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Sandtray hypnosis


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Sandtray hypnosis

  1. 1. Sandtray Hypnosis© Julie H. Linden, Ph.D. A form of this paper was presented in Rome for ESH Sept. 2002 Hypnosis and The Other Therapeutic Modalities in The New MillenniumAbstract:The author presents a new useful hypnotic technique called Sandtray Hypnosis whichcombines hypnosis with a well known treatment modality called sandtray.The parallels between these two therapeutic modalities are reviewed. Hypnosis andsandtray utilize the imagination and creativity of the client as well as foster thedissociation often vital to dealing with difficult clinical material. The theoreticalfoundation of sandplay, its alliance with hypnosis, and the combined technique ofsandtray hypnosis will be explained and exemplified in several case examples.On imagesThe study and interest in images, also referred to as visualization, or guided imagery, hasgrown exponentially in the last two decades. A cursory search on the internet revealed124,000 sites for guided imagery. Spurred by the study of the eastern meditativetraditions, the trauma literature of recurrent and intrusive images, the improvement ofhealth, creativity and performance, right/left brain study, as well as the hypnoticcontributions to guided imagery, there are few in the helping fields who discount thesignificance of utilizing images, whether iatrogenic (coming from the patient) orintroduced (suggested by the therapist), in the treatment of individuals. Images arenecessary and effective in both our internal communication (how we think) and ourexternal communication (how we relate). While hypnosis stands apart from guidedimagery in that it does not depend on images alone, but can use simple thoughts andsuggestions to achieve its goals (Naparstek, 2000), the third most commonly usedhypnotic induction is guided imagery.The road to SandtrayThe absorption with hypnosis and images is what inevitably led me from the single caseindividual’s experience to the universality of experience and images. One cannot usehypnosis and imagery for years with hundreds of patients, without noticing similarities,and patterns in the unconscious, and, like Jung, I was led to the study of symbols andarchetypes (Kalsched, 1996). It is this associative route combined with my clinicalexperience of play therapy with children that created interest in sandtray theory. In manyactivities of play therapy, internal images (both conscious and unconscious) areconcretized with objects, toys, drawings, and drama. In children’s play therapy, whengiven a choice about play, children usually drift towards play with concrete objects whichpermit “picture telling”, i.e. non verbal communication of their internal stories, feelings, 1
  2. 2. affect and problems through the use of toys and concrete objects. Sandtray is a uniqueform of therapeutic play which uses concrete objects placed in a sand box of particulardimensions. The inclusion of sand is thought to connect one to the “primordial elements”(Mitchell & Freidman, 1994, p.53) and research has confirmed its importancetherapeutically (ibid, p. 68-69.) The objects chosen and their placement by children,hypothetically representing internal images, reminded me of the power of spontaneouslyproduced hypnotic imagery I encountered in deep psychotherapy work with traumatizedadults. I wondered how to adapt this experiential form of treatment with children,sandtray, into a form that would be more palatable for adults. While sandtray is usedincreasingly with adults, couples, families and groups, it was honed on children. Iwondered if it could be made available to adults in “imaginative” form. I was attracted tothe metaconstruct of taking an image of a concrete object, placing it in an imaginedsandtray and combining it with hypnosis to achieve similar results of affect expression,affect containment and resolution of symptoms that I had observed in children duringplay with concrete objects and sandplay. I shall review briefly the origins of the sandtraytechnique.Origins of SandtrayAfter World War I, when psychology received its first stupendous growth spurt from thepsychoanalytic group of Freud and his followers, the importance of child development,child psychoanalysis and treatment of children were studied by such notable women, asAnna Freud (1926-27), Melanie Klein (1984), Maria Montessori (1965)and MargaretLowenfeld (1935). Each of these women made contributions to the importance of theplay of children and its healing potential. Melanie Klein first introduced the use of toys intreatment of children, while Lowenfeld was a leader in developing and studying atechnique which utilized sand called “The World Technique” (Lowenfeld, 1979). Theliterature from such leaders in child therapy and development as Piaget (1951), M. Klein(1984), Slavson (1947) and Eric Erikson (1950) note the importance of different naturalmediums, water, sand, clay, which stimulate kinesthetic and sensory development inchildren.Sand play was first mentioned in the counseling literature by Margaret Lowenfeld, aBritish pediatrician, in 1939 (Allen & Berry, 1993). It was brought to the USA byCharlotte Buhler in the 50’s (Allan and Berry, 1993) but mostly for assessment andresearch purposes (Mitchell & Friedman, 1994). The real expansion of the technique iscredited to Dora Kalff (1980), a Swiss Jungian analyst, who developed the theory oftherapeutic sand play and trained practitioners worldwide. “Kalffian Sandplay may be anexperiential extension of Jungian psychology”, a relative of dream interpretation andactive imagination (Mitchell & Freidman, 1884, p.76). Her work with disturbed childrenled her to postulate that a break in the attachment bonding of child to mother weakenedego functioning in the developing child. Like most analysts at that time there was focuson drives, instincts and the inner psyche as the source for healing. She believed that thistraumatized internal condition could be externalized in the sand through fantasy play withconcrete objects, and lead to resolution of the trauma by the child’s development ofmastery and control of impulses. This method of therapeutic play utilized sandplay as the 2
  3. 3. process, the sandtray as the medium and the sand world as the product (Allan & Berry,1993, p.118).Definition of sandplayWhat is sandplay therapy? Sandplay usually refers to Kalff’s technique, while sandtray isthe more generic term for use of miniature objects in a shallow box of sand (Mitchell &Freidman, 1994). I have used the terms sandtray and sandplay interchangeably exceptwhen capitalizing, which always refers to Kalffian Sandplay. Trays of sand of certaindimensions are the containers for the concrete objects. Usually the trays are oblong orround and of a size to create containment and boundaries. Utilized in this technique aretoys and objects from a variety of categories: people, buildings, vehicles, nature, religion,symbols, a list of possibilities without limit. In sandplay the therapist provides the placeof safety and unconditional acceptance, where the child’s unconscious may unfold in thedrama of the sandtray. Nonverbal play, i.e., action, is preferred by most children. So thetechnique of sandplay allows psychological issues to be symbolized at the unconsciouslevel without interpretation (Hunter, 1998).For example, the child creates a picture in the sand, a projection of his worries, needs,defenses, etc. These usually begin as spontaneous trays in which affect, behavior andcognition are expressed in object format. This may transition to directed trays, suggestedby the therapist. This brief description of sandplay therapy captures only the essence andis not meant to describe the details of this important therapeutic modality. Fullerdescriptions are provided in two outstanding books on the topic, Sandplay (Mitchell &Freidman, 1994) and Sandplay Therapy (Boik & Goodwin, 2000). To continue, themovement of objects, the change in the sand world, correlates with the child’sunconscious images and outward change.Parallels of sandtray and hypnosisThis is the juncture where sandtray and hypnosis come together. Hypnosis allows muchwork to be done at an unconscious level. Bloom (2002) has noted the usefulness ofhypnosis to achieve change in clients without conscious insight or interpretation. Thischaracteristic of resolving problems at an unconscious level is one feature shared bysandplay and hypnosis.Sandplay therapy has grown beyond the child’s play room and therapists now use it withadults, couples, families and groups (Boik & Goodwin, 2000) for all kinds of therapeuticissues. This is another characteristic hypnosis and sandplay therapy share- each techniqueis useful across age, groupings, and therapeutic presentations. Absorption in the processis another shared feature, and as I have mentioned imagery is key to both techniques.Another element critical to hypnosis and sandplay is the dissociation experienced in both.(Cardena, 2000; Boik & Goodwin, 2000). The person in trance may dissociate from thephysical surroundings to be attentive to the inner world, or conversely escape out of hisor her body to be relieved of the inner world’s pain (Linden, 2002). The person absorbedin sandplay dissociates, too, from either the outside world to enter the sandtray that has 3
  4. 4. been created, or conversely (and sometimes simultaneously), escapes the inner world byentering the newly created sandworld where needs are met or impulses allowed.“The power of the symbol can be seen in Sandplay as well as in dreams, fantasies, mythsand religion” (Ibid, p. 77) and one might add, in hypnosis. Both sandtray work andhypnosis share this veneration for the image and its healing power.Sandtray hypnosis techniqueSo what is sandtray hypnosis? It is, put simply, the combination of the process ofsandplay, applied without the concrete objects and toys, and hypnosis with imageryutilization, which supplies the objects and symbols through imagery to create thesandtray world. Instead of using concrete images, the hypnotized individual, an adult oradolescent, is able to choose any symbol, object, or image he/she creates or is suggestedto him/her internally.The procedure for the techniqueThe procedure involves several steps. First, the client is placed in trance. This step maybe done formally or informally, i.e., taking advantage of naturally occurring trancebehavior. Second, the client is asked to imagine a sand tray. (Consistent with permissivehypnosis, the dimensions of the tray are vague, so as to allow the production of what theclient needs.) The usual verbalization for this is: “Please imagine that you have in front ofyou a small tray, it may be rectangular, round or square, about 3 inches deep that is filledwith sand. It is lovely sand. Notice the color of the sand and feel its’ grain. You may wantto take a moment to just let the sand run through your fingers as you feel its’ texture, its’temperature and sense it through your fingertips.”Third, the client is asked to choose an object, symbol or image to put in the tray that bestdescribes the situation or problem. This step requires a formulation on the part of thetherapist, just as in any hypnotic technique or treatment, of what the goal of theintervention is to be. For example, I have used this technique to reduce distress, toachieve containment of otherwise overwhelming affect, to explore the meaning of afeeling or an experience, to both assess and strengthen ego-functioning, and to createtransformative experiences. This first object chosen and its placement, just as intraditional sandtray, are of particular significance and often are key to the treatmentoutcome. The client is invited to place other objects in the tray until an “adequate” (asdefined by the client) portrayal of the problem is achieved. During this step the client isinvited to verbalize aloud what objects they have chosen and where they are located.This may be frustrating to some therapists who are used to working in sandtray andseeing the concrete objects chosen from the shelves rather than imagining the innerpsyche’s archetypes of their clients, but I think it is the strength of the technique that itcontinues to remind the therapist of the importance of the client’s internal image.Fourth, the client and therapist “work” with the sandtray picture. During this step, theclient may view the tray from various perspectives, and may briefly enter the tray for an“emotive check”. Such verbalizations are used as: “Take the time to walk around thesandtray and view it from each side. Each perspective may provide you with different 4
  5. 5. information. Is there anything you want to change about the arrangement of the objectsyou have placed in the sandtray? If so, go ahead and make the change.” Or, “In amoment you may step into the tray as I count to 5 (time is determined by the therapist’sassessment of what the client is ready to experience) and experience what it feels like tobe inside this picture you have created. One…, Two…Three…Four…Five…Step inside,notice the feeling, look around. Now step outside. What did you experience, feel andnotice”. For example, to change the feeling or situation to a more acceptable one, a clientwould be invited to change the object chosen, add another object or change its placement.To provide ego strengthening, the client might be invited to stay inside the tray andluxuriate in a pleasant emotion. The “work” in this step is repeated until a change occurs.It has been my experience that change is usually rapid in this step.Fifth, the client observes this new tray and stores it in a “safe place” for later access. Thismental picture storage is the equivalent of taking a photograph of the tray as is done intherapeutic sandtray work. The sandtray literature reports the image of the actual sandtraybecoming a “transitional object” (Mitchell & Freidman, 1994, p. 80) when it is carriedaround in the head of the client. This step may facilitate the integration of new learning.Sixth, the client is realerted. At this time s/he may chose to discuss the experience, butinterpretation is not done by the therapist. Often there is spontaneous understanding ofmaterial that has previously stymied the client.Benefits of the techniqueI do not utilize this technique with children, since I believe that developmentally they stillrequire the concreteness of sandtray work, and it may be beyond their developmentalability to both hold and work with memory in this way (Levine, 2003). However, withadolescents and adults, it has proven very successful in my clinical work and whatfollows is an accounting of its benefits.There are several advantages to the replacement of concrete objects with an imaginedone. In traditional sand play, the subject is sometimes frustrated by the lack of an objectto represent accurately a feeling or experience being portrayed in the sand world. While aclient may bring objects from home, or even make them in the therapy room, there issometimes a disappointment in the outside representation’s mismatch with the internalrepresentation. For example, what object captures the smell of a rose, or the winds of ahurricane?In other instances an internal image can be rich with affect, behavior and cognitions thatcannot be adequately replicated with any miniature object. This is similar to thefrustration experienced by the artist who attempts to translate an internal picture ontopaper and fails to achieve what he/she is after. We are not all Michelangelo’s in theexternal world. However, internally we can all be gifted artists, who are not limited bytalent or genetics, nor by just the visual. This is one of the attractions to hypnosis manytherapists share. Sandtray hypnosis encourages the internal artist in all of us, because wecan create the sensory experience needed to resolve problems, strengthen the ego, andactivate the unconscious processes. 5
  6. 6. In guided imagery many fine clinicians experience the dilemma (sometimes theembarrassment) of being caught in their own image rather than that of the client. Withsandtray hypnosis, just as in Eye Movement Desensitization and Reprocessing (EMDR)(Shapiro, 1995), this may be avoided since the clients use their own internal image,concretize it, and place it in the sand tray for further therapeutic work.Some sandtray research has found that the “concretization of inner archetypes” (Mitchell& Friedman, 1994, p.98) (i.e., the use of concrete objects in sandtray) often leads to aninsight or a new perspective. Hypnosis may serve as the concretizer in sandtrayhypnosis, since the vividness of imagined objects may replace the use of actual objects.For those clinicians familiar with the reliable developmental markers of sandtray workwith children (Mitchell & Freidman, 1994), inquiry into the content and spatialorganization of the imagined sandtray may provide information on the developmentalstage of the client’s presenting problem. Understanding child development in work withadults is in general a benefit, and often underutilized in hypnotic work but this notion isbeyond the scope of this particular paper. Related to this, is the usefulness of sandtrayhypnosis for traumas which happened in early development and remain non-verbal forthe adult. Most adults can describe the concrete objects that they place in the imaginedsandtray, while the content, feelings or knowledge of the trauma remain non-verbal.In addition, it is less messy than the traditional use of sandplay. The therapist does notneed to supply sand, water, trays and objects, provide physical space for the equipmentnor clean up after a client’s visit. And, like hypnosis, which is often “marketed” topatients because of its portability and cost effectiveness (you can take the skill ofhypnosis with you anywhere, and it costs nothing once developed, unlike prescriptiondrugs, or biofeedback machines) sandtray hypnosis utilizes imagined sandtrays andobjects and is very “portable and cheap”.Sandtray hypnosis also has the elements of novelty and surprise that Rossi (2000) positsas requisites to change in the psychobiology of human healing. His theoreticalspeculations about the numinous experience echo another very important feature ofsandtray hypnosis: the client’s passionate description of the experience. Kalff’s premise,based on her Jungian orientation, that when the self is expressed symbolically “it can beexperienced as a deeply personal and numinous moment” (Mitchell & Freidman, 1994, p.60) may explain these passionate descriptions when clients share the resolution they feelafter sandtray hypnosis work.But how, you may ask, is this different from ordinary hypnosis? There are several waysin which sandtray hypnosis is different. First, it creates a contained space which theunconscious seems to experience as safe and protected. This does not seem to rely on theinternalization of the therapist’s safeness nor on the projection or transference of thetherapist’s safeness to the sandtray. This is not to say that the rapport with the client isunimportant. But, rather, it is to emphasize that the visual image of a tray, the geometricspace itself, may transport the adult into that contained space in such a way as to separate 6
  7. 7. fantasy and reality, the past and the present, the conscious and the unconscious processeswhile allowing the dichotomies to both be present. This visual separation or boundary initself seems to create safety, over and above that provided by the therapeutic relationship.(This may be why Lowenfeld emphasized the importance of “transference” to thesandtray rather than the therapist. {Mitchell & Freidman, 1994}). Janet, for example, inhis “sandwich technique” (van der hart et al, 1993) encouraged the subject to movebetween present and past, with the safeguards of time orientation as a method ofcontainment. It is a powerful technique, that relies on “actual” memories rather than theunconscious symbolism of memory, which I believe requires the presence of the therapistto create safety because of the risk that the clients affect may regress so quickly as tofrighten them. Some of the early work in EMDR was controversial because of this samerisk of overwhelming the client with affect without safeguards of containment of theaffect. Kluft (1989) has written extensively about containment techniques in work withdissociatve disorders to avoid this risk of retraumatizing, flooding, or otherwise causingfurther distress to the already scared individual, while doing the uncovering worknecessary to healing. Watson’s “affect bridge” technique (1971) is another example of apowerful therapeutic tool that uses movement and may lack adequate containment. TheTV technique comes closest to providing an imposed boundary, the outline of the TV set,but the action of the show being watched, again, may move the client full speed intoaffect not ready to be handled. When a client is asked to picture a tray full of sand and tocreate a picture of what the problem is, of what he/she is thinking or experiencing, or ofwhat he/she wishes for, and to stand outside that tray and observe it, the images, symbols,affect placed inside the tray are naturally dissociated from the client. It also seemspossible to manage the movement inside of the tray, if there is any, or the imaginedmovement of the client into and out of the tray, without disrupting trance, oroverwhelming the client with conscious awareness of his/her own psychical process.One might poetically say it allows the primitive to ooze up from the unconscious and bethrown on the primordial sandy shore to be contained in its own archetypal desert.Sacerdote’s (1967) work with dream hypnotherapy shares the use of symbolic andarchetypal images that sandtray hypnosis utilizes, and the reliance on the unconscious,but while a significant contributor to insight and uncovery work, it lacks the moreobjective containment of a boundaried world defined by the outline of the tray. Hissuggestions also imply the action of the dreams are important in contrast to the staticpicture which can be achieved in a tray. In addition, in dream hypnoanalyisis movementbetween “reality” and “fantasy” relies on the movement in and out of trance, which wenow know is not always predictable or complete.A second way in which sandtray hypnosis is different from ordinary hypnosis is, ofcourse, the use of symbols by the client as directed by the therapist’s suggestion. Here, Iwant to differentiate the use of the term symbols and objects, from that of imagery.Visualizations, mental images are representations of the world, which imply accuracy.For example, and here I will refer to the pictorial sense only, I ask the reader to picturethe ocean and you see some representation of the ocean. If I ask you to choose a symbolfor the ocean, you may see the ocean, or you may see a cup of water, a stylelized wave, asea shell, a boat on the water, etc. The request for the symbolic taps into the archetypal in 7
  8. 8. the unconscious. If I ask for an object to be placed in the sandtray, that object may beeither an image or a symbol. I believe that the request for an object, image or symbol,rather than visualization, influences what the client produces and is important to theprocess of sandtray hypnosis. Previous experience with actual sandplay, sand andobjects, does not seem to be required for this technique.A few case illustrations will be useful to clarify this technique. The names and details ofclients have been changed to preserve anonymity.Case 1Maria is a middle aged woman in treatment because of mild depression, concerns abouther marriage and what she describes as a neurotic attachment to a high school romance.She is a therapist with a great deal of insight and sees many of her unproductive patternswhich she has been able to change but the latter has plagued her for some years and shebelieves is part of the marital unhappiness. She described the neurotic attachment as afantasy that this person would be a perfect partner, of course having all the qualitiesmissing in her marital partner, although the original romance was full of disappointmentsand ended with her being rejected. Meeting this boyfriend at a high school reunion hadcreated significant anxiety and longing for her, and was the reason to return to therapy.Uncovery work focused on her relationship with her parents, hypnotic work to ageprogress her to a wished for outcome, desensitization to reduce the thought obsessionsabout the old romance, and lots of talking therapy were unable to shift this neuroticattachment. She recognized that something unconscious was at work which eluded her. Idecided to try sandtray hypnosis with her, explaining that it was a new induction I hadcreated.Maria went into trance and was instructed to see a tray full of sand. She was then asked tothink of the problem bothering her, the longing and obsessions for this ex-boyfriend.Then she was instructed to place in the box a symbol for herself. She chose a magnet.Next she was asked to choose an object or symbol to represent the boyfriend. This toowas a magnet. At first she placed them near the side of the sandtray, and described theenergy she could see between the two magnets. I then instructed Maria to move themagnets in a way that made the uncomfortable affect lessen. She placed the magnet,symbolizing herself at the front center of the box, and dressed it in flowing white clothes,which she described as goddess like. The other magnet, was placed in back of the nowgoddess figure, in a worshiping stance. When asked how it felt to look at this sandtrayshe said she felt much better with the magnets thus arranged. I made no verbalinterpretation, but was marveling to myself at the way her unconscious was healing herwound from the rejection. I gave her a suggestion that whenever she had one of thethought obsessions to picture this sandtray. Maria did not interpret this sandtray image,but reported how powerful it was to see the magnets and to move them. Clearly the senseof control she gained in this exercise was significant. In addition to the relief shereported immediately, over the following weeks she found the obsessions lessened andthen stopped and she began to do work on her relationship with her husband. While I amtempted to comment on the analysis of her therapeutic change, I will resist and insteadpoint out that Maria never noted conscious awareness of what her sandtray meant. And as 8
  9. 9. many of us in hypnosis have learned (Bloom, 2002) conscious awareness is not neededfor change.Case 2Here is another case illustration, but in this example conscious awareness was achieved,but only after the sandtray experience was over. Linda is a 40 year old therapist whoconsulted with me from time to time on hypnosis cases, and came in for personal workwhen she felt stuck. Significant pieces of Linda’s background include the loss of hermother when she was a teenager, and feeling she had to parent herself and an older sisterinto adulthood. This current presentation involved both a client with whom she hadworked for years, and a personal situation, and as you might well imagine the two wererelated.Linda described the current transference issue with the client, who had a DissociativeIdentity Disorder (DID) and had responded to years of renurturing, as being fed up withthe constant demands of the client and the way it pulled at her to “do something” for theclient. She had shown good clinical judgment in the management of boundaries with theclient, but the feelings she experienced were sometimes overwhelming. For example, sheexperienced unusually strong anger when a phone message from the client was tenminutes long, worry and anxiety when the client was threatened with being thrown out ofher apartment, or exhilaration, bordering on manic feelings, when the client was acceptedinto a graduate program. When I asked if there were other clients or people in her lifewith whom she experienced these same intense feelings, she responded with, “Funny,you should ask.” She then launched into a story about her sister whom she described asentitled, who had spent all of her inheritance money, was out of work, and had called herto borrow money.She wanted to say no to the sister, but was sure if she was that direct with the sister, pasthistory, suggested the sister would reject her and they would be alienated. Throughdiscussion about the feelings generated with the sister and the client Linda saw there wasa pattern to her reactions, and began to remember times from the past when she had feltthis same way, of wanting to say no, and feeling she could not. We agreed she wouldenter hypnosis and do some work with this feeling, and again, I said I had a newinduction I thought would be useful. Once in trance, I asked Linda to imagine a deeptray, filled with sand, and to stand outside this tray and to place a symbol of herself as alittle girl wanting to say no and not being able to. She described an image of herself in aspecial outfit, wearing a blue hooded top similar to her friends. She added details of thekind of day it was, the sun was shining, it was bright and clear. I point this out becausethe sensory details were significant to her, and undoubtedly tapped in to an implicit,physical memory. This symbol of herself was one of strength, confidence and agencyrather than the helplessness I expected her to symbolize. This girl in the sandtray wasable, in control and what we would call full of a sense of mastery. Linda hadspontaneously placed her childhood friends in the sand tray with her, all dressed in thesame blue clothes. I then asked Linda to place what other objects she needed in thesandtray to allow her to say no to her sister or client without experiencing bad feelings.Linda then placed a figure on either side of the “sandtray blue-hooded self”. One was herhusband and the other her grandmother, both significant sources of love and egodevelopment for her. She stood outside the tray and observed it and said that was all she 9
  10. 10. needed. She commented, still in trance, that it was good to be a child while adults were incharge. She stored this sandtray image in a safe place and came out of trance. Sheimmediately said how powerful the symbols in the sandtray had been, that she hadremembered a time when her needs had been indulged and how good it felt. Whatfollowed was the insight that she needed to first have her own narcissistic needs metbefore she could meet those of others, and was not the mother of either her sister or clientand under no obligation to meet all of their needs. She kept talking about how wonderfulthe feeling was of being that little girl on the day she was allowed to buy a blue top, withall of her friends and be just like them.Case 3This illustration of sandtray use involves a woman who was part of a workshop trainingin which I used the technique with a group. After induction into hypnotic trance I askedeach participant to make a picture in a sandtray using symbols, objects and images, ofhow they would see themselves if they were of the opposite gender. I did not havebackground information on this woman, but following the exercise she said that she hadseen a long sword and placed it in the sandtray and felt empowered and strong with thissymbol of strength. She said she was pleased to discover this inner strength and glad tokeep it with her.Summary and conclusionThese samples of sandtray hypnosis, while brief, illustrate this technique and its potentialusefulness clinically. In no way is this technique meant to replace either traditionalsandtray work or other forms of hypnotic work. It is presented here as an additionallyuseful technique to add to one’s repertoire. I was delighted to read, sometime after I hadstarted using this technique, the following comment by Jung:When a patient presented with a certain mood, or a confusing dissociated affect-“I therefore took up a dream image or an association of the patient’s, and, with this as apoint of departure, set him the task of elaborating or developing his theme by giving freerein to his fantasy. This, according to individual taste and talent, could be done in anynumber of ways, dramatic, dialectic, visual, acoustic, or in the form of dancing, painting,drawing or modeling,. {Finally} I was able to recognize that in this method I waswitnessing the spontaneous manifestation of an unconscious process which was merelyassisted by the technical ability of the patient, and to which I later gave the name“individuation process” ….In many cases, this brought a large measure of therapeuticsuccess, which encouraged both myself and the patient to press forward despite thebaffling nature of the results. I felt bound to insist that they were baffling, if only to stopmyself from framing, on the basis of certain theoretical assumptions, interpretationswhich I felt were not only inadequate but liable to prejudice the ingenious productions ofthe patient….And so it is with the hand that guides the crayon or brush, the foot thatexecutes the dance-step, with the eye and the ear, with the word and the thought: a darkimpulse is the ultimate arbiter of the pattern, an unconscious a priori precipitates itselfinto plastic form… Over the whole procedure there seems to reign a dim foreknowledgenot only of the pattern but of its meaning. Image and meaning are identical; and as the 10
  11. 11. first takes shape, so the latter becomes clear…the pattern needs no interpretation, itportrays its own meaning. Jung 1947, paras 400-2.” (Kalsched, 1996, pp.199-200)Therapists who are not equipped to do sandtray work, but are impressed by the elementsof containment inherent in the sandtray structure, and its access to unconscious materialwhich it shares with hypnosis, will be impressed by the union of sandtray and hypnosis.Intertwining traditional sandplay therapy with the hypnotic trance may nourish ourclinical work and open us to exploring other therapeutic modalities which would benefitfrom the understanding of trance phenomenon.ReferencesAllan, J. and Berry, P. (1993). “Sandplay” in Schaefer, C. and Cangelosi, D. (Eds.) PlayTherapy Techniques. London: Jason Aronson Inc.Bloom, P. (2002). Bridging the Gap Between Brain and Behavior: Hypnotic Routes toPermanent Change. YT1 Audiotape 2002 ASCH Annual Meeting. Sound of Knowledge,Inc.Boik, B. L. & Goodwin, E. A. (2000). Sandplay Therapy: A step-by-step manual forpsychotherapists of diverse orientations. New York: W. W. Norton.Bradway, K.; Signell, K.; Spare, G.; Stewart, C.; Stewart, L.; & Thompson,C. (1990).Sandplay Studies. Boston: Sigo Press.Cardena, E. (2000). “Hypnosis in the Treatment of Trauma.” The International Journalof Clinical and Experimental Hypnosis. 48, 2, .225-238.Erikson, E. (1950). Childhood and Society. New York: Norton.Freud, A. (1926-27) “Introduction to the technique of child analysis.” In ThePscyhoanalytical Treatment of children. New York: International Universities Press,1955.Gil, E. (1998). Play Therapy for Severe Psychological Trauma (Videotape and Manual).New York: Guilford Press.Hunter, L. (1998). Images of Resiliency: Troubled Children Create Healing Stories InThe Language of Sandplay. Palm Beach: Behavioral Communications Institute.Kalff, D. M. (1980). Sandplay: A psychotherapeutic approach to the psyche. Boston:Sigo Press.Kalsched, D. (1996). The Inner World of Trauma: Archetypal defenses of the personalspirit. London, New York: Routledge. 11
  12. 12. Klein, M. (1984). “The Psychoanalysis of Children” (A. Strachey, Trans.) In R. Money-Kyrle (Ed.),The Writings of Melanie Klein, Vol. 1. New York: Free Press.Kluft, R.P. (1989). “Playing for Time: Temporizing techniques in the treatment ofmultiple personality disorder”. American Journal of Clinical Hypnosis, 12, (2), 90-98.Levine, M. (2003). The Myth of Laziness. New York: Simon & Schuster.Linden, J. (2002) The Application of Hypnosis to Children and Adolescents Traumatizedby War in Munich 2000, the 15th International Congress of Hypnosis, Eds. Peter, B. et al.Hypnosis International Monographs Number 6, MEG: Germany, 2002, pp. 21-29.Lowenfeld, M. (1935). Play in Childhood. London: Victor Collancz. Reprinted (1976)New York: John Wiley & Sons. Reprinted (1991) London: Mac Keith Press.Lowenfeld, M. (1979). The World Technique. London: George Allen & Unwin.Mitchell, R.R. & Friedman, H. (1994) Sandplay. Past, Present & Future. New York:Routledge.Montesorri, M. (1965). Dr. Montesorri’s Own Handbook. New York: Schocken Books.Naparstek, B. (2002). “What’s Guided Imagery” in, J. (1951). Play, Dreams and Imitation in Childhood. London: Routledge.Rossi, E. (2000). “In Search of Deep Psychobiology of hypnosis: Visionary hypotheses for a New Millennium.” American Journal Of Clinical Hypnosis, 42:3/42:4, pp178-207.Sacerdote, P. (1967). Induced Dreams. New York: Vantage Press.Shapiro, F.S. (1995). Eye Movement Desensitization and Reprocessing. New York:Guildford Press.Slavson, S. (1947) The Practice of Group therapy. New York: International UniversitiesPress.van der Hart, O., Steele, K., Boon, S., Brown, P. (1993). “The Treatment of TraumaticMemories, Synthesis, Realization, and Integration.” Dissociation, VI, 2/3, 162-180).Watkins, J.G. (1971). “The Affect Bridge: A hypno-analytic technique.” InternationalJournal of Clinical and Experimental Hypnosis, 19, 21-27. 12