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APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.
In Ericksonian Hypnotherapy for an Impulse Problem, Dr. Jeffrey K. Zeig demonstrates his approach to treating clients having problems with impulsive behavior. In this approach, the therapist creates experiences in therapy that increase clients' access to their hidden strengths that may be used to help reduce impulsive behavior. Hypnosis is used to heighten the client responsiveness and open up dormant resources. In this session, Dr. Zeig works with a 30-year-old woman with an impulsive spending problem to help her uncover resources she already possesses for resisting her financially harmful habit. This video features a client portrayed by an actor on the basis of actual case material. Precipitating Events A year before seeking treatment, the client, Elena, had moved from California to Arizona. In California, she had been depressed and overweight, and she felt at a dead end personally and professionally. She blamed her weight problem on her unrewarding, high-pressure job as a legal secretary and on her mother's overinvolvement in her life. She thought the geographical move would give her a "fresh start" and that perhaps she might locate her "lost" father, who was last known to have lived in Phoenix, where Elena was born. Once in Phoenix, Elena began working as a typist for a government agency, a job for which she was overqualified and that was consequently much less stressful than her previous position. She was able to lose weight, but as the weight dropped, she began overspending on clothes and cosmetics, eventually developing a significant credit card debt. With her credit cards charged to their limit, she began borrowing money from family and coworkers. She had also begun to compulsively buy lottery tickets, in hopes that a sudden windfall would solve her problems. Aside from her concrete problems with debt, Elena had begun experiencing sleep problems and frequently woke in the middle of the night fearful that everything was "out of control." She felt hopeless about her financial situation and eventually began having panic attacks at work. At the point she sought treatment, her creditors had begun calling her at work and at home, and her family and friends refused to bail her out financially. Questions
Notes on Previous Sessions Session 1: Elena described her problems with creditors and her symptoms of sleeplessness and panic. Dr. Zeig empathized with her anxiety, agreeing that her situation was difficult, if not desperate. He suggested that she was at a crossroads in her life where she must face her internal foibles—her "black beast." Her life could become a tragedy or she could confront and surmount her black beast, turning her life into a heroic drama. In passing, Elena mentioned that she had been deeply religious at an early age but had given up her faith when her prayers had not been answered. Later in the session, Dr. Zeig suggested that she was still waiting for a savior or a Santa Claus and that this was a noble aspiration. Too many people had lost their faith, he said, and she could serve as an inspiration to others. When Elena requested a second appointment, Dr. Zeig reluctantly agreed on the condition that she complete one of three assignments: (a) climb Squaw Peak on Saturday at 8:00 a.m., (b) spend 1 hour each day watching cartoons on television, or (c) buy cheap clothing from a secondhand store and wear them in public on Sunday. She was to choose the assignment that was most constructive and to speculate on the meaning of the remaining two. At the end of the session, Dr. Zeig asked her to ponder this riddle between sessions: "If Santa Claus and Julia Roberts raced from the North Pole to the equator, who would win?" Between Sessions: On Saturday, Elena went to Squaw Peak. She was about to quit half way up the mountain because the hike was very difficult. To her surprise, she met Dr. Zeig climbing the mountain with a priest, Father Marmini, who was visiting from Brazil. Dr. Zeig left Elena with Father Marmini, and the two of them climbed to the top of the mountain, talking along the way. Elena was exhilarated by the climb and the conversation, and by the end of the day she committed to attending church regularly. She and Father Marmini exchanged addresses and phone numbers for future contacts. When Elena arrived home, in the mail she found a copy of the Phantom Tollbooth by Norton Juster, a book that Dr. Zeig had mailed to her earlier in the week. Father Marmini called Elena later in the week and gave her the name of a local priest. Session 2: Elena reported that she was going to climb Squaw Peak regularly for her health because it made her feel better about herself. She had been thinking that she had been living a childish, second-class life and that she no longer needed to live that way. She had not overspent during the week and had not even bought a lottery ticket, which was the first time she had been able to do that in months. Dr. Zeig chided her that she was changing too fast and suggested that she find a way to spend a little too much money in the next week. When Elena tried to answer the riddle posed in the last session (she thought Santa Claus had won the race), Dr. Zeig told her that Julia Roberts had actually won, "since there ain't no such thing as Santa Claus." The remainder of the session was spent exploring Elena's resources. She loved children and dogs and was particularly fond of plants, which responded well to her care. She spoke perfect Spanish and was becoming interested in religion again. In response to these interests, Dr. Zeig loaned her a copy of The Alchemist by Paulo Coelho. He also provided her with a copy of the workbook Mind Over Mood by Breenberger and Padesky, from which she would complete assignments between sessions and discuss them with Dr. Zeig during sessions. Dr. Zeig also gave her the name of a local nonprofit Christian organization that offered relaxation training. In response to Elena's stated desire for a pedigreed dog, Dr. Zeig suggested that when she was ready, she could go to the pound and find a good dog. Between Sessions: Dr. Zeig mailed to Elena a postcard that read as follows:
Elena carried the card with her in her purse. Session 3: The majority of the session was dedicated to trance training. Elena was an excellent hypnotic subject. They discussed her goals for therapy and for life. Dr. Zeig and Elena agreed that she would come for seven more sessions and that if she needed more sessions at that time, they would renegotiate. Toward the end of the third session, Elena reported on her progress. She had continued climbing Squaw Peak, and a man she had met there had invited her on a date. She had worked on some of the exercises in Mind Over Mood and had signed up for a course in relaxation training. She also had begun to attend church where she had signed up as a volunteer at the day-care center that served disadvantaged children, an activity she was finding very rewarding. The church also had connections with a credit service that would help her with her finances. She had bought a few plants and had also found a small dog at the pound, which she had adopted and was enjoying. Finally, Elena had found a new place to live with an elderly childless couple whom she met through church. She would receive lodging and a small supplemental income in exchange for helping them with household chores and other activities they could no longer do for themselves. This in turn would help Elena to reduce her living expenses so she could begin to pay off her debt. Dr. Zeig suggested that whenever she felt like spending money, she could walk the dog or pull the leaves off of her favorite plant, observing whether these activities made her feel less anxious. Elena noted that in the next session she wanted to work more on her impulsive behavior, fearing that she might begin to overspend and overeat unless she understood herself better. She wondered whether there was a tie between her impulsive behavior, her fantasy life, her depression and anxiety, and her low self-esteem. Session 4: To be viewed. Questions
Stimulus Questions About the Session Dr. Zeig begins the session by pointing out what Elena wishes to accomplish and reminding her how she has been more in control during the past week. He reframes her doubt and ambivalence as "curiosity" and "therapeutic commitment."
Dr. Zeig reflects on Elena's "scare" of becoming fat again by means of a humorous metaphor about "spreading out." Elena acknowledges his reflection with a knowing smile.
Elena denies that her impulsivity is an "heirloom" and denied that her mother experienced similar problems in this regard. Dr. Zeig, knowing differently from preceding sessions, smoothly corrects Elena without drawing attention to doing so. Elena then tries to reassert that her mother was not impulsive, but Dr. Zeig corrects her gently on each occasion.
About 20 minutes into the session: Dr. Zeig carefully explains and directs a two-chair experiment between Elena's active impulsive side and her healthier but passive side.
During one point in the experiment, Dr. Zeig asks "Eleanor" to change chairs with him and speak face to face with "SLAGI."
Dr. Zeig acts out a scene in which he dumps a number of books in Elena's lap.
About 35 minutes into the session: Dr. Zeig returns to the trance work he and Elena had begun in the previous session. Most people experience his style of hypnotic induction as smooth, soothing, and nonintrusive, but many comment that this was not what they expected of hypnosis.
During the course of the session, Dr. Zeig has suggested three homework assignments for Elena: (a) continue the dialogue between the different "parts" of herself, in an attempt to balance their needs in a complementary fashion, (b) lavish extravagant complements on other people, and (c) make up stories and tell them to others. Elena appears to accept the first homework assignment but appears to be more reluctant about the second and third assignments.
Throughout the session, Dr. Zeig extensively uses vivid metaphors and stories, drawing them from a variety of sources such as biography, song lyrics, postcard messages, humorous anecdotes, and family games.
General Questions
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