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Hypnosis
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Use of Hypnosis for Psychogenic

Epilepsy in a Child
a
G. Gail Gardner Ph.D.
a
University of Colorado Medical Center , USA
Published online: 20 Sep 2011.

To cite this article: G. Gail Gardner Ph.D. (1973) Use of Hypnosis for Psychogenic
Epilepsy in a Child, American Journal of Clinical Hypnosis, 15:3, 166-169, DOI:
10.1080/00029157.1973.10402240

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 Tw AM~RICAN
JOURNALOF CLrmca~HYPNOSIS
Volume 15, Number 3, January 1973
Printed in U.S.A.

Use of Hypnosis for Psychogenic Epilepsy in a Child

G. GAIL GARDNER, PhD.

University of Colorado Medical Center

Modifications of hypnotherapeutic technique are described in the treat-

Downloaded by [University of New Hampshire] at 18:06 12 February 2015

ment of an eight year old girl with familial epilepsy whose seizures were
uncontrolled and were found to have a significant psychogenic component.

Uncontrolled seizures are one of the most
debilitating problems in children, impeding
both intellectual, social, and emotional de-
velopment. When complex regimens of med-
ication and diet fail to bring improvement,
there may be a strong psychological compo-
nent to the seizures, in addition to the basic
neurological problem. Several writers (Am-
brose, 1962 ; Kroger, 1963 ; Raginsky, 1962)
have postulated a relationship between ten-
sion and seizure frequency and have re-
ported improvements with hypnotherapy
for both adults and children.
I n order to obtain optimal results
quickly, it may be important, especially for
children, to avoid, in the hypnotic treat-
ment, any sensations which are usually as-
sociated with the seizure episodes. Exam-
ples would include eye closure, feelings of
drowsiness, amnesia, and a sense of lost
time. The following case report illustrates
the utility of certain modifications of tech-
nique.
The patient was an eight year old girl
with familial epilepsy whose first general-
ized convulsion occurred a t age nine
months. By three years her EEG showed a
petit mu1 variant disturbance, and it has
continued to show this pattern up to the
present. The seizure episodes have consisted
clinically of brief eye-fluttering spells. A
brother, three years older, also has epilepsy,
with an EEG and seizure pattern very simi-
166
lar to that of the patient. From the time of
the patient’s preschool years, the neurolo-
gist noted that she seemed quite jealous of
the attention given to her brother because
of his seizures. For example, when he was
seen for neurological examination, she often
requested to be examined too.
The patient’s seizures were relatively
well-controlled when she entered kindergar-
ten. However, in the spring of that year, she
began to manifest increased seizures with
associated increased irritability and hyper-
activity. Despite a trial ketogenic diet and
many medication changes, the problem
worsened. Two years later she manifested
virtually constant eye-fluttering, could not
function a t home or in school, and was hos-
pitalized for further evaluation.
I n the.hospita1 it was soon observed that,
while she indeed had constant eye-fluttering
when in conversation or when she knew she
was being observed, the spells markedly di-
minished when she engaged in solitary ac-
tivity such as watching television. During
the psychologist’s initial visit she had eye-
fluttering during 113/180 consecutive five
second intervals (15 minutes) when en-
gaged in conversation, but only during three
intervals in a 15 minute period of watching
television. Her intellectual functioning was
in the borderline retarded range (I& 72) on
the Stanford Binet, compared with an aver-
age score (I& 93) obtained on the same
 PSYCHOGENIC EPILEPSY
test, eighteen months earlier. Her behavior
and responses to projective tests contained
many hysterical features, including appar-
ently complete lack of concern about her
problem. When first confronted with it by
the psychologist, she casually remarked
“but I don’t want to see.”
During the course of extensive psycholog-
ical evaluation, it was discovered that the
eye-fluttering could be virtually extin-
guished not only when actually watching
Downloaded by [University of New Hampshire] at 18:06 12 February 2015
TV but also when asked to watch “imagi-
nary” TV, looking a t the television screen
with the set turned off. This indication of
high suggestibility, together with the child’s
ability to develop strong rapport with the
psychologist, led to the decision to use hyp-
nosis as a major therapeutic modality, in
conjunction with play therapy.
In the initial therapeutic session, the girl
was told that she had a problem about
blinking and that the goal of treatment was
to help her “keep her eyes open.” We would
spend about half of each hour working on
this problem, and during the rest of the
hour she ((could do whatever she liked.” She
accepted the idea of treatment and quickly
began to cooperate in trying to keep her
eyes open. The change in her motivation
was probably related partly to her desire to
please the psychologist but especially to the
fact that she was now getting attention di-
rected toward resolution of her problem
rather than toward concern about the
symptom itself. Thus, her parents were en-
couraged to try to ignore the blinking spells
but to praise her for periods of no blinking
and also for general alertness and respon-
siveness.
Following the results of the diagnostic
TV watching sessions, the first attempt at
hypnotic induction consisted of asking the
child to watch an imaginary T V s e t t h e r e
being no set in the office-but her mild dis-
tractibility prevented her from cooperating
successfully. Since the goal was to have her
relax with her eyes open, the visual stimu-
167
lus was then increased by abandoning the
television idea and instead having her fixate
on a flashlight which the therapist held and
switched back and forth from green to
white light, flashing a red light whenever
eye-fluttering occurred. The red light was
an important cue since she was never con-
sciously aware of a blinking spell. She read-
ily achieved a high degree of motivation to
“keep the red light off” and was able to
fixate on the flashlight for about 20 minutes
during each session.
Initial attempts t o teach progressive
physical relaxation proved difficult because
the child seemed unable to grasp the con-
cept of “relaxation.” There was little im-
provement following demonstrations of the
therapist relaxing, contrasting relaxation
with demonstrations of stiffness, and more
concrete suggestions to the child such as let-
ting her arms and hands (‘get so loose and
heavy that they flop like a mop, if I pick
them up.” When it seemed that she needed
to have some experience related to relaxa-
tion itself in order to develop the concept,
the therapist finally hit on the idea of using
her braids as an example. Saying, “Let me
see if your pigtails are relaxed,” the ther-
apist picked up and dropped the braids,
then commenting “Oh yes, your pigtails
certainly are very relaxed. See how they
flop down on your shoulders. They aren’t
stiff at all. Now let’s see if you can let your
arm be just as relaxed and floppy as your
pigtails.” Immediately the child caught on
to the idea and from then on proudly dem-
onstrated her increasing ability to relax. I n
subsequent sessions progressive relaxation
was utilized in the usual fashion, suggesting
that each part of the body could “get more
and more heavy and floppy and relaxed.”
The only deviation from the usual procedure
was that, instead of the usual suggestions for
eye closure, she was given repeated sugges-
tions that she could “keep her eyes open”
and that “it is fun to see what is going on.”
Since one of the treatment goals was to
 168
give the child the idea that she could grad-
ually teach her body to do what she
wanted, i.e., control the blinking, the ther-
apist chose hand-levitation as a major
deepening technique, again emphasizing the
child’s control of the situation. “If you
really want to be very relaxed, you can im-
agine balloons tied to your wrist, and you
can let the balloons pull your hand up little
by little. You can let your hand feel so light
that it floats up higher and higher until it
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touches your face and flops again down in
your lap.” The child readily mastered hand-
levitation while keeping her eyes open.
The patient was also given suggestions
along general lines of ego-strengthening
(Hartland, 1971). “This is hard work, and
you are doing a very good job. More and
more you can make your eyes do what you
want. You can keep them open. And we are
both happy that you are getting better. You
are also happy because you are doing better
work a t school and having more fun a t
home. You can be happy because you can
do more and more of the things you like.
And you can make more friends. I am your
friend. I am happy that you can do such
good work.”
Post-hypnotic suggestions were also uti-
lized, namely that the patient would prac-
tice relaxation daily a t home, that she
would be able to keep her eyes open more
and more, and that she could feel proud of
her new skills.
The only dificulty encountered with these
suggestions was that, after two weeks,
mother reported that the child was indeed
keeping her eyes open more during the day
but was having trouble getting to sleep a t
night, apparently lying wide-eyed in bed.
The problem was easily eliminated by add-
ing suggestions that, when it was time to go
to sleep, she would easily close her eyes and
fall asleep.
At every other session, the seizure fre-
quency was recorded, using a stopwatch
and graph paper. I n addition to providing
GARDNER
necessary data, this seemed to heighten the
child’s motivation. As soon as she came into
the ofice she took responsibility for getting
out the flashlight and stopwatch, and she
seemed quite impressed that this important
apparatus was part of her treatment. She
was encouraged to look a t the stopwatch
whenever she liked, and she made frequent
comments pertaining to her progress during
these recordings. Eventually, she discovered
that she could become very relaxed just by
looking a t the moving hand on the stop-
watch. This self-induction technique was
then used regularly, since it maximized her
feelings of autonomy and self-control and
thus weakened the feelings of helplessness
associated with the seizures.
During the play therapy in the latter half
of each session, the therapist continued to
make suggestions that “it was fun to see
what’s going on, to keep her eyes open and
to look a t things around her.” Since she en-
joyed competitive games such as checkers
and cards, it was easy to emphasize the
value of watching and looking. This included
not only looking a t the position of cards or
checkers, but also looking a t drawings of
her feelings after she had won or lost a
game. While she enjoyed making pictures of
happy faces when she was victorious, she
was more reluctant to look a t her feelings of
sadness or anger when she was defeated.
After drawing sad faces, she would actually
throw them in the wastebasket!
The therapist tried to “rescue” the sad
feelings from the wastebasket, but the child
continued to want to avoid them, and it
soon became apparent that she felt she was
helpless in the face of these feelings and
could not change them. She was, however,
willing to explore whether hypnosis could
help modify her feelings. Specifically, she
was asked to relax and then to imagine a
previous happy experience very vividly, es-
pecially remembering the happy feelings.
Once she had achieved strong affective im-
agery, it was suggested that she could have
 PSYCHOGENIC EPILEPSY
these same happy feelings now and that the
sad feelings would fade away. Just as with
the other hypnotic techniques she readily
became able to utilize this sort of “affective
transplantation” at home.
The specific issue of the competition with
her brother was not dealt with in any de-
tail, since this was part of a complex family
pattern and would probably have required
a long time to work through. Instead, the
therapist focused heavily on giving the girl
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the general idea that she had skills and val-
ues in her own right, thus reducing her need
to compare herself to others. The parents
were encouraged to proceed along these
same lines.
The child was seen for a total of 18 ses-
sions over a three-month period beginning
twice weekly and then tapering to once
weekly. The seizure frequency decreased
markedly from the pre-treatment level of
113 spells during consecutive five second in-
tervals in a 15 minute period to 6 spells at
the fifth session and remained stable at
0-10 spells thereafter. Her schoolwork im-
169
proved significantly, and the positive be-
havior changes prompted both mother and
teacher to say “she is a different child.”
Father took her to his office for the first
time, saying that he never would have done
this previously since “she would just have
been into everything and been a terrible
nuisance.” Three months after treatment
was begun, her I&had increased from the
pre-treatment score of 72 to 103. Ten
months after treatment was begun, she was
continuing to make progress both at school
and a t home.
REFERENCES
Anwaos~, G. Hypnotherapy for children. In
Schneck, J. M. (Ed.), Hypnosis in modern med-
icine. Springfield,Ill.: Charles C Thomas, 1962.
HARTLAND, J. Further observations on the use of
“ego-strengtheningJ’techniques. American Jour-
nal of Clinical Hypnosis, 1971,14, 1-8.
KROCER, W.S. Clinical and ezperimental hypnosis.
Philadelphia: Lippincott, 1963.
RAGINSKY, B. B.Hypnosis in internal medicine and
general practice. In Schneck, J. M. (Ed.), Hyp-
nosis in modern medicine. Springfield, Ill.:
Charles C Thomas, 1962.