MAURÍCIO DA SILVA NEUBERN. PART I
Abstract
Through a brief case study, this paper seeks to illustrate the construction of individualized hypnotic suggestion processes for a young mother who had difficulties breastfeeding her baby. After presenting the case, the paper focuses on three axes of interpretation of the suggestive processes that were present during the hypnotic session: the first focuses on the physical senses, the second on the use of metaphors involving milk and the third on ways of redefining the young woman's competence as a mother. These three axes seek to highlight the importance of hypnotic suggestions taking into account the mother's uniqueness, contemplating her particular emotions, senses and meanings. Finally, the paper concludes by stressing that the need for more qualitative research should consist of recognizing the clinic as a field of research so that it is possible to contemplate subjective processes present in hypnotic relationships such as trance, communication, language, symbolization, emotions and constructions of meaning. Keywords: Hypnosis; singularity; breastfeeding difficulties.
The current literature on hypnosis is dominated by nomothetic perspectives, marked by a strong instrumentalist content, the search for knowledge of general patterns of suggestibility responses and the measurement of certain responses (Nash & Barnier, 2008). In this sense, studies on the use of hypnosis in breastfeeding tend to investigate the subject from different perspectives, but from the same general perspective. While some focus on the chemical effects of hypnosis on milk (Berthold, 2004; Cepicky, Pecena, Roth, Stroufova & Sosnova, 1995), there are those that emphasize the use of scales and protocols (Montgomery & Hale, 2006), those that focus on its efficiency as a complementary therapy (Ayers, 2000; Duddridge, 2002; Tiran & Chummun, 2004) and those that focus on the use of this therapeutic modality by health professionals (Raysler, 1999; Tiran, 2005). These perspectives, typically linked to a medical perspective, are useful insofar as they provide general information about the phenomenon and can situate it within the understanding of the population of people who visit health services.
However, the subjective dimension of the breastfeeding process, which plays a fundamental role in the view of certain authors (Arrais, 2005; Golse, 2003), is completely excluded from these studies, which focus on responses and not processes, as well as general patterns and not the singularity of the subjects. According to clinical observation (Arrais, 2005), the mother's construction of meaning in relation to her baby is affected, among other processes, by her life history, the social pressures she receives, her plans for the child, the way her pregnancy took place, the changes of different kinds that have arisen as a result, as well as the network of relationships the mother has established, including with her family. Therefore, the integration of multiple processes present in breastfeeding a child refers to a singularity that does not occur through a simple sum of variables, nor can it be contemplated by nomothetic studies aimed at obtaining general answers.
This problem brings up the need for individualized research that takes into account the unique characteristics not only of the person, but also of their context (Erickson, 1983; 1986; Erickson & Rossi, 1979; Zeig, 1994). Thus, the apparently simple act of breastfeeding has multiple articulations that involve mother and baby and need to be contemplated in a hypnotic process: between the two, there is an intense, multiple and profound communication that involves both the sensory and emotional dimension, as well as the first symbolic registers of the child's subjectivity (Golse, 2003). In addition, this relationship is permeated by a series of social and cultural messages, which have a marked influence on the construction of the subjective processes in which the mother and child take part. For these reasons, we believe that the therapeutic and hypnotic process of breastfeeding, rather than being based on standardized suggestions, should take into account the uniqueness of each person, with their own expressions, forms of communication and ways of constructing meaning that are integrated into diverse socio-cultural processes.
In view of this situation, this paper proposes a brief case study to illustrate the construction of individualized processes of hypnotic suggestion that aim to contemplate the uniqueness of a person. It involves a young mother who asked for hypnotic help because of her difficulties in breastfeeding her newborn baby, as she was very angry, insecure and incompetent in the situation. The work will be developed with the aim of highlighting the fact that the construction of the inductions was closely related to the subjective processes of the young woman, both in terms of her physical senses and her forms of communication, and in terms of her emotional and meaning constructions (Erickson, 1980). The interpretation, based on clinical and qualitative references (Gonzalez Rey, 2005; Neubern, in press) will be developed around three axes of suggestion that occurred simultaneously for most of the process. It should also be noted that these suggestions, made by the main researcher in the study, who provided the young woman with care, will only be shown in some of their moments, due to space limits.
THE CASE
Maria Luíza, 21, an architecture student, had told the researcher in an informal conversation that she was having trouble breastfeeding her baby. She was very tired and said she hadn't slept well for nights. She then accepted the researcher's invitation to an experimental hypnosis session in his research group, which consisted of the researcher and four psychology trainees. It was known that the child had come unexpectedly, as the young woman had not yet married her boyfriend or finished university. In addition, it was common for her family to criticize her, as if she didn't know how to take care of her baby, especially when it cried. In the midst of this dynamic, the baby's crying made her more irritable, giving her a sense of incompetence and paralysis, which was made even worse by her family's criticism.
So, although she produced milk, it didn't flow when she breastfed and her irritation increased even more when the baby bit her, trying to suck on her breast. However, when she heard about the hypnosis research group, she became interested in the idea and decided to take part in the session, saying she was willing to do anything to improve her problem. In a joking tone, she added: "I want to come out of there like those dairy cows that you just have to squeeze to get that milk to come out! "So she went to the session on the appointed day in the presence of the research group. The session with Maria Luíza consisted of a moment of clinical and qualitative research (Gonzalez Rey, 2005; Neubern, in press) which, as well as being therapeutic for the young woman, seeking to meet her demands as far as possible, sought to illustrate to the group how hypnotic suggestions are constructed for a particular case.
Given these circumstances, the researcher decided to avoid a more detailed interview about Maria Luíza's subjective scenario, asking her to express herself as far as she felt comfortable in front of the research group. As well as giving her an active role in the work, exercising control over the information, which is important for both hypnosis (Erickson, 1985) and clinical research (Gonzalez Rey, 2005), there were two basic reasons for this way of approaching the subject. On the one hand, to preserve her privacy, since she would be in front of a group and, as such, this could make her feel exposed or pressured, which already happened in her everyday family life. This risk did exist since some of the people in the group were known to her from other contexts, even though the group members reported that they had no emotional closeness to the young woman. On the other hand, it was also important to demonstrate that certain interventions don't need a very detailed assessment in order to lead to a good result which, at the same time, preserves the subject's integrity and offers efficient proposals for their demands (Erickson & Rossi, 1979). In short, these circumstances were relevant to demonstrating the possibilities of constructing clinical research in the field situation typical of today's health contexts, in a way that reconciles the different demands that permeate the research scenario.
Thus, although there is a risk of exposing the subject in front of professionals and students, it can be minimized by offering them control over the information to be passed on (where they decide what, when and how it should be expressed) and through the use of indirect techniques, such as metaphors and analogies, in which the work turns to a symbolic level and not to literal information about the subject (Erickson, 1983; 1985). At the same time, it was possible to demonstrate that, despite limitations such as a shortage of time, in certain circumstances it is possible to intervene in such a way as to produce research information and meet the subject's needs.
Therefore, in a first interpretative approach (Zeig, 1994; 2006), it was possible to use the information provided by the young woman in that single informal conversation. It was clear that one of the important points was her own acute hearing which, in the midst of a dynamic of family accusations, contributed to a deep irritation towards the baby, as if her crying were amplified and added to the chorus of accusations she was already suffering from her family. It was also possible to notice that her feeling of paralysis was related to a dynamic in which she felt deeply pressured by her family, as if her private space and her own subjectivity were frequently invaded, leading her to feel disqualified. From this perspective, the researcher devised some strategies that could address Maria Luíza's situation so that her competence as a mother could be restored and the breastfeeding process could flow normally. Therefore, the aim was not to provide an intervention that would highlight the relational dynamics of criticism and accusations from the family, but only resources that would point to her potential as a mother and that could also help her not to take part in this type of transaction.
Os recursos hipnóticos adotados foram profundamente influenciados pela noção de comunicação indireta (Erickson & Rossi, 1979; 1980). Tais técnicas, que incluem metáforas, analogias, jogos de palavras, consistem em estruturas linguísticas que são oferecidas ao sujeito em transe que não lhes impõem um conteúdo específico, mas permitem que eles mesmos construam suas associações dentro de determinado tema que é proposto pelo pesquisador.
What characterizes this form of communication is its emphasis on resources, usually unconscious, which the subject doesn't value or even doesn't know about, but which could be of great value to a broader process of change (Neubern, 2004). Erickson (1980) considered that techniques based on indirect communication tend to be more effective, since it is the subject who appropriates their own resources and potentials and uses them in favor of their own demands and needs, and the therapist's interventions are no more than triggers for these processes. In this way, during Maria Luíza's trance, the researcher developed three axes of intervention which were worked on simultaneously, aiming at specific objectives linked to her demands.
About the author: Maurício S. Neubern:
Psychologist (UnB/1995)
Master in Psychology (1999/UnB)
PhD in Psychology (UnB/2003), with a sandwich internship at the Université Paris VII (2001/2002-Capes).
Therapist - Ericksonian Therapy and Hypnosis (Milton Erickson Institute in Paris, 2001/2002 and Milton Erickson Institute in Belo Horizonte, 2005)
Master Certificate (Belo Horizonte and Milton Erickson Foundation, 2007)
Post-Doctorate (Senior Internship): Center Edgar Morin (CEM), École des Hautes
Études en Sciences Sociales (EHESS), Capes 2015/2016. 2009 article.
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