Last time, we explained how trauma impacts the way our Parts are created. We learned about Amy’s story; she was only five years old when she started caretaking for her father who struggled with alcoholism. In this article, we will examine how different Parts of you can be in direct conflict with each other and how this impacts your well-being. We will revisit Amy’s story to understand how her Parts, that were originally meant to protect her, eventually created distress in her inner world.

The brain is an adaptive organ and it is constantly processing information for you. It works much like a filing cabinet, extracting information from your typical day-to-day activities and automatically filing it away into the appropriate folders.

When something scary or traumatic happens, your brain will be sure to file away the details of what happened along with the thoughts, feelings, and sensations that were triggered by the traumatic event (Gonzalez & Mosquera, 2012). Unfortunately, during a traumatic event, the brain is unsure how to make sense of the new information from the experience, and is unable to organize everything in a healthy way.

It is only natural to want to forget scary memories and if we are really young we do not have the ability to understand and organize a scary event. Because of this, instead of understanding the information and filing it away in an organized manner, your brain does the equivalent of throwing the papers into a messy pile with a sticky note on top labeled, “file later. ”

Those papers to be “filed later” start to become a problem. Every time you are reminded of the traumatic event — through a memory flash, thought, feeling or sensation — your brain adds another paper to the “file later” pile. The pile continues to grow over time and it becomes distressing for the brain to not be able to organize it.

The content of this pile holds highly intense emotional information. Looking at just one piece of paper would likely feel like you’ve traveled “back there” to the time when it happened. The brain doesn’t know the difference between what’s happening now and what’s happening in a memory; this can set off its alarm system even if you are currently safe. Because of this, looking at that pile of paper can feel unsafe and overwhelming. This is where we come in.

“A child may become overly pleasing and compliant in order to secure some form of safety.”

Parts begin to form during the critical time of childhood and adolescence, therefore, our interactions with parents and caregivers play a central role in their development. If a parent is frightening, unpredictable, or emotionally or physically unavailable, over time this creates an experience for the child that is very intense and difficult to deal with. It becomes almost impossible for the child’s brain to file the experiences in an organized way.

In order to cope with his or her experiences, this child will begin to develop and test out different strategies. For instance, one Part of the child will hold the belief that, “My father is unsafe because he hits me.” This Part will likely feel insecure, scared, constantly on high alert, and ready to fight or flee at any moment.

Another Part of the child figures out how to bond with the parent that hurts them. Children need their parents to survive. The parent-child relationship is crucial for brain development and how the child learns to relate to the rest of the world (Gonzalez & Mosquera, 2012). A traumatized child might realize that if they follow all the rules and only do as they are told, their father will not hit them and they can feel some sense of love from him. This child becomes overly pleasing and compliant in order to secure some form of safety.

How do you imagine these two Parts would get along internally? One Part sees the parent as someone who is unpredictable and even dangerous. The other Part loves the parent deeply and would do anything for the relationship. It is common for the Part that holds the memory of the damage, pain, and confusion to reject, and even belittle, the Part that needs the parent. This Part that feels scared and on alert can view the Part that loves the parent as weak and a danger to your survival.

This sort of internal conflict creates an unbearable emotional burden (Gonzalez & Mosquera, 2012). The conflict manifests in different ways for each child. Some children internalize the inner turmoil and experience anxiety, have nightmares, withdraw from other people, and/or have physical symptoms like headaches and stomachaches. Others will externalize their disturbance by doing things like showing physical aggression, disobeying rules, and/or bullying.

“I can’t tell anyone about this because it would hurt my dad. ”

In our last article, we shared about the Part of Amy that needed to have a relationship with her father. Since the time she was a little girl, Amy felt responsible for her father and would do anything to be with him. This is no task for a child to begin with, but especially for Amy because her father would drink heavily every day. This Part of her held the attachment to her dad and valued their bond over her own physical safety. Let’s call her “Little Amy. ”

Little Amy had her own set of thoughts, behaviors, and coping responses. She had thoughts like, “I love my dad,” “I have to keep my father safe,” and “I can’t tell anyone about this because it would hurt my dad.” Little Amy had a way of “going somewhere else” in her mind when things got scary. She knew how to tune out, and this ability helped to keep Amy sane in such an unpredictable environment, like when her father drove her to a friend’s house while drunk.

At the same time, another Part of Amy was developing — the part that held the trauma — who we will call “Siren.” Siren would not let Amy forget about her father’s alarming behavior, his inability to be emotionally present, and the pressure he put on Amy to keep him alive. Siren had thoughts like, “I hate my father,” “Tell mom!” and, “You have to get out.” When Siren was activated, she would yell at her dad, have uncontrollable crying outbursts, and leave his house abruptly. Siren had a way of getting Amy out of dangerous situations when it was really bad. For Amy, it was this Part of her who decided she had to stop seeing him midway through high school.

Here you can see how both Little Amy and Siren were important in helping Amy get through her childhood experiences, however, they did so in very different ways. As Siren became stronger, she could not fathom why Little Amy would stay with her father and endure such pain. However, when Amy’s father died shortly after she stopped visiting, the Little Amy could not forgive Siren for keeping her away from her father. This resulted in immense guilt for Amy, and Amy felt completely lost.

As an adult, the only way Amy knew how to manage the guilt and shame her Parts were experiencing was by drinking alcohol herself. Unhealthy coping behaviors, such as excessive drinking, are a way for our Parts to avoid the impact of negative experiences. It can be an effective way to protect oneself from thinking, feeling, or experiencing painful memories through positive anticipation (Gonzalez & Mosquera, 2012).

Amy knew that drinking as a way to cope and was out of alignment with the person she wanted to be. In therapy, using the techniques of Part Identification and Integration, Amy was finally able to put the battle between Little Amy and Siren to rest. By looking at herself through the lens of empathy and care, she came to a new understanding about her Parts and how each Part’s feelings were valid given all that she had experienced. For the first time in her life, she realized that she had done what she needed to do in order to survive. Making peace between her conflicting Parts could now allow Amy to thrive.

We have given you a lot of information on how trauma impacts the Parts of us. Next time, we will focus on identifying and growing the Parts of you that are positive and helpful.

Gonzalez, A., & Mosquera, D. (2012). EMDR and dissocation: The progressive approach. AI.

Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Publications.


Create Outcomes is an organization devoted to supporting individuals in growing toward their highest potential. We offer individual therapy, couples therapy, group therapy, therapy for children, teen therapy and retreats. Our therapists integrate psychodynamic theory, cognitive behavioral approaches, and their own unique perspective and training to provide the most clinically relevant care to each individual. We are in-network with Humana insurance and offer in-person therapy in Denver, Colorado, New York, NY and Long Island, NY and provide teletherapy for residents of Florida.

“Multiplicity is our first characteristic; unity is our second.” — Theodore Sturgeon

In our last article, we gave you a brief overview of Part Identification and Integration (PII), our theory on how you are a whole person made up of many Parts. Our way of understanding how people become who they are is not a unique idea. In fact, there is a wealth of literature and research supporting the notion of “multiplicity of self;” within each of us exists a number of different selves and our ability to live authentically depends on how well these Parts of you are working in your current life (Bromberg, 1996). Are they relating to each other to support your overall growth? Or are they so separated that you don’t feel whole? In this article, we will dive into the theoretical roots of PII and use Object Relations Theory to illustrate how and why Parts develop in the first place.

Parts are the self-states that begin to take shape from the day we are born. The basis of Object Relations Theory is that from infancy we are interacting with various “objects” in the environment; our parents and caregivers are the most important of these objects. Through our early interactions with the world, for better or worse, we create and hold mental pictures of relationships, feelings, and things we experienced over time. These mental pictures become memories and if repeated enough times, become the foundation for self-states to develop.

We all have an idea of who we are or want to be. Some Parts can feel aligned with this idea, while other Parts feel completely separate from who you think you are. Sometimes, we are aware of the existence of a Part and sometimes we are not. Nevertheless, as we grow and mature, a Part will develop into a complex tapestry of thought patterns, emotions, and behaviors. Let’s find out how!

The Parts of who we are primarily developed in relationship with others. In childhood, our parents or primary caregivers are the first relationships in which we develop self-states. As we grow, these self-states shape how we look at and interact in other important relationships; such as with peers, friends, teachers, and romantic partners. So the cliché is true: you are who raised you!

Parts develop through processes called introjection and internalization. Introjection occurs when we adopt the attitudes and actions of those around us. This typically occurs through mimicking, our natural way of “trying out” behaviors. Let’s consider the example of Jane, who, like most children, naturally mimicked her parents as a little girl. To connect with her father, she showed interest in sports he liked. She watched wrestling matches and played football with the boys at school. Her father, noticing and being delighted by Jane’s interest in these sports, even gifted her a football for Christmas. As you can see, Jane’s father positively rewarded Jane’s behaviors through gifts and attention.

Here’s the thing about introjecting, or mimicking, the Parts of important people in your life: sometimes we don’t integrate these Parts into our overall sense of who we are. Watkins (1997) uses the following metaphor: “An introject is like a stone in the stomach, within the self but not part of it, ingested but not digested” (p. 16). When Jane entered adolescence and began relating to her peers, she lost interest in watching and playing sports, which she initially developed in imitation of her father. Instead, she began to notice, perceive, and record the behaviors and interests of her female peer group. Thus, Jane’s fascination with wrestling and football was “ingested, ” rather than “digested” — her father’s love of sports never became one of her Parts.

Internalization refers to the process of incorporating the values, beliefs, behaviors, and experiences of our loved ones into our overall self. When our initial introjections shift from purposeful mimicking to automatic and begin to occur without our conscious awareness, that is when the introject becomes internalized as a Part of you (Watkins & Watkins, 1997). Our various self-states begin to deepen and we develop specific thoughts, feelings, and behaviors based on what we have internalized.

“So the cliché is true: you are who raised you!”

Our upcoming article dives into details about when a Part has developed to protect you. We will share Joe’s story and how identifying and integrating his Parts helped him find joy again.

Watkins, J. G., & Watkins, H. H. (1997). Ego states: Theory and therapy. New York: WW Norton. Bromberg, P. M. (1996). Standing in the spaces: The multiplicity of self and the psychoanalytic relationship. Contemporary psychoanalysis, 32(4), 509–535


Create Outcomes is an organization devoted to supporting individuals in growing toward their highest potential. We offer individual therapy, couples therapy, group therapy, therapy for children, teen therapy and retreats. Our therapists integrate psychodynamic theory, cognitive behavioral approaches, and their own unique perspective and training to provide the most clinically relevant care to each individual. We are in-network with Humana insurance and offer in-person therapy in Denver, Colorado, New York, NY and Long Island, NY and provide teletherapy for residents of Florida.

I deeply respect my clients who willingly attend sessions week after week with the burning question, “Can you help me?” With a sense of duty, I set out to determine what therapies work best, especially for people who have experienced trauma. Trauma can be defined as any event that has a lasting negative effect. It can involve physical harm or threaten our emotional safety. Trauma can be experienced or witnessed; it can be a one-time event or ongoing (Shapiro, 2018). I see trauma as the unfair things that happen to us in life, especially in childhood, that are out of our control. It is the moments that shape our life’s trajectory and our capacity to live freely.

EMDR is a unique treatment approach that helps people recover from the haunts of specific memories. It provides an opportunity to derive wisdom and meaning from life’s most painful moments. I hope you find Francine Shapiro’s (2018) four tenets helpful in understanding how EMDR works quickly and efficiently to help people heal from a variety of symptoms and mental health conditions.

1. Mental health conditions are linked to the way we remember earlier life experiences.

EMDR assumes mental health conditions come from scary, threatening, unpredictable, and/or disturbing life experiences. When something scary happens to a child, they have a reaction-new thoughts and feelings in response to the event, and may start acting differently. “What will I do if that happens again? Am I safe? How can I fix this? My tummy hurts. Maybe if I stay in my room everything will be okay,” are some likely reactions. The child is working to make sense of an event that is unpredictable and unsafe. Adults in the child’s life may not be able to explain what happened or why. This may result in the child’s thoughts and feelings never being fully processed, leaving them “stuck”.

This reaction to an earlier life experience can begin a lifetime pattern of thoughts, feelings, and behaviors. These patterns ultimately compose a set of beliefs about the self that are negative, unhelpful, and cause suffering. For instance, maybe the child decided that this bad thing happened is their fault.

With this pattern set in place, the brain is ready to see how the “It’s my fault” belief is true over and over again. It is like a pair of sunglasses the developing child sees the world through, coloring experiences and making the world a little darker. When emerging into adulthood, a routine moment in daily life may trigger a childhood memory of the scary thing that happened. The same thoughts, feelings, and beliefs connected to the early memories take over. The day goes on, and the adult is left feeling bad, unable to come up with the right words to explain why.

2. Our brains are great at processing information most of the time and this can help us move forward after trauma.

EMDR heals mental health symptoms by stimulating the brain similarly to how the body heals a physical injury. The brain is able to process an abundant amount of information consistently and with ease throughout our lifetime. It is this capacity that lets EMDR take the “stuck” memories and store it in a new way. During the reprocessing phase of EMDR, the brain can access the bad stuff (i.e., earlier memories that are disturbing) and the good stuff (e.g., a positive world view, your ability to cope) at the same time. It can take the positive adaptive thoughts and feelings and apply that to reprocess old disturbing memories.

Let’s look at one client’s story to see this in action:

Jill’s parents had heated fights when she was a child. Her parents thought she was sleeping during their shouting matches but, instead, Jill would stand with her ear pressed against her bedroom door, listening to every word. Sometimes she would hear glass shatter against the wall. Other times, it was the front door slamming followed by a car speeding off. Jill never knew when these fights were going to happen and she would anxiously stay awake as long as she could every night, listening to make sure her parents were safe.

Jill felt scared that one of her parents was going to get hurt during these fights or leave and never come back. One night, Jill heard her name in the midst of the yelling. This was the moment when Jill finally made sense of it all. She decided it must be her fault that her parents argued like this.

There was no way for Jill to see that her parents’ fights had nothing to do with her. Her explanation (i.e., “It’s my fault”) perfectly matched her stage of child development. She was unable to process the intense thoughts, feelings, and body sensations that came with her nightly high alerts. These early memories were stored in a maladaptive way-stuck and never processed.

As an adult, Jill often felt she was responsible for the events in her life that were completely out of her control. She felt scared and anxious whenever little things reminded her of what happened, like a door slamming shut or someone raising their voice. Although Jill was no longer a child in a helpless situation, she did anything possible to avoid confrontation.

Jill was unhappy in her romantic relationship and taken advantage of by her friends. She felt like it was her fault that her partner did not show affection or express his feelings. With her friends, Jill was the one who organized gatherings, took care of people when they were sick, and listened during times of crisis. She felt good about showing up for her friends but also drained by the amount of energy she put into her friendships. At her job, Jill worked hard for two years towards a promotion. When she found out that a new hire landed the position, Jill had a meltdown at work. The next week, Jill made her first therapy appointment.

In therapy, Jill’s focus was to reprocess those “stuck” childhood memories. For many people, one goal of therapy is to take the sunglasses off and to see the world without blame, shame, and guilt. Trauma therapy gave Jill the opportunity to see the world in full color by being present, connected, and free.

3. You can transform the way you see yourself after reprocessing earlier, bad memories.

After trauma, the brain puts forth an unbelievable effort to avoid experiences that may bring up those disturbing memories. It becomes a priority to avoid any thoughts or feelings about the event. So when I ask my clients to share with me what they have worked so hard to hide away, I ask because I know how powerful it is to let the memories surface. After reprocessing these memories, your life changes.

Reprocessing the disturbing information associated with earlier memories shifts thoughts, feelings, and actions. With the old beliefs gone, a new way of being emerges. In my experience, clients rediscover who they really are-their authentic selves-as there is an opportunity for the client to fully express and embrace their unique, whole self. Once the client starts feeling better, they naturally begin making decisions that are healthier and create a more fulfilling life. It is safe to care about yourself.

Let’s check in on Jill to understand how she began to see herself after therapy:

Jill found EMDR therapy difficult at first because she revisited those childhood memories that she was quite good at never thinking about. But, in just one session, Jill had a better understanding of how those early memories were connected to her current problems. By the end of EMDR, Jill had empathy for the little girl who had to experience her parents fighting. She used the positive, adaptive parts of her brain to understand how her parents’ fighting was not her fault.

Jill reprocessed the bad memories and no longer held the “It’s my fault” belief. Instead, she knew “It’s not my fault, I was just a kid” to be true. This realization led to a new, deeper understanding of herself. She felt invigorated and started making decisions in her current relationships that helped them become more reciprocal and fulfilling. Jill began expressing her feelings and asking for what she needed from her partner. She set boundaries and realized when she was giving too much in her friendships. There was less pressure to deal with life’s tribulations on her own and she could lean on others when she needed some support.

4. Healing takes less time than we thought!

Decades of research studying the treatment outcomes of EMDR show that healing from trauma takes less time than has been traditionally assumed, regardless of how many years have passed since the traumatic or disturbing event. Shapiro (2018) wrote, “Some controlled studies have indicated that 84–100% of single-trauma PTSD has been eliminated within 4.5 hours of treatment” (p. 18).

Jill was in therapy for one year. She finished EMDR in five months and then decided she wanted to spend time getting to know the “new Jill.” It is common for a client to want to practice their new way of being in relationships with their therapist. Therapists are the perfect people to practice new skills on, like asserting oneself or asking for help.

*Jill is not a real client. Her story is inspired by a range of client experiences.

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Publications.

Sarah Freeze, LCSW is a clinical director at Create Outcomes, a group, private practice with offices in New York and Colorado. She specializes in working with people who have experienced trauma, abuse, or who have emotionally shut down parents.

Originally published at https://www.denvertherapymatch.com


Create Outcomes is an organization devoted to supporting individuals in growing toward their highest potential. We offer individual therapy, couples therapy, group therapy, therapy for children, teen therapy and retreats. Our therapists integrate psychodynamic theory, cognitive behavioral approaches, and their own unique perspective and training to provide the most clinically relevant care to each individual. We are in-network with Humana insurance and offer in-person therapy in Denver, Colorado, New York, NY and Long Island, NY and provide teletherapy for residents of Florida.

By Terence Coyle, LMSW

Most people who have heard of hypnosis recall a stage show entertainment form of it where the performer gets a volunteer from the audience to quack like a duck and everyone laughs. Unfortunately, this presentation creates distrust and continues the myth of losing control of your thoughts and actions to a stranger.

The Mayo Clinic defines hypnosis as a trance-like state in which you have heightened focus and concentration. Hypnosis is usually done with the help of a therapist using verbal repetition and mental imagery. When you’re under hypnosis, you usually feel calm and relaxed, and are more open to suggestions. It’s important to know that although you’re more open to suggestions during hypnosis, you remain in control over your behavior.

Before starting hypnosis, the careful process of evaluating and assessing the client for their appropriateness in using hypnosis is essential. Hypnosis can be used to help you gain control over undesired behaviors, help you cope with anxiety or pain, and give you access to insight you may not have had before.

Hypnosis is only one part of hypnotherapy. The term hypnotherapy refers to a holistic psychotherapeutic approach to treating common mental health problems like anxiety, depression, and trauma, as well as other issues like chronic pain.

In hypnotherapy, the therapist utilizes progressive relaxation, guided visualization and verbal repetition to induce a hypnotic state in which the client attains a sense of deep relaxation in the moment. This enables the therapist to guide the client to the feelings and thoughts that are blocking them from creating change in their lives.

After creating a trusting and safe environment, the therapist begins a gradual “induction” experience into the memories, feelings and somatic clues left behind, searching for their origins in order to release and transform them. This is a way of directly accessing a person’s subconscious mind and uncovering the creative, emotional and physical information your body receives and has stored over the years.

This information and access allow the client and therapist to locate the origins of limiting beliefs, disruptive behaviors and habitual reactions. Accessing fears, memories and repressed emotions, can help clarify difficult issues and bring resolution to persistent problems.

There are several theories related to hypnosis, but I have found the most effective evidence-based approach to be Ego States Therapy. Ego states are the parts of our personality that cause us to act different ways in different situations. Often, there are parts of our personalities that may be hidden or reluctant to communicate with not only the therapist, but to our own self.

John and Helen Watkins, authors of Ego States Theory and Therapy, assert that hypnosis is a direct, safe and effective way to contact an ego state and determine what other parts are in conflict with it. During any guided-journey with a client, it is crucial to create a feeling of safety to prevent the client from re-experiencing difficult feelings from their past, and to allow their ego states to feel safe before revealing themselves.

Hypnosis has been used to treat various medical, psychological and psychosomatic conditions for over two centuries (Spiegel, 2013). There have been many studies conducted on the efficacy of hypnosis, or hypnotherapy, over the past few decades. The studies range over a wide variety of conditions and symptoms. Specifically, research has focused on hypnotherapy in relation to individuals with cancer, trauma, acute and chronic pain, depression and anxiety (Spiegel, 2013).

1. Chronic pain. Studies have found hypnosis to assist in the reduction of chronic pain (Jensen et al., 2008). Participants in Jensen et al,’s (2008) study reported reduction in pain following sessions of hypnotherapy and for several months after. Similarly, participants in a study involving hypnosis as treatment for chronic low back pain (CLBP) reported improvement following sessions, as well (Tan, Fukui, Jensen, Thornby, &Waldman, 2010).

It is important for clients to learn hypnotic techniques from their therapist to use on their own so that they may find relief between or after the discontinuation of therapy.

2. Terminal illness or cancer. Taylor and Ingleton (2003) found that a combination of cognitive behavioral therapy (CBT) and hypnotherapy left cancer patients with a better ability to cope with the procedure-related and psychological-related impacts of cancer. Patients described that they were better able to relax with the use of this intervention. The researchers found that the therapeutic relationship was a large mediating factor in the success of the interventions. Liossi and White’s (2001) study found hypnosis to be an effective modality in treating terminally ill cancer patients. The study found that this intervention helped increase quality-of-life in participants, as well as decrease feelings of anxiety and depression associated with the stress and difficulty of adjusting to life with illness. It is important to note that participants did not report enhancement in physical quality of life, but rather psychological quality of life. While hypnotherapy has been found to help patients with cancer cope with their illness, reduce anxiety and find moments of relaxation, the majority of sample sizes are extremely small and most findings have been insignificant, especially for adults (Chen, Liu, & Chen, 2017).

3. Anxiety and depression. Cognitive hypnotherapy (CH) was found to significantly reduce the symptoms of depression in a sample of adults (Alladin &Alibhai, 2007). Feelings of depression, anxiety and hopelessness were all reported to have been significantly decreased. The combination of CBT and hypnotherapy in this study was found to be effective not only during therapy, but at six and twelve-month follow-ups. Case studies conducted on the effects of hypnotherapy as treatment for individuals with depression have also yielded positive results (Schreiber, 2010). The five individuals followed in the Schreiber’s study found that participants’ levels of anxiety and feelings of depression were lessened over the course of treatment sessions. Additionally, meta analyses conducted on the efficacy of hypnosis in the treatment of depression found a medium effect size (Shih, Yang, & Koo, 2009). The researchers of this study suggest that this alternative means of treatment can be beneficial for those struggling with depression.

4. Trauma and Abuse. Hypnosis has also been studied in relation to trauma. A case study following a woman struggling with trauma related to child sexual abuse found that hypnosis can help clients gain access to traumatic memories and aid in desensitizing clients to past trauma (Poon, 2007). Hypnosis allows clients to engage in this process in a safe environment. In Poon’s (2007) particular case study, the client reported a significant reduction in trauma symptoms. The lessening of symptoms was also able to be measured and confirmed through observation and objective tests. Additionally, a study conducted on the efficacy of hypnosis on burn patients yielded positive results (Shakibaei, Harandi, Gholamrezaei, Samoei, & Salehi, 2008). The re-experiencing of trauma was reportedly reduced among participants. It is notable that this study had a small sample size and several limitations so that results may not be generalizable as is the case with case studies.

If you are looking to try hypnosis, it’s important to find a certified therapist with at least a master’s level degree in social work, marital/family counseling, nursing or psychology in addition to a specific number of hours of approved training in hypnotherapy.

Terence Coyle is a psychotherapist based in Huntington, NY. He specializes in hypnotherapy, mindfulness, emotionally-focused therapy, and EMDR.

Alladin, A., & Alibhai, A. (2007). Cognitive hypnotherapy for depression: An empirical investigation. Intl. Journal of Clinical and Experimental Hypnosis, 55(2), 147–166.

Chen, P. Y., Liu, Y. M., & Chen, M. L. (2017). The Effect of Hypnosis on Anxiety in Patients With Cancer: A Meta‐Analysis. Worldviews on Evidence‐Based Nursing, 14(3), 223–236.

Jensen, M. P., Barber, J., Hanley, M. A., Engel, J. M., Romano, J. M., Cardenas, D. D., … & Patterson, D. R. (2008). Long-term outcome of hypnotic-analgesia treatment for chronic pain in persons with disabilities. Intl. Journal of Clinical and Experimental Hypnosis, 56(2), 156–169.

Liossi, C., & White, P. (2001). Efficacy of clinical hypnosis in the enhancement of quality of life of terminally ill cancer patients. Contemporary Hypnosis, 18(3), 145–160.

Mayo Clinic. (n.d.). Hypnosis. Retrieved November 21, 2018, from https://www.mayoclinic.org/tests-procedures/hypnosis/about/pac-20394405

Poon, M. W. L. (2007). The value of using hypnosis in helping an adult survivor of childhood sexual abuse. Contemporary Hypnosis, 24(1), 30–37.

Schreiber, E. H. (2010). Use of hypnosis in psychotherapy with major depressive disorders. Australian Journal of Clinical and Experimental Hypnosis (Online), 38(1), 44.

Shakibaei, F., Harandi, A. A., Gholamrezaei, A., Samoei, R., & Salehi, P. (2008). Hypnotherapy in management of pain and reexperiencing of trauma in burn patients. Intl. Journal of Clinical and Experimental Hypnosis, 56(2), 185–197.

Shih, M., Yang, Y. H., & Koo, M. (2009). A meta-analysis of hypnosis in the treatment of depressive symptoms: a brief communication. Intl. Journal of Clinical and Experimental Hypnosis, 57(4), 431–442.

Tan, G., Fukui, T., Jensen, M. P., Thornby, J., & Waldman, K. L. (2009). Hypnosis treatment for chronic low back pain. Intl. Journal of Clinical and Experimental Hypnosis, 58(1), 53–68.

Taylor, E. E., & Ingleton, C. (2003). Hypnotherapy and cognitive‐behaviour therapy in cancer care: the patients’ view. European Journal of Cancer Care, 12(2), 137–142.

Watkins, J. G., & Watkins, H. H. (1997). Ego states: Theory and therapy. New York: WW Norton.

Originally published at createoutcomes.com on December 4, 2018.


Create Outcomes is an organization devoted to supporting individuals in growing toward their highest potential. We offer individual therapy, couples therapy, group therapy, therapy for children, teen therapy and retreats. Our therapists integrate psychodynamic theory, cognitive behavioral approaches, and their own unique perspective and training to provide the most clinically relevant care to each individual. We are in-network with Humana insurance and offer in-person therapy in Denver, Colorado, New York, NY and Long Island, NY and provide teletherapy for residents of Florida.

By Jasmine Narayan, Psy.D.

Since I began working with children, I have realized how important playing is to a child’s social and emotional development. This is the age of communication and we have become so accustomed to talking, discussing and analyzing. The children I work with have taught me that sometimes talking is overrated. It’s better to just “be.” Through play, children are free to be themselves, to express their deepest wishes, and most of all to have some sense of control. One little boy, named Billy, learned to deal with some very difficult emotions and gain a sense of freedom through his play.

I stood in the doorway of the classroom and looked for the fair-haired boy. He caught my eyes from across the room and asked with an expectant look on his face “is it my turn?” I smiled and nodded. He ran over excitedly, dropping the toys in his hand and practically mowing over his classmates who stood in the way. We walked together to my office. Upon entering the room, Billy waited as I set the clock and then proceeded to take the polka-dotted box full of animal puppets off of the bookshelf. He balanced the box on his head as he hobbled over to the carpet. “I’m strong,” he told me as if sensing my desire to reach out and help him. He dumped the boxful of animals onto the carpet and searched for his favorite one. He dug through the pile of plush, grabbed a shabby brown dog from the bottom and paused to examine the shiny green sticker on the dog’s paw. Billy put that sticker on the dog in a previous session. He then gestured for me to pick one for myself. Following his lead, I too picked the same animal as last time, a light brown golden retriever puppet.

The stage was set. The characters cast. We both knew our parts because the play had been nearly the same for the past few weeks. Despite his initial excitement, Billy sat frozen and stared at the animals. The lines of uncertainty on his face could be read like sentences in a book. As he collected himself, he began to slowly act out his inner world. Themes of anger, fear and rejection began to unfold before my eyes. The animals joined together to form a club and purposefully excluded a large bird from the play. The bird, bright pink with lanky yellow legs, felt great rage. He began to break into the club, pulling members out and throwing them violently across the room. All the animals ran to hide. All the animals cowered in fear, all the animals, but two. The shabby brown dog stepped up to help the other animals, aided by the golden retriever. Together the two unlikely heroes recovered the hurt animals and built a shelter to protect them, one that could not be penetrated by the angry bird. Toward the end of the session, I could sense that Billy was unable to resolve this inner conflict. He was both the hero and the bully. He did not know how to reconcile the two. Through the golden retriever puppet, I was able to make suggestions that would help the bird make amends with his friends. The bird listened and began to apologize to other animals and say, “I was just so angry because you wouldn’t let me play.”

Billy was an angry and scared little boy. He acted out with aggression in the real world because he felt so little control in his own. During sessions he was learning to master difficult feelings and express them in more adaptive ways. Billy, just like other children, was communicating and integrating his experiences through his dramatic play. I feel lucky that he invited me to participate in his world and to have an impact. I am mindful that this July it is easy to get bogged down by family obligations and activity packed schedules. Let’s take a page from a child’s book and set aside some time to play!

Create Outcomes is an organization devoted to supporting individuals in growing toward their highest potential. We offer individual therapy, couples therapy, group therapy, therapy for children, teen therapy and retreats. Our therapists integrate psychodynamic theory, cognitive behavioral approaches, and their own unique perspective and training to provide the most clinically relevant care to each individual. We are in-network with Humana insurance and offer in-person therapy in Denver, Colorado, New York, NY and Long Island, NY and provide teletherapy for residents of Florida.