The Relevance of Being Hypnotic in Addressing Trauma in Children (PDF)

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/346550894 The relevance of being hypnotic in addressing trauma in children across settings Article in American Journal of Clinical Hypnosis · October 2020 DOI: 10.1080/00029157.2020.179443...

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/346550894 The relevance of being hypnotic in addressing trauma in children across settings Article in American Journal of Clinical Hypnosis · October 2020 DOI: 10.1080/00029157.2020.1794433 CITATIONS READS 2 153 3 authors, including: Wendy Lemke Louis Damis Lemke Counseling & Consulting Integrative Health Psychology 3 PUBLICATIONS 14 CITATIONS 4 PUBLICATIONS 9 CITATIONS SEE PROFILE SEE PROFILE All content following this page was uploaded by Louis Damis on 09 December 2021. The user has requested enhancement of the downloaded file.  American Journal of Clinical Hypnosis ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/ujhy20 The relevance of being hypnotic in addressing trauma in children across settings Taylor Leslie , Wendy Lemke & Louis F. Damis To cite this article: Taylor Leslie , Wendy Lemke & Louis F. Damis (2020) The relevance of being hypnotic in addressing trauma in children across settings, American Journal of Clinical Hypnosis, 63:2, 128-138, DOI: 10.1080/00029157.2020.1794433 To link to this article: https://doi.org/10.1080/00029157.2020.1794433 Published online: 29 Oct 2020. Submit your article to this journal Article views: 53 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=ujhy20 AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2021, VOL. 63, NO. 2, 128–138 https://doi.org/10.1080/00029157.2020.1794433 The relevance of being hypnotic in addressing trauma in children across settings Taylor Lesliea, Wendy Lemkeb, and Louis F. Damisc a Saint Mary’s University of Minnesota, Apple Valley, MN, USA; bLemke Counseling and Consulting, St. Cloud, MN, USA; cIntegrative Health Psychology, PA, Oviedo, FL, USA ABSTRACT KEYWORDS Clinical hypnosis has proven effective in the treatment of trauma, not Affect regulation; children; just for adults but for children as well. Given the prevalence of children hypnotic language; trauma; with trauma and the trauma-related dysregulation evident in school trauma-informed care settings, promotion of emotional regulation skills and access to emo­ tional management tools are necessary. Trauma-informed care is on the rise in both medical and academic settings. Some schools are even employing hypnotic-like methods such as meditation with substantial success to address symptoms of dysregulation. Given the suggestibil­ ity of children without formal inductions and the ease of which hyp­ notic-like interventions can be employed, this article will explore how the art of “being hypnotic” and the use of hypnotic language is, and can, be used in various settings, not to treat trauma, but to foster affect regulation, reduce observable distress, improve self-confidence, and promote resilience. Prevalence of trauma The devastating impact of trauma in children is evident in many clinical, medical, and academic settings. Almost fifty percent of adults have experienced at least one adverse childhood experience (ACE), and almost twenty-five percent have experienced at least two ACEs (Felitti et al., 2019). ACEs include physical, sexual, or emotional abuse, neglect, death of a parent, or witnessing a violent act (Felitti et al., 2019). Among the leading causes of death for children aged five to fourteen, suicide is ranked third, and trauma is associated with increased suicidal risk (Harford, Yi, & Grant, 2014; King & Merchant, 2008; Miller, Esposito-Smythers, Weismoore, & Renshaw, 2013). In schools, teachers are experiencing many challenges in the classrooms with children who have endured trauma such as decreased attention span, emotional dysregulation, acting out, and defiance (Foran, 2009). Along with high suicide rates, many Americans are suffering from Post-Traumatic Stress Disorder, including children, especially at-risk children. Research shows ninety percent of children who have been sexually abused, seventy-seven percent who have witnessed a school shooting, and thirty-five percent of urban youth who are exposed to violence in the community will develop PTSD (Hamblen & Barnett, 2009). Many children who are refugees also have developed PTSD from being exposed to war and persecution (Heptinstall, Sethna, & Taylor, 2004). With all of these difficulties and the new challenges CONTACT Taylor Leslie [email protected] Saint Mary’s University of Minnesota, 14905 Embry Path, Apple Valley, MN 55124, USA. © 2020 American Society of Clinical Hypnosis  AMERICAN JOURNAL OF CLINICAL HYPNOSIS 129 children are facing with the current crisis of the 2020 Covid-19 pandemic, our clinicians, pediatricians, and teachers need more ways to foster healthy behavior, assist with emotional regulation, improve academic performance, and promote resilience. Trauma-informed care Awareness of the negative mental, emotional, interpersonal, and physical health conse­ quences of traumatic experiences have become increasingly known to the healthcare community. Moreover, the widespread nature of trauma has been associated with impaired child and adult functioning across all settings. These occurrences have been documented by the Substance Abuse and Mental Health Services Administration (SAMHSA) and culmi­ nated in their publication of the Concept of Trauma and Guidance for a Trauma-Informed Approach (SAMSHA, 2014). These guidelines define trauma as resulting from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being (p. 7). These authors identify four key assumptions of a trauma-informed approach noting that a program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices and seeks to actively resist re-traumatization. (p. 9) This trauma-informed approach, or Trauma-Informed Care (TIC), recognizes symptoms as originating from adaptions to the traumatic event(s) or contexts and shifts the focus from “what’s wrong with you?” to “what’s happened to you?” Elliott, Bjelajac, Fallot, Markoff, and Reed (2005) emphasize that “understanding a symptom as an adaption reduces a client’s guilt and shame and increases self-esteem, and provides a guideline for developing new skills... ” (p. 467). TIC validates a person’s strengths and resilience, fosters more effective coping, and promotes recovery. Primary care pediatric and adult settings serve high percentages of patients affected by histories of trauma, abuse, and neglect. TIC in these healthcare environments minimize the potential for medical care to become traumatic or trigger trauma reactions, addresses distress and provides emotional support for the entire family, encourages positive coping, and provides anticipatory guidance regarding the recovery process (Machtinger et al., 2015; Marsac et al., 2016). TIC is regarded as a best practice (Czabafy, 2017) and the future of healthcare (Oral et al., 2016). Moreover, the integration of TIC into healthcare education is reflected in the inclusion of trauma-informed physical examinations in first-year medical school curriculums (Elisseou, Puranam, & Nandi, n.d.) and trauma-informed baccalaureate programs in social work (Hepscher, 2020). TIC has also been promoted in academic settings where children with trauma histories are at risk for adjustment difficulties, disrupted learning, and re-traumatization if their behavioral difficulties result in disciplinary actions. One way children in academic settings who have experienced trauma can be helped is through TIC. TIC considers the trauma the individual has experienced while fostering 130 T. LESLIE ET AL. safety and respect (Wilson, Pence, & Conradi, 2013). It is guided by ten principles, including “safety, trustworthiness, and transparency; collaboration and mutuality; empow­ erment; voice and choice; peer support and mutual self-help; resilience and strength; inclusiveness and shared purpose; sensitivity to cultural, historic, and gender issues; and change process.” (Wilson). Several schools in small clusters, at the district-wide level, and even at the state level have taken on TIC (Overstreet & Chafouleas, 2016). In trauma-informed schools, all employees have a fundamental realization of the nature of trauma. They understand how it affects students, know how to respond to the needs of students, and how to prevent re- traumatization (Overstreet & Chafouleas). TIC allows school administration, teachers, medical workers, clinicians, and many other care providers to help children rebuild a sense of control. It is quite often that medical providers, teachers, and even some clinicians are not aware of what traumatic events a child has endured, but observe the emotional and/ or behavioral impact of that trauma. Being trauma-informed is a first step, but tools are necessary to implement trauma-informed care. This is where having an understanding of how the art of being hypnotic and incorporating hypnotic language can be constructively used when working with traumatized children throughout many settings. What is the art of being hypnotic? When one thinks of art, they often think of paintings, poetry, or other creative modalities of expression. One could argue that “being hypnotic” can be a creative mode of communica­ tion and expression as well. A major contributor to the field of clinical hypnosis, Milton Erickson, has been referred to as “A Master of Creativity” by Rossi and Erickson-Klein (2013). Certainly, there are creative ways of “doing” hypnosis but there are also creative ways of “being hypnotic.” Often when versed in clinical hypnosis, “being hypnotic” becomes second nature. Much of what we have learned is used without formal inductions. Being hypnotic can incorporate many different things, such as language, attunement, formulation of suggestions, utilization, telling stories, and prosody. Children are often in a trance like state, which obviously heightens their suggestibility and responsiveness (Sugarman & Wester, 2014). The art of being hypnotic can make use of presenting trance states by using creative, tailored strategies based on their individual symptoms and situations. Those who are traumatized are often highly dissociative and often present in trance states whether they are children or adults. “Being hypnotic” in this instance isn’t about “doing hypnosis,” it is often “undoing,” in other words grounding and re-alerting, or providing an alternative trance experience, one that is more positive or comfortable. Hypnosis and hypnotic language Clinical hypnosis has been demonstrated to be effective for the treatment of trauma (Alladin, 2013; Kluft, 2016; Lemke, 2007; Phillips & Frederick, 1995; Spiegel, 1996, 2016). It has been utilized to help survivors of sexual assault, accidents, and other traumatic experiences, with numerous populations, including children (Cardeña, 2000). Clinicians use hypnosis to help modulate and integrate memories of trauma (Cardeña) but hypnotic methods are also employed for grounding, regulating affect, ego strengthening, and  AMERICAN JOURNAL OF CLINICAL HYPNOSIS 131 developmental repair (Phillips & Frederick, 1995). Unfortunately, many children are never diagnosed, brought to treatment, or have access to treatment, and often their only exposure outside of their traumatizing environment is school. Given that practices of attunement and utilizing hypnotic language in a constructive manner enhance emotional regulation, improve behavior, and foster academic success, we should be sharing such strategies with the professionals that deal with the welfare of children. Formal clinical hypnosis uses induction or elicitation to focus attention and elicit trance. Research shows hypnosis can also be explained in terms of more ordinary psychological processes, such as imagination, relaxation, attention, and distraction (Wagstaff, 2013). In other words, there are ways of being hypnotic besides conducting formal hypnosis. Moreover, trance is a naturally occurring lightly altered state of consciousness that we all experience on a regular basis to varying degrees. “All communication is potentially hypnotic with varying degrees of success at getting people to focus on certain representations and not on others” (Murphey & Bolstad, 1997). In this respect, many educational providers can apply the art of being hypnotic to empower students. By using positive hypnotic language when working with children, one can help decrease anxiety, ground to present setting, and promote relaxation; all of which are able to assist with emotional regulation. As quoted from Tim Murphey, “The changing of words changes the thought. Thought leads us into either positive or negative action. Needless to say, the right words produce the right thoughts, which produce the right action, which produce good results” (Murphey & Bolstad, 1997). In his article, he is mainly talking about using hypnotic language to produce academic success, but childcare providers, whether therapeutic, medical, or academic, could also use hypnotic language to foster social-emotional skills and positive affect regulation. After all, children are talented with the use of their imagination, and many have already learned to dissociate or disconnect in auto-hypnotic ways that may not be particularly useful. It would be very beneficial to arm children with constructive language that they can internalize to foster their own sense of self-efficacy and regulate their own emotions. Teachers and clinicians often use hypnotic language by telling stories, or by creating imagery for their students and clients. Teachers also use contemplative education which incorporates trance-like experiences. “Contemplative education” is defined as “a set of practices that may foster particular forms of awareness in students, forms conducive to the conscious motivation and regulation of learning, and also to freedom and transcendence in life more generally” (Waters, Barsky, Ridd, & Allen, 2014). Meditation is a common example of contemplative education that often facilitates a trance experience to assist children in developing helpful ways to regulate affect. Youth meditation programs have been developed in Canada, England, Israel, and India over the past ten years, and are on the rise in schools in the United States as well (Waters et al., 2014). By encouraging meditation in schools, teachers are using hypnotic language and focused attention which helps students develop their own affect regulation skills. Adam Kuranishi is a teacher who utilizes meditation and mindfulness in his classroom every day (Kuranishi, 2016). He has his students meditate for the first five minutes of every class he teaches, and he shares that meditation benefits “overall health, reduces negative feelings, and fosters compassion” (Kuranishi). This is just one example of how successful meditation can be. Many teachers are also beginning to use meditation in the classroom to help students with affect regulation by calming their minds and bodies. 132 T. LESLIE ET AL. For example, as noted above, teachers can structure their routine to include a brief calming meditation. A routine helps children experience a sense of predictability and comfort. In this regard, using a cue to start a meditation, such as ringing a bell or doing a countdown, helps students quickly transition to the start of a meditation. Teachers can give suggestions for students to get into a comfortable position with their eyes open or closed, whatever is the most comfortable and calming for the student. Teachers can change their tone of voice to co-regulate and facilitate a calmer climate. Teachers can also instruct their students in deep breathing exercises to help reduce anxiety and decrease distract­ ability. All of these techniques would be considered hypnotic-like in nature. In school, children who have experienced trauma often have behavioral problems in the classroom such as acting out and being perceived as defiant. This often results in them being disciplined instead of being helped. Unfortunately, what these children really need is attention, co-regulation, and support, not an office referral. Fortunately, some schools are making advances by using apps such as Calm and Headspace (Wells, 2019), and different social-emotional programs in their curriculums such as Responsive Classroom, which all include elements hypnotic in nature. Responsive Classroom is currently being used in the United States, Australia, the UK, and other parts of Western Europe (Stearns, 2015). It is a teaching approach that focuses on using positive language, intertwining academics with social-emotional learning, and effective classroom management (Stearns), especially for students who have experienced trauma. Research shows that teachers’ use of responsive classroom practices is associated with improved academics, stronger teacher-student relationships, better pro-social skills, and less fearful­ ness (Rimm-Kaufman & Chiu, 2007). It is a social-emotional learning program that is helping students learn and grow, and is a step in the right direction toward TIC in school settings. The power of utilization & suggestion The use of positive language and cognitive reframing is utilized not only in Responsive Classroom but in many approaches to teaching as well as clinical strategies by therapists and physicians. Clinical hypnosis emphasizes the strategies of Milton Erickson’s utilization techniques, which often require no formal elicitation of trance. He certainly mastered the art of being hypnotic with his creative use of utilization. His utilization approach often addressed unconscious dynamics by accepting presenting behavior rather than through conscious attempts to immediately change it. He describes this approach where the usual procedure is reversed to an initial acceptance of the patient’s presenting behavior by the operator and a ready cooperation with it by the operator, however seemingly adverse that presenting behavior may appear to be in the clinical situation. (Erickson, 2009, p. 342) Although not a clinical example, an excellent teaching illustration that demonstrates the utilization approach that Erickson (2009) emphasized lies in the story of Clint Pulver that was presented on YouTube titled, “Be a Mr. Jensen” (Pulver, 2017). This story is about a student who struggled in school, not academically, but was picked on for obsessively tapping his hands, which was perceived as disruptive behavior. Others found this annoying and disruptive. Students and teachers told him to stop, and he was sent to the principal’s office for his tapping. The principal advised him to sit on his hands when he had the urge to  AMERICAN JOURNAL OF CLINICAL HYPNOSIS 133 tap them. Although he tried, he could only do it for a short time, increasing his sense of failure and further instilling the belief that he was a problem. One day, his teacher, Mr. Jensen, told him to stay after class. The student was sure he was in trouble fueling his sense of despair and desire to give up. However, Mr. Jensen assured the student that he was not in trouble. He calmly sat down and asked, “Clint, have you ever thought about becoming a drummer?” while pulling out a pair of what would be Clint Pulzer’s first set of drum sticks. Mr. Jensen told Clint, “You’re not a problem, I think you’re a drummer” (Pulver). This story, much more powerful when viewed on Youtube and told by Clint himself, illustrates the hypnotic concepts of utilization and the power of a carefully constructed suggestion. Clint was perhaps in a trance while tapping to help him focus. However, teachers, students, and even the principle made his habit a problematic behavior. This made Clint feel like he was the problem. Mr. Jensen, however, reframed his tapping as an ability rather than a problem by suggesting he could be a drummer. This transformative suggestion went on to change Clint’s life in many ways: From that moment on, I’ve never put those sticks down. I’ve toured, recorded, and played all over the world. My whole college education was paid for with drumsticks in my hand just because of a single moment in time when somebody believed in me and he saw something in me that I didn’t even see within myself. (Pulver, 2017) Suggestions can have a lasting impact on children. Even though the prior example comes from an educational setting, it illustrates how the power of creative suggestions can have lasting therapeutic value whether used educationally or clinically. Developmentally, chil­ dren are highly suggestible, especially during the stages of imaginative thinking. “Children are developmentally in motion both physiologically and psychologically. They live in a land of discovery where ideas realize themselves and imagination prevails” (Wester & Sugarman, 2007, p. 477). Thus any trauma strategy that can creatively utilize what the client/student/ patient presents contributes to the art of being hypnotic. Effective trauma treatment is phase-oriented (Herman, 1992) and can be quite complex (van der Kolk, McFarlane, & van der Hart, 1996). It is beyond the scope of this paper to describe all of this complexity. However, the following examples, when incorporated into a treatment plan, can potentially be effective. The following suggestions illustrate the utilization approach described above: A twelve-year-old boy diagnosed with PTSD who stays up late playing video games because of the associated “sleep dread” that often accompanies PTSD. “Isn’t it intri­ guing how well you’ve become at mastering the ‘controller’ you use for this video game, I’m curious just how good you ‘will’ get at mastering the ‘controller’ in your mind to change or stop the nightmares you’ve been having. Should we see what happens if you practice with an imaginary dream of your choosing right now?” A six-year-old girl who is fearful of doctors due to repetitive painful medical proce­ dures who frequently talks to her dolls in a comforting manner. “Your dolls are so lucky to have you. I wonder if you could teach me what magic words you use to help when they are afraid?” She responds, “they just know, because I’m with them.” “Wow, that’s awesome! How cool you’ve learned to be with them in such a comforting way! 134 T. LESLIE ET AL. You’re a very good doll mom!” You know, the little girl that you once were, could use ‘you’ to be with her in such a comforting way when you go to the doctor. I imagine she still sometimes gets scared and needs to know it is ‘now’ ok.” Even though formal inductions aren’t utilized, the professional engages the child with something they’re already doing well, utilizing their strengths to assist with solutions. Those versed in Ego-State Therapy will also recognize the principle of accessing one state of self, a developing maternal state, to help another state of self, a traumatized younger child state (Watkins & Watkins, 1997). Too often, we see the impact of repetitive verbal abuse and destructive suggestions on vulnerable minds. Thus, it is crucial that we consider the power of our words, and how we can use them constructively when treating or teaching children. The American Society of Clinical Hypnosis recognizes the value of words and regularly offers The Power of Words: Effective Clinical Communication Workshop first presented by Thompson (2013). This workshop is often taught to medical providers, including nurses, who are on the front end of trauma and, depending on their choice of words, can often create more stress or provide comfort. Carefully chosen words can assist in creating positive, successful outcomes regardless of the setting. Erickson stated, “Work primarily with, and not on, the child” (Erickson, 1958). Mr. Jensen exemplifies the incredible impact one person and one carefully crafted suggestion can have on another. Watkins (1978) also referenced this when discuss­ ing the importance of the therapeutic relationship. Therapeutic interventions, whether analytic or behavioral, carry far greater weight with the suffering one because they draw upon one of the most widely used and successful healing principles known to man: the constructive impact of oneself upon another. It has been estimated, if one considered all methods of treatment ever used by all healing arts persons in all ages and throughout all societies in the world, that more people have been treated by one interpersonal technique alone, suggestion, than by all other approaches, physical, surgical, or pharmacological. This attests to the immense power that human relationship has in altering physiological and psychological processes (p. 251). Hypnotic language and creating positive expectancy Often children who have been traumatized feel stuck and don’t believe things can change. Hanley and Gibb (2011) found that those with verbal victimization were at greater risk of developing a sense of hopelessness. Fostering positive expectancy is a skill taught early in clinical hypnosis training and an excellent tool for enhancing a sense of hope. Dr. Daniel Kohen, coauthor of Hypnosis and Hypnotherapy With Children (Kohen & Olness, 2011), has taught many clinicians the value of the word yet. It can be used in clinical, medical, and therapeutic settings to foster positive expectancy with or without formal trance. Certainly, this can be adapted to educational settings as well. For example, consider the following transformative clinical suggestions: Child’s statement Transformative clinical suggestion “I can’t get the pictures out of my mind.” “You mean, you haven’t been able to get the pictures out of your mind, yet.” “I have nightmares every single night.” “So, you haven’t had a peaceful night of sleep, yet.” “I’m too scared to go to the doctor.” “You haven’t summoned the courage to get there, yet.”  AMERICAN JOURNAL OF CLINICAL HYPNOSIS 135 Years ago, a client with severe trauma and depression presented with extreme despair after working with several therapists. She said, “I’ve always been depressed, and nobody has been able to help me”. I (WL) responded with, “you mean you haven’t found a way to manage your depression yet?” She responded with, “I’ve never thought of it like that, if you could help me manage it, that would be great.” Combining the term manage with yet, put things into a realistic, doable framework that provided a sense of hope and a willingness to give more therapy a chance. Children who have experienced verbal and emotional abuse often lack self-confidence and develop negative self-talk or an internal critic. Often they do not even try to do things because they have come to believe they are not capable. By using positive language, and reframing negative thoughts, clinicians, teachers, medical professionals can boost self- esteem and shift personal outlooks to positive expectancies. Imagine a teacher who asks a student to read a sentence. The student gets upset and replies, “I can’t read that word.” The teacher reframes the student’s thought with one powerful word, and says, “you can’t read that word yet, let’s practice.” One-on-one, they practice, and the student is able to read the sentence. The teacher tells the student, “See, you can do it, won’t it be interesting to see what else you can do!” The teacher sees the student begin to smile and witnesses a cognitive shift, one where hope and optimism can grow just because a new seed has been planted. Using positive language based on hypnotic principles and reframing thoughts can benefit trau­ matized students, clients, and patients who lack self-confidence, hope, or who have been made to feel they aren’t good enough. There are many language strategies to incorporate into TIC besides the word yet. For example, consider the use of “when.” Erickson’s principle of presupposition involves making a statement that makes sense only with the acceptance of an unstated assumption (Bandler & Grinder, 1975). When it happens, assumes that it will happen. “Perhaps it will happen today, or later this week, I’m not sure, but when it happens, won’t it be interesting to see how it helps you!” The literature is rich with creative ways to enhance therapeutic success with hypnotic language when working with children (Kohen & Kaiser, 2014; Kohen & Olness, 2011; Pendergrast, 2017; Sugarman & Wester, 2014). Conclusion It is devastating that so many children are experiencing trauma on a day to day basis. With the 2020 pandemic, children are likely experiencing even more stress and trauma on top of their already challenging histories or difficult circumstances. For many children, school is a safe place, a place with predictable rules, a place where they experience being cared for, where they can escape into learning, or a place where they get their only meal. Now more than ever, teachers, clinicians, school counselors, nurses, and pediatricians need to be trauma-informed and armed with tools, strategies, and constructive language, whether that setting is clinical, medical, or academic. By using the art of being hypnotic, incorporating hypnotic language, the concept of utilization, the power of constructive suggestions, fostering positive expectancies, and other tools discussed in this article, we as a community of child caregivers and educators can significantly influence the success and functioning of our traumatized youth. Children can develop more self-confidence, self-efficacy, regulation skills, healthier inter­ nal speech, and increase their capacity for resilience. Indeed, teachers cannot treat 136 T. LESLIE ET AL. trauma, but they are faced with it on a daily basis. However, with the tools hypnotic language can provide to enhance their TIC efforts, they can avoid additional trauma and discipline, foster self-esteem, and instill hope. In other words, they can learn how to be a Mr. Jensen. References Alladin, A. (2013). Healing the wounded self: Combining hypnotherapy with ego state therapy. The American Journal of Clinical Hypnosis, 56(1), 3–22. doi:10.1080/00029157.2013.796282 Bandler, R., & Grinder, J. (1975). Patterns of the hypnotic techniques of Milton H.Erickson: V. 1 by John Grinder. Cupertino, CA: Meta Publications. Cardeña, A. E. (2000). Hypnosis in the treatment of trauma: A promising, but not fully supported, efficacious intervention. International Journal of Clinical and Experimental Hypnosis, 48(2), 225–238. doi:10.1080/00207140008410049 Czabafy, S. (2017). 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