by Robert Lanz, LCSW

In the early eighties I studied hypnotherapy with a psychologist named Sheila Rossi. She and her ex-husband, also a psychologist, had studied under a famous hypno-therapist named Milton Erickson. Dr. Erickson’s specialty was hypnotizing people who either didn’t want to be hypnotized or thought they couldn’t be induced into a hypnotic state. Hey, that’s the perfect kind of hypnotherapy for the Emergency Room.

Of course, being the upfront guy that I am, I told the doctors I wanted to be able to use hypnosis as a tool in the ER. Perhaps if I had been a slightly more aware social worker I’d have realized it would have been better to bring up such an arcane technique only after I had a few more years under my belt and a more solid reputation. Of course, a physician with no training at all in hypnotherapy might be allowed to induce hypnosis in a patient but a licensed clinical social worker with eighty hours of training would not. For me, that was just another rule set to overcome.

On the very the night I was told that it wouldn’t be appropriate for the social worker to perform hypnosis in the ER, I realized that a good clinician could substitute the term “deep relaxation” for “hypnotic induction” and no one would be the wiser. I was an experienced enough social worker to be allowed to do that.

Dr. Erickson, as noted, was famous for pulling people out of the audience during his lectures and hypnotizing them at the same time he was explaining why he wouldn’t be able to do it. In no time, he had the un-hypnotizable person on stage enjoying a deep, relaxed hypnotic state. No jumping around and acting like a chicken or any of that Las Vegas hypnotist-show stuff. A hypnotherapist should only induce a person for positive reasons, to help the individual in some way.

One of the keys to these inductions is to pick the right subject, for example, a person who is already making eye contact, which is a form of interpersonal communication and a key to establishing trust. From there, it is a matter of understanding what that person wants or needs. Through observation and feedback, the person will provide guidance to the therapist and the induction can take place.

Now, that is a method I knew could be very useful in the ER-as long as I didn’t call it hypnosis. And that’s just what I did with varying degrees of success over the years. In many ways, it was like trying to shoot a music video in a nursing home. No privacy. Constant noise. Bright lights. HIPPA rules. But the video you get is a delight to the residents so you do the best you can under the circumstances. I was surprised that it worked at all but over time, hypnosis became a valuable addition to my tool kit.

What I couldn’t have predicted, until I had to use them under dangerous circumstances, was that Dr. Erickson’s techniques could not only help bring a difficult situation under control, but would save my butt in the process. Oh yeah. A couple of staff members saw the whole thing and asked me later where I had learned that trick. They, too, sensed the danger and were amazed and relieved that things went the way they did. I was, too. It had been a long-shot but it was the only shot I had:

A young man had come to the trauma center after being shot several times. He didn’t survive. His friends — mostly rough gang guys — and his family were all in the quiet room when I told them he had tied in the trauma room. That would be the moment the quiet room ceased to be quiet. Cursing and loud wailing took over. Walls were punched. Chairs were thrown. As usual, I remained stoic. It took about ten long minutes of my stoicism for everyone to calm down enough to finally view the body. At least that’s what I thought.

As soon as we opened the door to start walking down the back hallway, the victim’s mother went down hard. Not hard as in falling on her her face or banging her head vigorously, hers was more of a swooning fall. Now remember: I am an Emergency Medical Technician as well as a social worker, and at that moment Mom needed an EMT a lot more than she needed an LCSW.

“Does she have any medical problems?” I asked her husband.

“She takes some medicine for her heart.”

Great. Something for her heart. Now she’s on the floor, not a doc or nurse in sight. From where I was, kneeling down next to the unconscious mom, I could see Danny, the ER tech. At that very moment that ER tech, who had worked with me for years was staring right into my eyes. We were about to have an Ericsonian moment.

“Danny. Move that baby out of room nine. Put her and her parents in the hall. We need to get this woman into that bed, and do an EKG.” Done in an instant, despite the fact that I had gone far beyond the scope of my ER social work job description.

My victory was short lived however. The victim’s younger sister, a big girl of about seventeen, went to ground just outside her mother’s room and had a full meltdown and flailing tantrum on the floor. The tantrum brought the rest of the troops  –about fifteen in all — out of the quiet room. They took up a position where they could not only observe the full tantrum’s effect, but also hear the full amplified effect of the victim’s mother, still unconscious, hooked up to the beeping EKG machine. I was right in the middle of that mix and couldn’t have been more vulnerable to the impending attack of the hostile crowd reacting to emotional pain with physical violence instead of with tears like many of us might have done.

Behind me, Danny was finishing up with the EKG. In front of me, the hostile crowd was seething with negative energy, and between the seething crowd and me was the large teenage girl screaming and jerking on the floor.

I looked at the crowd. I looked at the girl. I looked over my shoulder back at Danny. Like any good EMT, I did a primary survey of my environment and realized I was in trouble and could easily end up a patient in my own trauma center, a victim of mob violence.

Apparently the ER was so busy that no one heard the commotion. I was alone. Well, I thought I was alone. Then it occurred to me that Dr. Rossi and Dr. Erickson were with me. I glanced at the crowd again and realized that one of the gang guys was looking me square in the eyes. He was desperate for me to take control.

“You.” I pointed at him, “Take this girl back to the quiet room. She needs some water.”

Bam. Like magic — or more like Dr. Erickson coming into the audience to do an induction — the young man did just as he was told. The crowd parted and the young man took the victim’s sister back to the quiet room and everything calmed down.

The EKG was fine, according to Danny, and I reassured him that if there was any trouble for me making him do the EKG that I would take the heat. He knew that already, of course. I went and told the charge nurse what had happened and got a chart started on the fainting mother who took some kind of heart medicine.

“Good work, Bob,” she said. “We were really busy up here and didn’t even know you were in trouble.”

Maybe it was coincidence, I don’t know. I didn’t ask. A couple of months after that incident, one of the surgical residents came up to me after a difficult trauma code.

“Bob. I’m really stressed out. Can’t sleep and I’m having trouble concentrating. I heard you can hypnotize people.”

Yes, I could. It just took me twenty years to admit it.

Dividing line


About robertjlanz

Author and health care professional.
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