Dealing with what emerges: pain control in the church pew.

Dealing with what emerges is not limited to the office sessions. As an opportunistic hypnotist, I don't always get summoned to serve in the ideal office setting. I like to deal with what emerges in whatever situation. In this article, the words in quotes are my memory of what I recall hearing and saying. The subject, Leo, is an AIDS patient who insisted that I not disguise his identity.

We were seated in the second to the last pew at the church. The first pews had already filed up for communion. Leo said, "I'm having pins and needles in my legs." The emergent opportunity appeared to allow sufficient time for a rapid intervention. I wanted more information, and slipped into uncovering, "Neuropathy? Is it a pins and needles feeling like when damage is being repaired, nerves are growing back, nerve damage is being repaired, or is it a painful feeling that feels like something is being damaged?"

"Pins and needles."

No time for further uncovering to help me formulate direct suggestions, the ushers were getting closer. I slipped into direct suggestions that emerged intuitively based on my experiences working with other folks seeking healing, pain reduction, and repair of nerve damage.

"Every time you notice those feelings, you become aware that something is cleaning you out. There is something moving through your nerves healing, cleaning, and processing, getting rid of all things other than you. Everything that needs to be removed, all things other than you, all viruses, parasites, and bacteria are being swept out, removed. Every time you notice those feelings, or feelings like that, everything that needs to be removed, things other than you, are being swept out of the body. All viral and bacterial things being removed are part of the process of healing. Every time you notice those kinds of feelings, you become aware that something is happening inside. Those feelings remind you that the immune system is being restored, improved, and healed. Nervous, lymphatic, immune and gastrointestinal systems are being restored, improved, and healed. Mind, body, and spirit are being nourished, restored, and healed. Every time you notice those feelings, you become aware of the feeling of angels' wings sweeping you clean, cleaning you out, and restoring your health."

He leaned in closer on that last line and said, "What?"--I repeated that concept, "Every time you notice those feelings you become aware of angels' wings brushing you out, cleaning you out, cleaning your nerves, immune system, lymphatic system, digestive system, brain, mind, body and spirit."

My first practice with double binds was in 1985 when I took the first certification course and learned to elicit eye catalepsy. "Now close your eyes and relax them to the point where they just won't work. Once you have relaxed them to the point where they just won't work, test them and find that you have been completely successful. They just won't work no matter how hard you try. The harder you try, the less they work."

Later in my hypnotic education, I observed a live case demonstration in which a double bind was used to diffuse a client who began exhibiting potentially violent behavior. During abreaction, the client balled up and bowed up on the therapy chair. It looked like an assault was imminent. Adouble bind, direct suggestion diffused the danger for the hypnotist, "The tighter you get, the more you relax." The client's entire body relaxed abruptly, and then went through several repetitions of resumed body tension with clenched fists, bowed body, and sudden relaxation.

After church, I asked Leo how he was doing. I did not ask, "How are you feeling?" I asked. "How are you doing?" This is a deliberate strategy to avoid elicitation of the kinesthetic pain response. He said that the pain went way down as soon as he stopped fighting it.

If I had done this intervention in an office setting with more time, I would have established a more explicit measure of pain and greater detail about the "pins and needles." To measure the pain, I would ask, "On a scale from zero to ten, with zero representing no pain, and ten representing the worst it has ever been. Where is that pain?"

A post measure after intervention helps me and the client determine the efficacy of the intervention used. I would want to elicit the client's own words to give me more details about the "pins and needles". A simple request for detail is, "Tell me more about that." If the client had difficulty articulating more detail, I offer forced choice questions, "What color, shape, and size is it? Is it moving or still? Near or far? What is its function? What purpose does it serve? What kind of voice does it have, if any? If it had a voice, what would it say? What color eyes does it have, any? What will you be able to do when you are successfully beyond this that you cannot do now?"

The reason I used a double bind, post hypnotic suggestion is that Leo's "pins and needles" are part of a progressive neuropathy. He will encounter these feeling again. Without a positive reframe, the perceptions of pain can pull a person into the vicious pain cycle of pain causing fear which amplifies the pain. I interpreted Leo's expressed, emergent need to be for an intervention that would address both his immediate and cumulative needs. I do not seek to help clients run or hide from, reject, or fight with pain. Pain is a friend. It lets us know something needs help. Engaging pain as an ally can help stimulate and amplify a healing process. Working effectively with pain patients requires service providers to recognize and seize emergent opportunities to stimulate and amplify the client's innate healing capacities.

Monica Geers,--Key West, FL

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