Comments on the Case of Milton
Comments by Dr. Harold Golan on Cases of the New England Society of Clinical Hypnosis, Case Study Number 1.1 by Daniel L. Handel, M.D.
Dr. Golan was a Past-President of the New England Society of Clinical Hypnosis and a Past-President of the American Society of Clinical Hypnosis. He was a frequent contributor to the scientific literature, and an Assistant Editor of the American Journal of Clinical Hypnosis. He served for many years as President of the American Board of Hypnosis in Dentistry, and was an Assistant Clinical Professor at the Tufts University School of Dental Medicine. Originally trained by Dr. Milton Erickson, Dr. Golan practiced and taught hypnosis for over forty years.
This highly interesting case of misdiagnosis, resulting in many iatrogenic near-death sequelae, has been ably described by Dr. Handel in a most generous way. His treatment has been impeccable.
Several special comments come to mind in regard to this particular paper. First is the fact that previous professional treatment of this patient did not utilize any of the alternative methods of medical care. The patient, who had intractable pain, was self-referred as a result of a news broadcast. His physicians, part of a group which had treated him erroneously for esophageal cancer with the wayward results of stricture, pain, depression, disability, and anger, had discharged him with the expectation given to him that he had less than a year to live (a very powerful suggestion at a particularly vulnerable time).
Second is the splendid use of pain control. Glove anesthesia is a wonderful technique. Dr. Handel was able to allow the patient to see and feel the change in physiological control which he experienced. This realization that he could successfully control one part of his body was enough to transfer that control to other parts of his body. This resulted in the patient's:
dropping his morphine use of 10-20 mg q. 2 hrs. PRN, (averaging 5-6 times a day) to none;
dropping his methadone elixir. 20 mg q 12 hrs to q 24hrs, then none;
depression to lift;
appetite to return;
disability to be alleviated;
learning self-hypnotic relaxation skills which significantly calmed his anger, as well as improving his sleep.
Third is the other effects hypnotic suggestions produced. The "second skin" technique of self-actualization for imagining weight gain, athleticism, and physical control added to the effects noted in the second comment. The "squeeze technique" allowed the patient to go at his own pace in slowly releasing his anger and changing his life circumstances.
The splendid changes (of reducing his pain levels, using weights several times a week, returning to school, practicing hypnosis at least once a day, reducing the need for esophageal dilatations to every 6-8 weeks (instead of 1-3 weeks) culminated in a situation which is most gratifying to the patient and congratulatory to Dr. Handel.