WOUNDED BY WORDS
I was comfortably pursuing my passion of hypnosis and conducted workshops in many centers of academic learning. I conducted one such workshop in RG College, Meerut (India) in December 2007 which was covered by the print media. Having read the content in a newspaper, a patient named Mr. Chand (disguised name), an adult, approached me for treatment of his problem through hypnotism. He was having thoughts of ‘nash’ (ruin) of his family members which kept on troubling him for 15 years. He comes from a rural background where the ‘nash’ and similar words are used frequently by the local people as an expression of anger and curse in particular. He was unable to face the persons who use this term and would change the route to avoid encounter with the people involved in a conversation that could involve the usage of word ‘nash’. Due to avoidance of many known people in his village, his life became almost dysfunctional over the years. He was not able to talk to people and even stopped discharging his family and occupational responsibilities. He would keep on removing the ‘nash’ word from his mind. He was severely disturbed. Whenever, he bought new pair of clothes, and upon wearing the new pair of clothes, if he heard the ‘nash’ word from any person, he would associate ‘nash’ with the new clothes and then he will not wear those clothes and would go to the outer of the village and through the clothes in pond/river.
He unsuccessfully tried to suppress the ‘nash’ word from his mind for several years. He is a graduate and has an interest in spiritual and hypnosis related literature. He also read self-help books. He formed an opinion that ‘nash’ word could be wiped away from his conscious mind through the application of hypnosis. He was in search of a hypnotist who could help him out in removal of ‘nash’ word from his conscious mind. When he read my coverage of hypnosis in newspaper he got thrilled and highly optimistic and located me in Agra (India).
I listened to his full story which revealed that he was wounded by following words: (a) Nash (2) Guldiva (3) Punja Chhipna. He was scared that by having these thoughts in his mind, there can be an actual loss/devastation in the family. There can be a substantial loss of life and material in the family. He also felt that if any such loss occurs he will be held responsible for having such thoughts in his mind.
He had already seen some psychiatrists and clinical psychologists and also received some sessions of CBT. Since he was not getting the desired relief he was looking for a hypnotherapist for pushing his thoughts to deeper layers of subconscious mind. Being into the field of hypnosis, I knew very well that I would not be able to push away his thoughts through hypnosis. Neither, I was confident that I could achieve desired success by teaching him the technique of thought stopping. In this thought stopping technique, we teach the patients to sub-vocally shout stop as and when an unwanted thoughts intrudes the mind. In fact, I did not know how to handle his problem through psychological means. Also I was not finding myself in a position to refuse hypnotherapy/psychotherapy to him for two reasons. (1) He would get demoralized. (2) I would also feel bad for not able to help him out.
I regained my composure and made a referral for psychiatric consultation. He was not much inclined to do so. Since I recommended him and impressed that it should be a combination treatment, he accepted the idea. On priority, I am inclined for a combination treatment for OCD instead of standalone psychotherapy. He had come specifically for me and stayed in Agra.
We commenced our psychotherapy session next day. While he was reporting his problems, I noticed that he was using future tense in most of his problems. His statements were as under:
1. My brother will be ruined
2. My mother will be ruined
3. I will be ruined
4. I will be held responsible for the ruin
I could not let him know that hypnosis would not serve his purpose. Instead, I impressed him that let us first try something else prior to resorting for hypnosis. Although I was not fully clear what alternative I would be doing. Since my attention was drawn to his usage of future tense, an idea of linguistic pattern crossed my mind. I thought let me try changing the sub-vocal linguistic pattern. I had pre-existing idea that the language patterns affect emotions and behaviors. Keeping this in mind, I decided to give the idea a try.
Specifically I considered changing the statements of future tense into past tense.
After changing the tense to the past, the above statements would become as under:
1. My brother has been ruined
2. My mother has been ruined
3. I have been ruined
4. I have been held responsible for the ruin
For modifying linguistic pattern, I would require him to repeat these statements. The idea of ‘ruin’ was frightening to him. He thought the repeated idea would get converted into objective reality.
Before making him to rehearse above tense converted statements, I decided to correct his magical thinking. In magical thinking, a person thinks that mere mental repetition of some words can cause physical events in the external world. His repetition of ‘nash’ in his mind can actually cause ‘nash’ in his family. I had to correct his magical thinking by explaining that only by repeating thoughts in his mind, he cannot cause a physical event. I invited him to move his mobile only by his thoughts; or kill an ant by performing mental acts or repetition of any words mentally. He could understand the concept of magical thinking. He seemed to accept the idea that thoughts by themselves cannot cause physical events. Now the ground for repetition of the scary words was set in.
I also explained him the idea of tense and its neural correlates. I told him that let us call three tenses – Past, Present and Future as ABC. A=Past Tense; B=Present Tense (c) C=Future Tense. The three tenses do not have identical neural correlates in the brain. We can speculate separate areas for each tense in the brain. If it is so, let us call the corresponding centers in the brain as ABC (A for past tense, B for present tense and C for future tense). Whenever, a person uses past tense (A) the information travel to the A centers in the brain; during usage of present tense, the information travels to B centre and during usage of future tense, the information travels to C center in the brain.
Anxiety looks into the future. Fear is future. As and when the mind is affected by fear, the sub-vocal language becomes future oriented and the centre C in the brain become more active. Over the years of fearful state, the C centre in the brain remains active and the person also continues to remain fearful. If we change the language pattern in above statements, the information will not travel to C centre in the brain and the fear associated with these words will cool down. This linguistic pattern was totally my speculation which I was trying for a few years with other patients too; albeit in other forms and problems.
Now the actual rehearsing of tense converted statements was in order. Having educated him in above concepts, I asked him to repeat above statements. The statements were to be taken up in sequence. The first chosen statement was “I have been ruined” (In Hindi: mera nash ho chukka he). When I asked him to repeat that, instantly there was a withdrawal response and visible signs of fear were present. He found it extremely scary to repeat this statement. I reminded him of the concepts of magical thinking but still he failed to accept the idea of repeating the words which have been wounding him for several years.
I wanted him to repeat the tense converted statement in a row. I could understand his fear and inability to speak the tense converted statement. I then resorted to approach the task by diluting it. I told him that let me repeat it for me and just listen to it. I started verbalizing “I have been ruined” (in Hindi: mera nash ho chukka he), “I have been ruined”, “I have been ruined”… The signs of distress were visible in him even if I was repeating it for me. I kept him encouraging that whenever he feels comfortable, he can begin to repeat it. Then I shifted to enemies; “enemies are ruined” (In Hindi: Shatruaon ka nash ho chukka he). He quickly picked up it and commenced repeating. Gradually, I removed the enemy word from it and now he was required to repeat “ruined” (In Hindi: nash ho chukka he). I noticed that upon commencing the verbalizations in such manner he was having distressed reaction, which got raised to high level.
I explained him the concept of anxiety curve. I told him that while repeating, his distress will rise from low to medium and then to high level; and then it will show a declining pattern to medium and low and finally zero. If this pattern of rising and declining pattern of anxiety is plotted on a graph, it will result in a curve similar to bell shape.
Also I reminded him of the magical thinking; that mere repetitions in this manner will not produce actual physical effects and urged to keep on repeating. He kept on repeating. The anxiety which rose to high level now began to resolve and cooling down. After a few minutes of repetitions, he reported minimal distress for repeating the statement.
When his fear reaction subsided to the spoken statements, I gave a pause of about 3-5 minutes and chatted with him on other topics. After a gap of this pause, I once again asked him to repeat “ruined” (In Hindi: nash ho chukka he). This time, withdrawal reaction was not present. He readily accepted the idea of repetition. When he repeated it this time, the fear reaction did not shoot up. Within a few minutes he reached the minimal level of distress. Again a pause of 3-5 minutes was given. Once again he was required to repeat the above statement, this time he found it comfortable to repeat. Even if there was no discomfort this time, I made him to repeat for over learning. When both of us agreed that there were no distress while speaking it, we decided to switch over to other statement. In the course of applications, I finalized a criterion of three or more consecutive repetitions without or with minimal distress as the pass criteria to move on to other statement.
The session continued for about one hour. Seeing the response of reducing fear to the verbal exposure of fear provoking words, I got thrilled and optimistic that this approach can be continued on him for other statements too. I thought if this pattern can be replicated to other statements, then he can be expected to make substantial healing of his psychic wounds.
I labeled the bulk repetition of fear related terms and statements as “Drill”. We met daily for further sessions except on Sunday. He seemed to have regained his hope and optimism. We identified more objects and situations associated with fears. Following additional objects/situations were identified:
1. Ladies in his village speaking ‘punja chhip jayega’
2. Ladies conversing amongst themselves, ‘Guldiva ho jayega’
3. Vansh nash ho jayega
4. Group of people conversing themselves in the front portion of his house and using the word ‘nash’
5. Hearing the word ‘nash’ while wearing new pair of clothes
I then encouraged him to take up other statements for drill. “Guldiva ho chukka he”, “Guldiva ho chukka he”, “Guldiva ho chukka he”… Upon commencement of this statement, again the fear reaction showed spike to medium and then high to very high levels. Since the fear reaction was shooting almost instantaneous to high or very high level; I gave him pauses for a couple of minutes. I reasoned that during the pause his mind will become prepared to handle the massive emotional processing rapidly. My this idea of giving pauses worked exceedingly well in expected direction. After pause, when he resumed to verbalize “Guldiva ho chukka he”… the fear reaction did not shoot up to very high level. He continued to perform the drill which was essentially involving verbal exposure. His distress was perfectly following the pattern of anxiety curve. The remarkable feature was that the pattern of his fear reaction was returning to minimal level within a few minutes of repetitions; approximately 5-10 minutes.
The pattern of resolution of anxiety boosted the self-efficacy of both me and the patient. We were feeling happy that this method of healing the wounds was working perfectly well. After 2-3 days of application, he softly asked me “Sir, can I buy a register?”. I got surprised and asked what he would do with the register. His response simply illuminated me. He told that he was not having any work to do after one hour session with me; he can write all these statements repeatedly on the register. Without any second thought I told him to go ahead. Most psychotherapy work happen between sessions. Homework is an essential and important aspect in psychotherapy. I was missing this component of homework with him. He himself came up with the idea of homework even without me suggesting for it. He bought a register and kept on writing the statements on the register. The writing drill accelerated his improvement to a great extent. Now I think, I could also have given him MP3 recordings of drill statements for him to listen as homework. The homework in any form is bound to reinforce the improvement.
As sessions progressed he was verbally exposed to following statements through drill:
1. My brother has been ruined
2. My mother has been ruined
3. I have been ruined
4. I have been held responsible for the ruin
5. Punja chhip chukka he
6. Guldiva ho chukka he
7. Vansh nash ho chukka he
8. People around in the village ‘nash’ bol chuke hn.
9. I have heard the word ruined while wearing new clothes
It was readily apparent that mere repetition of these words were producing visible psychophysiological reactions. As he continued to perform drill, the reactions were cooling down and he was feeling comfortable. Extinction was taking place. As and when he was found to express future oriented statements of fears, all such statements were taken for drill.
He continued to gain mastery over fear reaction for the drilled statements. The surprising feature of the application of the drill was that little if any generalization was taking place from statement to statement even if the key term in the statement was identical. For example, I have been ruined vis-à-vis my brother has been ruined. Each drilled statement contained some distinguishing mental image and features which was not amenable to spontaneous generalization. He had to perform drill for each identified statement for extinction to take place. However, the generalization gains were visible in the quantum and duration of repetitions. With progressive applications of drill, he needed relatively less time and frequency of repetition for extinction to take place.
He was giving me surprise after surprise in most sessions. Upon commencement of one session, he reported that he heard two persons using the ‘nash’ word at his place of stay in Agra. He went near those persons and intently listened them using ‘nash’ word. His body and mind no longer reacted fearfully to the usage of ‘nash’ word by them. He designed his own behavioral experiments in real life situations. His confidence in improvement and the procedure got strengthened tremendously. Had he shown fear reaction to real life situations, I would have taken it as an evidence for doing more drill for the word for those situations.
The sessions were being conducted through verbal exposures and imagination of objects and situations which were linked with his irrational fears. I noticed that spontaneous generalization was taking place from verbal and imagination level work ups to the real objects/situations. I did not purposely exposed him to the real objects and situations. Neither, I had an opportunity to do so. But his own intellect was doing it for me.
In another session, he added one more pleasant surprise for me. He came wearing casuals to my session and revealed that he had heard ‘nash’ word for these pair of clothes. He had purposely brought that pair as a testing and confirmation of improvement. That is, if after the treatment he could wear that pair and felt comprtable then he would consider it as a positive and strong evidence of improvement. While wearing that pair he reported nil distress. He was as comfortable as with other pair of clothes.
He improved tremendously. I myself was not believing to the quantum of improvement which happened very fast. But it was there. I had nothing to prove it as otherwise. I tested him for all the statement repeatedly. I asked other neutral persons to speak all the statements before him. He felt comfortable and did not react in feared manner to any of the verbalizations of third party. I had no other way than to accept the improvement as authentic.
Only seven sessions were conducted on him and he declared himself completely out of the irrational fear of these words. His psychic wounds had healed substantially. He expressed his desires to take leave from me in Agra and return to his village. I could not identify any further statement for drill and no work left for further sessions, I agreed to his request for termination of therapy with follow up recommendations of psychiatric medications and applications of drill.
I continued to follow him up over phone and he maintained his improvement beyond six month follow up. I was quite happy and got involved deep into theorization and conceptual understanding of the work done with him. My own core striving and passion to heal the scary wounds of mind were healed. I too got a sense of relief that at least I could change the life of one person through applications of the principles of psychology. This case was a turning point in my practice of clinical psychology. I was finding myself full of enthusiasm but at the same time felt that I need to refine my conceptual understanding as well as applications of this unread and untaught form of psychological treatment.
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