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.
