First Article: Case Studies of Immediate Solutions to Obsessive Behavior, or “Brief Therapy”

The following are three case studies pertaining to obsessive behaviors which affected the entire family. In each case, I chose a strategy designed to accomplish immediate symptom relief. The studies have been abbreviated for the purposes of this article.

First Case: Tommy Bangs His Head

The mother, Julie, called me, and related: “Our Tommy is five years old and we are worried about him.”

“What does he do that worries you?”

“Whenever he spills milk at the table or makes any mistake, he gets out of his chair and bangs his head against the wall while saying, ‘You are stupid. You are dumb.’” I invited them to come in as a family.

It appeared that the parents were a normal couple. There were no red flags in their relationship with Tommy. Nor was there anything of note in Tommy‘s body language. Julie reported her son enjoyed kindergarten and played well with friends. He had no other strange behaviors. However, Tommy would bang his head a few times a week on average. This behavior had been going on for “at least several months.”

I first considered recommending testing for autism. But in my experience, behaviors can often be addressed by simple, self-hypnotic suggestions. I began telling a story. I looked directly into Tommy‘s eyes. “Once upon a time there was a little boy squirrel named Timmy who felt bad because he couldn‘t do anything right.” Tommy nodded his head. “When Timmy climbed trees with his friends he would slip and fall down.” Tommy nodded his head again. “When Timmy hid nuts he would forget where he hid them. He felt dumb.” Tommy nodded his head again. I embellished the story in great detail so Tommy would fully identify with Timmy the squirrel.

Timmy the squirrel‘s parents finally bring their little boy to visit the Wise Old Owl who lives in the big oak tree. “Because owls have wonderful eyesight he saw them coming from afar and said, ‘I see you are a squirrel family, how can I help you?’ Mommy and Daddy told the owl that Timmy banged his head against trees and called himself names when he made a mistake.”

“The Wise Old Owl thought for a moment and then he looked right at little Timmy and said, ‘Little Timmy Squirrel, do you have a belly button? Let me see your belly button.’” At this command, Tommy pulled up his shirt and looked at his belly button.

“The Wise Old Owl continued, ‘Little Timmy, take a good look at your belly button because everyone who has a belly button makes mistakes. From now on, whenever you make a mistake, just look at your belly button and say, ‘It‘s OK. Everyone who has a belly button makes mistakes.’” Then I told him, “Now you and your Mommy and Daddy go home and enjoy being part of a loving family.” At that, I ended the session.

Julie called the following week to report Tommy had stopped banging his head.

Second Case: Clinical Depression Following the Loss of a Parent

An acquaintance whose husband died ten years ago called out of concern for her 30-year-old daughter, Amy. This mother reported Amy had never gotten over the loss of her father. In fact it appeared Amy‘s depression was affecting her health and her marriage. When Amy came into my office, she revealed she was working as a nurse in the very hospital where her father died following surgery. At the time, Amy was concerned whether her Dad was getting the medical attention he needed, but she felt powerless to do anything about it. When he died, she berated herself for not doing something. I learned from questioning her that there was a voice in her head that kept saying: “You could have saved his life!” No wonder she felt depressed.

Amy was stuck in the past. She couldn‘t enjoy her marriage. She wept as she said, “I can‘t stop thinking about his dying and the funeral and that I could‘ve done something.” I asked her if it was like a movie running in her mind. Amy agreed that a movie of her Dad‘s death played over and over in her head.

Brief Therapy strategy: “Change the movie!” I asked her whether her father would like her to remember the good times they had together or whether he would want her to obsess about his death. Amy didn‘t know she had a choice. I suggested, “Because we think in pictures and sounds, it‘s like we have a TV set in our minds with various channels. You got stuck on the tragic ‘Father Dying Channel’. Just imagine you have a remote control. Now switch channels to the ‘Happy Memories with Father’ channel. Memories he would like you to remember and share with his grandchildren.”

With a sigh of relief Amy did that easily. We practiced the Happy Memory channel for awhile until she felt sure she felt confident accessing it.

The following week she called to report she no longer felt depressed and, in fact, was now enjoying showing photos of her father and sharing happy memories with her children.

Third Case: My Husband Needs to Change His Attitude

A middle age woman called to say she wanted her husband to come in for hypnosis to change his attitude. “I am sick and tired of his negative attitude.” I was amused and asked her to have him call me.

She was right. When Bill came in for an appointment, he said, “I grew up in a very negative, unhappy family. There were no ‘atta boys’ in our family. There was only criticism. It was a rare day when Dad or Mom laughed or showed happiness. They were unhappy with their marriage.” He went on: “My wife complains that I come home from work grumbling and complaining. She says I‘m just like my parents, and she‘s probably right, but I can‘t seem to help myself. I don‘t see how you can help me change. I don‘t like being so angry with the kids, and I don‘t like having an unhappy wife. If you can help me change, great.”

After some questioning, Bill identified his parents’ negative voices in his head. I asked if he could imagine a room in his head with the voices coming from a radio or some device over by the wall. He was able to imagine a radio.

Then I wondered whether he would like to go over and turn down the volume or perhaps pull the plug on the radio. As he did so he gave a big sigh. “What‘s going on?” I asked. “My head is quiet for the first time ever,” Bill said. I told him, “Since it‘s your head, you can put in anything you want. For example, because you are thankful for your family and your health you can fill that room with your own thankful voice, if you wish.” To his surprise Bill discovered he could do that quite easily. We rehearsed him reviewing all his thankful thoughts while driving home from work so he could greet his wife and children with joyful energy. After some rehearsal, he felt confident he had installed new voices in his head. He had changed his attitude.

Bill‘s wife called later to report she was enjoying a new, positive Bill.

My concluding comment is that formal hypnosis was not used in any of these cases. Rather, the patient‘s imagination was guided to form new patterns of thinking and behavior. Each patient was seen for a single session. The psychological bases for Brief Therapy can be found in the following resources:

Problem Solving Therapy, Jay Haley, Jossey-Bass, 1976

The Answer Within: A Clinical Framework of Ericksonian Hypnotherapy, Stephen Lankton and Carol Lankton, Brunner-Mazel, 1983

Becoming Solution-Focused in Brief Therapy, John Walter, Jane Peller, Brunner-Mazel, 1992

Author Ronald Soderquist, Ph.D., MFT, has both a family counseling and medical hypnosis practice in Westlake Village. He was a founding faculty member of the Phillips Graduate Institute where he taught for ten years. He was also Director of Counseling and Lecturer at California Lutheran University. He is an elected member of the Board of the American Association of Marriage and Family Therapists, California Division. Ron is co-author with his wife, Elda, of Equality! Secret of Lasting Love, a self-help book for couples, and is a regular contributor to the magazine, “Your Health Connection.”

He did his training in hypnosis more than 25 years ago with some of the country‘s leading medical hypnotists. He has taught hypnosis both here and abroad, including Australia, Russia and England and has served on the staff of four colleges and graduate schools, including California Lutheran University. Dr. Soderquist is also a licensed Marriage and Family therapist. For more information, see his websites:

www.westlakehypnosis.com
www.sunlitpress.com
www.familycounselingcenter.net

Second Article: When to Forgive and When to Withhold Forgiveness

In the now classic movie, “Love Story,” Ryan O‘Neal says to Ali McGraw, “Being in love means you never have to say, ‘I‘m sorry’.” Anyone who has been in a relationship more than six months knows how silly that statement is.

We are all imperfect. Therefore we sometimes thoughtlessly or selfishly offend our partner. If offended partner puts up a wall of anger and if the offender puts up a wall of guilt—those walls can destroy a potentially wonderful relationship.

“I‘m sorry” is essential because the best of us will sometimes do or say hurtful things. It is helpful to look at two categories of hurt. The first is the ordinary every-day misunderstanding. When we are tired or rushed, Elda or I may snap at the other. We may forget to do something we agreed to do. A simple “I‘m sorry” is usually enough. It‘s important. But it‘s not a big deal because we accept that we are both imperfect.

The second category includes more serious, heavier, hurts. We give a number of examples in this article. For those hurts, a simple “I‘m sorry” won‘t be enough. For those serious hurts every couple needs to know what we call “the ten most important words to heal a relationship in pain: “I‘m sorry ... I hope you can forgive me some day.” Those words may get stuck in your throat. Practice saying them out loud when you are alone. Practice saying them over and over until you discover your world doesn‘t end when you admit you were wrong

What‘s So Hard about Saying, “I‘m sorry?”

Let‘s eavesdrop on a healthy couple who practice mutual respect in their marriage:

“Hey, you hurt my feelings when you said that!”
“Oh, I didn‘t mean to. I‘m sorry.”
“O.K., but don‘t do that again.”
“I hear you. I don‘t want to hurt you.”

This is followed by a loving hug and kiss. No nagging guilt. No wall of resentment. No back turned in bed. There is mutual understanding that we all make mistakes. No one is perfect.

Very simple, right? Wrong! This is not the way most couples handle hurt. Some couples escalate hurt feelings into a nasty fight. Other couples just withdraw into cold silence. Walls of resentment protect feelings of hurt and loneliness. No more cozy cuddling. Sex life goes down the toilet.

The power of an apology:

Paul‘s jaw was set in bitterness and anger. “Angie put me down in front of the children. I felt a kind of helpless rage. But I didn‘t want a big fight in front of the children. So I just withdrew from her emotionally. I could tell that she knew she had done wrong. But she never apologized so there‘s always a wall between us. I hate that wall. It ruins our sex life. What if she never apologizes? What will we do?”

With some help in counseling Angie finally sat down with Paul, took his hands in hers and said: “That was wrong of me to criticize you in front of the children. I am sorry. I will work hard to stop doing that. I hope you can forgive me some day.”

Building Trust After an Affair

The courage to look within: Matt sat with a hopeless look on his face as he said to Mary, his wife of ten years: “You say you want to keep the marriage, but you had a six-month affair with someone from your office. You want me to forgive you—but how can I trust you?”

Matt was right to connect trust with forgiveness. First we helped Matt and Mary identify practical ways in daily life to build trust. They thought of acts of kindness and phone calls from work to say: “Just thinking of you. I love you”. They scheduled romantic dates and getaways.

Matt realized he had taken Mary for granted. Fortunately he took her affair as a wake up call to enrich their marriage in dozens of ways. Matt had the courage to stop blaming Mary and look at his own personality. When he looked back at his childhood he saw a family where there was no closeness. “I think my family motto was ‘Every man for himself.’” He realized it didn‘t come naturally for him to be emotionally connected with anyone, not even his wife. He wasn‘t used to sharing his thoughts and feelings. But he was willing to learn. Gradually they became comfortable with being best friends and lovers. As they developed this new close bond Matt was surprised that his anger about her affair just seemed to disappear. Now he could trust Mary and he could trust their relationship.

Escaping the Forgiveness Trap

Stuck in the trap: Robin had a secret she had managed to keep from family and friends. About twice a year her physician husband, Chet, came home drunk, and he was a mean drunk. After a screaming match, he would hit her. The next day a sober Chet was always very sorry. “I‘ll never get drunk again. I‘ll never be violent again. Can you forgive me?” Because Robin didn‘t believe in divorce she tearfully forgave him over and over. She always managed to cover up her bruises until the last time, when he broke her jaw.

Out of the forgiveness trap: Robin‘s broken jaw brought her in for counseling. She thought she had only two options: forgive Chet or divorce him. We helped her see she had other choices. For example, she could respond to his pleading with, “What will you do differently so I can trust that you will never hit me again?”

Instead of tearfully forgiving she learned to ask, “Do you think I should forgive you before we get professional help?” She also took some responsibility for their violent marriage dance by telling him: “It is obvious I am also part of this problem, so let‘s get professional help rather than go through our twice-a-year cycle again.”

When Robin stopped getting caught in the forgiveness trap Chet agreed to join her in marriage counseling. Chet was able to see how manipulative he had been to plead for forgiveness. He learned to say from his heart, “I hope you can forgive me some day.”

Through marriage counseling they stopped their semi-annual melodrama. They discovered they could have a marriage without alcohol and without violence.

In summary, there is a time to forgive and a time to withhold forgiveness.

Write Dr. Ron, “The Voice of Experience,” about your own forgiveness experiences. This article includes excerpts from Chapter 6 of Equality! Secret of Lasting Love.

Third Article: What To Say When You Don‘t Know What To Say

It was early Sunday morning when I picked up the phone and heard the terrible news. My weeping son called to tell me he had wakened to find his pregnant wife cold and dead in bed beside him. There was no warning. Our entire family was in a state of shock.

Within the hour I was in my driveway loading up for the drive to San Francisco where our son lives. Two neighbors happened to be standing talking nearby. I walked over, with tears streaming down my face, to tell them the awful news. One neighbor (of course he meant well) said, “Well, you can be thankful it was quick, and she didn‘t suffer.” Poor guy. Usually we men are so uncomfortable seeing another man cry we blurt out the first thing that comes to our minds. He was trying to be reassuring. But his words made me cringe.

Later, when I had time to think, I wondered why his reassuring words didn‘t help. Upon reflection I realize my internal response was pretty normal. His words didn‘t help because they didn‘t meet my needs. At some subconscious level I felt, “He wouldn‘t try to cheer me up if he really understood how horribly sad I feel.” I didn‘t need reassurance. I needed empathy, understanding, call it what you will.

My internal reaction to my neighbor‘s well-meaning words of reassurance was confirmed when I read an article in the “New York Times” about grief workshops for medical doctors in New Jersey. According to the article, physicians often feel tongue tied when they come out of surgery to deliver sad news to a waiting family. Doctors do not learn in medical school what to say to a sobbing wife who just lost her husband.

According to the “Times,” in the workshops the doctors learned to say seven simple words, “I am so sorry for your loss.” They actually rehearsed those words over and over until they could say them with feeling. They discovered it is not enough just to mouth the words. They needed to dig deep inside their own humanity, deeper than the doctor-scientist self who moments before may have held a bloody scalpel, deep enough to convey compassion for a suffering fellow human being.

For myself I noticed how comforted I felt when friends, with tears in their eyes, and with a long, warm hug said, “I am so sorry for your loss.” At our daughter-in-law‘s funeral I saw some of my son‘s friends just hug him, without words, mingling their tears with his. Their shared tears were all about sorrow for his loss.

I believe every suffering has within it potential for spiritual and emotional growth. Now, three years later, I look back and think about what I learned by going through that tragic, draining time of grief.

I do seminars on many topics at our church and by coincidence I had already been scheduled to lead a seminar on grief just a few weeks after the funeral. Because of our family‘s tragedy I re-titled the seminar: “What I have learned about grief recently.” I told my fellow parishioners, “My most important learning is what to say when we don‘t know what to say. In the midst of my grief, I found most comforting your hugs along with the simple phrase: ‘I am so sorry for your loss.’”

Now, like the New Jersey physicians, you know what to say when you don‘t know what to say.