Georg Ivanovas From Autism to Humanism - systems theory in medicine

Appendix

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V. The Viet Nam Veteran

a case of Milton Erickson

The case demonstrates the limitations of a logical system not taking signs and signification into account. There are even no tools to describe this process except of meaningless explanatory principles such as ‘hypnosis’, ‘suggestion’, ‘psychological’ etc.

Jim was a high school graduate and a very idealistic young man. Grade was a classmate, and also a very idealistic young woman.

Jim was drafted for the war in Viet Nam. He was serving in Viet Nam in noncombat duty. In a truck accident, he had his spinal column broken and his spinal cord severed.

He returned to the Veteran's Hospital in a wheelchair suffering from convulsive pain about every five minutes, night and day. The Veteran's Administration operated on Jim to relieve him of his pain, but that didn't work. In fact, that made his pain worse. And then they operated on him a second time, and that served no purpose at all. They were planning on doing a third operation to relieve him of that convulsive pain every five minutes.

And somewhere along the way, Jim or Grade, or both, heard about me. They told the chief surgeon that they were going to see me for hypnosis about pain. So the surgeon took them into his office. For one whole hour, he told them that hypnosis was nonsense, and witchcraft, black magic, and sorcery. He described me as a charlatan, a faker, an ignoramus. In fact, he didn't like hypnosis, and he didn't like me. He considered it awfully wrong of them even to think about hypnosis.

And Jim still had his convulsions of pain every five minutes.

And Gracie was very sympathetic, and despite that hour-long lecture against hypnosis, they decided to come see me.

Gracie wheeled Jim's wheelchair into my office. The looks on the faces of both were the looks of fear, of unhappy expectation, the look of resentment, a faint look of hopefulness, a look of antagonism and a look of wariness. They were certainly not in good emotional state to listen to me. But they told me about the back injury and the two operations, and how the highly respectable chief surgeon at the Veteran's Hospital had said that hypnosis was black magic, witchcraft and the work of a charlatan.

So I told Gracie, "You stand over there on that rug. (Erickson points.) Stand up straight; look straight ahead, your hands beside you. And, Jim, here is a heavy oak cane. I used it when I walked. It's a heavy oak cane. You take it. If you see me doing anything you don't like, clobber me with it." (To Siegfried.) Clobber means "hit." (Everyone laughs.)

Siegfried: With the piece of wood?

E: An oak cane, a long stick that you use when you walk.

Jim took the cane and gripped it very tightly in his hand, and he watched me.

Then I told Gracie, "Gracie, I'm going to do something to you that you won't like—to which you will object very strenuously. I will stop doing it just as soon as you go into a hypnotic trance. Now you don't know what hypnosis is, nor what a hypnotic trance is, but in the back of your mind you know what it is. So you stand there and if I do something offensive to you, you can know that I'll stop just as soon as you are in a trance."

I lifted the point of my bamboo cane and began sliding it back and forth at the point of cleavage, trying to expose her breasts. And Gracie slowly closed her eyes and was in a deep trance. I put my cane down and Jim was watching me. He couldn't take his eyes off me. I said to Gracie, "Where is your hometown? What high school did you go to? Name some of your classmates. How do you like Arizona weather?" A few things like that. And Gracie answered with her eyes shut. I reached out and took hold of her arm and lifted it up and left it cataleptic. (Erickson lifts his arm and leaves it cataleptic.)

I turned to Jim and said, "You heard Gracie speaking to me. Now you talk to her." I reached out and put Grade's hand down. (Erickson puts his hand down.) And Jim said, "Gracie? Gracie? Gracie?!" And he turned to me and said, "She doesn't hear me." I said, "That's right, Jim. She is in a deep trance, she can't hear you. Ask her any question you want to. She won't hear you." So he asked a few more questions and got never a quiver of movement.

Then I said, "Gracie, how many students were there in your high school?" She told me. I reached out with one finger and lifted her hand up again, and with one finger I put it down again. (Erickson gestures with his left arm.) I told Jim, "Lift Grade's hand." He reached over and started to lift it, but I had put Grade's hand beside her and it was cataleptic. Jim couldn't pull it away from her side. I reached out and lifted her hand with one finger and told Jim to put it down and he tried. Grade's muscles contracted and she kept her hand where it was. (Erickson demonstrates with his hand.)

I took my time doing all of this. And then I said, "Grade, stay in a deep trance, but open your eyes and walk from that rug to over there to that chair." (Erickson points.) "And when you sit down in the chair, close your eyes. Then awaken, open your eyes and start wondering."

Grade sat down, closed her eyes, opened them, and said, "How did I get here? I was over there on that rug. How did I get here?" Jim said, "You walked over there." Grade said, "I did not. I was standing over there on that rug. How did I get here?" Jim tried to tell her, but Grade disputed it. "I was standing on the rug. How did I get here?" I let that argument go on for a while.

Then I told Jim, "Look up at the clock. What time is it?" He said, "It's twenty-five past nine." I said, "That's right. You came in at nine o'clock and you had a convulsion of pain. You haven't had any more convulsions." Jim said, "That's right," and went into a convulsion of pain. I said, "How did you like

that pain? You were free of it for 20 minutes." He said, "I didn't like it and I don't want it to happen again." I said, "I don't blame you. Now Jim, you look at Gracie. Grade, you look at Jim. And, Gracie, as you look at Jim you will go slowly into a deep trance. And as you look at Gracie going into a deep trance, Jim, you will go into a trance." And within a minute's time, they were both in a deep trance.

I pointed out to him, "Jim, pain is a warning that the body gives. It is like an alarm clock that awakens you in the morning. You awaken, and you turn off the alarm. Then you proceed with preparing for the day's work." I said, "All right Jim, and you listen, Gracie. Jim, when you feel pain beginning, you just turn off the alarm, and let your body go about the day's work of comfort, and anything else that needs to be done. And listen well to me Gracie, because Jim doesn't have to see me all the time. Since you are his wife, when Jim feels pain coming on, he can ask you to sit down. He can look at you and you can look at him, and you both will go into a trance. After you are in a trance, Gracie, you can repeat some of the things I am going to teach you right now.“ And so I gave Gracie full instructions on how to talk to Jim.

So, I saw them a few more times to make certain that they had really learned. After the first meeting, they went back to the hospital and demanded to see the chief surgeon. For about an hour, they gave him a lecture about hypnosis. They told him how wrong he was, how very, very wrong. Jim said, "You don't see me having any pain convulsions, and you wanted to do a useless operation. You really ought to be ashamed of yourself. You should learn something about hypnosis." And at the next meeting of my class at Phoenix College, the surgeon came in and took notes.

A few days later, Jim and Gracie left the hospital and went to their home in Arizona. And the government, because Jim was disabled, furnished him with money to build a home. Jim, working in his wheelchair, helped build a great part of that home. The government furnished him with a tractor and 15 acres of land. Jim learned how to get out of his wheelchair and up onto the tractor seat, so he plows his own land.

At first, every two months, they would drive to Phoenix because Jim thought about hypnosis like he thought about anti-tetanus. He would ask me for a "booster shot." I would give him a booster shot. But pretty soon, Jim started showing up only every three months, then twice a year. Then they had a happy idea. They could telephone me. Jim would call me up and say, "Gracie is on the extension line. I think I need a booster." And so I would say, "Are you sitting down, Gracie?" She would say, "Yes." I would say, "All right, I'm going to hang up. You and Jim stay in a trance for 15 minutes. You say whatever is necessary to Jim, and Jim, you will listen to what Gracie says. At the end of 15 minutes, you can awaken."


Zeig JF (1980): A teaching seminar with Milton H. Erickson, Brunner/Mazel, New York: 175-179

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