Children are developmentally in motion both physiologically and psychologically. They live in a land of discovery where ideas realize themselves and imagination prevails. Children are always in a creative and imaginative trance-like state. (Sugarman and Wester 2014)
Children have very creative and active imaginations. A child experiencing a problem generally wants help to move forward by learning a variety of skills that will resolve the problem – and children do not come to treatment with the same baggage of myths and misconception as adults.
To help clarify the myths and misconceptions about hypnosis, the therapist can send the child’s parents, prior to the first session, a brochure entitled “Questions and Answers about Clinical Hypnosis” (2013) Gahanna, Ohio: Ohio Psychology Publications Inc. Another good reference is My Doctor Does Hypnosis (Elkins, 1997 Chicago: American Society of Clinical Hypnosis Press).
The therapist is continually confronted with the issue of determining the most effective strategy based on the medical and psychological need as well as the child’s developmental level. The therapist must decide what level of distraction, hypnosis or metaphor would be most helpful.
It is easy to move from a distraction technique to an induction, especially in an emergency situation. A babysitter brought a young girl into the ER with a severe cut on her hand. She had been playing with her brother, slipped and put her hand through a window. She was hysterical with this injury and without her mother.
I happened to be on the psychiatry unit, and the chief of psychiatry said we were going to the ER. When we got there he basically said that I should “do my thing” to calm this girl down.
After putting on a pair of gloves I approached the girl, introduced myself, pulled her arm out straight and said “that’s the prettiest blue blood I have ever seen.” The girl calmed somewhat and said, “That’s not blue; that’s red,” at which point we were engaged in a discussion.
I then asked her to try something and close her eyes. “I wonder if you can use your mind in a creative way to find the right switch to your right hand. With your eyes closed just see all the wires going to your brain and find the one that operates your right hand.” (Meanwhile, the staff had started to clean the hand).
“As soon as you find the right switch let me know by raising this finger on your other hand,” I said. “That’s great and now for just a moment, turn that switch off so the doctor can fix your hand. You will feel pressure on your hand but you will not feel discomfort because you have your switch off.” (The ER doctor puts several stitches in the hand.)
“The doctor is finished now,” I said, “so you can turn that switch back on but you can still control the discomfort and keep it very low. When you open your eyes we can see if the blood was really red or blue.” She opens her eyes and immediately I said, “You were right and the color is red. Isn’t it great to have learned something new? You did a super job teaching the doctors about how you can control your switches.”
In older children hypnotic relaxation, imagery, arm levitation or eye fixation may be the best induction technique, whereas in younger children the TV technique, “Fluffy the dog” modeling, and the magic carpet imagery may be used.
It is important to remember that all hypnosis is really self-hypnosis and that the therapist is only the teacher or director in the process. Graduate students quickly learn that some form of induction (age appropriate) is fairly easy and the child will go where they need to go. The real work begins after the induction in developing various therapeutic strategies and appropriate suggestions.
I also use magic as a way to develop rapport with children. I never refer to hypnosis as magic even though I incorporate a story of a magic carpet or magic castle in some inductions. At the end of a session the child is given a simple magic trick to practice until the next session.
My favorite story is of the child with the diagnosis of Oppositional Defiant Disorder who came into the office, sat on the couch, covered his eyes with his hands and said, “I don’t want to be here and I don’t have to talk with you.”
My response was, “You are correct and you don’t have to talk with me but with your hands over your eyes it will be hard to see the magic marble.” With that the child lifted one hand to look and the rest is history.
Children and adolescents have heard about hypnosis and accept that they are going to learn new things that will help them with their presenting problems. Recordings are made if the presenting problem requires reinforcement between sessions.
Hypnosis is just one more skill that we have available to use with a patient. We have all had various types of training and approach therapy with different orientations. Use the skills you are good at and, if you have not had any hypnosis training, consider adding it to your training.
My orientation is cognitive/behavioral and, where appropriate, I also use my hypnosis skills. This article is about children, but hypnosis can be a wonderful adjunct with adults. I remember speaking to a group of psychiatry residents about hypnosis, encouraging them to go beyond medicine when treating such things as anxiety.
I can’t imagine treating anxiety problems without some form of hypnosis. When appropriate, with adults and children, I use a prop I call the “It Monster.” In the beginning I simply referred to the tissue box on my desk as the It Monster as a way to focus (dissociate) the anxiety away from the patient. A patient I used this approach with brought me an ugly looking cartoon-type prop, saying that this was more like the It Monster than the tissue box. The new prop was then used for years. My “It Monster” approach is in the literature.
William C. Wester II, Ed.D., is a retired psychologist in Cincinnati, Ohio. He is an ABPP diplomate in Counseling and Family/Couple (American Board of Professional Psychology), an ABPH diplomate in Clinical Hypnosis (American Board of Psychological Hypnosis) and a past president of ASCH. He may be reached at: firstname.lastname@example.org.