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Vol.
8 No. 1 March 1987 ABSTRACT A great deal of verbal direction is necessary in many forms of psychotherapy and hypnosis as patients with psychosomatic symptoms often tend to dominate therapy at times by insisting on describing the symptoms and speculating on their cause to the detriment of the therapeutic situation. This is quite a natural phenomena, because of the patients’ preoccupation with symptoms. Autogenic training introduces the relaxed state of hypnosis with the standard autogenic training steps and this provides a form of guidance to the patient. The therapist expresses trust and confidence in the patient’s “hypnotic abilities” and the patient is encouraged to do his or her best. In this manner it becomes possible to promote in the patient certain self normalising functions which are directed and co-ordinated by the brain. It is possible to postulate that these include the return to self-normalisation of the specific organs involved in the psychosomatic condition for which the patient has presented himself. It is beneficial to explain to the patient that autogenic training is a form of both guided from the outside by the therapist and also patient assisted self-hypnosis. Standard autogenic training procedures provide the necessary structure and in turn the images to be suggested are predicated on the anatomic details of the psychosomatic condition or organ system to provide the strived-for self normalisation. By providing the patient with accurate anatomic descriptions and references for the images to be conjured up helps to raise the patient’s confidence level as they know the suggestions are scientifically accurate. As a result the patients respond better. The average patient has only a marginal insight into the fact and ramifications that we live in an age of anxiety and stress, although often they do perceive that this does perhaps exist in our cultural society at large. However, it is important that they comprehend that the therapy situation is quite unique in that it is protective, supportive and conducive to good patient participation. I have found it to be advantageous to tell patients that when we take three deep breaths, we should tell our brain that all tension has faded away and that we are very relaxed – and then have the patient do so. It is extremely vital in the case of psychosomatic disorders that the patient understands that he will feel and be assisted by a large degree of therapeutic structure during the therapy session.. METHOD The autogenic state is characterised by a variety of physiological changes; for example the progressive increase in skin temperature corresponding with changes of blood flow and so on. The possibility of using autogenic training specifically aimed at psychosomatic conditions was suggested by Schultz when he hinted strongly at the possibility of incorporating suggestions to the organs as part of the autogenic training process. However, possibly as a result of the historical flow of events and of his success with the standard form of autogenic training, he left it to others to explore and to expand into these areas. Further, the technique of combining autogenic training with specific suggestions relating to organs involved in psychosomatic conditions represents the opportunity to capitalise on the psychoanalytical method of free association. As a result it should be explained to the patient that additional thoughts which may frequently occur are to be stored for further explanation after completion of the formal induction procedure. In this way thought intrusions become therapeutic. CASE
HISTORY The patient was then given suggestions to concentrate on a sense of heaviness in the area of the skin tissue on his face and upper back which were the primary areas of complaint. In order to assist him with enhancing the feeling of heaviness he was told to transfer this heaviness to these areas from other parts of the body affected by the earlier autogenic training. Eventually he was given the repetitive suggestion that shortly after he awakened his body and mind would work together and be ready to respond to the suggestions that the affected areas of the skin would clear. At this point additional reinforcing suggestions were given that later his skin would begin to appear quite normal. Each suggestion was repeated several times and with the encouragement to concentrate on the organ areas and to accept the suggestions positively. One of my suggestions to him was that “the blood flows so much easier through those regions providing more needed oxygen and nutriments thus alleviating this condition for you.”. RESULTS In the fourth and final session the patient indicated thorough satisfaction with the treatment. His skin surface confirmed very good to almost total recovery of the reported condition except for some scar tissue of long standing. This case history, then clearly demonstrates a method that has yielded excellent remission from a severe condition of acne. The advantage of the treatment method is that it approaches the psyche of the patient through the demonstrated benefits of relaxation techniques that are part of the steps of autogenic training. The particular application of autogenic training in combination with therapeutic suggestions were selected because of the structure and proven benefits of such a technique. In other patients treated with this method there has been some degree of diversity of psychosomatic symptoms, varying from mild muscular tics to functional hypertension. It is also noted that the deepening techniques implemented seemed to be particularly effective. Erickson has said so well that “with the use of hypnosis and the semantics that are an integral part of it, we strive to accomplish health by the use of words that heal.” REFERENCES |