ENGLISH VERSION

ABSTRACT FORM

A CASE OF ANOREXY TREATED WITH HYPNOSIS.

LIA, THE PATIENT, SEEMS TO HAVE COME OUT FROM THE TUNNEL OF ANOREXY.

THE STORY IS EXPOSED POINTING OUT SOME SITTINGS OF THERAPEUTIC PROCESS AND THE RELATIVE HYPNOTIC: SUGGESTIONS THAT DERIVE FROM M.ERICKSONIAN HYPNOSIS. I

AT PRESENT LIA, HAPPILY MARRIED, HAS A DESIRE-FEAR TO CONCEIVE A CHILD, THIS HAS CAUSED A RETURN OF VIOLENT ATTACKS OF BULIMIA RAPIDLY OVERCOME WITH THE TAKING UP OF THE HYNOTHERAPEUTIC SITTINGS AGAIN .

SOMETHING HAS WORKED EVEN IF SOME QUESTIONS REMAIN A REGARDS THE FUTURE OF THE PATIENT. TODAY PSYCHOTHERAPY NEED NEW AN SWERS AND NEW PERSPECTIVE ELABORATING ON WHAT WORKS MAY BE THE RIGHT PATH.

PRESENTATION PREFERENCE BEVORZUGTE PRENTATIONS FORM

A Brief Communication

GIOVANNA GENOVESE Messina, ltalia

The model and the procedures used to help Lia, the patient, to get out of tunnel of anorexia, are described. Lia’s story is exposed pointing out some sittings of therapeutic process and the relative hypnotic suggestions, that derive from Ericksonian Hypnosis. By some presupposition we will arrive hypothesis that it is possible to change behaviour changing the emotion determined by the meaning that we give to ours experiences, and since the meaning is determined by the sequence in which the stimuli, (images, sounds, smells, sensations) arrived, changing one of hem we can change the meaning and the emotion.

Whit hypnosis is possible obtain information about the dysfunctional sequences and modify it. The sequences that have influenced Lia’s behaviour, and the hypnotic procedure utilized to modify athem will be descript.

The model used with Lia has been based on same presuppositions: the meaning of our experience is determined by the sequences in which the stimuli coming from the external word and by the emotional reactions that these sequences arouse.

The sequences of images, sounds, sensations, smells are recorded in the brain and produce “neuron ways”. The depth of these pathways is directly proportional to the intensity of the emotions determined by the sequences. These emotional reactions will urge the individual towards choices of behaviour, which serve to utilize resources so as to decrease anxiety and increase satisfaction.

If the sequence is changed, whether voluntarily or not, the emotional reaction will be modified. The modified emotion will be the reinforcement that will facilitate the repetition of the new sequence. But the change in the sequence may be functional to reduce anxiety, but dysfunctional for the behaviour associated with it.

METHOD

According the model, having focused on the sequence that the patient uses, the therapeutic action will tend towards the modification of the dysfunctional sequence, so as to build up other functioning sequences on a behavioural level. In this way, using hypnosis, Lia got out of the tunnel of anorexia.

THE CASE

I met Lia in April 1992. She was 20 years old. Her body weight was 34 kilos and she had not period .

She elated only vegetable. When she weight was 56 kilos she had began a diet whiteout end. In her childhood she had been mute for a long period, and she wasbrought to a psychologist, a friend other mother. This psychologist asked Lia

This paper has been communicated the first Congress of the world Council for Psychotherapy Vienna-Austria Centre 30 June 4 July 1996

A case of anorexia solved with hypnosis

SEQUENCES THAT HAVE INFLUENCED LIA’S BEHAVIOUR

Sequence 1

1 – Mental representation of her mother’s gaze, which has as a meaning:

“You are not capable of being as good as we are”

2 -Voice that shouts You must succeed“, internal response “I will never succeed

3 – Fear that her incapacity can be discovered.

Sequence 2 utilized to modify the sensation of fear of the first one.

1 – The image in the mirror: Lia and her fat body beside her mother whose gaze has the meaning “You are not capable of being as refined as us

2 – Fear of being discovered as being incapable.

3 – Inner response “J must not eat” and “J do not eat or / eat and vomit”

4 Sensation of victory, more lightness and freedom

Lia in front of food:

1 – remember the image in the mirror and she asked herself “Do I eat or I do not eat ?

2 – thought of her thin body again and said to herself “I do not eat or / eat and vomit”.

3 if decided not to eat she felt capable. If she decided to eat and vomit she felt light and free.

SOME PASSAGES UTILIZED FOR HYPNOSIS, to obtain information and to modify the sequences

PASSAGES FOR THE FIRST SEQUENCE

1 – “Let us change the story” to look for a past experience and modify it.

2 – “Present, Past and Future “to look for resources, present or missing.

3 – “Let us change conviction” for the focalization on positive sensation, with the modification of inner hearing.

PASSAGES FOR THE SECOND SEQUENCE

4 – “Regression with dissociation-association” to search for the moment in which the substitution of the object of maternal disapproval: from intelligence to the body

5 – “Substitution of sensation in front of food after the anchorage to positive experiences”

6 – “Metaphors to determine objectives” –Tree -lift -clouds -mountain.

Therapy

I’m going to speak to you today about a method used by me on a patient

who suffered from anorexia.

My therapeutic work with Lia has been based on some presuppositions.

1 – Our senses are continually bombarded by images, sound, smell and sensations coming from the external world.

Our brain actis on the stimuli which arriving according to physical need,

predisposition and aptitude: these are communally being modified by the learning from behavioural and emotional responses

The flow of stimuli can come from external reality or from the. subjective representation of it : each of us has his own way of representing his own experience of the world.

The meaning that we give to the experience is determined by the sequence in which the stimuli are presented and by the emotional reactions that these sequences arouse.

These emotional reactions, that is anger, fear, depression and satisfaction, will urge the individual towards choices of behaviour which serve to utilize resources so as to decrease anxiety and increase satisfaction,

The sequences of images, sounds, sensations are recorded in the brain and produce “neuron ways”,

pathways that can became preferential passages of the electric message impulse.

The depth of these pathways is directly proportional to the intensity of the emotions, determined by the sequences.

Each sequence is reproduces at the repetition of old stimuli or its representation in the imagination, or of another stimulus that has some connection with the recorded sequence, and influences the behaviour.

For example, if a person remembers somebody that shouts and a door that slam, he can feel anger and pain which can be re-called to mind by another voice that shouts, producing a behaviour that is seemingly unmotivated.

If the sequence is changed, whether voluntarily or not, the emotional reaction will be modified.

The modified emotion will be the reinforcement that will facilitate the repetition of the new sequence.

While the change in the sequence will be functional to reduce anxiety. it may be dysfunctional for the behaviour associated with it.

Therefore according the my model, having focused that the patient un the sequence that the patient uses in place of the traumatic one, the therapeutic action will tend towards the modification of the dysfunctional ‘sequence, so as to build up other functioning sequences on a behavioural level .

In this way I helped Lia to get out of the tunnel of anorexia.

The time at my disposal does not permit the detailed reconstruction of the patient’s story. The salient points will emerge from my description of the hypnotic procedures used to understand and modify the sequences recorded in Lia’s brain.

During the trance, with the procedure that I call “Change story” Lia remembers an episode rom her infancy in which the mother, shouting “you must be the best”, pulls her hair, because she does not want to study.

She remembers that she thought “I will throw myself out of the window”. I ask her to change the scene and make it acceptable.

She visualizes her mother who kisses her and caresses her hair saying: <<Don’t worry>>

When I used the procedure that I call “Present, past, and future”, to look for a helpful resource, an experience emerge centred around Lia’s search for confirmation of the intellectual capacity; even when, in teality, Lia hated to hear the word “intelligent”.

Lia recalled that her grandfather encouraged her study by praising her.

With his support she felt successful, even though “ I felt was deceiving those who believed in my ability”.

Lia also recalled a time in her childhood. She had been mute for a long period and she was brought to a psychologist, a friend of her mother. This psychologist asked Lia to draw a picture of her family. Lia recalled the terror of being found out could not understand why she felt this terror.

It is likely that Lia reduced her anxiety by temporally changing a sequence, so as to become mute, but producing dysfunctional behaviour by eliminating sound, she decreased the sensation of fear.

Lia’s family demanded perfection, her father paraded his ability as a lawyer, and her mother did not conceal her desire for perfection, believing herself to be intellectually superior to everybody else: to have to live up to their expectations was a great strain for Lia.

Her conviction of her incompetence made her fearful of being found out.

Under hypnosis Lia’s experience in the present is to remember that her father always made her correct all her work.

Her frustration is replaced by a desire to rebel, to remain free to choose.

During the same session under hypnosis, the theme of the future experience was about her work. She says:” How strange! I do not care about my parents and I am surpassing myself>>.

Lia has two convictions about herself:

1- She believes that she is not very good at her work.

2 – She feels guilty that she deceived other people about her competence.

In the third procedure that I call “Change conviction” I asked Lia which one of these convinctions she wanted to change. She said <<the second one>>, her fear of being found out.

Under Hypnosis she remembers the feeling of happiness ad success when she passed her examination to become a lawyer. She thinks “the second one”, her fear of being found out.

Under hypnosis shr remembers the feeling of happiness and success when she passes her examination to become lawyer. She thinks “I can be successful”.

Let us focus our attention on the calm, smiling face, which shows competence and success.

I gave her to task of thinking of this image frequently when she is at work, so that the voluntary reoetition of the new sequence can become automatic.

Thus, the first sequence slowly begin to change. Whit the second sequence, her relationship whit her food is altered. The object of maternal disapproval here, is Lia’s body. Lia uses her body because she able to control her eating and this makes her feel successful and her mother to take care of her.

During the first procedure, which I call “Regression with dissociation-association” I asked Lia to take a jorney into the past. In this jorney, under hypnosis, I asked Lia to recall someof the sensations that she felt in front of food when she began to say”I must not eat”.

She rembered a trip that she had made whit her father to Nice, when she weighd 56 Kilos. And none of the clothes that her tather wanted to by for her fitted her well.

With her disconteded mother she looked at her fat image in the mirror. Then. In trance, she saw herself looking thin, with beautiful legs, black stoking and a mini-skirt, but she said “The obsession continued”.

Not even her thin satisfied her. She felt she was deceiving herself and others. The thin image cannot be real because it does not bring her contentment.

In relation to her problem with food the sequence was.

1 – She looked at the food and saw the fat image of herself when she weighed 56 Kilos.

2 – The confusion and frustration that arose from the conflicting messages “Eat not eat” made her feel uncomfortable.

Then she thought “either I must not eat, or I eat and vomit”.

Two positive sensations followed this: a feeling of strength and success if she did not eat or a feeling of liberation after vomiting.

My work is to change what Lia hears from “I must not eat” to “I can eat. I can get fat and then I can get thin again”.

During hypnosis, I used procedures, which stimulated Lia to recall moments of achievement and success, when she was able teat freely and make satisfactory choices.

I used metaphors in which I solved sequences, which helped, in different ways, to show Lia’s developing competence. Thus, she began to have confidence in herself and in her capabilities.

Slowly, Lia acquired the confidence and strength to leave her fiancé, and to begin a new relationship without sexual inhibitions.

Also slowly, her relationship with food changes: she eats a little of everything and her body weight goes up from 34 to 41 Kilos and her period returns.

Then she got married. When her husband wanted them to have a child she returned to me with violent bulimic fits.

I played a tape for Lia, ofmy voice describing procedures using metaphors. The fits disappeared.

While she expecting her child I prepared her for the birth using hypnosis.

In April of last year Francesca was born, a beautiful baby weighing 2,750 Kilos. Lia rang me up. I met her again and during a conversation she said “Trying on my clothes. I see that everything has returned normal, but I am afraid I will not be able to manage my life, with my job and the baby’s needs. This strikes fear into my heart”.

The old sequence has appeared again: “I might not be able to face the problem”, but now it is easy to neutralize it.

During my work with Lia I told her many stories, and now I should like to tell one of them to you.

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