Breaking Patterns of Depression: Hypnosis and Building Resources*
(Videotape Review) Michael D. Yapko, Ph. D*
reviewed by Steve Andreas
©2000 

        Michael Yapko is a prominent and capable Ericksonian therapist, presenter, and author, who specializes in the treatment of depression. Depression is a major and widespread problem, and NLP has not developed a specific process for its resolution. This videotape ( 3) offers a rich example of efficient information-gathering and effective intervention, one I have found useful to review over and over again. It is a great tape, both for advanced practitioners, because it is so rich, yet also for teaching beginners how to do simple, straightforward, direct-to-the-point hypnosis. A book could be written about a great session like this (as I did with a session of Virginia Satir’s some years ago (1) and still only mention the major elements that it presents so well. A complete verbatim transcript is now available for study. (2)

Introduction (21 min.)
        In the introduction to the live client session, Michael’s responses to the interviewers, Jon Carlson and Diane Kjos, contain much that is very familiar to NLPers: the importance of asking “How?” rather than “Why?” the emphasis on specific goals, determining the resources that are needed, strategizing how to elicit and sequence those resources, and being sure that they are available in the appropriate contexts. Although familiar, it is refreshing to hear it so clearly from someone who does not consider himself to be a NLPer.
        In addition to Milton Erickson, Michael mentions the major influences on his work as being Jay Haley’s strategic therapy, Aaron Beck’s (cognitive therapy) pragmatism, Allen Funt’s ability to interrupt patterns, Virginia Satir’s emphasis on “planting seeds,” and the basic orientation of “solution-focused” therapy. He describes his work as an approach that emphasizes focusing on psychoeducation: providing information about choices.

Information Gathering (12 min.)
         Michael efficiently gathers information from the client, focusing on how his present functioning is a problem, and what he wants. Mike, a 34-year-old married father of two, is “moderately depressed.” A critical running commentary continually directs his attention to his unpleasant past, including living with a verbally and physically abusive father, placement in foster homes, etc.
        In Mike’s words, “It builds up and I have to get out of the situation and cry,” and “For a long time after I get home, I’ll be in another world” (and mostly not available to his wife and kids).
        Mike’s deep resonant voice is the first clue to his auditory sensitivity (later he says that “pictures click”) but most of his predicates are heavily kinesthetic: “I've been carrying a lot of emotional baggage for a long time,” “I can't seem to move forward,” “I'm stuck in the gutter and can’t get out.”  “People say bad things and it sticks to you,” (gesturing toward his chest).
        His past orientation is particularly evident in the statement, “When I’m not sure how to move forward, I start replaying the things that have happened.” (Mike’s eye accessing cues and gestures alone make this video worth having and using in training!)
        What I found particularly interesting and useful was Michael’s gathering information about Mike’s lack of ability to ignore his internal dialogue. When Michael asks, “How do you know whether to listen to the voices?” Mike replies “I don’t” (meaning both that he is unable to distinguish, and can’t choose to ignore them). Michael then describes asking people how they can have good self-esteem, even though they have critical internal voices, and mentions some of their answers: “I just turn the volume down,” “I imagine it as a barking dog, and I just walk on by,” etc.

Hypnosis (16 min.)
        The first time I listened to this session, I went under and couldn’t recall any of it--and I am not an easy subject! On going back through it a number of times it became very clear why. Michael’s soft, slow voice, his timing of pauses, and his impeccable syntax and sentence structure make it very easy.
The fundamental themes in the session follow directly from the information gathering:
        The past does not determine the future: “You know you're much more than your past, Mike, and that phrase of being much more than your past is going to surface at different times and different places.” “A hundred years ago, no one would have predicted the space shuttle and the space station. Things change.” “The best way to predict the future is to create it.”
        Accessing examples of times when Mike has already done things that prove that the past does not determine the future:  “There are already things that you have done, Mike, that you wouldn't have predicted from your past.” “There are strengths that you have, that you have used to cope, that you have used to build a life for yourself, being married, having your own family . . .”
        Dissociating from his habitual way of being absorbed in the past: “I invite you to step outside your usual experience of yourself.”
        Emphasizing changing Mike’s response rather than the world:
“We’re not going to be able to change the world, but your internal response is eminently negotiable.”
        Accessing pleasant past experiences: “You start to discover in yourself places and things that feel good to you, situations, even memories that you’d forgotten about, of things that were quite nice...the good people that you’ve met along the way, people who went out of their way to do something for you.” “To know that you can go inside yourself and find good experiences,  simple pleasures, the look on your child’s face when you do something funny and unexpected, simple things that remind you of the extraordinary range of feelings you’re capable of, perceptions that you’re capable of, understandings that you’re capable of.”
        Teaching how to discriminate between when it is appropriate to listen to an internal voice and when it is not, and teaching a variety of mechanisms for not paying attention to the critical voices: “Those are things that can drift past and not stick to you.” “What is interesting is how they can become quiet and easy to ignore.” “These are things that can drift past and not stick to you, things that you have clearly left behind.”
        Building a “wall” that “compartmentalizes” the past and isolates it from the present and future: “Slowly and steadily build a wall around what was, to create an endless range of possibilities of what can be.”
        Future-pacing special happy experiences of connecting with his family and friends: “. . ways that you want to be able to connect with your wife, your kids, evolve friendships with people.” “With every interaction with your family you have an opportunity to make things better.”

Feedback and Consolidating (9 min.)
        Mike reports enthusiastically on his experience in hypnosis, while Michael validates and builds on what he says. Mike had never experienced anything like this before, and, in fact, says that he had never even taken time to pause and relax. This is perhaps one reason why the session was so impactful for him.

        “I saw a lot of things . . . that I’m capable of feelings, and that I’ve used talents that I thought I didn’t have, but I have.”

        “It felt good, it felt real good. Almost, I could imagine like a wilting flower (gesturing elegantly with his hands, showing a bent-over flower straightening up) even though things have got me down, that I am capable of standing up.”

        ‘I processed, real quick, different things that people have said in the past, but they aren't true.”

        “I also saw my children, and I realized that I have a terrific influence on them, whether it’s positive or negative.”

        “I'm living in the past; I’m not living in the present. I’m not accepting things for what they are. I’ve got them doomed before they start.”

Discussion of Clips from the Session (40 min.)
        Michael responds to questions from the interviewers about specific segments from the session. There is some interesting commentary, much of which recapitulates the introduction and the session; the real gold is in the session itself.       

Follow-up report
        Although follow-up is not included on the videotape, at five months Mike is still doing well. He reports that he has slept straight through the night ever since the session, has had better contact with his wife and kids, and continues to reorient toward the future rather than the past, etc. “It has not been easy by any means, but it takes daily commitment. Every day I am thankful to just get up. I really feel as though I have been given a new lease on life. I do not want to waste it.”

Commentary
        This is a wonderfully rich session. I know well how much easier it is to play “editor” after the fact than it is to conduct a session from scratch, and I doubt very much that I could have done as good a job with Mike, particularly in such a short time. Nevertheless, there are a few things that I would have done differently, and they might be of interest.
        I would have done some serious reframing of his abusive past, so that when he thinks of it, he could look on it in a more balanced way, and see that despite the pain and unpleasantness, there were also valuable learnings there. “You have experienced how awful that was, and that is valuable information about what you don’t want to do with your loved ones. If you hadn’t had those experiences, you might have made the same kind of mistakes that your father made with you.”
        Rather than build a “wall” between Mike and his unpleasant past, I would have suggested either distance, or a more permeable barrier, so that he could continue to have useful access to the unpleasantness, while controlling its intensity so that it no longer overwhelmed and depressed him.
         “You want to become free of those depressing memories, and that is very important. But if you were to forget your past entirely, that would be a great loss to you. No matter how painful they were, you learned many valuable lessons from those experiences, and not the least of those lessons is that you had the will and the stamina to survive them. You can learn to see all those events at a comfortable distance, small and far away, perhaps through a curtain, or as if shrouded in mist, knowing that they are still there and can be called upon and reexamined whenever you decide it might be useful to you.”
         I am very wary of disregarding any part of a person’s experience, because of the danger of losing the valuable information contained in even the most unpleasant memory. This is definitely my strongest comment about what Michael could have added to the session. (Michael and I have had an exchange on this topic, and we agree on the importance of retaining access to the past; we still disagree somewhat on the best way to accomplish this.)
        I also would have done some vigorous reframing with the commentary voice, inquiring about its positive intent, and redirecting its attention toward positive outcomes in the future, and adjusting its behavior (voice tone, orientation to the future rather than the past, etc.) to align it with those outcomes. Again, I am wary of simply disregarding voices; often they have very important and useful messages, no matter how badly the messages are expressed, and no matter how much difficulty they cause for the person. Often the outcome of a discouraging voice is to avoid disappointment, and it is very comforting and healing to realize this, particularly when it the outcome is stated in the positive “I want you to have a good life.’
          In Mike’s report, he describes his experience of depressing himself in present tense rather than past tense (“I’m living in the past; I’m not living in the present.”) which indicates that he is not fully associated into the new behaviors. There are a number of interventions familiar to NLPers that could have made the movement from past-orientation to present- and future-orientation more complete, and if this review were not already quite long, I would mention some of them.       
         I found Michael’s jerky head movements distracting (only when my eyes were open) and did not detect any positive use for them. To me, at least, these movements were quite different from Erickson’s, but I may be missing something here. Certainly they did not seem to distract Mike, who was in excellent rapport throughout the session.
        Finally, I would have avoided (infrequent) negations like “not stick to you,” “not take it in,” “not being a magnet,” during the hypnosis session. These are negative commands, which tend to re-elicit the problem state. However, they did not seem to detract from the overall effectiveness of the session.
        This is a videotape that is well worth experiencing, studying repeatedly, and using in teaching. I have learned a lot from it, and I think every NLP institute or training program could benefit from making use of it .

References

1. Andreas, Steve: Virginia Satir: The Patterns of Her Magic. Real People Press, 1991
2. Yapko,  Michael D. Treating Depression With Hypnosis: Integrating Cognitive-Behavioral and Strategic Approaches
3. Yapko, Michael D “Breaking Patterns of Depression: Hypnosis and Building Resources” (Videotape) Zeig, Tucker & Thiesen Inc. @ZeigTucker.com

*Originally appeared in Anchor Point, Vol. 14, No. 9, September, pp. 40-44