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Hypnosis and Super Heroes

Dr. Jan Mark Burte - Articles and Publications

by Jan M. Burte MSCP, Ph.D.

 

Introduction

 

From the time that we are very young, fantasy is a crucial part of our development. We are taught and intuitively seek out fantasy characters to model ourselves after. It is part of our character formation and part of our self image. However, as we get older we also get the message that overt behaviors, such as running (flying) with a towel pinned around our neck through the house as Superman is no longer acceptable and so we take it under cover and hide our super hero abilities beneath our more mortal disguises. We create covert fantasy in order to maintain those identities a little longer. In essence, we become legends in our minds. This is where hypnosis becomes such a powerful tool. In hypnosis we are again returned to using fantasy as a coping mechanism and for character development. We give ourselves permission to be both Superman and Lex Luthor. Interestingly, in hypnosis patients who are caught in their own negative self hypnotic statements, find it easier to identify themselves as the super villains like Darth Vader or those with negative characteristics such as The Hulk. After all, in hypnosis you are “not responsible for what your mind chooses.” Because of this I have found in my practice of hypnosis that utilizing superheroes and supervillains represents an incredible resource for fostering self examination, change and growth.

 

In this chapter I hope to detail some of these areas, offer a suggested techniques, a few caveats along with vignettes where superheroes have been especially helpful. I intend to discuss how hypnosis utilizing superheroes has been shown to be an effective tool in treating pain (Burte 20002, Burte 2004), in enhancing psychoneuroimmunological interventions (Burte 2002), bolstering ego-strength and overcoming trauma. I will focus this chapter on these three areas of pathology though the use of superheroes in hypnosis can encompass a much broader scope of clinical issues. For children, any condition treated with hypnosis can utilize superheroes as part of the metaphorical or storytelling techniques’ employed. For adults, a range of conditions such as performance anxiety, insomnia, panic and anxiety disorders to name a few, have shown their amenability to utilizing superhero characters in treatment. For adults, superheroes may at times include those we typically identify from contemporary literature or those from more biblical or classical sources of literature. Mythological super heroes are an ingrained part of adult self-concept.

 

About Hypnosis

 

Before introducing the use of super heroes in hypnotherapeutic interventions, it may be helpful to entertain a brief discussion of hypnosis, especially in how it applies to patients who are experiencing pain and various other medical conditions.

 

The induction of hypnoidal states via breathing exercises, Yoga and chanting has historical as well as most likely pre-historic roots. Were our earliest ancestors entranced by the wall paintings and stories told before the flickering lights within the inner recesses of their caves? However, clinical hypnosis can be directly traced back to John Elliotson (1792 – 1869), an English surgeon who utilized hypnosis for pain management (Bassman & Wester 1992). Milton H. Erickson utilized hypnosis with acute and chronic pain patients (Erickson 1966, 1986) and later Hilgard (1975), Hilgard & LeBaron (1982), Robert & Adrian (1982) and Melzack & Wall (1965, 1983) broadened its clinical applicability in pain management. More recent researchers have continues to understand the applicability and mechanism of action of hypnosis in both the clinical, medical and psychological arenas.

 

A legend in their own minds

 

In order to face the challenges of life one must believe in themselves. When the task or challenge before us appears insurmountable it is our faith in ourselves and not reality based facts or data that get us through. We need to believe that we are more than the sum total of our past experiences if we are to be able to take risks. What is it that enables us to be a risk taking species?. It is that we can invision ourselves as more than we are at any given moment in time. In super heroes we can conceptualize and quantify these images. In this way the super hero becomes the animated embodiment of our inner strengths and weaknesses. Through the use of hypnosis the individual’s internalized strengths can be brought out. And through the utilization of super heros in conjunction with hypnosis they can be solidified into the patient as viable identifiable character traits.

 

The super hero selected by the patient is a symbolic metaphor. It is wise for us as therapists to minimize interpreting the patient’s choice of character in order to best understand the client’s metaphorical meaning. A character may represent power or some other attribute. However, to the client the presence of that attribute may have a positive, negative or neutral meaning. One might see Superman as a control freak using his super abilities to throw off the balance of nature by preventing necessary natural disasters. In deed, questioning a child about super heroes often leads to as many disliked as liked superheroes as liked super heroes. Some super heroes are preferred for their flaws as much as for their strengths.

 

As Erickson might argue, using hypnosis may represent a more respectful way to work with clients than direct confrontation of their conscious beliefs. The use of metaphor, especially via representation of super heroes, allows patients to express unconscious feelings, self perceptions and desires. They can embrace and internalize desired traits while rejecting undesired ones. Does every fan of super heroes know that “The Flash” is full of himself? It is, therefore, tantamount to the clinician utilizing super heroes in hypnotherapy to respect the patient’s unique connection to the character and not interpret the character selected based on stereotypes. Through the use of metaphors and indirect suggestion deeper meaning can be conveyed. The etiology of the super hero as well as how they live their lives conveys messages which take on greater significance when a super hero is presented in a story. In some cases the super hero represents only an anchor to draw the patient into the “indirect messages” relayed in the hypnotic story telling technique. Children are primed by fairy tales and later by stories of their first super heroes, their parents. Lessons about life and “experiences” not personally experienced help to educate. The super hero in hypnotherapy becomes a powerful medium for focusing and learning new behaviors, skills and emotions within the subconscious. The use of metaphors in daily language creates a common story or denominator we all share. We all know the fairy tale or the super hero and in sharing it we engender trust and rapport from our clients which in turn enhances our ability to do hypnotic work. I have often found that creating hypnotic stories of a pleasant nature initially for children such as all the super heroes playing baseball is a way of encouraging them to engender and embrace super hero story telling techniques in hypnosis. Then moving on, more difficult themes (i.e. loss or separation), complicated issues or behaviors (i.e. symptoms) which motivated their seeking out therapy can be addressed with less anxiety.

 

Dissociation as a hypnotherapeutic tool when united with super hero’s imagery can allow for pain control and new ways of processing information as well as for experiencing events without actually being there. As described earlier in this chapter dissociation via super heroes offers a variation on the many uses of inducing a dissociative state as illustrated in the hypnotherapeutic literature.

 

In this approach the patient is age regressed back “to a time before they can remember” (a confusion technique) and then progressed slowly. During the age regression they are reminded of how their mind and their body continued to heal them and take care of them even though they were too young to consciously understand. “When you were born your body and your mind knew how to heal your wounds and fight infections… and you didn’t understand but your mind did… and it took care of you…You needed to do nothing at all… and your mind and your body took care of you… just as they will take care of you now”. The focus is on allowing the individual to trust his or her unconscious mind to allow healing and to support it. From this point forward images the mind may want to introduce to help in the process can be suggested. “The mind may remember (for adults) images which help you to feel very strong in helping you heal. These images or feelings may be real or imaginary or anything your mind creates but you know that you can allow these sensations to occur so you can continue to heal…Perhaps there is a character or memory which made you feel super (disguised suggestion) in the past. Take your time and see what your mind presents to you.”

 

Managing Pain with Hypnosis

 

Pain has been viewed as evolving from either physical or psychological causes (Fordyce 1976, Sternbach 1978). In deed, even the most recent DSM-IV-TR edition offers diagnostic categories for a “real/organic” or “functional/imagery” basis for pain. In this context, Sellick & Zaza (1998) found that in randomized controlled studies of hypnosis in managing cancer pain, substantial evidence of improvement exists when nonpharmacological pain management approaches are being sought.

 

A constructionist view was proposed by Chapman & Nakamura (1998) who suggested that hypnosis alters the learned pain experience by interacting with feedback processes that prime the associations and memories tied to pain. This associative learning processshapes the formation of pain experience and expectations- ultimately reducing the experience of pain. What then is the pain response when a post-hypnotic suggestion with associated superhero imagery (Superman) is triggered in response to anticipated or actual pain? In deed, the response I have observed is a type of induced dissociative experience, in which the individual reports significantly reduced levels of anticipated pain or rather, that the discomfort is tolerable and controllable.

 

From a neurocognitive perspective, Gruzelier (1998) noted the significant role of the interior cingulate cortex in managing sensory input in conjunction with the frontolimbic inhibitory processes allowing patients to suspend reality testing and critical evaluation. In addition, the amygdala is inhibited and the hippocampus is activated. Suspending reality may be exactly what is needed if one is to become Wonder Woman or Superman in dealing with their pain. Hypnosis represents the means by which the super-abilities of super heroes can be ’experienced’ in an unobstructive cognitive and physiological manner. In addition, patients may be more susceptible to hypnosis (and induced super hero qualities). Pain patients may spontaneously shift to an altered state of awareness and may rapidly enter trance as a means of escaping their pain (Araoz, 1985).

 

Applications

 

Pain comes in a myriad of forms too numerous to delineate; ranging from acute to chronic, trauma and burn-related, illness and post surgical. Pain reductions in acute burn victims (Wright & Drummond, 2000), those undergoing acute procedural pain and/or chronic pain conditions (Patterson & Jenson 2003) and burn patients requiring debridement (Ewin 1986) as well as pediatric patients (Foertsch, et al, 1998), can benefit from hypnosis and super hero strengths. In these populations, clinical experience has demonstrated that super hero imagery may represent a powerful means to assist in the dissociative and regressive patterns reported by Patterson & Ptacek (1997).

 

Hypnosis has been applied to preoperative, operative and postoperative procedures (Deefochereux, et al, 1999; Meurisse, et al, 1999; Howard, 2003). Chronic pain has been shown to have both a physiological and psychological component. It has been shown to result in lowered self esteem, hopelessness and despondency, which can be alleviated, in part byhypnosis (Turk & Holzman 1986) via empowerment and pain management. Acute pain is frequently associated with an increase in anxiety where the patient seeks to escape the pain, and has not yet developed ’neural pathways’ (Melzack & Wall, 1986) or strong emotional associations to the pain. If these associations and pathways can be circumvented by empowering the patient with super heroic levels of physical and emotional strength, the acute pain pathology may be prevented from becoming chronic pain pathology? I believe that in many cases it can. Anbar (2001) found that children with recurrent abdominal pain in the absence of an identifiable or physiological cause, respond positively following a single hypnotic session. Traditional approaches may utilize glove anesthesia with transference of the pain off the body and various forms of dissociation and suggestion. Carlson, et al (2000) report on the effectiveness of hypnosis in helping patients to reinterpret painful experiences and reduce negative associations.

 

A key term commonly utilized in the hypnotic process is ‘transformation’. It is the process whereby individuals can alter their sense of self and in so doing, engender alternate qualities and traits, either covertly (self perceived limitations) or overtly (habit changes). Hypnotic intervention enables patients to experience the qualities of super heroes in overcoming a multitude of emotional and physical limitations. By becoming that character while in trance and maintaining the ability to call upon that character-via post hypnotic suggestion, the person can, at will, transform into the character regardless of the place in time. Character traits can be “locked in” and become viable parts of their “selves”.

 

Adults and children alike are capable of utilizing ’multi-sensory experiences’ to enhance their trance experience. In this way, the incorporation of the unique physiology of the super hero as well as the imagery of the abilities super heroes possess can be utilized in treatment. For example, patients may utilize the self-healing powers, the ability to see inside the body, and the ability to separate parts of their body, qualities that various super heroes possess, in order to manage pain and to promote healing. Since superheroes always eventually get better, the use of superhero identification in hypnosis can also provide encouragement and promote positive self hypnotic statements. The literature on hypnosis in pain management is prolific, yet in none have I found specific references to utilizing superheroes. Though I am sure many of the pain practitioners I know employ metaphors and story-telling techniques, which may incorporate superheroes, it is an under represented technique in the published literature. In what follows, I hope to give specific examples of one or two techniques which employ super hero imagery which I have found especially helpful with pain patients.

 

Case Presentation

 

One such case was that of George (Burte & Araoz 1994, 2002, 2004), who was a 12 year old boy brought to my office after being diagnosed with cancer. George was on multiple medications and was experiencing pains ranging from the annoying ’pin sticks’ to ’Broviac changes’ to “pain directly attributable to his illness. In addition, he experienced nausea and discomfort secondary to his medication regime.

 

Individual tests of suggestibility indicated that George was a good hypnotic subject. He was taught how to relax his mind and body. Then, utilizing super hero metaphors, George was taught to draw upon his favorite character-He Man. He Man, like many superheroes feigned fearfulness in his disguised state and was all powerful but mortal in his super hero state. Once in trance, George was encouraged to ’feel’ the transformation from ’Prince Adam’ (the ordinary character), into He Man (the strongest man in the universe). What was extremely relevant to George’s case was his ability to identify with his fears of cancer and pain in the mortal state, yet face them with reduced fear and head on’ in his super hero state. An interesting note, He Man’s arch enemy was a supervillain names Skeletor (a skelatenous looking villain). George’s illness had metastasized to his bones, so that was where the battle was to take place.

 

Trance logic is the ability to suspend reality. In George’s case. not only did he suspend reality by transforming from himself to Prince Adam and eventually He Man, but he could then, as He Man, enter into the body of Prince Adam and fight Skeletor (his cancer) while feeling less pain. Pain became a dissociated discomfort which he could shake off. Unfortunately, in the real world, Skeletor ultimate won the final battle but via hypnosis and superhero transformation, George fought until the end with less pain.

 

The approach chosen involved having George first learn how to enter a trance. Once there, he began to experience the feelings and senses of being Prince Adam. It was important to engage all five sensory modalities (sight, hearing, taste, touch and smell) as well as kinesthetic (place in space) in his experiences. Once he was Prince Adam, George could then transform into He Man. He would raise his imaginary sword and recite “By the power of grey skull and He Man” and transform. Once He Man, he would imagine that he had been transported to ’a new world that existed inside the body of Prince Adam. Trance logic allows this to occur-he would feel no pain and defeat Skeletor time and again. Also as He Man, pain associated with pin sticks and Broviac changes were reduced, and bone pain and medication side effects were also diminished. It was critical to teach George how to induce trance for himself, and at one point he developed his own rapid induction. He would raise one of his crutches and recite the transformation phrase, “By the power of grace go I and He Man”, and upon returning his crutch to the side of the chair he became He Man. (For girls a similar character named She Ra, the strongest woman in the universe can be employed).

 

In George’s case two goals were being sought. The first was direct control of his illness-based pain, as well as the pain and discomfort associated with his medical procedures and medications. The second goal was to empower George to fight his illness via a psychoneuroimmunological imagery approach.

 

Trauma

 

The use of hypnosis for treating trauma is well represented in the literaturePre – written hypnotherapeutic scripts in which experienced hypnotherapists provide an induction and series of suggestions and/or post hypnotic suggestions for a range of disordersis readily available for the novice hypnotherapist. In many instances the therapist can read the monologue like story or script to the patient. Scripts[l2] for recovery from trauma (Havens & Walters, 1989) and working through ongoing emotional consequences of trauma for adults (Yapko, 2003) and children ( Mills and Crowley 1986) are helpful and readily available. However, for more experienced hypnotherapist writing their own scripts unique to the patients needs or generating a story or metaphorical script based upon what the patient brings to each session is more common. In the New Hypnosis (Araoz 1984) it is often a matter of following and leading the patient into their own internal representations of the trauma that is most effective. At these times calling upon super hero images can assist in helping the patient feel either safely removed from the trauma or more capable of confronting it. Prior trauma also lends itself to the hypnotic application of superheroes. Patients can be induced utilizing an approach known as the ‘New Hypnosis’ (Araoz, 1985). In this technique, in the course of conversation, the patient’s self-talk or negative self hypnotic statements are investigated to determine the underlying language which is maintaining the symptomology. Individual traits of superheroes can then be imposed onto their symptoms. Utilizing this model in the course of conversation, a patient discussing their anxiety is asked to focus on their psychosemantics-the descriptive language used to describe their emotions, (i.e., sick to my stomach, a pain in the neck) and their somatopsychic behaviors-the physical behaviors and physical manifestations they express while describing their emotional state (i.e., clenching and unclenching their hands, a hand motion). The patient is then led into focusing on the phrase or emotion as part of their induction.

 

Through a progression of observing, leading, discussing and checking (OLD-C), the therapist guides the patient’s experience toward a hypnotic state via the symptomology, while circumventing the need for inducing a relaxed trance state. During the subsequent discussion phase, the patient presents unique associations and imagery. By permissively suggesting supports (superhero abilities), the therapist can guide the patient away from the negative self hypnotic statements toward strategies of greater control and mastery. The role of incorporating superhero imagery becomes relevant as the patient produces negative self-hypnotic associations and experiences in any of the five sensory modalities. Both superheroes and supervillains can be associated with the negative self hypnotic statements and self perception.

 

A situation where hypnosis utilizing superheroes is helpful is seen when the negative self-hypnotic language places challenges before the patient, which they believe they cannot overcome with their own perceived abilities. Some of the advantages of utilizing superhero imagery in this instance includes: 1) specific traits unique to a particular super hero can be incorporated. 2) the process of becoming a superhero often engenders a certain degree of anonymity-with that anonymity comes an ability to take risks with a reduced fear of failure, 3) super heroes can be brought in to assist in situations without the patient necessarily having to become that character or even identify with him/herhypnosis has been used to get in touch with the inner child or to allow overt communication with loved ones who have died to resolve unfinished business; 4) hypnosis can also call upon superhero characters to assist in facing fears. As noted earlier, facing anxiety provoking situations or facing fears, may be made easier if first addressed in trance with the assistance of a superhero, then later overtly with the post hypnotic suggestions that the super hero will be there to assist.

 

In this technique, the patient is asked to discuss what qualities he or she needs in order to face a given task or past trauma, and is then asked which superhero could be of the most help to them. This technique without the use of a superhero is often employed in ego strengthening exercises, as well as when increased physical stamina (as in physical rehabilitation) is required. Rather than getting in touch with an inner child, the patient is encouraged to get in touch with an inner super hero. Research has supported the use of hypnosis, improving rates of rehabilitation and recovery for trauma victims. For some individuals, using super heroes as role models can be effective in developing patterns of how they face their fears and physical challenges. Super heroes always get up, even when facing defeat or despair. Luke sought out Yoda to become a Jedi. Batman overcame the loss of his family to become who he is eventually became.

 

I have found that rehabilitation patients often go into spontaneous trance by way of ’becoming another character’ and can often push their abilities beyond that of mortal men. Hypnosis to reduce perceived pain intensity allows patients to become more compliant and able to withstand physical rehabilitative interventions (Mauer, et al, 1999) as well as promote increased rates of anatomical and functional healing (Ginandes &Rosenthal, 1999). I have also observed that some individuals, while in trance, call upon others to assist them through the process. Superheroes become the coach, the physical support to increase endurance and stamina.

 

Especially with children, avoidance of addressing issues can be better faced with the support of superheroes and hypnosis. Boredom also can be reduced by utilizing super hero imagery to increase attention and endurance. A child pretending to be his favorite sports hero can often engage in a repetitive activity like throwing a ball against a wall for hours, long after he would have been otherwise bored or fatigued. Wayne Dwyer once said, “You’ll see it when you believe it.” A variation on that might be, “You’ll be it when you experience it.” Hypnosis, through its power to provide a multi-sensory experience, allows for the transformation from ordinary self to super hero to occur.

 

The use of superheroes as a tool during hypnotic intervention is illustrated by a patient who could “not even imagine” accomplishing a given behavior or overcoming a given emotion. Hypnosis can be described as a state of “focused internally directed experiential learning” (FIDEL) (Burte 2004). Patients often have difficulty spontaneously imagining symptom reduction or the desired behavior or emotion occurring. It is difficult to have individuals imagine behaviors that they have not engaged in or which are so anxiety evoking that they are avoided at all costs.

 

Case Presentation

 

Prior trauma even of a seemingly minor nature can have a significant impact upon children’s future functioning. Sam from an early age had been eneuretic, Consequently on multiple sleep-overs he experienced bedwetting resulting is peer ridicule. Subsequently when coerced to continue to attempt future sleep-overs he became highly anxious and attempted to control the situation by staying awake all night. Fatique and fear of falling asleep resulted in the development of panic attacks and an urgency to go home in the middle of the night when he felt he could no longer keep himself awake.

 

Sam became a phobic child who was afraid to sleep at other children’s homes As a result of the multiple attempts which had resulted in the multiple late nights of embarrassment. Sam came to therapy because as he approached his 14th birthday, his school was planning an eighth grade two-night trip to the nation’s capital. Sam greatly wanted to go on the trip but feared the embarrassment of being unable to sleep out overnight.

 

Medication and psychotherapy had been to no avail and it was suggested by his prior therapist that hypnotherapy be employed. Sam was eager to try anything to be able to go on the trip. During the first few sessions of hypnosis Sam was hyper vigilant and resistant to trance. He also avoided approaching any imagery associated with sleeping out of his home. Sam had a history of attention deficit hyperactivity disorder and was currently being treated with psycho stimulants. He had a history of enuresis, which had been resolved some four years earlier. Sam was asked to focus on his body image and to imagine himself at home in his own bed. He was asked to focus on any sensations, images, sounds, smells of which he became aware. He was gradually led into a state of focused self awareness. Once in that state, Sam was asked to imagine a superhero who could endure emotional stress. He was asked to try to recall any super heroes who had to endure separation from family in order to become stronger. He was able to create images of Anakin Skywalker leaving his mother behind as well as Luke Skywalker going to a distant planet to train to become a Jedi Knight. Sam was then directed to imagine himself at his friend’s house once again, trying to re-experience the feeling which he had previously described as “depressed but ten times worse” and to listen to the negative self hypnotic statement; “I just want to go home” that he repeated to himself at those times. Then once he was able to feel the upsetment he was asked to introduce the imagery of the super hero to “feel” the strength of his super hero character. “Hear the voice inside telling him to endure, because in the end he would be stronger”. He stated that he was able to feel strengthening. He was then directed further into the experiential learning experience. He repeated to himself frequently “Feel the force.” This proved helpful to him as he learned how to feel stronger. The induction proceeded with him describing himself on a planet with Yoda from Star Wars, of having to go to a place to face his greatest fears, and calling upon the power of the force to remain calm. This scene had had a profound impact on him as he described in detail the scene with himself now as the character. It is likely that he had unconsciously internalized the scene, which in hypnosis, he could now call upon to help him address his deeper fears. He could be both dissociated and yet learning a new skill at the same time.

 

Another quality of super heroes is that they don’t die at the end of the day (or movie). By allowing the superhero to merge with him, it assured Sam that he would ultimately succeed and endure and further ensured that his irrational fear of dying (associated with panic) would not come to pass. In my many years of doing hypnosis, I have learned that patients often look to their therapist to give them new or different skills, or to offer them opportunities to explore things in ways they would not condone on their own. The therapist is the catalyst and permissive agent, “to go where no man has gone before”, and so even adult patients are much more willing to embrace fantasy in hypnosis. Children, of course, go there with little or no prompting. I would urge therapists not to be afraid to ask patients to attempt using superhero imagery in hypnosis as a means of bringing about profound changes in their patients. Erickson often used metaphor and symbolic imagery to enhance specific behaviors, cognitive self interpretations or non critical judgments of the symptoms to bring about change in his patients. Metaphorical superhero ego strengthening stories provide patients with patterns they can readily call upon.

 

As part of another hypnotic induction, the individual is guided into visualization of favorite super heroes. Generally speaking, I have found that with adults and teens, it is helpful to take a very non directive approach when doing this due to the sense of silliness that many patients experience at this point. We are taught to see ourselves as we really are (whatever that means) and to put aside illusions of ourselves (though I am sure Shakespeare would beg to differ). By embracing a very permissive approach in treatment, patients are encouraged to envision a favorite super hero, to experience the world via his or her extended powers and abilities. By utilizing age regression-bringing the adult back to their childhood,, we can dissociate them from their rigid adult beliefs, self images and fears of looking foolish, thereby allowing giving them permission to engage in fantasy, to restore their belief in their abilities (super human or otherwise that have been lost in time). Such a dialogue might include, “as you go back to the age of 10, perhaps you can recall a favorite comic book or cartoon super hero. Can you recall a favorite… super hero…? Good… Try to recall as much as you can about how you felt as you watched his adventures occur. What do you see or hear happening as you observe him or become him”. The goal here is to engage the adult in childhood memories and use new hypnosis techniques of OLD-C to deepen their experience.

 

Ego Strengthening and Self Perception

 

Patients often seek Hypnotherapy for alleviation of specific symptoms and habits. However for some patients what is sought is to explore past issues which have resulted in damage to their sense of self and self-perception relative to others. For these patients ego strengthening via hypnosis is a powerful tool. Unlike some other forms of psychotherapeutic intervention, ego strengthening by means of hypnosis and selfhypnosis offers the patient the opportunity to examine “alternative selves” and to experience and not just verbalize “what if” and “if only” scenarios.

 

Patient can also question negative self-hypnotic statements (NSH) which may be damaging their self definitions and learn to reframe them into more positive selfstatemenst and images. Ego strengthening then is the process by which in hypnosis patients develop new self-empowering definitions in an “experiential multi sensory manner”. They get to try on new personas and discard old ones that eventually no longer fit.

 

Many times the patient has no prior model to draw upon when attempting to create these new personas. Role models have either been absent or discarded and consequently fantasized charaters may often filled those voids.

 

Super heroes provide ideal archetypes for some of these personas both positive and negative. Eventually for some individuals the “as if” becomes the “I am”. Examples of this are the children or adults who have convinced themselves that they can not accomplish a task (i.e., face a socially stressful situation or quit smoking), or have defined themselves in a negative manner (i.e., I’m fat or I’m ugly”). For many of these individuals the ability to visualize themselves as something different from their current self definition seems impossible.

 

One patient recently explained how at the age of 15 her mother suggested to her that if she lost 5 to 10 pounds she would fit into a size 7/8 dress and not be fat. From that moment on the woman (now 47) defined herself as a fat person. Through hypnosis she was taught to alter her ego dystonic image as a fat person who wanted to be thin and instead see herself as a thin person with excess/surplus layers (even Shreck have layers).

 

No one wants to lose any part of their identity, even layers of fat but ridding oneself of excess or surpluses is often easily accepted. For some individuals the metamorphosis can be even more profound as illustrated by the case below.

 

A standard age regression is utilized in this scenario whereby a patient is brought back to specific events and memories until a desired age is reached. Alternatively utilizing a technique presented in hypnotic realities (1976) by Erickson, Rossi and Rossi, patients can be regressed to a time before they can remember, and then progress slowly but endowed with super hero abilities or identities.

 

Case History

 

One such case is that of a teenage boy I treated who had Marfan’s syndrome and who was bitter and angry. He was the brunt of jokes due to the elongated limbs symptomatic of the condition as well as suffering from cardiac vulnerability commonly associated with Marfan’s syndrome. Consequently he was prohibited from engaging in contact sports or getting into fights. John was asked if he had ever been hypnotized before and he indicated he had not. It was suggested that he might try. After two sessions of learning how to enter into trance he was ready to attempt applying his abilities to achieving transformation.

 

John was asked to talk briefly about his favorite TV shows and movies and eventually conversation was informally brought about to any movies he saw with super heroes. He could identify quite a few cartoon, comic book and movie super heroes. He stated he especially liked super heroes who could change their appearance including Reed Richards (the stretchy character of the Fantastic Four). Interestingly enough, he stated that it was the intellectual component that he found attractive. He had difficulty admitting to the idea that Reed Richards could change his body shape and have extended limbs, which might also have attracted him to the character.

 

John was regressed back to childhood to birth “to a time before you can remember” and then slowly progressed back. But as he grew he was to watch his body develop to learn to see what was unique about his body and what he could accept about being unique. For children, especially teens, the ability to accept their physical limitations or differences at a time when they are starved for acceptance is critical.

 

John described observing his arms and limbs as being disproportionate, his hands as being ugly. Slowly the image of himself and that of Reed Richards were merged and he was asked to describe his unique physique if he were to see himself as Reed Richards to understand his ability to see himself in a more acceptable way. Interestingly though and perhaps typical of “trance logic,” John switched to a different character stating “I’m not Reed Richards any more, now I’m “The Thing”. When asked why he had become “The Thing” he stated it was because he truly saw himself as “The Thing” because like that super hero he couldn’t change back to being normal whenever he wanted and that “The Thing” was always angry and bitter about his physical appearance. Once this was brought out, work began on him being “The Thing” and coming to explain “The Thing”. We focused on the emotions being felt and the perceptions of how the world viewed him. At the conclusion of the session I asked John if he had ever thought of himself as “The Thing” and he said it had not occurred to him until the moment he recognized it while in trance. This is relevant because John had used Reed Richards to overtly identify with but it was only once in trance that his sense of self shame came forward with regard to his personal self loathing. His anger rapidly dissipated in therapy and John’s academic performance and social functioning at school improved. He began to speak to girls more and develop through imagery ways of seeing himself as a positive being like “The Thing” who girls could be attracted to and in whom he could trust his feelings without a fear of rejection. Self acceptance is a metamorphosis which “The Thing” goes through as he comes to value his unique attributes.

 

For young children the super heroes with which they identify are usually not the same ones with whom we commonly associate. Commonly young children do not find themselves drawn to the adult or even teen super heroes. To them other more lovable characters often take on the super hero qualities with which we identify. As early as 1986 Mills and Crowley (1986) were pointing out how some children like The Hulk. who can take on protective roles for a child by allowing them to identify with powerful characters. However, they go on to point out how for younger children “Scooby Doo”, an unlikely super hero, takes on super hero proportions by scaring away the ghosts. A melding of this can be seen in cartoons where typical leading man type super heroes are paired with comic super heroes more comfortably identified with by children.

 

Psychoneuroimmunology

 

Psychoneuroimmunology, in its simplest form, is a reciprocal communication between the psyche (mind), central nervous system and the immune system. Yang (2000) notes that stress via bidirectional interactions between central nervous system, endocrine and immune system impacts the hypothalamic, pituitary, adrenal axes (HPA) and the sympathetic adrenal medullary (SAM) axes resulting in immunosuppression. Pain is a factor which in and of itself may promote immunosuppression (Paige & Ben Eliyahoo, 1997). Stress is a second factor which has a deleterious effect on immune system functioning, and stress reduction has been shown to promote immune system functioning and improved prognoses in disease processes (Sali, 1997). Hypnosis has been extensively utilized in pain control and stress management as well as in indirectly addressing the immune system enhancement and disease processes. Bressler (2004) points out that most people do imagery all the time primarily by worrying.

 

Through the use of hypnosis, stress and pain which are two significant variables influencing immune functioning, can be controlled. Specific to this chapter, superhero imagery within hypnosis can be directly and indirectly applied. Since psychoneuroimmunology can be represented by directional triad of psyche, neurology and immunology, hypnosis can be introduced at the point of intervention where it can operate on any one of these variables. For example, superhero imagery can be introduced through the psyche to indirectly strengthen the immune system or to attack disease processes via imagery associated with healing. Imaging Pac Man scouring the lungs, cleaning up cancer cells as well as carcinogens like tar and nicotine. Another example might be Superman freezing or burning out destructive tumor cells. Along similar lines, Atom Ant can shrink to molecular levels and repair damaged parts of the body.

 

Of course, the use of healing imagery is nothing new and authors have written on this technique for many years (Erickson, Rossi & Rossi, 1986). The restorative powers of the body can be enhanced through imagery. One healing technique I have found helpful is a derivation on the technique presented by Rossi and Erickson (1976) in their classic introductory book called Hypnotic Realities.

 

Case Presentation

 

From a psychoneuroimmunological perspective, the use of super hero imagery to fight cancer dates back to Pac Man, a video-game character of the 1970’swho munched his way through the body chewing up cancer cells. Superheroes offer a focusing device for children and adults. Their images can be easily called upon as a means of either inducing or maintaining a trance.. A simple “yes set” suggestion such as “as you rest there with your eyes closed…I wonder if you can imagine a picture of Superman? Can you see his red cape?…and the big S on his chest?…Good…Now as you see Super Man, can you imagine using one of his wonderful super powers of flying through the sky?... I wonder if he will fly to the right first or to the left?… which way is he flying?…Good. Super Man often fights villains. As you see Super Man fly I wonder which villain he will come upon…What happens when he meets this villain?…can you see the villain?…(notice I avoid the word super villain. We don’t want to empower the disease)…Good. How does Superman defeat the villain?…Which of his super powers does he use?…Good…He uses his heat vision and what happens?…It shrinks…Good…Do you know how it shrinks?…Good…You’re shrinking it by burning it up.

 

This is a much abbreviated version of a forty-five minute session with a college aged male who in addition to standard medical care, requested hypnosis to shrink a tumor. In this case, he was not Superman but rather, Superman provided the treatment. In this process patients are led to seeking an inner healer or hero to help them promote their healing, but above all, to trust their unconscious mind to find a healing method[l5].

 

An alternative approach is to focus on the patient’s presenting symptomology as a “royal road to their unconscious.” By again focusing on their psychosomatics (i.e. he makes me sick) or their somatopsychic manifestations (i.e. movements, muscle tension), the patient is led into an altered state of awareness. The concept is as stated earlier, to achieve focused internally directed experiential learning (FIDEL). For example, patients may come in discussing various stressors which may be ultimately affecting their physical well being and health. The patient is encouraged to converse about the stressors until a psychosomatic phrase or somatopsychic manifestation is observed. The patient is then encouraged (led) to perhaps repeat “he makes me sick” over and over again while noticing any other images, thoughts or sensations which arise. If the patient reports for example that they can feel the pain they are led into the visceral experience, if other associations arise they are encouraged to focus on them. In so doing, the hypnotherapist works backwards from the negative self hypnotic statements to deeper and deeper levels of distress. Once there the hypnotherapist can begin to see if the patient can draw upon phraseology, imagery or sensations of a more positive or restorative nature. During these processes superhero imagery can be introduced to assist the patient in dealing with those experiences and learn more adaptive responses.

 

A more symptom specific approach is utilized when the patient presents a specific painful symptom such as a neck or back pain, which as noted earlier, may be immunosuppressing. The patient is asked to focus on the pain and visualize what it looks like to them. “Is it sharp or dull, constant or throbbing?”…Do any images come to mind”? A patient may use psychosomatics to describe it as “It looks like a rope (muscle) all knotted up”. Via suggestion the patient is asked to alter the image “to unknot it”. In another case patients may then be encouraged to “wrap an area in healing bandages” or in super hero imagery to call upon abilities to self heal. The classic super hero dialogue may go something like this; “Must…get…to…switch…must…save…the…world.” This type of super hero language can be called upon to help patients turn on healing processes even when they feel unable to do so in their normal states. After visualizing the switch to be reached patients can create a self image of turning on or off the switch to promote healing, shut off unwanted behaviors or shut off pain

 

Caveats

 

Utilizing super heroes in hypnosis with children seems an easy and useful tool and, in deed, it is. Children embrace the opportunity to become super heroes in hypnosis “because it feels so real”. However, we need to be careful and responsible about our use of hypnosis and post hypnotic suggestion to ensure that children do not attempt super hero feats (like flying) in ways that will place them in danger. Therefore, it is important that therapists who utilize these techniques are well trained in suggestion and post hypnotic suggestion, as well as in assessing for abreactions (negative and unwanted reactions while in or after trance). As Spider Man learned, “with great power comes great responsibility.”

 

Utilizing super heroes with adults is no different. I believe it is the therapist’s fear of looking foolish and not the patient’s concerns which prevent many hypnotherapists from employing super heroes in hypnosis. I have found that some adults may feel uncomfortable with this technique and the light heartedness of incorporating their favorite super heroes from childhood often puts them at ease. Hypnosis has found its application with adults in not just pain management, psychoneuroimmunology and trauma, but most notably in dealing with various forms of sexual dysfunction (Araoz 1998, Araoz, Burte & Goldin 2001, Burte & Araoz 1994). One of the interesting things about trance logic is that the physiology of the skill learned does not need to be the physiology of the symptom treated. What this means is that learning finger rigidity in hypnosis (a muscle tensing behavior) can be applied to improve functioning in erectile dysfunction (a blood flow issue) and that learning to increase salivation can be utilized in treating hypo-lubrication disorders in women. Super hero imagery in trance logic takes on similar qualities. One need not understand the etiology of the super heroes’ abilities for it to be applicable to treating a variety of sexual dysfunctions. I am sure that more than just a few adults have pondered what it was like for Lois Lane after she married Clark Kent or what it would be like to date Wonder Woman.

 

As we become adults the ability to alter physiological functioning via cognitive processes such as hypnosis becomes increasingly valuable. The use of super hero imagery can significantly enhance that process. Even the geriatric population were young once and had more prowess than they currently possess. The opportunity to return to youthful fantasies is both psychologically and physically empowering. Suggestions of increased powers, pain control or functioning with anchors or super hero figures as queues associated with their prowess enable them to “return to those bygone days”, building self confidence and trust in the powerfulness of hypnosis and its ability to enable them to become “a man of steel, or a wonder woman.” Just a few examples of the super hero traits I have incorporated with my patients have included:

 

  • Johnny (the Human Torch) in Reynaud’s syndrome. It can be useful when any part of the body needs warming (i.e. hand warming techniques in treating headaches).
  • The Silver Surfer (especially useful with teens and surfer types on the barrier island beach town I once lived upon) who would surf through the universe coming to the aid of others. Having once been a villain, this charactercan be used to address the ideas of changing ones self definition and utilizing coping skills for anger and remaining calm in difficult situations, “A very cool dude”.
  • The Hulk can be helpful for developing the ability to transform back to the meek David Banner, and in so doing, be experience and anger management emotions and images. A combination of hypnosis with Rational Emotive Therapy is useful in visualizing and experiencing how what one tells themselves (beliefs) in a given situation (activating event) causes changes in ones behaviors and emotions (consequences).
  • Super Man, Super Girl, and Wonder Woman can be enlisted for a myriad of pain control, anxiety and sexual dysfunction issues.
  • Super villains like Darth Vader can offer qualities we admire. Perhaps even “The Donald” would see Darth as an ambitious apprentice who was able to successfully overcome numerous hurdles and handicaps in climbing The Empire’s corporate ladder.

Conclusion

 

The utilization of superheroes in hypnosis represents an exciting and interesting approach to reach the inner self defining concepts that patients carry within themselves. Hypnosis, imagery, story telling techniques and metaphors have been shown to be effective with a plethora of medical and psychological conditions in reducing human suffering since earliest times. I have no doubt that some derivation of a superhero can be found in the inner psyche of all people. In this brief chapter I hope to have introduced a rather new twist to an old story telling tradition. I encourage all therapists with training in hypnosis to incorporate superhero identification, imagery and experiences into their repertoire of hypnotherapeutic techniques and those not trained, to seek out reputable training in hypnosis and to apply these imagery and experiential techniques with their patients.

 

References

 

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