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Educational Objectives Using Hypnosis with Children and Their Families 41st Annual Congress of the Australian Society of Hypnosis Lynn Lyons, LICSW

Why Use Hypnosis with Children? •  Takes advantage of imagination, fantasy and story telling •  Teaches a skill •  Uses the power of the experiential •  Addresses problem in a different way (‘cause there’s probably been a lot of talking already)

•  List three benefits of using hypnosis with children. •  Describe three hypnotic techniques that could be used to treat common childhood problems •  Identify examples when hypnosis with children should not be utilized.

Why Use Hypnosis with Children? •  Translates to other areas (you start specific, but then can go global) •  Kids (especially teens) think it’s cool •  Engages parents, who learn the skills, too •  It works

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Things to Consider… •  •  •  •  •  •  • 

Age of child Important! Get some info about child’s interests Recording of sessions Eyes open or shut Presence/role of parents Do we call it “hypnosis”? The structure of a session: formal or informal?

Structuring a Hypnosis Session •  •  •  •  •  •  •  • 

Orient to hypnosis Induction Response set Introduce a theme(s) Offer suggestions addressing the themes Check in Post-hypnotic suggestions Closure and disengagement

I am using hypnosis with a child when: I am able to absorb a child in an imaginative experience that allows us together to alter sensations, change perceptions, or shift a perspective on something. The experience itself, the post-hypnotic suggestions, and the “practicing” that follows allow the child to then apply these new skills and perspectives to future situations.

Orient to Hypnosis •  Positive expectancy…sell it! •  Look for signs of spontaneous trance •  “Sounds to me like you have a great imagination. I think we should try something that will help.” •  Showing how I record sets the stage and shifts us toward next step

Yapko, 2003

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Induction

Induction

•  Shorter (you often don’t have or need much time) •  More informal •  Very permissive: “If you want to close your eyes you can. Or you can just focus with your eyes open.” •  “Let’s use that imagination and pretend.”

•  Give casual examples of absorption: “You know when you’re supposed to be doing a math worksheet, but you’re just staring off and thinking about what you’re going to be for Halloween instead?” •  Older kids might want something more formal and “hypnosis-y.”

Response Set

Introducing the Theme

•  Building momentum in the direction you’re headed; paving the way for the response/shift you’re creating •  Using truisms that set the stage, and are easily understood and agreed with •  “We’re going to work on XXX, so I’m going to plant the seed of possibility by talking about XXX now in a general, unchallenging way.”

•  First, have a simple, clear goal that can be stated in one sentence –  What does this child need to learn, and how can I teach it? –  What pattern/reaction do we need to shift? –  What perceptions or perspectives are stuck? –  Where is the rigidity, and how do I inject flexibility? –  What does this child already do well, and how can I use it?

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Introducing a Theme or… Creating the Blueprint •  Be concrete, and tell the child where you’re going next: “I’ve been talking about how bodies and minds do some pretty amazing things together. Now we’re going to plan together how you can do that, too.” •  Let the child take the lead, but be ready to offer examples if needed: “One boy imagined he had a pain-free force field, while another apparated his body, but left his arm with the doctor.”

Introducing a Theme or… Creating the Blueprint •  Generic structure –  How about practicing that right now? Every time you get to practice, you get better at it. Let me know when you’re done. –  Because it’s your plan, you may want to change things or make some adjustments as you go. You’re in charge here, so do that whenever you want to.

Introducing a Theme or… Creating the Blueprint •  Generic structure –  We’ve been talking about ______, and our goal is to _________ . We can work on that together now. –  Can offer one story or example: “Your goal reminds me of my neighbor’s dog that…” –  If you want to _________, then what can you imagine in your brain (what can tell your body to do, what message do you need to send to your brain/part of body, etc…)

Possible Techniques •Age regression… “Let’s go back to a time when…” • Future progression… “Move forward to a time when the problem is gone…” • Symptom substitution… “Imagine doing something that will provide the same relief without the problem…” • Jettison technique…”Imagine how you can send the symptom far from here…” • Ideomotor signals

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Check In •  With children, sessions tend to be interactive throughout. •  Talking, opening eyes, getting up and moving around are all common.

Post-Hypnotic Suggestion •  “In the future, when you’re in situation XX, you’ll be able to do YY.” •  Critical to connect what you’ve just done to future real life experience •  Children will often be “awake” at this point. •  Little trick: “Repeat after me…” and then do something “magical” to make it stick

Introducing the Theme •  First, have a simple, clear goal that can be stated in one sentence

Establishing the Target

–  What does this child need to learn, and how can I teach it? –  What pattern/reaction do we need to shift? –  What perceptions or perspectives are stuck? –  Where is the rigidity, and how do I inject flexibility? –  What does this child already do well, and how can I use it?

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Establishing the Target •  You need to: – Calm your body – Slow down – Manage uncertainty – Go away for a bit (dissociation) – Let your body do what it knows how to do – Interrupt a pattern

Some Uses of Hypnosis •  Anxiety/Fears/Phobias •  Medical Procedures/Pain •  Physical and Somatic Conditions –  Asthma, headaches, stomach pain –  Sleep issues –  Bedwetting

•  Decision Making/ Impulsivity/Planning •  Flexibility (individual and family)

Establishing the Target •  You need to: – Think ahead – Send better messages between brain and body – Shut down messages for a while – Remember what you do well (and access it)

Anxiety/Fears/Phobias Target: I can handle what the world throws at me •Calm the body down (turn off the alarm system) Breath/Face/Heavy Hands Normalize sensations The First Sign Technique •Emotional/Physical Management “I don’t like it but I can handle it.” •Managing Uncertainty “This is new and unfamiliar, but I can handle it.”

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Anxiety/Fears/Phobias Target: I can handle what the world throws at me •Build on Past Experiences “I’ve done it before, and I can remember that experience.” •Use that Imagination (and follow the child’s lead!) ~ Rehearse handling the situation using the skills that child has learned ~ You are the follower or leader… structure as needed

Medical Procedures/Pain Target: I can handle this; I can go far away •Calm the body (turn off the alarm system) Heavy Hands •Emotional/Physical Management “I don’t like it but I can handle it.” • Dissociation “I can go away from here for a bit.” •Time Distortion • “Would it be okay if it didn’t bother you this time?” (Olness and Gardner, 1988, p.228)

Two Important Points 1. Hypnosis in the treatment of anxiety and phobias is used in conjunction with other experiential strategies (homework) and CBT. 2. Hypnosis seeds the work to come. It equips the child with a sense of mastery, so movement forward is possible.

Anxiety Before Surgery Complicates Recovery In a study done in 2006, researchers found that anxious children experienced: • more problems emerging from anesthesia • significantly more pain both during the hospital stay and over the first three days at home. • consumed significantly more codeine and acetaminophen • had a higher incidence of postoperative anxiety and sleep problems (Kain, et al., 2006)

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When dealing with physical symptoms in children… 1. Hypnosis is not a substitute for medical treatment. 2. Hypnosis is not a cure for physical conditions. 3. Do not use hypnosis as the treatment for a physical condition without communication with child’s physician. 4. Hypnosis is a wonderful tool to help children and parents frame and cope with physical conditions in a way that can lead to a decrease in symptoms and discomfort.

Physical and Somatic Conditions Target: I can send messages between my brain and my body • “When a physical symptom starts, how can you respond differently to it? What message can you send to the ____________?” • “What can you imagine doing/happening in your body that would change the sensation?” • “What could you focus on instead of _______ that would help?”

Physical and Somatic Conditions Target: I can send messages between my brain and my body •Calm the body (turn off the alarm system) •Change the reaction to the symptom (emotionally, cognitively, physically) • Interrupt the pattern or rituals around the symptom (“what you focus on you amplify”) • Offer the potential for mastery here • Hypnosis sessions become the “practice” for when symptoms arise

Getting the Body Back on Track Target: I can let my body do what it knows how to do Sleep • Often have anxiety issues and parenting issues to address • Building the response set in the direction of… “your body already knows how to do this.” • Physical calmness as a start (“We know when it’s time for bed, your muscles are tired and your eyes are tired, aren’t they? So let’s just let them relax like they want to.”

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Getting the Body Back on Track

Getting the Body Back on Track

Target: I can let my body do what it knows how to do Sleep • “You don’t have to pay attention to falling asleep, just like you don’t have to remind your heart to beat, or remind your toenails to grow… you can just stay out of the way, and take your brain and your thoughts somewhere else, to something easy, just drifting around, while your body does what it knows how to do, without any help from you… • ABC Game

Target: I can let my body do what it knows how to do

Other Examples of Potential Targets

Other Examples of Potential Targets

Impulsivity •Need to slow down; ability to pause and think before taking action; the “decision box” Decision Making • How do you decide what to do next? • What information do you consider when making a decision? • Thinking a few steps ahead; the ability to predict outcomes

Bedwetting • “We need to send a message from your bladder to your brain. How should we do that?” •Practice is important. •Parental involvement tends to decrease success rates, while sense of mastery in child increases success. • Must rule out possible physical issues

Rigidity…Moving Out of Stuck Patterns •Let’s change the reaction: “You can manage external situations differently by shifting your internal reactions.” • Let’s create a different voice in your head. • The role you are in now is not permanent (or roles in families can change) • If you shift one step in the sequence, the outcome can shift

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Including Parents – Often need to learn the same skills – Help with handling fear/anxiety (medical issues) – Provides opportunity for positive modeling – Mastery vs over-involvement – Age of child – Addressing family issues •  Family flexibility •  Changing family roles •  Stress and reactivity

Exercise •  1. Client describes the presenting problem in one sentence. What is the TARGET? •  2. Find an interest of the child. •  3. Orient to the hypnotic experience…start being hypnotic, drop seeds, move toward trance state. •  4. Do a short induction using the information from child AND incorporating the target.

References Ginsberg, Golda, et al. (2009). Journal of Consulting and Clinical Psychology: 77(3): 580-587. Hudson & Rapee. (2002). Journal of Clinical Child & Adolescent Psychiatry; 31(4): 553.

Thanks for coming!

Kain, Mayes, Karas, & McClain. (2006). Pediatrics; 118: 651-658. Kain, et al. (2004). Anesthesia & Analgesia; 99: 1648-54. Olness K. & Gardner G. (1988). Hypnosis and Hypnotherapy with Children. Philadelphia: Grune and Stratton. Sugarman, L. and Wester, W. (2007). Therapeutic Hypnosis with Children and Adolescents. Crown House Publishing Limited: Carmarthen, Wales.

Lynn Lyons, LICSW lynnlyonsnh.com Specializing in the treatment of anxious families

Yapko, M. (2003). Trancework: An Itnrorduction to the practice of clinical hypnosis. New York: Brunner-Routledge.

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