HYPNOSIS in SYMBIOSIS Occasionally I Use Hypnosis in A
Total Page：16
File Type：pdf, Size：1020Kb
HYPNOSIS IN SYMBIOSIS Occasionally I use hypnosis in a family therapy context. At times it can be difficult and complex, but often it is very creative and rewarding work. In this case I was using a series of dual inductions, rotating family members as my co-therapists, utilizing their mutual co-dependency as a therapeutic asset. Sharon was a 45-year-old accountant who came in with Cheryl, her 25-year-old severely bulimic daughter. Cheryl worked as an administrative assistant. Recently her bulimia nervosa had escalated in severity such that she vomited on almost all eating occasions. She was acutely depressed, but not suicidal. Currently she was on medical leave due to the severity of her condition. Sharon had been anorexic as a teenager and young adult. Her condition improved only slightly around the time of her engagement and marriage to Paul, and engineer. Two years after their wedding, Sharon gave birth to Cheryl. She was a good but overprotective mother, and her food restriction began to get worse in Cheryl’s early years. Although Sharon had been treated in hospital in her teenage years, she refused treatment now, saying she could overcome her condition by herself. After years of putting up with Sharon’s rigid thinking, mood swings, food and figure obsessions, anxiety, depression, and other symptoms, Paul could not stand it any longer. Despite his caring for Sharon and Cheryl, he left them in Calgary to take a well-paying job in Toronto. The couple went through a separation and divorce when Cheryl was age eleven. Surprisingly, after Paul left, Sharon realized that, as a single parent, she would have to recover from her anorexia. After a few brief sessions with a counsellor, she began eating normally and her symptoms subsided. Essentially she made a full recovery with minimal support. However, for many years she still remained hyper-vigilant about her only child, fearing that her parenting might lead to Cheryl developing similar tendencies as a teenager. Cheryl seemed to be an ordinary adolescent, although overly dependent and very emotionally close with her mother. In high school Cheryl was an average student despite working very hard for her grades. She was shy and had few friends. She was often moody, depressed, and obsessed by appearance. In an effort to politely break away from her well-intentioned helicopter mother, Cheryl decided not to go on to university but instead do several business courses, enter the career world, save some money, and find her own apartment. By the time she was twenty, Cheryl was living on her own, but her mother called her several times a day and visited many evenings a week, being so involved that it was difficult for Cheryl to find time to develop her own friendship network, despite Sharon’s urging to do so. Mother and daughter were symbiotically joined in closeness but repressed resentment that neither was truly autonomous. Finally, by age twenty-two, Cheryl’s well-hidden eating disorder emerged. She had been secretive about her bulimia nervosa for years, making excuses for her brief trips to the washroom shortly after eating, and wanting to spend more evenings alone with seemingly little to do in the way of activities or hobbies. Whenever Sharon would confront her daughter about her suspicions, Cheryl would find alibis and excuses, denying that anything was wrong; she was just tired from working hard, or had a stomach flu, or whatever. Finally, after more than two years of these patterns becoming more frequent and severe, Cheryl finally admitted to her mother that she was bulimic. Sharon was guilt-ridden but relieved that her daughter had finally broken through denial, deceit, and isolation. Still, Cheryl wanted to solve her problem without therapy, feeling she could do it for herself. Within several months it had now come to this: she was unable to concentrate and function properly at work and was now on medical leave. She accepted her mother’s invitation to move back home for a while to work on her recovery. With her mother’s urging, Cheryl reluctantly admitted she was ready to give therapy a try. In their first session, both Sharon and Cheryl were trying very hard to be polite and respectful with each other, but the frustration in their relationship was palpable. Mother felt somewhat betrayed that daughter had been secretive about her disorder for several years, allowing it to fester and worsen. She also felt embarrassed at being naive and being duped for a while by her daughter’s denials. Cheryl was embarrassed by her condition and how severe and constant it had become. Mother wanted to be as helpful as possible in promoting her daughter’s recovery. Both had relatively few other friends and activities, except working out frequently at local fitness centres. Mother had heard from my former clients how I used hypnosis in helping eating disorders, and was hoping we could use this approach with her daughter. Cheryl also was intrigued with the idea of hypnosis. After interviewing using the standard protocols for assessment of bulimia nervosa, I highlighted how enmeshed Sharon and Cheryl seemed to be. Cheryl was concerned that her mother seemed to be obsessed with Cheryl’s eating disorder, asking endless questions and voicing worried concerns. I told them my comment about over-involvement. Q: “How do you know you are co-dependent?” A: “When you are about to die, someone else’s life flashes in front of you.” Then I proceeded to outline an interesting approach to help them help each other. We would use mother and daughter’s enmeshment as a strength rather than a liability. With my help and instruction, we would do rotating dual inductions. That is, in one session I would be conducting hypnosis with Cheryl as the subject or client, with the assistance of her mother as co-therapist. In the alternate session, I would have Sharon be the subject or client, while engaging her daughter as my co-therapist. At first they were somewhat overwhelmed with the requirement of being a co-therapist, but I reassured them that they would be more than adequate reading scripts that we would prepare in advance of the hypnosis segment of each session. For those of you who are not familiar with dual or multiple hypnotic inductions, I’ll take a moment to give you a primer. Trance is any state of sustained focused awareness, where the attention is so focused that other thoughts or sensations are far in the background, almost as if they do not exist in consciousness. Hypnosis is the use of words and/or repeated actions to attain and utilize trance states. Another key point to remember is that dual or multiple inductions are unusually powerful, in that they induce confusion in the listener and greater imprinting of key messages in the client’s subconscious mind. Dual inductions typically begin with the primary hypnotist doing the beginning induction primarily on the left of the client, then a second hypnotist begins talking on the right side of the client. The two alternate several sentences back and forth, then both hypnotists begin simultaneously talking their individual scripts of messages to be imprinted by the client. After several minutes of simultaneous speech, gradually the prime hypnotist prevails and ends the trance session with a proper reorientation of the client back to normal waking consciousness. Each session featured a dual hypnotic induction following the first part of the interview where we would talk about the key theme that had emerged for mother and daughter that week. Although we tended to alternate the roles between Sharon and Cheryl, we used some flexibility in case either of them had the primary concern for that week. Of course, we addressed the usual eating disorder themes: distorted body image, obsession with slimness and weight, identity, self-esteem, worthiness, distorted thinking patterns, black-white thinking, mindfulness, balanced nutrition, protein and blood sugar regulation, emotional regulation, communication, validating oneself and the other, tolerating differentiation and separation, appropriate boundary management, mind state management, etc. This written description does not do justice to the beauty and care with which mother and daughter nurtured their greater sense of helping each other while growing a sense of individual identity. It was easy for each of them to come up with ten supportive and insightful statements which they would then read on cue for their part of the dual hypnosis section. As I conducted these sessions, it was like a sequence of rotating duets with two different voices and perspectives on life. It was an honour to be part of this mutual collaboration of all three of us. Over the course of several months, Cheryl got progressively better. By week four, bingeing and purging episodes went from nearly all eating occasions to perhaps two per week. By week ten, these episodes had ceased altogether, so Sharon had gradually let go of her policewoman role in attempting to control her daughter. Of course, that ease of tension led to further affection and validation between mother and daughter, and greater confidence that Cheryl could continue to get better without intense supervision. Despite Sharon’s misgivings, Cheryl was able to remain stable living in her apartment. She returned to full-time work without incident. After three months she had continued to be symptom-free. Our individual sessions were now down to once per three weeks. She continued to do favourably, and all seemed well until the next crisis loomed. Now that her daughter was in therapy and recovering, Sharon was ready to take her next step. She listed her house for sale, and bought a condominium in Victoria, B.C., a warm and friendly community in which to retire.