Rationale. When our learning history teaches us to automatically recall and even savor positive experiences, we may be more likely to grow into adults who, without thinking, can collect, store, and more easily retrieve positive experiences from within. So, when we want or need to feel confident in a group, for example, we can access that quality of experience; when we need to have the experience of aggressiveness to succeed in a job interview, we can access that particular type of experience; or when there are stressors, we can look for relevant personal resources and then are more likely to seek out and feel support from within.
However, many of us do not have a personal learning history that taught the retrieval of positive experiential resources on a global level. Many people have not learned to use their conscious experiences to deliberately bolster themselves.
Instead, their learning history taught them to doubt themselves, “tough it out”
alone, rarely or never ask for support, push people away, have low expectations, avoid positive expectations, and so on. As a result, many people, or even most people, automatically anticipate a negative experience, and they anticipate, appre-hend, and store memories that keep them on guard with the goal of avoiding more negative experiences. This is especially true of people who suffer depres-sion, a disorder in which these negative patterns are commonly manifested (Beck, 1997; Burns, 1999; O’Connor, 2001).
One of the most fundamental teachings from Milton H. Erickson, M.D., was that a cure is having the required experiences (i.e., personal resources) in each context (Erickson, 1980; Erickson & Rossi, 1979, 1981). There are innumerable situations that call for innumerable resources; thus, it would be impossible to list them all. Although some logical agreement may exist about which experiences are relevant to particular situations, each individual will have a unique set of labels for the experiences he or she wishes to have in the course of daily living.
It would not be best to ask, “What are the experiences a person who is depressed needs?” Rather, for each individual it seems better to ask, “What are the various experiences this person needs to have in the varied tasks in which he or she engages each day?”
There is a 100% certainty that every client who presents as depressed is at least partly unaware of how to retrieve desired experiences in the course of his or her daily life. Clients who are depressed spend a majority of their time having unpleasant experiences. Although they may state that they wish to feel good, they
do not know how to retrieve positive experiences, and in the absence of relevant strategies, they do not spend any time doing so. Thus, a significant portion of time in therapy is spent training clients to identify and retrieve experiences that they consider desirable. Homework assignments should be given that require clients to spend time retrieving positive experiences on a daily basis in order to reinforce the key learnings of therapy. Furthermore, clients need to learn to enjoy and even savor the positive experiences they retrieve.
During the first session with clients who are depressed, I endeavor to quickly move beyond assessment and begin the process of retrieving positive experiences, either with or without formal hypnosis. Clients will move at varying speeds with regard to this intervention. It is important for therapists to reinforce clients for whatever degree of progress they make.
Method. The basic intervention for retrieving positive experiences is quite simple, yet it eludes most depressed clients. After explaining the importance of retrieving and indulging in positive and desirable experiences as a counterbalance to their emphasis on the negative, I ask clients to begin the hypnosis session by becoming relaxed. If necessary, I lead them through an exercise in systematic relaxation. I then ask them to recall a time when they felt the experience of being safe or some other similarly positive experience. Some depressed clients will claim that they cannot recall any positive memories. They usually can recall a few, however, when they are given sufficient reminders of common enjoyable events. It is permissible to ask them to imagine what it would be like to feel a positive and desirable experience. Clients can use their imagination and pretend to have one, if necessary, although pretending is usually not necessary. If a client can only produce one such positive experience in the first few weeks of therapy, that single experience can (and should) be used repeatedly. Typically, clients begin to recall other positive experiences after participating in this protocol a few times.
I ask them to notice that they have sensory memories (e.g., pictures, sounds and smells) of this earlier experience. They are to try to enrich or revivify the sensory impressions until they begin to remember this earlier time in an experi-ential way (rather than as merely a spectator). As they remember experiexperi-entially, they are to allow themselves the luxury of feeling the positive experience both viscerally and emotionally. The following is a sample transcript illustrating this approach:
Stephen: From what you’ve just said, you worry about things all day long, all night long, postpone sleep with your worrying, and possibly even have dreams that concern worrying. And furthermore, you’ve done this for at least the last 22 years.
Clark: Yeah, that’s the way it seems. I worry all the time. [Clark launches into describing some additional area of life wherein he worries.]
Stephen: Do you not know one thing that you never do?
Clark: You mean just feel happy or content or satisfied?
Stephen: Well, yes; I didn’t expect you to make it so clear. You have practiced and become very good at wondering what’s going to happen in the future and being worried about it. In fact, you’re an expert. But you have forgotten to take the time to relax yourself, allow your immune system to recharge, clear your mind, and just have a sense of happiness and satisfaction with something.
Clark: I don’t know how to do that. I never feel that way.
Stephen: I don’t want to seem oversimplified about this, but I think we should spend some time on that very issue. The question is “What does a person do, or how can you specifically have some of those feelings in your life?” And that’s the bottom line, isn’t it?
Clark: What are you getting at?
Stephen: Lean back on the couch, get comfortable, and close your eyes for a moment. I want you to relax for just a moment—maybe for a few minutes. Let your shoulders relax, relax your chest, then let your upper arms, and then your forearms, relax. [A progressive relaxation protocol continues until Clark’s entire body is relaxed.]
Clark, your conscious mind does not need to do much of anything right now.… Let your unconscious take over … and don’t do anything more than recognize how interesting it is … that you can function without consciously doing anything.… The first thing that I want you to do is focus your attention … focus in a way that will disrupt your normal conscious association … so much so that you’ll have an opportunity to have a new experience.… An interesting way to do this is to concentrate your attention on the area between your eyebrows.… And in the next few moments, I will count backwards from 5 to 0 … and I want you to move your awareness deeper into your brain with each count.… That is, I’d like to have you imagine with each count that your awareness moves back about an inch into your brain.… So that by the time we reach zero … your awareness will be focused on your medulla.… It’s not really possible to know that you have succeeded in this … 5, and going just a little deeper.… Because this is a very unusual situation
… 4 … if you concentrate your attention on your hand … you can alter the temperature in your hand.… If you concentrate your attention on your heart … you can change your heart rate … and getting just a little deeper … if you concentrate your attention on your breathing … you can change your breathing … 3, and getting a little deeper … and if you concentrate your attention on your bladder … you can increase or decrease your awareness of a pressure in an area.… But it is indescrib-able.… I just wanted you to experience how good you can feel … when you concentrate your attention in the middle of your brain … 2 … a little deeper.… However, it’s very likely that we increase the functioning
of that area … when we concentrate our attention there … after all, we increase the functioning of all those other areas when we concentrate our attention on them.…
One … and still deeper.… And in just a moment you’re going to be as deeply concentrated in that area of your mind as you have ever been
… and you can transform the words that I say so that they are relevant to you.… Zero.… Now take a moment … to let the first incident you recall come to mind.… Let yourself skip to the first memory you come to wherein you had a feeling of joy or safety.… It might be a time when you were playing with a puppy that insisted upon licking your face.…
Maybe it was a time when you were getting sloppy eating a watermelon
… maybe it was a time when you got an unexpected good grade on a college paper … or maybe it was a time when you simply relaxed on a beach and soaked up the sunshine for an hour or two.… Just wait and let your conscious mind find out what your unconscious brings forward.… Now, with the slightest memory of such a time … I want you to make all of the sensory memories more vivid.… Notice what you see.…
How bright was it?… How in focus was it?… And who was there?…
What was the rhythm of their speech?… What do you remember being said?… What do you remember saying?… What smells do you remember occurring at the time?… Remember all of the senses that you have present in the experience at the time.… And soon, use your imagination if necessary … you can put yourself back into that situation so that you can remember the actual feelings you had.… You can begin to feel what it was like then.… And, you remember the experience on your face.…
Let yourself smile, and even smile the way that you smiled then.… Have that experience again and luxuriate in that feeling.… Hold onto it—all of the feelings—and keep them for a few moments.…
Now, before you stop this experience … allow your awareness to move around through your body.… Become aware, even for a small period of time … of what it feels like in your shoulders, your stomach, your chest, and your thighs.… Become aware of what it feels like to have a sense of joy in your chest and in your face, in your back and in your legs.…
Let your awareness scan your entire body … and recognize that for just now, you have intensified a memory of the time when you felt joy and safety.… And, you have let these experiences fill your body and your mind with a desirable experience you can have any time you want
….When I count backwards and ask you to come out of hypnosis … you’ll remember a bit of this experience.… Maybe you will remember a lot of this experience. But there will be a hollow effect, and you’ll continue to experience a positive feeling for a few moments after the trance is over.… This is what I’d like you to do several times a day between now and our next session.…
Twenty, 19, and 18, 17, 16, and so you begin to reorient yourself to the office little by little … as I count backwards, 15, 14.… And as I do this, you recover those motor skills and attention skills, 13, that are necessary for you to carry out driving and conducting yourself in a safe way for the rest of the day, 12, 11, and throughout the evening.… And also, 10, 9, you will bring back with you from this concentration 8, 7, some of those positive experiences and desired resources that you thought about … 6, 5, while I was speaking to you, 4, 3, and you were enjoying. Two, and just open your eyes and return to the room, 1.… How do you feel?
Clark: I feel strange. I … I feel pretty good.
Stephen: What I’d like you to do, Clark, is sit down two or three times a day until I see you again next week and remember this experience. You can remember this same experience that you remembered now, or you can even change it or include a different one. But each time, indulge yourself in the experience that’s positive at the feeling level. And when you stop this practice, you will have 15 minutes up to maybe a couple of hours or even more of the halo effect. That is, there will be some time after you stop the experience that your positive feelings continue.
Now, this will be only a few drops in the bucket for you. It might not make you feel wonderful the very first time you do it. It might not make you feel wonderful the second or third time you do it. But each time you do it, you begin to accumulate more and more ability to recognize and tune into and hold onto positive experiences. And so, very soon this will begin to be recognizable as positive feelings during the day. As a result, the overall depression you face will have to diminish.
Clark: Well, I guess I understand it. So, I will give it a try. I’ll let you know next session what I accomplished.
Stephen: Terrific, Clark. That’s all I can ask. Let me know how it was for you, and we’ll take it from there.
The typically depressed clients will either terminate the memory prematurely or retrieve the memory in a cognitive manner but not feel the feelings. When this happens, it is important to explain to the clients exactly what is intended and to be patient as they attempt to reach the goal. It is necessary to take sufficient time at this stage so clients can really grasp the extreme importance of proactively using their memories to enhance their feeling states in a desirable way. This reduces their sense of helplessness, increases their internal locus of control, and is thus empowering to them. These activities then become expanded into home-work assignments with a rationale that their life has been “relatively impoverished by the absence of these positive feelings and it is time to change that state of affairs.” Although the process of therapy will, realistically, vary, with each client focusing on different skills, each client can learn to better manage his or her mood, and it is important to take time during each session to reinforce this
particular learning about the merits of retrieving positive resources from within.
As clients increase the amount of time spent retrieving and savoring desirable experiences, the impact of their depression diminishes.
Confronting “Racket” Feelings
Rationale. The concept of “racket” feelings was introduced by psychiatrist Eric Berne (1972). In presenting this term, he referred to the emotional “noise” that often accompanies communication. In psychoanalytic terminology, this phenom-enon of substitution is referred to as a “neurotic affect” (Fenichel, 1945, p. 21;
Freud, 1938, p. 448; Langs, 1973, p. 346). In more common terms, this is a person’s most commonly experienced emotion, even though it might not be the person’s most desired emotion. Thus, for the person who regularly feels aban-doned, rejected, misunderstood, overworked, confused, or enraged, this racket can be viewed as the person’s emotional “comfort zone.”
The premise behind the acquisition of a racket feeling is that as children, people learn or decide upon an acceptable substitute feeling in their family of origin when a natural or more vulnerable feeling appears to be unacceptable. This substitute feeling and the cognitive schema that supports it may lead to a percep-tion that outcomes are independent of one’s efforts. These form the basis for learned helplessness (Peterson, Maier, & Seligman, 1993) and will then recur throughout the person’s life. The cognitive schema that explains the feeling contains elements that comprise a self-fulfilling prophesy.
As an example, consider a man who frequently feels depressed and hopeless because, in his mind, nobody cares about or understands him. Such a man will not be assertive about making clear his contributions to the interactions in which he engages. In addition, he will likely demonstrate social behavior (e.g., irritability and impatience) that precipitates shunning, avoidance, or rejection by others. In the course of social interaction, he will naturally encounter some individuals who understand him and some who do not. He will also encounter people who shun and avoid him and some who will not. However, his negative conduct will most likely elicit a greater number of individuals who do avoid him and do not demonstrate understanding. In any event, he will selectively overvalue or focus on those who avoid him and do not understand him, and continue to conclude that he is misunderstood and that nobody cares, thereby reinforcing his self-limiting belief.
Often, depressed clients will not recognize their role in creating, continuing, and co-creating negative outcomes. In labeling this as active racket behavior, then, Berne also apparently intended a double meaning by emphasizing that individuals will selectively behave and, in essence, manipulate social reality in a self-injurious attempt to arrive at their common but undesirable feelings.
Clients who suffer from depression may have one or even two personal racket feelings. In some cases, the feeling of depression is itself a racket feeling. How-ever, some depressed clients do not consider themselves to be depressed. Indeed,
some clients diagnosed with clinical depression do not label their emotional state as depressed. Instead, they may refer to their condition as feeling rejected, feeling that they “don’t care” about life, and feeling “what’s the use,” dejected, unim-portant, and so on. These feelings are substitute, or racket, feelings that, during their lifetime, have habitually concealed other chronically unexpressed feelings (Berne, 1972).
In clinical practice, it may be desirable to help a client learn to accept and express his or her chronically ignored feelings. However, in brief therapy for depression this may not be a realistic or desirable goal as it will require using precious therapy time that might be better used in teaching clients to identify and make use of their positive resources. It is a desirable goal, however, to help a client come to realize that there are situations in which he or she will want or need to express his or her feelings, but it is not a necessary given. A case example would be useful to illustrate this point.
One of my former clients used to report that she was often rejected by others in social situations. She felt rejected by individuals at her workplace, and she
One of my former clients used to report that she was often rejected by others in social situations. She felt rejected by individuals at her workplace, and she