The Elman-Turner Induction: Making hypnotherapy easier, self-hypnosis and other good stuff

In this entry, I'm going to address the most common protocol I use, the Elman-Turner Induction.

Here's the short of it
There was this hypnotherapist (and all around interesting character) named Dave Elman. He developed an induction -- a protocol for helping someone get into a hypnotic state -- that works pretty consistently and makes it pretty easy to go to different "levels" of trance state.

Then another hypnotherapist and student of his came along, Maureen Turner, and she added anchors to the induction, making it considerably easier to return different levels of trance state.

Voila. The Elman-Turner Induction was born!

I learned this process from Maureen Turner and find it immensely helpful for a variety of situations.

Why this is helpful
When I recommend we do the Elman Turner Induction to someone, it's for at least one of two reasons--usually both.

First reason: they could benefit from having more relaxation skills or inner resourcing.
Because the protocol makes it easy to do self-hypnosis, I often like to use it with people who could benefit from having more control over their emotional state.

Second reason: they are coming to me because there's some deep hypnotic work they want to do: maybe deal with a phobia or work on some trauma, or something else that requires going deeper than might be easy to do in the average guided meditation or visualization.
The Elman-Turner Induction offers a relatively clear way to "go deep" and know where you are. It also makes it faster to get back to deep hypnotic states using the same anchors that allow it to be useful for self-hypnosis.

Anchoring
In practice, the Elman-Turner Induction involves me helping someone get into progressively deeper levels of therapeutic trance. I say me helping because I can't "make" anyone go into trance (hopefully that's clear by now?) But if someone wants to go there, I can help. So, I help someone go into progressively deeper levels of trance and then we do the anchoring.

Anchoring is a term from Neurolinguistic Programming. Basically, what it means is something like bookmarking a psychological state or feeling. Why would you bookmark it? So you can get back to it easily, like you might bookmark a page of a book or a website that you want to return to.

Usually I propose we anchor/bookmark four states of progressively deeper relaxation, though depending on circumstances, we might do more or fewer. The basic four are relaxation states--the first one is a calm state, like sitting on your back porch or in your living room, or hanging out with a friend. The second one is a more deeply relaxed state, like being on a nice vacation or being out of school for the summer--not having anything you need to worry about.
The third and fourth are even deeper levels of somatic relaxation. Because therapeutic hypnosis involves deep relaxed states, the anchors can be used to aid with going into deep hypnotic states just as easily as they can be used for run-of-the-mill relaxation during the day or for falling as asleep at night. The four anchors correspond to Dave Elman's "map" of the levels of hypnotic trance state. While it can be very difficult to describe and pin down "levels of trance," Elman's map is a convenient and practical guide.

When I do the induction with someone, I typically give them a "cheatsheet" afterward that explains what to do to "pull the anchors"--to use the bookmarks on their own. The anchors won't cure a problem, but they are a tool that someone can use to tell their unconscious mind, "hey--now it's time to relax." Literally, it gives someone a tool to say, “relax 1 - calm” and feel that sense of calm. If you or someone you know has struggled with severe anxiety or another run-away unconscious process, you could probably see how this tool could be pretty life-changing. For serious issues (like the abovementioned phobias and trauma) this is a powerful first step.

After I do the Elman-Turner induction and the client comes back for another session, we use the anchors as an induction— as a way to go into deep enough hypnotic trance to do whatever hypnotic work that the client and I have planned. While the Elman-Turner Induction we do the first time takes 30-40 minutes, using the anchors it only takes 5-10 minutes to return to the deep hypnotic state we got to the first time, letting us focus on hypnotherapy for the rest of the time.

edited.jpg

Sometimes people ask more about this anchoring stuff and how it works. The short of it is that anchoring is very common— common enough we don't pay attention to it most of the time. Say, for instance, you have a job where you have to answer an office phone. Over time, your mind learns that when the phone rings, you divert your attention from other things, maybe you modulate your voice so you sound professional, or even unconsciously reach for a message pad and a pen as you pick up the phone receiver. This is an anchor. Like a behavioral conditioning situation but with clear unconscious involvement, your unconscious knows that phone ringing means going into “answer the phone mode.”
Most anchors are set by repetition, including most of the stuff in NLP literature about setting anchors for good or bad. The only special thing about what we're doing here is that in deep hypnosis, anchors don't need repetition: we can set an anchor once and it's there whenever you want to use it.

Also, sometimes people are concerned that the anchors could be abused or create problems, as if they could give someone else control of your mind. This isn't the way they actually work because hypnosis isn't mind control. Also, I always do this in such a way that only you can pull your anchors, not anybody else. Even when we do it in session, it's you that's saying the cue to yourself.

Actually, the only danger is that the relaxation anchors can work too well, causing people to be too relaxed in situations that it's not a good idea, like driving a car or operating a meatslicer or a chainsaw. For this reason, I always tell people to avoid using the last two anchors unless they can rest with their eyes closed, and to avoid even using the first two if they're in a dangerous situation or one that requires strong alertness. Typically I’ll even include in the anchor-setting process suggestions that the anchors can only be called "when it's safe to do so."

In the next entries, I'll talk more about specific problems that someone might come and see me for and how hypnotherapy could help.

How to make your therapy go further...

Dear readers,

My apologies for blog radio silence for a few months. I've been having a period of reading rather than writing, learning rather than teaching--of taking in rather than putting stuff out there.

I've been researching primarily based on a question that has become a major area of interest for me: what kinds of activities or practices best augment psychotherapy? One very straightforward way of expressing the question I've been asking is:
Someone comes to therapy and spends money on it. What can a person do in between these 1-hour-a-week sessions to get the most benefit from that hour?
Or even more straightforward:
What can I tell my clients to do to make therapy work better?
Or really bluntly:
How can I make sure clients are getting the most for their money?

There are some great classic answers to these questions... Here are a few:

Contemplation and Creative Expression

For a long time, it's been clear to therapists like me that pursuits like art, writing, talking about personal stuff with warm friends and other forms of introspection, self-reflexion and self-expression help. What works best depends on the person. Some people draw or paint. Others write. Journaling is great. I often even just encourage people to have a white board they write things they're thinking, their goals, dreams, ideas. In a busy world, this helps a person focus on what's really important.

Exercise

Likewise, research suggests that for mild to moderate depression and anxiety, different forms of physical exercise may actually be the most effective intervention. Oriental medicine chimes in that moderation is key.

Medication

Likewise, In some cases, taking a good medication is an indispensable adjunct to therapy: if someone is in such rough shape that they can't focus during therapy sessions or can't look at what's happening easily, therapy won't go far. It's like trying to have an important conversation with loud music on: first thing to do is turn down the music. Of course--in my view anyway, the long term idea is to eliminate (or at least significantly reduce) medication. 

Bibliotherapy

Sometimes I will recommend a book. This can work in a number of different ways. The most straightforward way is that I might recommend a book that talks about some of the issues we're talking about in therapy, or which connects to a technique we're using. I recommend some books on my website. Feel free to check them out.
Sometimes, I'll also recommend a book that's less straightforward. For instance, I might recommend a fiction book or a book of essays. When I do this, I'm usually thinking about a client's need for a certain kind of psychological nourishment. If this sounds woo-woo, you should take it literally instead of figuratively: just like our bodies need good food, so do our minds. A good story provides nourishment. Put another way, reading a story can make someone feel less alone, or it can give someone strength, or even provide a map for how things could work out. This is necessary sometimes. Just like a person needs good food to heal from a physical injury or in order to gain muscle, a person needs good psychological food to recover from a psychological injury or to grow strong psychologically. Actually: good (physical) food helps a lot too.

Continuing the session...

There are also some more subtle things: one of my favorite therapists and I would often talk about the process of internalizing one's therapist. Or as I sometimes frame it to my clients: "even though you have to leave my office, you should take me home and continue therapy by yourself. Think about what we've talked about. Continuing talking.  Imagine me responding. Then, when you come back, tell me about our conversations."

What this really speaks to, of course, is something we all do: we rehearse and imagine conversations with people. If you have a skilled therapist that you like, no matter what kind of therapy you're doing, you'll probably find yourself doing this.

Rather than proof of some kind of psychotic process, this is a good thing (as long as you're aware your therapist isn't actually in your head). What you're really doing is continuing the session. When you come back and talk about your conversations (as I suggest) you're honing your internal imagine.

Effectively you're crafting your own internal therapist--one not limited to a regimented hourly schedule. And isn't what anyone who felt alone with a world of hurt has always wanted?--someone with wisdom and caring closer than their own nose?

More soon...

One of my major interests, of course, is meditation and other mental practices as an adjunct to therapy. I've studied mindfulness based approaches in great depth over the years. Likewise, of course, loving kindness (metta) practice, after which this blog is named. There are (of course) other practices.  I will write more about some soon. 

Home Practice?

I want to write today about home practices.

Home practices are "homework" I give as an adjunct to therapy to make therapy more effective.

I would say "to make therapy more efficient" but efficiency is a tricky idea especially when it comes to mental health: sometimes things change fast and sometimes slowly when it comes to mind. So efficient mental health care is elusive. But effective therapy--therapy you can look back on and say, "I got something out of that!"--that peaks my interest and is something I've been studying and thinking about for a few years now.

In a nutshell, home practices are activities, exercises or guided meditations I recommend people do when not in the office with me. One premise of this is simply that one hour a week (on average) of meeting with a therapist, though helpful, is not that much time. Anything that bolsters it is a good thing. 

I've been particularly interested in meditation practices that augment therapy.

There have been a number of studies over the last 20 years that document meditation's helpfulness when working with particular mental health issues. In certain cases, such as with Mindfulness Based Stress Reduction, an eight week course that utilizes mindfulness meditations as part of a program to manage stress and promote well being, the results have been quite dramatic.

The exploration of home practices has really just begin, though. The MBSR program, as amazing as it is, only uses a small portion of the array of mindfulness practices that exist. There are a number of others out there that are also potentially helpful.

Even the realm of mindfulness meditations is restrictive: though certainly a kind of "gold standard" for mental health promoting meditations, these meditations aren't the only type of helpful meditation out there. It's worth noting that just because one particular style or category of meditation helps one person, it doesn't mean it will help another.

The application of mindfulness to every mental health problem is like taking tylenol for every kind of physical illness. Though no one would argue that tylenol isn't helpful, it's not going to help everything. Traditionally, different practices are given to different types of people based on temperament and problems. As we learn about meditation in the West and apply it to our problems and our ways of understanding, we're learning how to do this.

Along with mindfulness practices, I've also been particularly interested in compassion practices (another heavily studied grouping of Buddhist meditations), and in what I call hypnoyogic practices--yoga nidra and forms of guided imagery--for their usefulness in augmenting therapy. All three of these groups of practices are forms of practice that are part of ancient understandings of how to work with the mind. 

What I've noticed is that people who have been willing to embark on the adventure of some of these practices are finding their therapy more effective. When I've discussed these practices with other therapists, I've gotten similar reports: those who do and stick with the proper practice do get results. 

You may notice I stuck the word "proper" in there. Really, this just goes back to the tylenol metaphor: what works for one person with a particular problem won't necessarily work for another person with another type of problem. I used to think that doing any kind of meditation practice was better than doing no practice. And (and not to contradict myself entirely), there is truth to that notion.  But there definitely cases where an expert is handy. I think anything where a clinically significant mental health issue is at play is a situation where it's best to consult an expert.

Of course, personal preference (and a host of other factors) also should be noted here.

Some people, for whatever reason, do not want me to give them home practices. This is okay. Therapy on its own is also a powerful practice for working with the mind. (If it weren't, I wouldn't be in this field.) Some people also have trouble making time in their schedules or find it difficult to take the risk on these sorts of adjunctive practices. This is also understandable.

That said, meditation isn't just about sitting on a cushion. Back to my old favorite, loving kindness (metta) practices: after you know how to do it, I think metta is just (if not more effective) to do out in the world: while driving, walking, shopping at the grocery store or waiting for a bus. Give it a try. It doesn't take any extra time--you just do it while going about your day.