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Rescripting: A Family of Therapeutic Techniques – Kenneth Kaisch (Is.5)

by Kenneth Kaisch, Ph.D.

Rescripting is a hypnotic technique which is occasionally used in psychotherapy. It also refers to a family of related therapeutic techniques. Re-scripting per se involves the hypnotic addition of life experience in order to modify the patient’s felt experience of him/herself. It is most often used when the patient has an experience deficit that is so profound as to be debilitating. For example, a patient who had severely abusive parents may be so deprived of ordinary parental affection as to be unable to establish an adequate sense of self worth despite the use of ordinary therapeutic treatment. In cases such as this, rescripting is the treatment of choice.

It is informative to consider the place of rescripting in the therapeutic armamentarium. Rescripting is the technical complement of reframing. Reframing is a more widely used therapeutic technique, and involves changing the context around a traumatic event: changing the symptomatic situation into a positive opportunity (Watzlawick P., Weakland, J., & Fisch, R., 1974). For example, an obese woman who wanted to lose weight found herself unable to do so, even though it was a medical necessity. Using the reframing technique, she found that she used her weight to appear unattractive to men, because she was unsure of her ability to handle sexual advances. Within this newly found context, she was able to deal directly with her sexual fears, and could then lose weight. With refraining, the content of her experience remained the same, but the context was radically altered.

Given the complementary nature of rescripting and reframing, and the current widespread use of reframing in such diverse modalities as Ericksonian hypnosis, neuro-linguistic programming (NLP), and cognitive therapies, it is curious that rescripting is seldom mentioned in the literature, or used in practice. In an exhaustive computer search of the literature in Psychological Abstracts and Index Medicus using a variety of key words, the author was unable to find a single reference to this technique. While rescripting is occasionally mentioned in the hypnotic literature, there is no systematic examination of this technique in the literature. The purpose of this article is to address this deficit in the literature: to collect data about this technique, to examine the data critically, and to draw tentative conclusions about the place and utility of rescripting in psychotherapy with adults.

History of Rescripting

Ericksonian hypnosis: The earliest recorded mention of rescripting is the case of the “February Man.” Mentioned in Haley’s review of the therapeutic contributions of Milton Erickson (1973), the “February Man” was a hypnotically developed construct used to transform the fears of a woman who was afraid to have children because of her own inadequate parenting. According to Erickson’s recollections, this case occurred in 1943. Rather than replace the patient’s parents with other, more nurturing parents, Erickson added the memory of “the February Man…a friend of your father’s” (1973, p. 181). Erickson used this construct to inject the feeling of being accepted and cherished—experiences lacking to the patient. From this, the patient was able to develop a stronger self-concept, and went on to successfully rear children of her own.

The case of the “February Man” surfaces occasionally in the hypnotic literature. Erickson and Rossi (1979) examined the case in detail in the final chapter of their last collaborative effort. They made clear that this was actually the synthesis of several cases, and that, although Erickson had prepared several papers on this subject; he had not finished or published them.

There appears to be some question, on the part of Erickson and Rossi, as to the validity of this technique of “adding to” the patient’s life experience. The chapter title, “Creating Identity: Beyond Utilization Therapy?” ends with a conspicuous question mark. The chapter itself begins with a series of questions about whether a therapist can, in fact, add to a patient’s life experience. These data suggest that the authors were unsure of the validity of the technique, even though it effected change in Erickson’s patients.

A recent report (Dormaar, 1987) of Ericksonian rescripting was notable for its clear description of the patient’s initial symptoms, the clinical procedures used, and a three-month follow-up. The patient, a 56 year old Dutch male, was suffering from somatic complaints, depression, a personality disorder with inadequate and compulsive features, and chronic tension. The patient sought therapy in order to learn to relax. Following relaxation training, Dormaar used rescripting for a total of five sessions, in order to address the patient’s early and current affective impoverishment. Shortly thereafter, the patient reported that his symptoms had nearly disappeared, that his marital relationship had improved, and that work was going more smoothly. These gains were maintained at a three-month follow-up.

Neuro-Linguistic Programming (NLP): The technique of rescripting was picked up from Erickson and incorporated as part of NLP in the late 1970’s. Although I was unable to find written references to this technique in the NLP literature, I recall hearing of it in several NLP workshops. NLP practitioners significantly altered Erickson’s approach by using rescripting to give new content to the parents themselves. Rather than introduce a “February Man” or some other imaginary character, an NLP practitioner would use hypnosis to write a different script for the parents themselves—changing the patient’s memories of her distant and aloof parents so that she remembered them as warm and caring.

In comparison, Erickson’s approach is conservative—adding a “friend of the family” rather than wholly rescripting the parents. As a result, Erickson’s approach does not run the same degree of risk of being “undone” by competing memories of the actual parents, of family members comparing their memories with the patient, or by the patient’s current experience of her parents. Unfortunately, there are no reports in the literature which have explored this dilemma of competing memories.

Creative Self-Mothering: There are currently several variants of the NLP technique of rescripting parental figures. Elizabeth McMahon describes a technique called “creative self-mothering,” “a process in which the patient dissociates into a child-self and an adult-self and then relives part of childhood with the adult-self giving ideal parenting to the child-self” (1986, p. 150). McMahon describes the technique to her patients, induces trance, and instructs the patient to visualize herself as an infant. She is then instructed to go back to that time as she is now and mother the infant. For men the instructions are to “father” the infant.

Advantages of creative self-mothering over Erickson’s February Man rescripting include fewer hours of hypnotic training for the patient, no necessity for deep trance or elaborate hallucinatory experience, and no need for amnesia. In addition, the patient has control over the experience, and the patient’s knowledge about his/her needs is utilized. However, because this technique is closer to consciousness and involves a degree of patient cooperation, it may be difficult to use with some resistant patients.

McMahon used this technique with patients suffering from chronic depression and low self-esteem, in which the parental message, either overtly or by implication, was that the patient was not good enough. She learned the technique from Joan Scagnelli (1982) who used it with some success for treating borderline and schizophrenic patients

Re-parenting: A related, non-hypnotic technique is that of re-parenting. Unfortunately the author was unable to find written references in the scientific literature regarding this technique. The process, as it is described here, is a clinical procedure used by the author and a number of his colleagues, and, as near as can be recollected, learned in conversations with other professionals.

In re-parenting the patient develops an image of her wounded child, and then uses her current adult resources to love and care for the wounded child. Functionally, this procedure is identical with McMahon’s creative self-mothering, but with the advantage that trance is not strictly necessary. Often, however, the process of re-parenting, with the attendant dissociation, will induce trance.

Re-parenting is used when the patient recalls traumatic memories that are generated either in a hypnotic regression or in the course of talking therapy. The patient is instructed to enter into the memory and “be” the hurt child—to experience the sensations, emotions and thoughts of the child. When this experience is developed fully, the trauma is thoroughly explored. The patient is then instructed to reach out to his older self—the one person in the world who fully understands the hurt and pain that the child has experienced—and to allow that older self to hold him and love him in the very ways that he needs love. The patient is instructed to hold the child by physically wrapping his arms around himself. The patient is allowed to continue this process internally until he feels ready to open his eyes and talk about it with the therapist.

After the re-parenting is processed verbally with the patient, instructions are given to continue this process on a daily basis. In this way, contact that was initiated in the re-parenting process is strengthened and generalized beyond the therapy hour. In future situations, when the hurt child reacts in fear—a fear which previously paralyzed the patient—the patient will have developed enough awareness of his internal dynamics to recognize that the child is afraid, and can then engage in re-parenting himself while the negative situation occurs.

The author and his colleagues have used re-parenting with a variety of clinical populations, including anxiety disorders, adjustment disorders, borderline, narcissistic, and multiple personality disorders, and schizophrenics. There is tremendous affect released during these sessions, and the patients often say that this technique was very powerful for them. However, while the patients’ anecdotal reports and the observed results seem generally positive, there are no outcome studies—published or unpublished—to validate these clinical experiences.

Richard Landis, a psychologist in Orange County, California, has used re-parenting exclusively with approximately 60% of his cases over the last 20 years (personal communication, February 25, 1988). In reviewing his clinical notes on this group, Landis estimated that roughly 6% were treatment failures Landis is still in touch with the first patient with whom he utilized this technique in 1969. He reported that the change which was evoked then was still in effect upon his last contact with the patient. These are extraordinary claims for our field, and worthy of empirical investigation.

Case Examples of Rescripting and Re-parenting

The following cases are taken from the files of the author and Richard Landis.

Case #1: Rescripting: The patient was an 18-year-old depressed girl, whose parents were going through a protracted and bitter divorce. The patient presented as an acting out, rebellious teenager, who stated her belief that she had never really been loved by anyone. Her behavior seemed to reflect this and was passively self-destructive.

In a trance in which the therapist was attempting to assist the patient to access unconscious resources, the patient spontaneously produced a picture hanging on the wall which she described as being “an ideal family—not like mine.” She was instructed by the therapist that her unconscious had produced this picture for her deep learning, and that she was to insert herself into the picture and become part of the family, so that she could get the love and affection she had missed in her own family. The patient entered the picture, and become the oldest daughter. Within this ideal family she had difficulty accepting both the father’s love, and her own responsibilities to the family. She was gently but firmly disciplined by her “ideal father.” When she acted out with him, he very carefully explained why the behavior was inappropriate, and he invited her to change and “become a real part of this family.”

The patient was instructed that her learning as a part of this ideal family could continue outside her conscious awareness, and that she should learn very carefully all of the things which she had missed in her own family, because she needed that learning to be happy and productive. In subsequent sessions, she went to the picture, and reported that a different scene was happening within the picture frame. In effect the picture frame had become a TV screen with a constantly running show. On occasion, the patient felt the need to enter into the picture when something “very important” was happening. Most of the time, however, she was content to note that change was occurring, and she preferred to allow the content of the change to remain in her unconscious.

The patient rapidly improved within three months time. Her mood lifted, interactions with her parents and peers improved, and she was able to get and hold an appropriate job. Five months after therapy terminated, the patient continued to maintain these gains.

Case #2: Re-parenting. The patient was a woman in her late 40’s who was very confused, and whose stance toward life was that of an extremely rigid martyr. She had been sexually abused repeatedly by her father, who then beat her for being a bad girl and told her that she was worthless. The patient feared that if her mother ever found out about the sexual abuse, the mother would abandon her. Prior to therapy, the patient had never told anyone of the abuse.

The therapist instructed the older self to go back to the scene of the sexual abuse, and catch father in the act. The older self, while standing by the door holding the younger self’s hand, turned on the lights, and screamed, “Stop that! Just what do you think you are doing?” The patient was then instructed to focus on the look on her father’s face. During the ensuing sessions, the therapist used slapstick humor to empower the little girl, and to render the father powerless.

This case was notable for the spontaneous behavioral change which occurred. The patient achieved both the symptom reduction that she desired, and an inner peace, and left therapy. Later, however, she contacted the therapist to inform him of a series of positive spontaneous changes in ritualistic behaviors involving eating and dressing that she had never shared with the therapist. In every instance, the changes had to do with removing unnecessary restrictions which she had placed upon herself.

Case #3: Treatment failure using re-parenting. The patient was a woman in her 20’s who was very effective in her work relationships, but very repressed in her relationships with men. Her father was distant and demanding, and she grew up distrusting logic. Instead, she trusted her intuition and feelings.

The patient was able to develop an image of her hurt little girl, but would do so out of fear of the therapist, who was male. As a result, the image always carried a sense of coercion and threat. This sense of threat was added to the original threat which she had experienced as a little girl, and actually exacerbated her problems. As soon as this was determined, re-parenting was stopped, and she was referred to another therapist for more conventional talking treatment.

Conclusions

Rescripting refers to a family of therapeutic techniques which function by adding material to the patient’s life experience in order to modify the patient’s felt experience of him/herself. Rescripting techniques are the technical complement to reframing. While reframing changes the context around the traumatic event—the picture frame, so to speak—rescripting changes the content of the event—the content of the picture, to extend the analogy.

The family of rescripting techniques appears to be extremely effective treatment for patients who have an experience deficit. These techniques have been used to treat a variety of patient populations, including schizophrenics, borderline, narcissistic and multiple personality disorders, patients with anxiety disorders and adjustment disorders, The techniques appear to be especially effective for patients who have experienced parental abuse which has inhibited the formation of loving parental introjects.

There are a few patients for whom the family of rescripting techniques appears to be contra indicated. These populations include patients who are unable to form or hold an image, and patients for whom the image becomes tainted with coercion, as in the case example above. These patients form a distinct minority of 5-10%, in the experience of the author and his colleagues. These armchair figures, however, need to be explored empirically in controlled studies before they can be accepted as valid.

 

References

Dormaar, J. M. M. “February man revisited.” American Journal of Clinical Hypnosis, 30, 28-35, 1987.

Edelstien, & D. L. Araoz (Eds.) Hypnosis: Questions & Answers. New York: Norton, 1986.

Erickson, M. L. & Rossi, E. L. Hypnotherapy: An Exploratory Casebook. New York: Irvington, 1979.

Haley, J. Uncommon Therapy. New York: Norton, 1973.

McMahon, E. Creative Self-Mothering. In B. Zilbergeld, M.G.

Scagnelli, J. Seminar on psychotherapy with severely disturbed patients given during the American Society of Clinical Hypnosis’ intermediate workshop, San Francisco, July, 1982.

Watzlawick, P., Weakland, J., & Fisch, R. Change: Principles of Problem Formation and Problem Resolution. New York: Norton, 1974.

 

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Topics on this article

Hypnosis, Hypnotic Regression, Regression Therapy, Rescripting

Keywords on this article

case study, Ericksonian hypnosis, hypnosis, reframing