INSIDE GLORIA’s PSYCHE
Let me begin by being honest about my personal bias. I dislike, no abhor, psychiatric jargon and diagnoses, along with long-winded case histories presented in graduate schools or grand rounds of a mental hospital. They sound solicitous and scientific, and sometimes unintentionally the diagnoses and presentation take the human out of the human being. These diagnoses tend to bias the doctor’s perception and attitude, let alone the students’, towards the person discussed, reducing him or her to an commonplace pathology—no longer a living, breathing person but an ill patient requiring treatment.
Moreover, in Gloria’s case, she had received multiple and different diagnoses by trained mental health professionals who could not agree on her diagnosis. Gloria appeared like a living, walking “Rorschach” ink blot test that had confounded them as they tried, in vain, to project their well meaning interpretations on her. However, the medical model of psychiatry, I know, has value and its place in treating the actual imbalances in brain chemistry; and such was the case with Gloria whose fleeting psychotic episodes were treated effectively with small doses of Zyprexa, while the core of her psychological suffering had yet to be exposed. If her treatment had ended there, she would have only been remembered as a case number or, worse, ended up a psychiatric casualty.
I being a card-carrying pragmatist chose an empirical hypnotic approach—sometimes flying by the seat of my pants—yet always utilizing what Gloria offered me, her traumatic experiences, intelligence, awareness, insights, and yes, her troubling symptoms to help heal her. My only theory was that her symptoms were the spearhead of an underlying corrective emotional experience struggling to surface which terrified Gloria, yet was the key to her recovery and healing. Here the art, skill, and understanding of the complexity of healing would take precedence over diagnoses, medicine, and scientific approaches to behavior change. A colleague chided me about my approach saying, “I had tossed caution to the wind.” But on thoughtful consideration, I could not help but chuckle at his outrageous warning.
By the time Gloria was referred to me, she had been diagnosed as suffering from a rogue’s gallery of major mental illnesses including Schizophrenia, Bipolar Disorder, Atypical Psychosis, and Paranoid Psychosis. It’s a wonder she hadn’t wound up lost on some back ward of a state hospital doing the Thorazine shuffle.
An old chum of mine just happened to be Gloria’s family physician and referred her to me saying Gloria had difficulty falling and staying asleep due to recurrent nightmares. She had reported what sounded like visual and auditory hallucinations about a girl upstairs who she thought was trying to scare and hurt her. He said she was exhibiting other strange behaviors, yelling at the upstairs neighbor and wandering around the neighborhood in the middle of the night, disoriented to her surroundings; and she had recently been found in a confused state collapsed on a pile of snow just outside her apartment. He said she was abusing her sleeping pills and, though a lovely lady, she was a handful and wished me good luck.
Prior to Gloria coming to see me, I had left her plethora of diagnoses and reports on my crafts table tucked inside my DSM-IV diagnostic manual that I used for pressing garden flowers. When Gloria came in to see me, I was struck by her small stature and thick auburn hair that hung lifelessly around her drawn moist face. She looked like she hadn’t sleep or seen the light of day for some time. She looked haggard.
What held my attention was her large, prominent brown eyes that displayed fear and dread. She was emotionally tense and expressed strong ambivalence about seeking help. She spoke incessantly with pressured speech about her anger at her doctor for thinking she was crazy and, worse, she feared I would. She described feeling like a concentration camp survivor who no longer had any meaning or purpose in life and anyone left who needed her. She expressed deep discouragement and hopelessness about her life and felt she had lost her will to live. However, she denied suicidal thoughts.
Gloria was beside herself with fear and anger. She irately complained about a girl above her head, in the upstairs apartment, who made alarming noises: clicking, stomping, banging sounds that disturbed her sleep and terrified her. She further complained that she had visions of wild animals on her ceiling that frightened her in the night. She expressed her fear that she would go insane if she knew she was imagining the noises she heard.
Despite her damning diagnoses, her distraught presentation and apprehension that teetered on panic, I had an overwhelming hunch there was something more beneath her panicky condition. I was most concerned with her mounting nightmares and dangerous sleepwalking episodes. However, because of her desperate emotional turmoil and inability to reflect on her experience with me, I decided to hypnotize her. I felt hypnosis would facilitate rapport and trust, on a deeper level, and help establish a good personal relationship with her. Given her combative stance, which reflected her deep-seated fear that I would think her crazy, I felt her unconscious offered the best solution to our budding conflict and impasse. The absurdity of my own anxious reaction to Gloria’s rising panic would only strike me funny later.
I told Gloria I understood why she was upset and reminded her I was a hypnotherapist. I asked her if I could help her relax and that she would not experience or express anything she didn’t want to. I emphasized that I would protect her so that she wouldn’t experience too much distress or emotional discomfort at any one time. This simple suggestion seemed to calm her and she agreed. Her body’s response to trance was palpable as she slumped relaxed in the chair. She was a virtuoso hypnotic subject and perhaps this was the source “spontaneous trance” of her unexplained and bizarre symptoms and behavior.
Gloria was a deep hypnotic subject and I immediately accessed her unconscious that called itself the “Helper” that stated she wanted to help Gloria. She began to describe traumatic childhood experiences in disjointed sequences that Gloria had suffered. She said they were responsible for Gloria’s terror, strange visions, and erratic behavior. The Helper had access to knowledge and information beyond Gloria’s conscious awareness. She also was able to observe and reflect on Gloria’s inner experience and behavior with penetrating objectivity. She said that Gloria was giving her trouble because she was resisting and afraid of change, and that she was remembering the past too fast and becoming terrified and emotionally too fast and becoming terrified and emotionally too fast withdrawn. She emphasized Gloria saw no reason to live and wanted to die because she was afraid to love since she equated love with pain.
Here, in our first contact, Gloria’s Helper began to outline Gloria’s psychological crisis and some of the difficulties that would lie ahead, for both of us, to reach and help Gloria. Because Gloria’s nightmares were the focal point of her terror and emotional disturbance and her emerging awareness of her underlying trauma, I suggested to the Helper that when Gloria awoke from a nightmare that she put Gloria in a trance and write down what was terrifying her, rather than Gloria being trapped in a confused state of arousal that caused her to rave at her upstairs neighbor or sleepwalk. I wanted to thwart any further perilous behavior and events. The Helper was receptive to my post-hypnotic suggestion and felt she could carry it out. At the conclusion of this session Gloria awoke feeling more relaxed and without any sign of pressured speech, fear, anger or panic that she had presented with. A good outcome, I thought.
However, intuitively I felt Gloria’s therapy would be like a combat soldier, on hands and knees, deftly placing a knife in a mine field’s dirt, then gently probing to get through the maze of mines without getting blown to pieces. Likewise, I had to be vigilant not to plunge her further into madness or suicide.
In our following session Gloria arrived looking perplexed holding a sealed envelope addressed to me, stating that she had found the envelope in her home but did not know who wrote it or how it got there. She brought it to me because it was addressed to me. I reassured that she had done the right thing and should bring any further letters to me. She accepted this suggestion without question.
This odd but critical development in our relationship Gloria seemed to intuitively trust. Thus began her hypnotic dream therapy and our quest. Over the strange course of her healing journey with me, she would bring me 202 sealed letters that I would read and then conduct her hypnotherapy. Amazingly, Gloria never read one of them or ever asked what was in them. She had put her entire trust in me—had put her life in my hands— from the first day we met.
Dr. Adam Jaxon