recollections. Therapy had included confrontation of the father.

The client was now married and had not been troubled by suicidal depression or drug abuse over the last three years. However, her history combined with her reported abuse by family, boyfriends, employers and treatment providers contributed to her depression, post-traumatic stress, and “victim” self-image.

Treatment began with the setting of clear boundaries and focusing on the client’s rights and expectations . Her abuse history was gradually disclosed, accompanied by expressions of fear and anger. The client agreed to the use of trance to shift her focus from the perspective of victim to one of curiosity and empowerment. She responded well to conversational inductions. The therapeutic focus was on learning and development as opposed to remediation. As she learned to express her feelings of anger and frustration, she began to express the need to “get away somewhere.” Her fantasy was to take an island vacation, but she believed that she required psychiatric inpatient services to stabilize her thinking.

In our discussion, she expressed that the dollar price of the short hospital stay would be about the same as the desired vacation, however, she was concerned about her husband’s “emotional price tag” that would result if she took a vacation. In therapy, I suggested that some people “prepay” vacations so they can enjoy the entire experience knowing that there would be no legitimate bill waiting on their return. She was challenged to determine all “hidden” costs and experience them affectively and inter­personally, as soon as possible, so she could begin anticipating her trip.

The client accepted this suggestion, and shifted her focus from anticipation of hospitalization to planning for the trip. She took the vacation while her husband stayed home. Upon her return, she reported that she had successfully set boundaries with her husband and did not assume any emotional debt for her trip.

The metaphor of the vacation was used to reinforce her inner strength and independent action. The client reported successful goal planning, boundary setting, calculated risk taking, initiation of interpersonal relationships, and a feeling of inner courage and empowerment. Over the following months, she remained in therapy and reported that the vacation provided a “turning point” for her. The client enrolled in college and performed well. While the change from “victim” to responsibility was rapid, and occasional slips into the former role occurred, the resources for change were integrated within her.

Suggested readings Otani, A. & Koska, M., (1992). “The dialogue technique of hypnotic induction.” American Journal of Clinical Hypnosis, 35, 1, 20-28.

Phillips, M., (1993). “Turning symptoms into allies: utilization approaches with post- traumatic symptoms.” American Journal of Clinical Hypnosis, 35, 3, (179-189).

Rosen, S., (1982). My Voice Will Go With You. New York: W.W. Norton

Discussion by Gene Davita, M.D.

Baumgartner  focused on present­ing issues in the past as well as present boundary violations and abuse from numerous sources including professionals. Establishing a therapeutic relationship with clear expectations, respect for the rights of the patient and opportunity for her to express her emotions was paramount. This established a fluid, process focused therapy in which change could be promoted.

The patient seemed adept at trance since conversational induction worked well. She was able to move from the victim position to one of empowerment rapidly. More traditional therapeutic approaches that encourage hours of exploring victimization experiences can further crystallize that role. Such a shift in the therapeutic paradigm for a patient allows responsibility, self-assertion and creativity that universalizes to all areas of living.

The patient’s concerns with the cost of hospitalization presented Baumgartner with an opportunity to employ an Ericksonian approach and the patient’s fears then could  become a useful part of therapy. The vacation metaphor allowed the patient to experience “getting away” and to create an experience that furthered her responsibility, assertion and individuation . This created even more encouragement for further growth and development in living by using the skills developed while turning a dream into a reality. She was further empowered by beginning to create a life of self hood rather than perpetuating the life of a victim.

Baumgartner’s work with this patient, who presented with a multi­tude of serious problems, demonstrates therapeutic elegance in his work with one aspect of her problems. The assistance of movement from being reactive in her life to being the source of creating her life was important. This resolution can serve as a springboard for future therapeutic advancement.

 

“I can use my computer again.” Brief Hypnotherapy with Super Anxiety by Angela Wu, LMFT

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.

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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.