Cerebral palsy, autism and hypnosis: a case Study.

"Mister Jim, would I like to be a hypnotist more than an engineer?" When Zach asked me that question, it was one of many real tugs at my heart strings since I began working with Zach and Justin.

I met Zach and his older twin Justin (older by about one and a half minutes) last summer when an occupational therapist was organizing a series of yoga lessons for children with autism and/or cerebral palsy. The therapist's concept was to put the children with cerebral palsy and/or autism in one room for yoga with whatever assistance was required and available, while the caregivers were in another room for a relaxing and de-stressing yoga lesson. My friend the occupational therapist asked me to assist with a thirteen year old male with a high level of dysfunction. Zach is wheelchair bound. He can move his arms but with very limited control. He had very little strength in his legs and what he had was not easy for him to control. For twelve weeks Zach and I did gentile yoga together. I helped keep him safe in yoga, helped him transition from wheelchair to a stool then to the floor and back. His brother who functions at a higher level had their physical therapist and helper work with him. The classes for the children averaged 8-10 students with 6-8 helpers. Zach learned controlled and relaxing yoga breathing and how to use his muscles as much as practical. While doing my best to help, I got to know a wonderful, intelligent, hard working young man with an infectious smile and a tremendous work ethic.

Over the next several months, my wife and l would see Zach and Justin occasionally, once at the IMAX Theater, other times just around town. Sometimes even though we did not see Zach and Justin, we would see their white van modified to carry two wheel chairs and all necessary support equipment.

In mid February, the occupational therapist introduced me to Karin, Zach and Justin's mom. We discussed her boys' accomplishments and some of the factors that were limiting her boys.

Both boys had a lot of pain. Both had many tears. Justin demonstrated his frustrations in outbursts of anger. Sometimes he struck his caregiver or his three year old sister. With this additional information, I suggested that hypnosis was very effective for most if not all fears and phobias. Hypnosis could always alleviate pain and sometimes eliminate it, and as anger is really just fear projected against someone else, I believed hypnosis could help manage and reduce his anger as well.

After getting a prescription from the boys' psychiatrist, I began to meet weekly with Zach and Justin.

I met with them in their home simply because it was easier for me to go to them than it was for them to come to my office. Not knowing what to expect, I started with two back to back individual sessions of about 30 minutes each. With few exceptions, we have met once a week since we began. As I was planning to work with Zach and Justin, I reviewed some of the scripts that Del Morrill has written and/or collected for children and adolescents. Reviewing what I had available, I learned how few inductions were appropriate for wheelchair bound adolescents. No walk on the beach, no descending the stairs at least not in their body suit. I found them both reasonably responsive to a modified Elman induction and elevator deepening.

Later I learned that Zach had frequent therapy riding horses and he really enjoyed his time on his horse. I also learned Justin was a very talented musician and composer. When I needed a little extra relaxation to deepen their trance, I would ask Zach to imagine the he was on his favorite horse and that he should just enjoy the ride with his conscious mind while his subconscious mind was listening to me. As we worked together one or both of us would say audibly "clipity clop" or some version of it. With Justin I usually would ask him to compose and play music while I communicated with his subconscious. As we worked together frequently Justin would be fingering an instrument (guitar or keyboard) or he would be nodding his head in time with his music. Sometimes I would ask about the composition and he would spontaneously hum a few bars.

As I worked with the boys more and more, I seldom used formal inductions. 1 would just instruct them, "Relax and follow your breath," or "count your breaths in some specific manner. This usually provided a light trance and I could use an ad lib deepening related to the work we intended to do that day.

Both brothers are required to get a lot of shots. Some of these shots are medications and others are vitamins. The shots are unpleasant and painful. In the second session I shared Elman's magic spot with both boys. It was an immediate success with them. From time to time they ask for explanations and reinforcements, but they now experience no pain with their shots. This simple exercise helped deepen the credibility of hypnosis in their minds and in the mind of their mother and their other caregivers.

During the first two sessions our main focus was pain control. Before the second session, their mother told me that she had heard Zach one night when he was in a lot of pain, ask his brother, "Pretend you are Mr. Jim and make my pain go away." When she shared that with me I knew we were going to continue to do very good work together. Now, both brothers control their own pain effectively.

After working with both boys on their pain control for two sessions, they both asked for help with their academic performance. I introduced sessions on self confidence, recall and testing. Both brothers were very impressed with the results. Justin told me, "Sometimes the correct answer simply stands out from the other answers on the exams. When I can't see the correct answer right away, I just go to the learning cottage, insert the correct disk in 'my computer' and I always remember the correct answer." Justin is on the honor roll.

At this point in the therapy I began taking different directions with Zach and Justin. Zach was going to have an operation. The operation was not complex, but it did involve general anesthesia. I emphasized:

1. His physicians were the absolute best in the entire world at performing this particular operation.

2. His surgeon has performed this operation successfully many times.

3. Zach knew how to relax and let the healing take place in his body.

Zach and I continued to practice slow even breathing and post hypnotic suggestions for peace, healing and health. His operation and recovery was smooth and without complication. Zach is being considered for a more complex operation. If he has this additional procedure, he will have to fly to another city. He was very worried, but for now he is convinced that his health care providers are the best there are and he will not worry about an operation that may never happen.

The next contemplated therapy with Zach is to do a joint session with his speech therapist. Zack is so motivated to do well in his work with the speech therapist that his extra effort has triggered gagging and spasms. The concept is that I can help Zack relax and relieve both his gagging and his spasms so the speech therapy will be even more effective. Perhaps I will report on our results in a future article.

Justin was exhibiting anger and striking out at his mother, his caregiver and his three year old sister. ! introduced Justin to calming thoughts and post hypnotic suggestions to maintain calm and peace. I reinforced deep rhythmic breathing and guided him in some behavioral change work and some parts therapy. MR. RAGE has been morphed into wimpy wussy rage that can be controlled, or easily excused from the scene.

Justin also has an anticipatory fear of loud noses. Part of the cause of this fear could be his very acute hearing (with perfect pitch) and part of this could be exacerbated by terrible eyesight (legally blind). Justin knows he has already controlled his pain, improved his academic performance, and replaced MR. RAGE with wimpy, wussy rage so he is a believer in the power of hypnosis. His job now is to be unaffected by Fourth of July fireworks. His mother and I are considering desensitizing Justin's anticipatory fear of loud noises with a "Mercury Living Presence version of Tchaikovsky's 1812 Festival Overture" with real cannons and musket fire. I will keep you informed.

While we started with two individual sessions of about 30 minutes each, depending on need and flow, sometimes individual work has been 45-50 minutes for one or the other brother or both. I have also had visitors in our sessions including one grandfather, two physical therapy assistants, and one caregiver. In general I welcome interested involved visitors unless one of the boys vetoes the participation.

The work with Zach and Justin has been influenced by everyone I have read or studied. While observed behavior of both boys has improved quite dramatically, the improved quality of life through hypnosis has been indirect. Hypnosis has helped the boys improve their self confidence, eliminate their pain, improve their recall and provide relaxation. The frequency and the severity of Justin's rage have been reduced. As these behaviors improved so did their quality of life. The boys, their mother, and their other caregivers have confidence in hypnosis and I hope to have the opportunity to explore other ways to improve the quality of their lives with hypnosis.

I have used hypnosis with other autistic children. This has been my first opportunity to work with children with cerebral palsy. This is the longest and most consistent opportunity I have had to date working with autism. I am looking for other opportunities to do similar work. We are having the yoga classes for special children again this year.

I am grateful for the opportunity to work with autistic children and children with cerebral palsy. My intention is to identify and work with additional children with autism and/or cerebral palsy and show how hypnosis can benefit them and improve their quality of life.

By: IMDHA Member--By James P. Ryan, C.Ht, Integrative Yoga Therapist, Ponte Vedra Beach, FL [e-mail]

A Short Tip From the On-Line Mentor Group

Re: more on bruxism 

Posted by: James Duncan, CHt, PhD(c) [e-mail]

Denise,

You might also use the "band-aide" technique I recommend at times while other issues are being unearthed. The direct suggestion would be to this effect:

"You now find that when you experience any stressors or stimulations that might possibly cause you to fall back into that useless habit of the past (you can even name it) you now find that the muscles and nerves in your jaw, neck and head simply forget how to move in any way that allows you to grind your teeth, either during waking hours or in your sleep. You know now that at any time you may be subconsciously or consciously inclined to grind your teeth that the muscles and nerves in your jaw, neck and head simply forget how to move in any way that allows that activity. You remember to forget and as a result you forget to remember how those muscles and nerves act in any way that allows you to grind your teeth ..."

You get the picture.

Blessings, Jim