Advanced Hypnotherapy Part Eight

Transcription

1 Advanced Hypnotherapy Part Eight The Dave Elman Induction Desesitization / Phobia Script Part Eight Copyright the British Academy of Hypnosis and the Knight Management Group All rights reserved 235

2 The Dave Elman Induction This method of inducing hypnotic trance was developed by the famous US Hypnotist Dave Elman. It has gained popularity with modern Hypnotherapists because of its ability to induce hypnosis, and test for responsiveness, extremely quickly and reliably. The method generally consists of the following stages, interspersed with direct suggestions of deepening relaxation: 1. Deep breath and eye closure. 2. Arm heaviness test (dropping arm to test for loss of muscle tension). 2. Eye catalepsy test (suggestion that subject is unable to open eyes). 3. "Fractionation" of trance by repeated eye closure. 4. "Losing the numbers", deepener for mental relaxation and test for amnesia. 5. "Elevator deepener" Although this tends to be called the "Elman Induction" it's actually a series of tests and deepeners which Elman seems to have normally used following an eye-fixation induction, or after simply asking the subject to close their eyes. 236

3 Elman's Own Transcript This is an excerpt from Elman's Hypnotherapy (1964) which gives his famous induction technique verbatim, in his own words. Rapid Induction Will you just take a good long deep breath and close your eyes. Now relax the muscles around your eyes to the point where those eye muscles won t work and when you re sure they won t work, test them and make sure they won t work [Subject opens their eyes.] No, you re making sure they will work. Relax them to the point where they will not work and when you re sure they won t work, test them. Test them hard. Get complete relaxation in those muscles around the eyes [Client now exhibits eyelid catalepsy.] Now let that feeling of relaxation go right down to your toes In just a moment we re going to do this again and when we do it the second time you re going to be able to relax ten times as much as you re relaxed already. Now open your eyes. Close your eyes. Completely relax -let yourself be covered with a blanket of relaxation. Now the third time we do it you ll be able to double the relaxation which you have. Open your eyes -now relax. I m now going to lift your hand and drop it and if you ve followed orders up to this point that hand will be just as limp as a dishrag and will just plop into your lap No, let me lift it -don t you lift it- let it be heavy - that s good- but let s open and close the eyes again and double that relaxation and send it right down to your toes. Let that hand be as heavy as lead You ll feel it when you ve got the real relaxation Now you ve got it. You could feel that, couldn t you? (Patient: Yes.) 237

4 Deepening That s complete physical relaxation, but I want to show you how you can get mental relaxation as well as physical, so I m going to ask you to start counting -when I tell you to- from a hundred backwards. Each time you say a number, double your relaxation, and by the time you get down to ninety-eight you ll be so relaxed there won t be any more numbers Start with the idea of making that happen and watch it happen. Count out loud please. (Patient: One hundred.) Double your relaxation and watch the numbers start disappearing. (Ninety-nine.) Watch the numbers start disappearing. (Ninety-eight.) Now they ll be gone Make it happen. You ve got to do it, I can t do it. Make them disappear, dispel them, make them vanish. Are they all gone? [The subject says yes but on questioning and testing Elman finds that he is simply too darn tired to continue.] So make those numbers completely disappear Banish them Are they gone? (No.) Make them disappear. I m going to lift your hand and drop it, and when I do, the rest of those numbers will drop out. Want them to drop out and watch them go Gone? (Yes.) (Elman, Hypnotherapy, 1964: 60-65) 238

5 Elman Induction Script (Adapted) Just begin by making yourself comfortable. Rest your feet flat on the floor and rest your hands on your lap, or by your side. Now drop your head forward slightly and roll your eyes up and back as though you were looking toward a point in your forehead. That's a bit of a strain but keep it up. Now, inhale deeply, filling your lungs all the way up as you continue to look up and back. Pause for a few seconds. Now keep looking up and allow your eyelids to grow heavy and close down... as you exhale slowly and patiently. Good, now send a huge wave of relaxation from the top of your head down to the tip of your toes. Let all of your muscles turn loose, and limp and wonderfully relaxed... just like a rag doll. Now, rest your awareness on those eyelids once again. Even though the eyelids are closed down comfortably already, imagine they are closing down all over again, even more heavy and tired and lazy than before. Now relax those eyelids right down to the point where it feels as if they just don't work anymore. When you know you've done that, make a test and find you've succeeded and they feel as if they're sealing shut. Push harder against that relaxation and find the harder you try to make the effort the more lazy and tired and relaxed those eyelids are becoming right now. Now stop trying, send a wave of relaxation right down into that part of you that was trying to make the effort. You're eyelids aren't really sealed shut, it just feels as if they are. That's a good sign, you're relaxing very deeply. Now, I'm going to help you to relax even more deeply, and those is how I'm going to do it. In a moment I'll count 1, 2, 3, when I reach the number three you can open your eyes for a second before I gesture and say the word "sleep." When I say the word "sleep", just allow your eyelids to close down and find you're going back, even deeper into hypnosis than before. Beginning now, 1, 2, 3... opening those eyelids, ready now, "sleep", relaxing much deeper than before, two times deeper... Good... Once again, 1, 2, 3, opening those eyelids, ready now, "sleep", relaxing much deeper than before, two times deeper... Good

6 One more time now, 1, 2, 3, opening those eyelids, ready now, "sleep", relaxing much deeper than before, two times deeper again... Good. Now you're relaxing the body very deeply, and as you relax the body you're relaxing the mind. Now, I'm going to help you to relax the mind even more deeply and this is how I'm going to do it. In a moment I want you to begin counting down backwards from 100, counting out loud, and repeating the words "deeper and deeper" after each number. Each time you say the words "deeper and deeper", you're doubling the relaxation of your mind, especially the counting part of your mind. By the time you've counted just a few of those numbers, to 95 or even 96, you'll find you've succeeded in relaxing your mind so deeply that you just can't be bothered even trying to locate those numbers, they've vanished completely, forgotten from your mind. Start counting now, losing the numbers to relaxation as you count, beginning now... [Intersperse suggestions of deepening until subject stops counting.] That's it. Good. Now relax even more deeply, and as you do so make an effort and try to locate those forgotten numbers and find that you've succeeded, they've faded completely from the mind. Haven't you? 240

7 Phobias and Desensitization Originating in ancient Greece, the word phobia' derives from Phobos - the god of fear. A phobia is a form of fear which is out of proportion to the demands of the situation and cannot be explained or reasoned away. A phobia is beyond normal voluntary control and so leads to avoidance of the feared situation. The DSM-IV (Diagnostic and statistical manual of Mental Disorders 4 th edition) divides phobic disorders into three categories simple phobias, social phobias and agoraphobia. In simple phobias the anxiety is provoked by a specific event, subject or situation. Whereas social phobias are evoked by a social situation. Agoraphobia is fear of being alone or in a public place where escape might be difficult or impossible. What is common to all phobias is that the fear experienced is most certainly real as the sufferer usually feels out of control' in a particular situation. Phobias therefore can have very debilitating effects on that person's quality of life as they go out of their way to avoid anything that might trigger it. Symptoms associated with the phobic reaction are: sweating with fear, panting with fear, paralysed by fear, butterflies in the stomach, thumping in the chest, and so on. Hadley and Staudacher (1996) suggest phobias that may be the product of: severe stress a series of stressful or negative experiences a fear of fear transmission from someone else (e.g. a parent or sibling) past trauma The aim of therapy is never to completely eradicate the fear since a certain amount of fear is usually adaptive since it allows the client to take sensible precautions to avoid danger. Rather the aim is to help the client to manage their fear. This is where hypnotherapy comes in. There are many different techniques now available to the phobic to help them to manage their fear: conventional psychological therapy; exposure treatment; gestalt therapy; transactional analysis; psycho synthesis; NLP; counselling; time line therapy and EMDR to name but a few. Conventional therapy is very time-consuming though as it can take several sessions simply to teach relaxation techniques before the phobia is ever tackled. 241

8 Desensitization Systematic desensitization is a type of behavioural therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. This classical conditioning therapy developed by a South African psychiatrist, Joseph Wolpe. To begin the process of systematic desensitization, one must first be taught relaxation skills in order to extinguish fear and anxiety responses to specific phobias. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy. Systematic desensitization is sometimes called graduated exposure therapy. Although as stated earlier that to begin the process of systematic desensitization, the individual must be first taught relaxation skills, it is not the only factor. Putting together visualization and relaxation of feared scenes helps certain individuals to attack their feared object or scenario in imagination, and may push them to attack it in reality as well. When individuals possess irrational fears of an object, such as height, dogs, snakes, and close spaces, they tend to avoid it. Since escaping from the phobic object reduces their anxiety, patients' behaviour to reduce fear is reinforced through negative reinforcement, a concept defined in operant conditioning. The goal of systematic desensitization is to overcome this avoidance pattern by gradually exposing patients to the phobic object until it can be tolerated. In classical and operant conditioning terms the elicitation of the fear response is extinguished to the stimulus (or class of stimuli). 242

9 Coping strategies Prior to exposure, the therapist teaches the patient cognitive strategies to cope with anxiety. This is necessary because it provides the patient with a means of controlling their fear, rather than letting it build until it becomes unbearable. Relaxation training, such as meditation with hypnosis, is one type of coping strategy. Administration of an anti-anxiety medicine prior to exposure to the phobia-inducing stimuli is another type of coping strategy. Patients who have serious anxiety that leads to breathing problems might be taught to focus on their breathing or to think about happy situations. Another means of relaxation is cognitive reappraisal of imagined outcomes. The therapist might encourage subjects to examine what they imagine happening when exposed to the phobic object, allowing them to recognize their catastrophic visions and contrast them with the actual outcome. For example, a patient with a snake phobia might realize that they imagine any snake they encounter would coil itself around their neck and strangle them, when this would not actually occur. These patients need to see that not all snakes are large and that most snakes are completely harmless so that they can get over their fear. Research has demonstrated the effectiveness of this technique in helping subjects reduce similar animal phobias. 243

10 Progressive exposure The second component of systematic desensitization is gradual exposure to the feared objects or situations. Continuing with the snake example, the therapist would begin by asking their patient to develop a fear hierarchy, listing the relative unpleasantness of various types of exposure. For example, seeing a picture of a snake in a newspaper might be rated 1 of 10, while having several live snakes crawling on one's neck would be the most fearful experience possible and a 10 out of 10. Once the patient had practiced their relaxation technique, the therapist would then present them with the photograph, and help them calm down. They would then present increasingly unpleasant situations: a poster of a snake, a small snake in a box in the other room, a snake in a clear box in view, touching the snake, etc. At each step in the progression, the patient is desensitized to the phobia through the use of the coping technique. They realize that nothing bad happens to them, and the fear gradually extinguishes. Systematic desensitation is a behaviour therapy technique. 244

11 Systematic desensitisation Often the client has no awareness of any specific traumatic event which has lead to the build up of a phobia. Desensitisation is therefore recognised as the treatment of choice with most phobic clients (Hartland, 1989). Its roots in the behavioural-therapy method of the treatment of phobias, systematic desensitisation involves developing a scale of fearful stimuli through which the therapist takes the client in the mind while the client is relaxed, calm and in control. The client is thus presented with gradually more fearful scenarios invitro to an agreed point on the scale creating new conditioned responses of calmness, confidence and relaxation as the hierarchy is worked through. There must be a target, usually negotiated at the first session and the target must be realistic and achievable. A contract for action' may be agreed whereupon the client agrees to face his or her fear in vivo, in terms of one of the scenarios on the scale, by the end of session four, for example, with milestones built into the treatment plan along the way. 245

12 Hypnotherapy and Desensitisation. Hypno-desensitisation affords the possibility of gradually confronting one's fears using imagination thus avoiding the potentially traumatic consequences of exposure therapy. Self-hypnosis can be taught to address anxiety and to repeat the therapeutic suggestions post session. The session can increase selfconfidence and self-esteem. Post hypnotic suggestions and anchoring help the client to control their breathing, slow their heart, and achieve a relaxed state of mind when faced with the phobic stimulus. Dissociation may be employed in order either to provide a safe place of relaxation or to negotiate with the part' responsible for the phobic reaction. Ideo motor responses can be invoked in order to receive permission for change, to create dissociation and to establish change without conscious interference. Age regression can guide the client back in time and help the client reexamine the event that initially triggered the fear from an objective point of view thus re-establishing control; it can also be employed to access positive feelings such a s self-confidence, calmness and assertiveness Progression in time can be employed so that the client can visualise themselves coping effectively in the future when faced with the phobic stimulus. Richard Bandler was asked what is the difference between systematic desensitisation and hypnosis. His answer was about six months! 246

13 The Fast Phobia Script OK, I want to imagine yourself seated in the middle of a cinema. Be there see the screen from your own eyes and notice the colour of the seats, the size of the auditorium. Be aware of the sensation of the seat comfortably supporting you. Up on the screen, see a black and white snapshot of yourself in a situation just before an experience in which you would have had this phobic response. Now, I would like you to imagine that you float out of your body and back, toward the back of the cinema, so that you can see your self in front of you in the middle of the cinema looking at the screen. And again, float out of your body, floating back, further back into the projection booth, so you can see yourself sat at the back of the cinema looking at yourself sat in the middle of the cinema looking at the black and white snapshot of yourself on the screen. In this cinema you are safe. You can safely view any experience, any part of your life. Nothing can happen to you while you are sitting in this cinema. Now, I want you to turn that snapshot into a black and white movie running all the way through that experience in which you used to have a phobic response. Let it run all the way to the end and freeze it as a still image, before stepping into the screen and into your body in that image. Now allow the film to run backwards this time in colour. Run the film backwards quickly now, so all the people are moving backwards, all the sounds are played backwards, but with you IN the movie. All the way back to the beginning now. Run the movie forward, but do it really fast, taking only one or two seconds to do it. Good. Now run the movie forwards, but with you in it, checking how you feel dealing with that situation in which you used to experience the phobic response (at this point, it is useful to fire some pre-set up resourceful anchors.) 247

14 That s it. This time as it gets towards the end, the whole screen shrinks in size until is as if you are watching a cartoon the size of a postage stamp. Good. Now, if you feel it would be of benefit, we can run the movie backwards again in just a minute. But this time, allow yourself to hear to funniest, most ludicrous background music you can imagine something from a circus act, maybe. OK, now, run that film backwards as before but with music. A ll the way back to the beginning. Excellent. And relax. 248

15 Hypnosis Desisitization for Pain. This script uses one of my favourite techniques for simply using a dial to turn down and manage chronic pain. This hypnosis script assumes that the subject is already in a state of induced trance. It is intended for generic use in allowing the subject to realise greater control in managing specific, chronic pain. The script uses phonetic and syntactic ambiguity to create a mild conffusional state, so will not read as a grammatically correct piece. The Script. In a profound state of relaxation, you can notice what you notice as you relax, still, further. And, relaxing, still further, can notice how you can perceive yourself in all sorts of new and exciting ways. You can wonder, for example, what it might be like to see yourself as only you can see your outer and inner self. I don t know just how you might make an inner sense of all this, but I do know that you clearly know ways of making that inner sense right now, so as you can clearly see yourself, all the inner experiences are clearly seen too. Allow your attention to wander to that area that has been experiencing the pain, you may give yourself the opportunity simply to notice just how you see that sense of pain, while you remember that pain is just a signal from the body to yourself telling you to be aware. This pain is neither good nor bad, but an important message you give yourself. And just as a message over a radio can be turned up and down while retaining its importance, so too you can learn new ways to attend to the signals your body sends you. So, as you continue to relax still further, and continue to breathe in and out automatically, just notice how you relax further each time you breathe out that which you no longer need, and how you breathe in only that which is useful to you. And just as there is one you, in your mind you can create in image of this you as you too, one imagined and one imagining a picture of yourself. 249

16 And I don t know just how you see those areas of pain, but as you do, in a minute just imagine that they change in whatever way is needed to make them less intrusive. Just as with a radio dial, you can move the dial down from 8 to 7 and the sound gets just a little bit quieter and the sensation becomes just a little less intrusive as the way you picture these areas of pain changes, maybe in intensity, or brightness or colour. And as you move the dial from 7 to 6, the image changes so that as the numbers go down, the area simply becomes number still. As the dial moves from 6 to 5, and everything gets quieter, those sensations can become less and less intrusive, moving further into the background. You continue moving the dial down from 5 to 4 and you notice that you just relax more. From 4 down to 3. Continuing to turn the dial down. Completely relaxed now. Still counting down the pain as the dial moves down. And as you turn the dial from 2, to 1, just notice how your two you self can become clearer and moves more to the fore as those unwanted sensations move further back still. And you can ask yourself, what would happen if I move the dial all the way down to zero? Pause And this dial is one that can go with you, so that any time you need it, you can simply count down from 5, to 1, breathing in only that which is useful and breathing out all that you no longer need. With each number, the sensation simply becomes number for only as long as is useful to you at that time. Part Eight Copyright the British Academy of Hypnosis and the Knight Management Group All rights reserved 250