Healing Scripts E-Book

Marlene E Hunter

• Herausgeber: Crown House Publishing
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 304

Veröffentlichungsjahr: 2008

Beschreibung

Healing Scripts focuses on the use of hypnotherapy to help trauma victims recover as well as helping individuals who are suffering from acute stress disorders. The field of trauma and stress treatment is constantly searching for new ideas and solutions and the hypnotic interventions detailed in this volume are designed to treat the source of the pain and the anguish of trauma so that clients with long term problems can finally be offered some relief.

Leseprobe

Healing Scripts

Using Hypnosis to Treat Trauma and Stress

Marlene E. Hunter MD

Dedication

As always, for Redner, with love.

Contents

Title Page

Dedication

Introduction

Section I: Pain

Hypnosis and the relief of pain

Pain and dissociation

Mind–body communication

Somatoform dissociation

Pain as a dissociative experience

Emotional pain

Physical pain

Physiological pain

Organic pain

Flashback pain

Chronic pain

Chronic pain syndrome

Section II: Stress Disorders

Post-Traumatic Stress Disorder

Denial

Hypervigilance

Hyperarousal

Lack of trust

Flashbacks

Sleep flashbacks

Other sleep disorders

Acute Traumatic Stress Disorder

Self-worth

Physiological response to trauma

Critical Incident Stress Disorder

Obsessive-Compulsive Disorder

Anxiety disorders

Reactive anxiety

Conditioned anxiety

Free-floating anxiety

Panic attacks

Phobias

Depression

Grief and bereavement

Children

Palliative care

Section III: Dissociative Disorders

Safety—inside and out

Helping the child part to tell

Ego strengthening

Getting along together—inside

Blending

Getting along together—outside

More about blending

Integration or resolution?

Preparing for resolution

More about preparation for resolution

Preparing for integration

Section IV: Children

For the teenager

References

Index

Copyright

Introduction

The idea of writing a book about the use of hypnosis when working with clients who have suffered severe trauma has been niggling away in the back of my mind for many years. After the publication of Understanding Dissociative Disorders: A Guide for Family Physicians and Health Care Professionals, the need for such a book became much clearer. In particular, the need for such a book specifically for those who have had training and experience both in clinical hypnosis and in working with what are now called “trauma-spectrum disorders” became almost a mission.

To my knowledge, there is no other book on the use of clinical hypnosis that is dedicated to this specialty—that of helping men and women (and, of course, children) who have suffered and are still suffering from the effects of child abuse, or those who have experienced dreadful trauma through wars and other disasters, and who still live with it in their day-to-day lives.

We need to recognize several aspects of this work:

It is specialized, and demands specialized training and experienceThose who suffer from these traumata are particularly vulnerable to misinterpretations and / or subliminal messages from past eventsThe healing of trauma always takes time, and the length of time is different for each person that we, as psychotherapists, encounter in our practicesThose who have suffered trauma are very vulnerable

It is because of the vulnerability of this client group that it is essential that the therapists are well-trained in all aspects of their approach: this includes recognizing and becoming proficient in the various therapeutic approaches that are helpful, and by-passing those approaches which could cause more harm than good or in which they do not have sufficient experience.

I had already been doing clinical hypnosis for several years before I met my first Multiple Personality Disorder client. Indeed, my training in clinical hypnosis was the reason that my colleague, a family physician who was moving out of town, asked me if I would take this woman into my family practice. The client, whom I will call “Jayere” because that is what I have called her in previous publications, was having terrible headaches, Healing and my colleague thought that continuing hypnosis—which she (the colleague) had been doing—might be helpful.

You may have read about Jayere in other publications or heard about her at conferences, because I have spoken about her many times. She, and two other dissociative clients whom I subsequently realized that I had in my family practice, taught me all of the basics about working with the long-term effects of childhood trauma. Of particular importance for this book, however, is the work with hypnosis in the context of traumatized clients—especially, although not only, those who were so miserably treated when they were young.

It is always important to use hypnosis carefully within the professional milieu. (Of course, it is always important to use it carefully, period, but not all entertainment hypnotists spend time recognizing that—which has led to many a lawsuit.)

Employing hypnosis as a therapeutic tool with clients who have endured trauma, however, takes the need for careful appraisal one big step further. Many, if not all, people who have a dissociative disorder or Post-Traumatic Stress Disorder or for that matter any significant psychosomatic problem, are particularly vulnerable to the possibility of being catapulted back into the traumatic situation while in an altered state of consciousness. This can lead to difficulties along many lines—exacerbating the traumatic response, for example, or creating an unsought and certainly unwanted new dilemma regarding veracity. In this regard, I had exceptional good luck, because these three clients from my own family practice, who knew me, undertook my education! And in many ways, they protected me from making huge mistakes.

It is because of the potential problems that I have written this book. Its various sections attend to pain in many of its various intrusions; to post-traumatic stress disorders, its seven main symptoms, and the precursors of these: critical incidents and acute traumatic stress disorders; dissociative disorders including dissociative identity disorder (which used to be called Multiple Personality Disorder); the concept of ego states (parts of the personality structure that have specific tasks in the system); other dissociative disorders not so well defined—Dissociative Disorder Not Otherwise Specified, as the DSM (Diagnostic and Statistical Manual) describes it; grief, especially the kind of deep grieving that does not abate with time but becomes a major psychological difficulty; and a special section on children who have been, or are still being, abused.

You will realize early on that many scripts are very basic indeed, or are simply ways to introduce a hypnotic intervention rather than a fulfilling word-by-word description. Other scripts are more complete, and some have alternative language suggestions. But the basic point is: never attempt to use hypnosis with trauma-spectrum disorders until you are very well schooled in the use of clinical hypnosis. That, at least, I did have when Jayere came so unexpectedly onto my horizon. And the same caution is required for those who offer psychotherapy for such clients. Professional education is a must.

Luckily, I became a member of the International Society for the Study of Multiple Personality and Dissociation at its very first meeting in Chicago in 1984, several years after my “training” by Jayere and the other two clients in my practice had begun. Subsequently that organization became ISSD (International Society for the Study of Dissociation) and now ISSTD (add Trauma to the name). Although I had learned a great deal from my clients, I needed professional help and found it in those organizations. Other countries have similar organizations—seek them out. And also seek out professional organizations for education in clinical hypnosis, if you have not done that already.

I sold my family practice in 1989 because the work with trauma disorders had overtaken my work as a family physician. Rather than attempt to do three things, and maybe do them badly, it was more important to focus on the two that were so in need of trained professionals. I miss family medicine, but am not sorry that I decided to shift my focus. The subsequent years have brought their own rewards

If the client has never done hypnosis before, then it is important for them to have some introductory sessions on basic relaxation techniques before starting on specific situations such as those described in this book.

I hope that you find this book useful. Hypnosis is a wonderful tool, but sometimes we forget that it is a tool, not magic.

Section I

Pain

Hypnosis and the relief of pain

For many decades, hypnosis as a means to relieve pain has been a very useful tool. Pain, itself, is a common experience in all walks of life and in all ages and populations. Pain can be a warning signal that something is wrong—injury, infection or a severe allergic response during which the person cannot easily take a breath. In all of these situations, hypnosis, when carefully done by a therapist who is well-trained in the various hypnotic techniques, can bring comfort.

Pain that is part of (or the result of) various kinds of trauma, however, has an added component—one that is important for us to recognize. That component is the emotional response to the situation in which the pain is experienced, or from which it is derived. The use of hypnosis as one—but only one—of the techniques that can be useful in psychotherapy is exemplified in the following scripts. Perhaps the client (or the therapist) is feeling stuck for some reason; perhaps the emotional aspect has become too intrusive or needs to be recognized. A session, or several sessions, of hypnosis may open the gate again, offering new insights or alternative ways of managing the situation.

Pain and dissociation

Pain is a dissociative experience. It can be dissociative in the sense that we put distance between ourselves and how we are experiencing the sensation itself, which is what we might do in the dentist’s chair. It could also mean that we distance ourselves from what is going on around us and focus instead on the pain. The former is useful insofar as it alleviates the physical discomfort; the second, however, could precipitate far more distress than one would ordinarily expect in any given situation.

When the latter occurs, careful hypnosis can be very helpful. We need to remember the role of hypnosis in relieving pain. It is not that hypnosis causes pain to disappear—often it doesn’t do that at all. What it does do is to help put some distance between the self and the pain, so that the pain per se doesn’t matter so much. The client is no longer so bothered by the pain and can therefore get on with whatever is happening in their life.

There are also situations during which the dissociation from pain is crucial—for example, there is a fire and the most important thing is to get the children out of the house. The sensation of pain is disregarded because the children take 100% precedence. However, later on, when the children are (hopefully) safe, then the sensation of pain can be overwhelming, even to the point where others cannot understand why it should be so overwhelming. It is so because the emotional aspect of the situation (“my children are in danger”) is then superimposed on the physical pain, even though the danger is no longer there. It is as if the subconscious is saying, “but what if—but what if—”, over and over again.

It is important to find out as much as possible regarding the origin of the pain. We need to remember that the client’s perception of the origin of the pain may not be the true origin of the pain. Does the dissociation mask an important part of the pain which would be crucial to an appropriate diagnosis? These are aspects that may need to be discussed with the family doctor or specialist, with the client’s permission.

Does the client’s lifestyle exacerbate mental or emotional pain? Are they in financial crisis? In trouble with the law? Alone, with no support from, for example, an estranged family? Are they ignoring another—possibly important—physical problem?

How we, as physicians and / or therapists, approach these possible problems may have a profound impact on the future health—emotional and physical—of the client.

Taking all of this into consideration, make the initial hypnotic intervention very generic, rather than explicit. The following two scripts describe this.

First script

Jane, we haveSetting the scene talked about the misery of the pain you experience when (carefully refer to the situation(s) that Jane has described in as few words as possible)Offering a possible escape Would you like to explore a possible helpful solution? (Yes)

Alright, then just settle into your hypnosis, as you know how to do, knowing that you are here, safe in my office.“Here, safe in my office …” is very important Let me know when you reach the level of hypnosis that you think would be useful today. (Signals)

Good. Now, begin to create a wonderful, safe barrier or shield of some kind, around you.This is the important suggestion, offering possible ways to do this It could be a cloud, or a colour, or warm, or music, or a magic fence—whatever you just instinctively know is the right one for you. Let me know when you have done that. (Signals)

That’s right. And now that you know that you are safe behind that wonderful barrier of your own choice,She now has created her own safety shield, not somebody else’s shieldnow you can allow yourself to recognize that pain, while knowing all the time that you have that strong, safe barrier between you and the experience of that past discomfort.Shifting to the word “discomfort” will alter the perception Let me know when you have allowed that to happen, under your own control. (Signals)

Excellent. You can stay there, in that same experience, for a few more moments—as long as you like in hypnosis time but just a very short time by clock time. That’s right. Good.

Now, in your own way, do what you needShe can do it herself to do to make the uncomfortable situation dissolve, and then let me know when have done that.Still protected—very important You will still be safely behind your protective barrier or shield. (Signals)

Excellent. And you can appreciate your own strength, in the way you managed that situation.“… your own strength …” gives her the sense of self-sufficiency And now you know that you can do that.

When I make the suggestion, you can bring yourself out of hypnosis in your own way.

Second script

(Note: Whilst the first script, above, has to do with safety, this one offers more variations, for example, a metaphor or simile that is appropriate for the client. The one below is offered as an example, with the suggestion that the client consider further possibilities that are specific for him.)

Jim,Offering another possibility it seems as if you need a more specific type of suggestion, one that is personal for you, to get you started. Is that right? (Nods)

That makes sense for you, so find out if this suggestion could help. You can go into hypnosis,Many people will go into a light trance anyhow, when offered this opportunity or just close your eyes and take the suggestion into your mind, to ponder on it, when and how you choose.

Some people find that they can link the pain with similes that relate to their own past experiences. For example, you might say to yourself,Offering a specific example “This pain is like a vise, gripping me just like the vise in my home workshop grips the (wood, metal, etc.) that I am working with. It is very, very strong, and feels like it will never let me go.

But you are also aware that, when you are ready to do so, you can release the pressure in the vise so that you can extract theMaking the connection between the simile and the situation (wood, metal, etc.) and begin to work with the object, maybe to fine-tune it, or to give it a finishing polish.

You can do the same sort of thing—releasing the pressure—when the intense discomfort becomes too much.Adapting the simile to the real situation Just work with the internal pressure in the same way that you would work with the object in the vise.

As I said at the beginning, it is important that the simile you use has meaning for you personally,Very important! so experiment, and next week we can work a little further in this direction.

Mind–body communication

Of all the things we know (but maybe used not to know), one stands out clearly: we are never disconnected at the neck.

Pain has many components; two of the most obvious are the physiological component and the emotional component. These are inextricably joined. At times the physiological response is foremost, at other times the emotions take precedence in the awareness and response of the person.

Many years ago, at a meeting in Vancouver, Dr. Barry Wyke, a neurophysiologist from the UK, offered this opinion: “Pain is an emotion”. It created quite a stir in the room as it was immediately interpreted as meaning “… and therefore not real”. The immediate implication, to many in the room, was that “emotion” was equated with the pain being unimportant or even malingering. He did not mean that; what he meant was that our minds, as well as our bodies, were responding to the awareness of pain.

In fact, pain can indeed be equated with emotion, if one recognizes the close relationship between mind and body. We respond to pain, and we respond emotionally, perceptually and with immediate mind–body interaction.

What happens in our minds—emotions, thought processes, perceptions, the five senses—is always reflected in our bodies. In the same way, what happens in our bodies is always reflected and recorded in our minds.

When the happenings in either mind or body are significantly important, they are routed or re-routed into one of the impressive mental libraries of experience and learning. And from there they can be elicited and interpreted, perhaps in new ways or as reflections of the past.

Some of the most important of all those happenings have to do with pain—be it emotional, psychological or physical. It may be a moot point as to whether the mind or the body was the first to recognize that pain; the results are the same—the mind–body communication between the conscious (cognitive, left brain), the subconscious (perceptual, right brain) and the body. Although the “left brain, right brain” distinction is too simplistic it does offer a perspective that people find useful.

All injury is traumatic to some degree. That degree depends on the depth of the intrusion and interference that the injury causes, or of the previous experience it may subsequently bring back into focus.

Often we are unaware, cognitively, what that previous injury may have been; at other times, we know, but may we be hard put to do anything about it.

Because of all these layers of mind–body communication, and because of the possible emotional scars that may be in place, we need to be particularly careful when using hypnosis to ameliorate the distress. It is a great tool but must be understood and activated in very careful ways. Generally, the less we say, and the more we allow the client to find their own path, the better. We are, however, there to guide, and that guidance is crucial.

Influencing the mind–body connection

(Tom has been suffering from chronic post-viral fatigue syndrome which started with an upper respiratory infection two years before.)

TodayRecognizing the importance and offering better opportunities for success we are going to discuss, in more detail, some of the many ways in which mind and body work together. It is a truly miraculous partnership, and one that we can utilize even more fully, in hypnosis.

Get very comfortably settled, then, in your own way, taking yourself a little further into hypnosis to that level which you instinctively“You can always change … whenever that change would be useful”; multilevel meaning—alter vocal tone accordingly know is just right for you at this time. You know that you can always change your level of hypnosis—deeper or lighter—whenever that change would be useful for you.

Turn your attention to your own body, now, and to what has been happening to it during these past two years. It has been a very distressing and discouraging time;Stating the fact Respect intuition now you feel within yourself that you are beginning to get well again. We want to foster that processHow to proceed by encouraging your mind and body to work together in the most positive way.

WeValidating the long illness have talked about the fact that chronic stress depresses the immune defenses of the body, and these past two years certainly have been stressful for you. So we will begin by focusing on the body’s immune system.

GoThe communication is always “bidirectional” (Rossi, 1986) even further within yourself now, to the very center of yourself, and ask your subconscious mind and your body to communicate, each giving the other the information it needs for your immune system defenses to become strong and vital again.Alliterative emphasis Your subconscious mind and your body together can communicate, collaborate, cooperate and do whatever needs to be done to achieve that return to strong healthy function.

That’s right.Kinaesthetic awarenessFeel that communication occurring, at your deepest intuitive level. Good. Very, very good. As your defenses become stronger and stronger,Good things are happening, which lead to more good things you know that you are protected from further infection, and so you can direct more energy to healing and restoring within your body.

Strength begins to return to your muscles, your appetite improves and you sleep better.

Ask your subconscious mind and your body to communicate on all these aspects, also, during your own hypnosis time every day, and in the same way, to doThe subconscious and the body together know what needs to be done; you can further the process with healing imagerywhatever needs to be done to achieve this return to health. Add your own healing imagery to this practical and effective convalescent program.

And with healing comes a lifting of those feelings of depression.The process continues You know that you are getting better, and it is wonderfully reassuring to know that.

Everything we say, or think; everything we feel, every emotion; how we behave, and why we behave thatMind–body communication way—all of these are directly translated into some response within the body. This is vital information for us when we are considering mind– body communication.

ThereforeSuggestion for deepening now as well as greater awareness later let yourself become even more aware of your thoughts and words and actions; and if you discover, for instance, that you are speaking in a negative way (“I don’t feel well”), then you can change that immediately to a positive statement (“I’ll feel better tomorrow”).How to utilize This reinforces, for your subconscious mind, the message that positive is what you intend.

Best of all is the knowledge that your mind and body are working together, a true partnership; and that you can enhance that partnership throughYou are important! your own resources and your own hypnosis every day.*

Another useful suggestion is the following concept:

You can think of the communication between your mind and your body as being part of a triangle: top of the triangle can be thought of as the brain, the conscious mind; then, on the left-hand side of the base we have the subconscious, and on the right-hand side, the body.

Communication occurs along all sides of this triangle between conscious and subconscious, between conscious and the body, and between the subconscious and the body. All are important, but the most important is the communication across the base, the subconscious–body connection.

This is the connection that is strengthened in your hypnosis, and why it is important to do your hypnosis every day.

And remember, the communication goes both ways. There are no one-way streets in this land—just wonderful sharing of information, communication, back and forth, along all sides of the triangle. Conscious, thinking mind; subconscious, emotional mind; sensate, experiencing body.*

You.

To give a reinforcing post-hypnotic suggestion that will enhance these mind–body communication concepts, you might say:

And you can ask your mind and your body to continue this communication, to collaborate and cooperate towards achieving your healing and recovery.

And you can reinforce this for yourself many times throughout the day by just repeating this little mnemonic: “M-B-C-C-C”. That’s right, you can make it into a little jingle: “M-B-C-C-C”. Mind–Body Communication, Collaboration, Cooperation. Say it to yourself many times a day, whenever you think of it, whatever you might be doing at the time.

M-B-C-C-C. Many times, every day.*

Somatoform dissociation

There are many connections between pain and trauma, but perhaps the most important for this book is “somatoform dissociation”. In such a disorder, the dissociativity—otherwise expressed as individual ego states—is instead expressed through somatic symptoms. “Ego states” simply refers to the part of the personality structure that takes care of certain situations. We all have ego states: I’m slightly different in the office than I am at home, different as a wife than as a mother, even slightly different with friends than with colleagues. These are some of my ego states. Luckily, they all know each other. In someone who has suffered severe child abuse—emotional, physical, sexual or some combination of these—the child develops ego states to cope with the traumatic situations. After a while, these ego states assume an independent quality. I will be speaking much more specifically about ego states in the Section 3 on Dissociative Disorders.

The phrase “somatoform dissociation” was coined by Dr Ellert Nijenhuis, of the Netherlands. His work opened up and recognized a huge omission in our knowledge of dissociative disorders—one that had never been thoroughly explored before. In so doing, it clarified many murky areas in the understanding of how past traumas, including emotional traumas, can be expressed through physical symptoms, even when the physicians would declare that “there is nothing wrong”.

The first thing to recognize is that somatoform dissociation has absolutely nothing whatsoever to do with malingering. It is simply a way for the body to express that emotion which is such an important component of pain. It turns out that there is a significant number of trauma survivors who are not dissociative, in the usual sense of the word, but who transfer that dissociation into an incongruity between mind and body—what the mind cognitively recognizes and what the body perceives. Put another way, the ego states assume mantles of pain as their individual identities.

These ego states and the pain which they carry are not necessarily age-related to the pain that they express. A young ego state may have pain which would ordinarily be associated with middle-aged, or even older, ego states. This becomes more relevant when working with a dissociative disorder in which the various identities are specifically described. In Dr Nijenhuis’s book, Somatoform Dissociation, he and his colleagues describe and ascribe dissociative characteristics to physical symptoms. It is an understanding that those of us who work with dissociativity need to recognize.

In such situations, we work with the ego state experiencing the pain, whether or not it makes cognitive sense.

First script

(Jackie has been very distressed because her physician doesn’t seem to understand her problems, and implies that she is over-reacting to her symptoms. No apparent cause has been found to explain her situation. Her past history is one of childhood abuse and neglect—especially neglect, as her mother implied that she was always “making it up” when she had some pain or physical symptom.)

Jackie, let’s explore a different possibility. You can think of your physical discomfort as another part of your personality.Setting the guidelines You have said that it often seems as if the (symptom) has taken on a life of its own.Is it very important for her to agree to the idea We can now pretend that that is what has happened. Do you feel comfortable with exploring that metaphor? (Yes)

Good. Then let yourself go into hypnosis in your own way, just to whatever level feels comfortable for you at this time.Whatever level she chooses, will be the right one for her at this time As we are exploring, you may choose to be at a lighter level, or a deeper level, whichever seems just right for this exploration.

That’s right. You can communicate with that wise subconscious mind in your own way.Offering possible scenarios It may be a conversation, or as if you were reading a book or watching a movie, or with a group of people, observing their behaviour or their manner of moving around. You’ll know what is the best situation for you.

Then, when you have found the right milieu, you can begin to have a conversation with that part of you which represents your painThis is the crux of the matter (or other symptom), because it may be that your body wants to tell you something. So listen carefully, recognizing all the little hints that present an important pictureShe can explore it in her own way for you to study—just as if you were looking at that movie, or reading that book, or being with that group of people.

And as the message begins to clarify, so your responseHypno-speak: she can interpret it in her own way will adapt to what the thought or message is really communicating.

It may or may not take several sessions, over a period of time,More hypno-speak to really understand that new message; but when you do, then you can begin to shift your response so that it reflects your new understanding.

AndThis is reassurance that you won’t abandon her halfway through this strange situation we may decide to have more sessions like this one, as you clarify more and more of your new recognitions.

Second script

For some clients, the above approach may be too difficult for them to grasp, especially if the whole concept of somatoform dissociation is new and / or unclear to them. In such a case, approach it from a more basic perspective.

Betty, we’ve been talking now for several weeks about the way our minds and our bodies sometimes seemA soft way to start the process of accepting the somatoform concept to take on each other’s roles. Let’s explore that a little bit further.

You have had whole-body pain for a long time now and nobodyThis is the basic fact seems to be able to find the cause, or to help you understand it.

You know how we sometimes say that a physical symptom or a habit or a sensation “seems to take on a life of its own”.A familiar idea—and reassuring her that she is not crazy Let’s pretend, for the sake of argument, that your pain comes into such a category. It should be fairly easy for you to do that, because I know that you sometimes speak of the pain asBecoming more specific “he”—in other words, the pain seems to be a person. Do you feel comfortable with exploring that a little further? (Yes)

Good. Then allow yourself to construct an image of what “he”This comment can be both reassuring and validating looks like. You may have already done that, without even realizing it.

When you have found that image, then begin to hold a conversation with him.Some patience might be needed before this becomes comfortable It may be a one-way conversation in the beginning, but will probably become a two-way discussion in time.

As time goes on, you could ask him what his real purpose is, or why he came to begin with,The questions everybody in this situation struggle with or—even more important—what needs to happen before he can move on.

And as you get to know and understand each other better,Setting the scene for a positive change—but not until the real reason for the pain is recognized you may find that the pain begins to soften a little bit. And you and he can talk about that, too.

As we are talking about somatoform dissociation, the real cause is almost sure to be found in trauma, probably in childhood. That will be the basis for a great deal of the ensuing psychotherapy.

Pain as a dissociative experience

This has been described in an earlier section, but it is worth a second thought, as it is very relevant to this next section.

It means that when someone is in pain, their overall attention is focused on the pain, not on what is going on around them. In other words, they distance themselves from the present to a greater or less degree. The more distance they put between themselves and their surroundings, the greater the dissociation.

This is often an advantage: it prevents outside experiences from interrupting the recognition and, perhaps, the acceptance of the pain. On the other hand, it can be severely disadvantageous, as it diminishes the possibility of distraction from the pain itself and thus may intensify the discomfort.

There are many questions that need to be asked: Does the dissociation mask an important aspect of the pain? Is it the dissociative quality of the pain that interferes with a diagnosis of the cause of the pain? Are emotional factors, and possible dissociative disorder factors, hindering the diagnosis?

There are many possible sources of emotional pain—grief, anger, depression, loss—that can be expressed in a variety of ways.

Emotional pain

A common route of emotional pain is through anxiety. Anxiety attacks are not fun and can create incredible interference in one’s life. Such attacks may inhibit performance in the workplace or even jeopardize the job itself; relationship with friends and family may be seriously affected. Often, the person has no idea why the attacks occur; they seem to come out of the blue, and they can interfere with almost every aspect of a person’s life.

Even more difficult for the client is the merging of anxiety into panic. Again, there is usually no reason why this should happen, but the reality of it is intense.

Often, the course of therapy will turn towards finding the answers to these questions, but that is in the realm of the psychotherapy sessions. In the meantime, people often need tools to keep themselves calm. Hypnosis can sometimes help.

(Lorna has asked about the possibility of using hypnosis to relieve some of the intensity of her anxiety attacks. She is doing well in her therapy sessions, but feels that she needs to learn a new approach for herself.)

Lorna,Setting the scene you’ve told me about the anxiety and panic that sometimes overwhelms you. Would you like to learn some hypnotic techniques that could ease those episodes? (Yes)

Alright, then, make yourself comfortable and ease into hypnosis to whateverShe can sense when she is at that level level feels right for you at this time. Signal me when you have reached that level. (Signals) Good.

Now, knowing that you are safe here in my office, you can allow the tension to ease just a little bit.There will almost always be some tension, so remarking on it in a positive way relieves some of the anxiety Not too much—you’ll know when it feels best for you. And then, when you have reached that easier awareness, decide whether you would prefer this littleHer choice—this is very important technique to be humorous or very straight. (She will signal you)

(If humorous) Then you can access your wonderful, rich imagination and clothe that sensation of panic in a costume—a ridiculous costume,It can be any kind of costume—an animal, a clown, a wizard, or whatever she chooses whatever you choose it to be. Be sure that the whole sensation is clothed in that really ridiculous costume. Yes, that’s right, I can see you smiling.Acknowledge her inventiveness It is truly ridiculous, isn’t it, that whole panicky sensation? Yes, it is, you’re right. Be sure that the colours fit the ridiculousness, too—ah, yes, I can see that strikes the right chord. Good.

(If straight) Then you can use your own knowledge to tell the part of yourself that really gets overwhelmed with that panic,It works well if she has some sort of image of strength—whatever that might be that you have a very strong core of yourself, deep within, that is there to protect you from danger, and that strong core knows how to do that. And you can alwaysIt is always there, deep within, so no one can take it away call on that strength when you need it most, so give it a name and use that name any time, any time, anywhere, whenever you need to experience that deeper strength. It’s wonderful—do you agree?—to know that you have that strong,Acknowledging her talents and strengths safe part of yourself, always there for you whenever panic even begins to show itself.

AndOne more talent—good you can recognize that early awareness to your advantage—it’s like having an Early Warning System right there within you. Yes, that’s right.

Now that you know you have the way to ease and take care of those miserable,Her capacity to take care of herself awful panicky feelings, you can rest so much more comfortably, because it always feels safer when you know that we have a solution. Do you agree? (Nods) Um-hum.

So come out of your hypnosis now in your own way, feeling so much more secure now that you know you have all the strengths that you need, within you.