HYPNOSIS IN PSYCHIATRY: Part 3

Harvey, the Sad Sack: Depersonalization and Projection to Free the Intellect for Therapeutic Change

Depersonalization and the projection of the self are other very helpful hypnotic phenomena. You can teach a subject to hallucinate a movie screen and to see his "self" up there on the screen. You can then have him forget his name, his identity, to forget everything about himself—the way all of us do normally in the theater when observing a suspense movie or anything that completely absorbs our attention. Then have your patient look at the screen and tell him that he is going to see a continuous series of events—you can have them in the form of moving pictures, or you can have them in the form of stills.

I can think of one person, a sad sack, who came to me, and the question was, could one ever make a man out of that sad sack? I was challenged to do that, and I had to conduct psychotherapy on that man using hypnosis and having an audience of antagonistic psychoanalysts and residents in psychiatry—some of whom were undergoing psychoanalysis. The simple procedure I used with the sad sack was this: Harvey had every known ache and pain, every known sense of inferiority. But he was intelligent, even though he didn't manifest much intelligence. He was fearful, and that was all I really needed to know about the man, because knowing that he was intelligent, I also knew that he could have a rather rich fantasy life. And so I suggested to him that he see a series of movie screens or crystal balls in which he would see still-life pictures of tremendous importance.

I had Harvey forget his name, his identity, his age, the fact that Harvey as a person really existed. All he was was an intelligence that was looking at all those things that I had scattered around the room for him to look at. He saw the little boy on his way to school as a moving picture—most of them were moving pictures. He followed the little boy to school. He saw the little boy getting his hands racked by the school teacher. He saw the schoolteacher forcing the little boy to change from the left hand to the right hand in writing. He saw the little boy getting punished rather brutally by the teacher. One particular day, he saw that boy walking home very sadly. And Harvey looked and commented on the paltriness of the scene. He saw that little boy walking home, reaching home, and looking into the yard over the gate. And there he saw the sheriffs deputy with a gun in his hand. The deputy had just finished shooting the little boy's dog. And then he saw the little boy crying.

And then I told him to start there and see another picture several years later when that same emotion would come forth. And he saw that same boy at the age of 10 out in the woods hunting with his brother and feeling terrible about killing a rabbit. Then he saw the boy about the age of 15 lying on the top of a ruined dam and thinking about all the dreadful things that can happen to human beings. And then seeing a young man of about 22 who had just been turned down by a girl and felt very wretched and very inferior. And then he saw that same young man in the same emotional state of depression who was walking out of a courthouse. He'd just been divorced and felt rather suicidal and tremendously inferior. And then he saw the young man at the age of 28 getting discharged from the job he liked. And then he saw the young man at the age of 30 feeling horribly wretched.

And I asked Harvey the intellect to review all of those pictures and what they probably meant, and Harvey reviewed and analyzed them for me. And we spoke about the thread of continuity and the repetition of traumatic experiences that goes through life. But Harvey didn't know that he was talking about himself, and Harvey didn't know that he was seeing himself. And I could ask him to speculate on what would happen to that young man. And his statement was that if anything more like that happened to him, he would undoubtedly try to commit suicide—always on the losing end, since he had lost out on everything throughout life, and maybe tried to commit suicide on the losing end. But the losing end meant what? [Erickson then helped Harvey resolve one of his problems in trance: He was to practice writing clearly instead of the self-humiliating scrawl he usually presented. Finally, Harvey was able to follow a posthypnotic suggestion to write clearly when he was awake.] "This is a beautiful day in March." He wrote that, looked at it, and jumped to his feet and said, "I can write clearly! I can write legibly!" And he went around and around that group of doctors and demanded that everyone praise his writing. He was literally a jubilant little boy. And he was utterly embarrassing to the audience because of his jubilance until they recognized the tremendous force of that.

Now Harvey's job was a fifth-rate job where his boss kicked him around. Harvey did this writing, and during the rest of the evening he bragged and bragged about his excellent handwriting. And I suggested that he would keep that sense of accomplishment, that sense of personal pride, with him, and that he would use it in every essential way. The next day when Harvey went to work, he talked back to his boss for the first time and he demanded an increase in payment in his salary. And he got it. Then he demanded a better desk. Harvey drove a car to work. He always parked it in a particular place in the parking lot. And there was one other employee there who always boxed him in with his car. And that employee worked half an hour longer than Harvey. Harvey would sit and fume helplessly, Casper Milquetoast fashion, in his car waiting for the other man to come to move his car. That night Harvey went out and told the guy, "Listen you big lug, I possibly could pick a fight with you for parking your car in that nasty fashion. You've done it for a long time and I've taken it. We could have a fight about it, but I'd rather invite you in for a glass of beer, so let's go talk it over."

That was the last time that guy ever parked his car in such a manner as to box in Harvey's car. Harvey repainted his car because he felt a joy of possession in it. He got new slipcovers. He changed his restaurant for a better one. He changed his rooming house for a better rooming house. That surge of joy over the simple matter of writing his name legibly and then writing a simple sentence, "This is a beautiful day in March," and giving him permission to feel that tremendous, boyish surge of jubilant joy was enough to carry him along.

I think it would have been an error for me to tell him to go down and demand better pay or to tell off that guy who parked that car in the wrong fashion—because he didn't need a direction about what to do. But he did need motivation. And that is one of the things in psychotherapy and the use of hypnosis—the motivation of a patient to do things. Not the things that you necessarily think they ought to do, but the things that they as personalities have the feeling that they really ought to do. And one usually starts with rather simple things. Because human beings are essentially, fundamentally, rather simple creatures. And therefore, you ought to start simply and let the patients elaborate in accord with their own personality needs—not in accord with your concepts of what is useful to them. You only interfere when they try to destroy themselves.

Indirect Suggestion and Implication

Much of hypnotic psychotherapy can be accomplished indirectly, like I had done with Harvey, with the use of posthypnotic suggestion. Often I will suggest to a patient, "Go home today and let your unconscious mind think over all the things that have been said, all the things that have been thought." I can think of one patient in particular who was making a psychoneurotic out of herself by going out into the sunlight and developing an extremely severe rash on her arms, neck, face. Then she would claw at the rash all night long until her arms and face and neck were horrible sights to look upon. She came to me because every dermatologist and doctor she had consulted had said that it was jut pure cussedness on her part. She stated very definitely that she also expected me to tell her that it was pure cussedness on her part. So I told her it wasn't necessary for me to tell her that because she had already told me, and I would take her word for it—but I was still entitled to believe my own thoughts on the matter. Thus, I accepted what she said to me, but at the same time I gave tremendous reservations. I was still entitled to believe my own thoughts, and she could believe her own thoughts.

My suggestion to her was rather simple—namely, that she ought to enjoy as much of the sunlight as she wished, that she really ought to enjoy the sunlight as much as she wanted to. I told her to go home (the patient was in a medium trance) and lie down for an hour or two and let her unconscious mind think over what that meant. She said that she didn't need to, that she consciously remembered what I had said. After she had gone home, after she had proceeded to sit down and rest for an hour, her reaction was to get up and go out into the garden. But she was also motivated to put on a very wide-brimmed hat and long sleeves. Now she found it very enjoyable out in her yard, and she worked in her flower garden. In the past she had been told, sensibly enough, to avoid the sunlight, to keep out of the sunlight, to shade herself, to protect herself from the sunlight. I, on the other hand, told her to enjoy it. Now, what does enjoyment of the sunlight mean? It means putting yourself in a situation where you do not have to fight against it, do not have to protect yourself, but can really enjoy it. She did like her flowers very much, and they were out in the sun, and therefore she was able to enjoy the sunlight. Do you see the implications of my suggestion to her? I did not tell her to avoid the sunlight, I did not tell her to protect herself, I told her to enjoy it. And her enjoyment of the sunlight would include enjoying herself post-sunlight, enjoying herself during her sleep, enjoying herself the next day.

All I needed to do was to give her the motivation to enjoy the sunlight. Since she was a rather hostile and antagonistic person, my suggestion did not leave her with anything to fight against. Her rash cleared up very promptly, at which point she protested that I charged too high a fee. And I told her, "Yes, my fee was high, but your enjoyment was much higher, and why not pay me my fee for the little that I have done." She sent me a total of 10 other patients, even though she protested my high fee. I had accepted her protests, and accepted them on the grounds that were acceptable to her. In other words, you try to accept the patient's ideas no matter what they are, and then you can try to direct [sic—we now prefer utilize] them.

Use of Regression and Amnesia: Gaining Control over Traumatic Experiences, Memory, and Repression

Regarding this matter of regression, I like to initially regress my psychiatric patients to something pleasant, something agreeable. I admit that we are wasting time because we are there to correct the unpleasant things, not the pleasant things. But in the trance state I impress upon them that it is tremendously important to realize that there are some good things in their past, and those good things form the background by which to judge the severity of the present. And so I use the happy memories of their past to train them to recover fully and completely the various traumatic experiences. I have them recover the traumatic experiences completely, then I repress them, then have them recover the memories again, and repress them again for the patient.

[The dynamics underlying this technique are the following.] A patient comes to you with forgotten, repressed memories. Once you get a hold of the memories and relate them to the patient, once you have the patient remember them, he can again use his repressive powers and forget those things. But if you yourself repress or create an amnesia for those memories, the patient is unwittingly turning over the control of those traumatic experiences to you. This means that you are at liberty to reproduce the memory, to cover it up again, to bring it forth again, to cover it up again, until your patient builds up enough strength to face any particular issue. Since hypnosis provides you easy access to, and control over, both the recovery and repression of material, the repressions of the patient are not likely to take over and control the situation.

Suggestion and the Centering of Resistance

The type of suggestions you give to a patient depends upon the attitude of that patient toward you and the therapeutic process. I have dealt experimentally and clinically with the negative, hostile patient and found various ways of meeting this particular brand of resistance. The patient can come into my office, intending to be totally contrary, absolutely resolved to try my patience, absolutely resolved not to go into a trance. I can recall the doctor who came to see me for therapy. He had called me long distance several times and written letters previous to our meeting, and from these contacts I knew I had an exceedingly antagonistic man on my hands. When he walked into my office, his shoulders were thrown back, his jaw jutted out, he sat down perfectly upright in the chair, and said, "Now, go ahead doctor and hypnotize me."

I told him I thought he had far too many resistances. And he said that he didn't care about his resistance—my job was to hypnotize him, not to make excuses. Would I please get going. I told him I would, and I proceeded to suggest that he go into a trance. The man had some knowledge of hypnosis, so I used the straightforward, domineering technique, knowing full well that it would be a total failure. I worked on him for about an hour, using the best domineering technique I knew, while he sat there smiling at me and resisting me very effectively. After I had built up his resistance in every possible way, I abruptly said, "Excuse me for a moment." (I had prepared for this, having heard him over the phone, having read his letters.)

I stepped out into the other room and came back with a young college girl—a psychology student and hypnotic subject of mine. I brought her into the room and said, "Elsa, I would like you to meet Dr. X. Dr. X came here to be hypnotized. Elsa, would you please go into a deep trance right now." She went into a deep trance, and I demonstrated a few hypnotic phenomena on her. Then I told her to sit down and put the doctor in a trance and to call me just as soon as she had the doctor in a trance. With that, I totally walked out of the room. Fifteen minutes later, Elsa came to the door and called me back into the office. What had I actually done? The doctor had his load of resistances, which I centered all on me so that when I walked out of the office, I carried out that whole load of resistance.

Furthermore, how can you resist somebody who is in a trance, somebody who is merely responding to hypnotic suggestions? Of course Elsa used good hypnotic technique and was able to induce a very satisfactory trance. Very often I use this technique in training especially resistant patients or subjects to go into a trance. It is one thing to resist me, but how can you really resist someone who is in a trance, whose one and only purpose is to put you in a trance, not to make any other kind of allowances for you. It's very difficult to do that.