Lilian Borges, LPC
PACT Level 3 Therapist
The two things I am most passionate about are hypnosis and PACT. I have been teaching hypnosis for almost 30 years and, as I am deepening my understanding of PACT, I have been exploring ways to integrate PACT and hypnosis. I’d like to share some recent experiences from my private practice in Arizona.
Naturalistic trances are embedded in the PACT experiential approach and interventions. The eye-gazing technique is a naturalistic hypnotic approach. An externally focused trance shows the couple’s dynamics in real time without the confusing smokescreen of verbal language. The eye fixation that eye gazing develops is a light natural trance as opposed to a more formal trance induction.
PACT uses experiential techniques as an intervention, and assessment tools to prove a hypothesis. The therapist can observe what’s happening and ask questions about those observations. For example, a couple might present the problem of a lack of connection, and the therapist may use eye gazing as a diagnostic tool, asking questions of each partner and observing their reactions.
The therapist has to determine a number of things. Has past trauma made it difficult for one or both to look in each other’s eyes? Does one or both have a neurological deficiency? Do they feel comfortable looking at each other? Why is that?
Separate in the Same House
Jane and Peter came to therapy because “we live separate in the same house.” These two engineers met at work many years ago. Jane retired last year and divides her time between the care of her aging parents and their 12-year-old ADD son Bob, whom they are raising. Peter, who has ADHD and mild cognitive impairment diagnosis, still works in a demanding job. I ask him how he copes with his issues.
“I take a lot of notes,” he says.
This couple has been thinking about separating because they have a lot of difficulties managing their schedule, making decisions together about their son, sleeping together — the list goes on. They both seem tired, hopeless, and helpless.
“I feel that my husband lives in his own world, making decisions that I don’t know about,” Jane says.
Peter spends the session taking notes on a notepad. “I need to give my wife the support she needs instead of doing what I think is right.”
One hour into the session, I use the eye-gazing technique. Peter’s eyes immediately soften, and Jane’s eyes start watering. “If your tears could speak what would they’d be saying?”
“We never do this. I’m not sure if we really ever did. We are good at doing things together but not as a couple,” Jane answers.
Peter nods in agreement.
I ask couple to close their eyes and tell me if having the eyes closed is more comfortable, checking the interpersonal stress. I’m using the eye-gazing technique as a container to explore a number of things, such as the couple’s connection, their possible deficits and capabilities, their ability to work as a team, and if separation is really what the couple wants or needs. I am curious about husband’s ability to keep his attention to the wife, how comfortable couple would feel with closeness, if they are able and willing to collaborate with me in our first session.
Noticing that the couple has shifted into a light trance, induced by the eye fixation on each other, I ask them to close their eyes as they are holding hands. I induce a more formal trance, suggesting that couple go to a time in the future when all these issues are solved. When they can see how different they would be with each other, I ask, “What advice would your future self give you now?” Time progression is a trance technique that uses a pseudo-orientation in time to help an individual to experience being in the future.
After opening her eyes, Jane says, “It’s good to have hope again.”
“Seeing our current problems solved gives me some ideas about what I can do to improve,” Peter replies. I ask Peter what some of those things are, and he said that he needed to be more attentive to his wife.
The couple proceed to talk more collaboratively about what they can do differently and how they can help each other. They see a future with each other without the problems. Having hope, becoming more collaborative, and seeing other solutions for their problems are the results of the trance.
Nervous About Having Kids
A much younger couple are nervous about having kids. I use a formal trance to help this couple go to the future and explore the next stage in their lives. Hypnosis as an exploratory experiential tool for the couple functions as a window into their fears and hopes for their future together. As a result, the couple comes back from the trance saying that they are very happy and ready to have the new child.
The wife was fearful about how much involvement her mother-in-law would have with the new member of the family. The trance brought clarification about why she was resistant to have babies. “It is really difficult to set boundaries with my mother-in-law. I’m not sure if we are going to have the same issues again.”
Bottom-Up Technique as Strategic Hypnosis
PACT relies on a “show, don’t tell” experiential style; once a hypothesis is formulated, the PACT therapist can choose from a series of interventions to prove or refute the hypothesis as well as to help the couple face the central tasks of building a secure-functioning relationship — a process which also necessitates individual growth.
The PACT therapist using hypnosis with patients will keep these priorities in mind:
As therapists, we can use hypnosis to change or influence both intrapsychic and interpsychic dynamics. During a trance, we can assist the couple in a creative reorganization of intrapsychic dynamics with past and present relationships. While the couple is in trance, we can work with both real and fantasized relationships. Let me give you an example.
A couple in their 60s, after several therapy sessions, keeps falling in the same argument over and over. They have made a lot of improvement as a couple who had originally come to therapy on the verge of divorce. They are gentler toward each other but still stuck in a cycle of criticism-defensiveness.
At one point, the wife says, “We keep triggering each other’s wounded child.”
“Criticism makes me want to defend myself,” her husband continues, “even when she is not criticizing me, I feel like she does. My father was so…”
The three of us know what he is talking about, since we had done the attachment interview several sessions before and worked on the effects of their critical parents on their relationship.
At that point I ask both to close their eyes and get in touch with the hurt child that each one of them is trying to protect with their anger. “See that little boy and that little girl who were criticized and emotionally abused? You can look at that child, how old they are, how they look, what they are feeling and, most importantly, what they need right now. You can give what the child needs.”
I also instruct each partner to give me some information about what is going on while maintaining the trance, so I know what is going on. Then I ask them to look at their partner while in trance and see their partner with their child. I say, “That child is under your care too, and you don’t want to hurt someone who is under your care. It’s your job to nurture and love that child. I’d like you to reach out and do so.” I give the couple time to see their own and their partner’s child. “Can you see the wounded child and what she and he are feeling?”
The wife replies, “Hurt.”
Her husband says, ”Shame, inadequacy.”
In trance they see ways to talk to each other without hurting their wounded child. The trance helps them to be more sensitive to their partner while in conflict and also gives them more insight about what happens to each other when they are at odds with each other.
Using hypnosis as a bottom-up technique helps clients experience reality instead of the usual top-down or intellectual understanding of it. Hypnosis reframes the continuous arguments that hurt partners and helps both of them connect and care with their child as with their partner’s child at the same time. This couple reports that the experience has changed their arguments radically. Couple continues in therapy to work on their complaints around sex. Even though they still get into arguments, the experience of seeing their partner’s inner child has changed the way they now see each other in conflict.
PACT encourages therapists to be clear on the rationale for using various tools:
Therapy needs a strong alliance with the couple for it to work. If there’s acting out, no good technique is going to work. Hypnosis is no exception.
Hypnotic Techniques for PACT Therapists
A trained therapist can bring the couple to the past or to a point in the future for different purposes. It can be done to one partner while the other watches or with both partners simultaneously. Hypnosis can be formally induced in a trance or naturalistically induced, like during the eye-gazing technique. The therapist who knows hypnosis will notice natural trances that develop during session and will utilize the trance strategically to achieve the therapeutic goals of the session. Each trance is built for each couple and is tailored to that specific couple’s needs.
There are many other hypnotic techniques that we as therapists can use but rather than exhaust the hypnosis possibilities for PACT couples therapy, my intention is to stimulate our creativity so we can keep creating a number of healthy and effective intervention possibilities. After all, the PACT therapist wants to create experiences that will change the couple, focusing on the session goal and asking, “How do I create an experience that will help the couple get there?” Hypnosis can be a powerful experiential tool in the PACT toolbox.