I work in a community mental health agency and have just been handed (from another therapist who quit) a 14 year old boy who has a history of abuse and who observed his sister being sexually abused (all of this prior to age 11). Symptoms started appearing shortly after this.  There is rage present towards  the abuser (his biological father). This boy gradually developed 2 pretend friends (the most recent one after an attempt to hang self about 4 months ago) and actively experiences command hallucinations from 'them'. Meds are not helping. His behaviors are deterioriating badly. I have never met this boy and his mother is in the process of finding long term residential treatment for him, and soon.

 My question, I may not have much time to work with this boy and his abuse has never been addressed in the several inpatient stays he has had. Instead, they focus on his angry behaviors.

Has anyone reading this post worked with someone (a child/teenager) who is having command hallucinations?  Would it be different from working with an adult? how advisable is it to zero in on the original trauma? at what point would an EFT'er do so? 

I know I need to gain permission from his two "friends" in order to gain headway while doing EFT.  and I know I have to attempt to build a safe relationship with this boy first.  I am open to any and all suggestions and I dont have alot of time before inpatient will happen.

 thanks all

Clair

Hello Clair,

Whew!  This is a tough one.  EFT is, still, largely uncharted territory and there is, frequently, no road map to guide you.  I would say, given your limited tme, that you go with your gut and go gently.  If he does not want to go there, he won't go.  If that is the case, tap for, 'Even tough I don't/won't/am afraid to go there...' and see if you can break down some resistance. 

This young man is blessed to have you, a caring therapist and EFTer, in his corner. I wish you both great success.

Happy Tapping!

Nurse Crilly

Clair,

I do not have any professional experience in this area, but I have a little personal experience (since you're open to all suggestions).

When my teenage son was being treated for clinical depression, he had severe reactions to medications (SSRIs, in particular). The drugs made him appear psychotic (and he was hospitalized). Even after he had been weaned from the drugs, he continued for some time to have visual hallucinations, particularly when stressed. One hallucination in particular was seeing menacing figures in trees. His situation was probably somewhat different in that he recognized that these people weren't "really" there, but he could "see" them nonetheless, and they kept him from sleeping, etc. (I'm sure they felt more real when he was alone in the middle of the night.) When he was feeling quite desperate about it, he allowed me to try tapping with him, but only for a couple of rounds. When that didn't work immediately, he didn't want to continue, and the "tree people" were still making him feel very afraid. So I spent quite a while that same day on surrogate tapping for him. I didn't look for any core issues, but just tapped on the intrusive visions, and feeling afraid.

After that, his complaints about the visions subsided, and I don't recall him ever mentioning having any visions again. To this day I have no idea what caused those hallucinations, other than the medications which he reacted so strongly too.

 Best of luck to you and this challenged young man,

Deb

Thank you, thank you, thank you, for posting a response to my questions. I met the  young man today for the first time. First, I met his mother and verified that to her knowledge no trauma work had been done in his treatment history. I explained EFT to her and gave her the "science behind EFT as well as the Basic REcipie" taken from the manual from Gary's website.  I finally got to sit down with the client alone.  He reported that only one of his "friends" were present (#2). he also verified that no work had been done on his childhood traumas. I got right to work and explained to him the probable connection with the appearance of his first friend who gives the commands to harm family and self and his intense anger/rage towards his abuser. 

During the session, the client changed his body position, bowed his head, and started rubbing his eyes. i could tell that some sort of communication was happening. Sure enough he stated that #2 "friend" who was present stated that it was not OK to use the 'technique', referring I guessed to EFT.  the client also reported that he was afraid that if he used the technique #2 would inform #1 and #1 would then get really angry which could lead to client being hospitalized. I suggested that no EFT would be done unless all three were present at the same time and that client could go as slow or fast as he was comfortable going. I asked him if that would work and he said yes. I told him my main concern was to keep him safe and to not agitate #1 (the really angry hallucination). However, I could not 100% guarantee that #1 would never get angry about the process. I noticed a hint of fear in the clients eyes as I shared with him that it would be my hope that #1 and #2 would eventually leave him alone in peace. it was a good reminder to me to remember that these hallucinations are protecting him and without them, client may feel vulnerable in a world that he has come to know as unsafe. (#1 is extremely powerful)

 A question I have at this point is......if #1 forbids using EFT and client goes along with that decision, then what??? I was thinking perhaps asking him if they would mind if I tap on myself while we are conversing during session.  for sure the suggestion you made about tapping on the 'fear of going there" would be valuable at that point since it would not be directed at getting rid of #1 & #2 (at least directly).

 Client also talks of being taken to an upper room called the 'check out room" where he sees his family being destroyed and he is part of the destruction. He believes it is actually happening in those moments and until he is released from the "upper room" and goes to check his sisters room and finds her OK, he believes it has happened.  So, he is both and observer and participant.

What a case to cut my teeth on, huh??  I do thank you for your support and feedback and will continue to hunger for anymore suggestions and feedback from the EFT community. I can use all the help I can get.

Many thanks  

Hi Clair,

Your client and his mother are really fortunate to have you in their corner. This is not exactly about EFT but it is about the energy of trauma and the power of the human spirit to create amazing avenues of survival. It may be of service to your client and to the two parts of himself now seeminlgy carved out as the most powerful "friends", to learn that sometimes what is needed at one time to manage a situation that no one kid could possibly be expected to manage alone, can require an update to effectively handle new times and new needs. Sounds like he is being driven by DANGER DANGER WARNING WARNING.

I get curious and wonder about the label of schizophrenia for a kid with signficant trauma not yet treated. Your description of his physical reactions, two friends etc. suggests the value of considering that perhaps he dissociates rathern than hallucinates. If there is internal communication known or unknown amongst his friends and/or himself it could appear very like your description of your client's situation. The specificity of his "room" descriptions sounds like it could be part of a flashback experience without a narrative context yet known to hold it within. Since trauma disrupts sequence it would be way soon to know what's up with that.

I wonder what each aspect of your client thinks about the whole idea of being safe, what safe would look like to each of them, if it is desired based on what (their) meaning of safe has become to be defined as, and what the thinking is of how EFT power tapping may support the determined work they are already doing. Maybe there is internal ageement about something that is or is not wanted and a willingness could evolve around EFT work for behaviors that create or get in the way of that.

It's possible that your client looked fearful at your expression of wishing that 1 and 2 would leave him alone and in peace because these inner components of his being developed to protect him from being alone, (perhaps they all believe that he is not good enough alone which eventually may be tappable) and perhaps peace itself was also somehow interwoven in his trauma composition so it may also be experienced as dangerous; guard is down so more hurting can occur etc. I think that any tapping done by you or by your client, for himself and or for or with his inner friends, needs to be tranparently clear about its intent on all levels of that intention.

How fortunate your client is to have a practitioner who respects the power of trauma at the core of his situation. If his mother is looking at residential settings maybe she can be educated to learn the questions to ask so it can be determined if the program is trauma sensitive, trauma informed etc. Unfortunately, there are not that many residential programs that operate within a trauma paradigm although a huge number of kids needing such services have life stories driven by trauma. If the program is local, perhaps they would consider supportive adjuncts for their work and/or inservice education for their workers about EFT? That's one way to keep the working word passing forward.

p.s. there are some good dissociative assessment scales out there to aid in determining with greater specificty what may be going on and thus most effective inroads to support treatment.

hope some bit of this babbling is of some service to you and your client,

be well,

It has been my experience that doing surrogate EFT will enable you to communicate with all three (#1, #2 and young man) of the "energy entities" appropriately.  You may find that you will need to resolve/heal whatever issues #1 and #2 have before you can get to doing and EFT on the actual trauma issues presented by the young man.

I would be more than willing to elaborate if you're interested.
 

Hello Clair, I'm a mental health counselor in florida, currently working at an agency for SPMI. For almost a year, I was in private practice for early recovery (substance abuse) clients and used EFT with nearly all for successful changes. One was an adult with schizophreniza who experienced sexual abuse as a 8-10 YO from female family persons and then a male neighbor. I successfully in session used EFT as surrogate to reduce the anxiety and shame of sharing the fact that he'd been abused as a child for the first time with anyone -- but he refused to personally use EFT on himself. He had a very hard time with "keeping things in his head" yet he was willing to permit me to tap for him during sessions. THE PROBLEM: he had a psychotic break about 3 wks after this revealing session and went into hospital several times over the next 10 weeks, once involuntarily the other 2 times voluntarily. My gut tells me that he could not handle the conscious awareness of the abuse and dissociated, reverted to old behavior patterns that were abusive, and the likes. This is the risk one runs into with dissociative mental illness -- it's simply too scary. If you can surrogate tap on the scariness and the shame and the fear, you may very well have very good results of calming and integration of the 3 persons. And, you may not for a while be able to tap with your client in session, sticking with surrogate before or after the sessions until you can surrogate during sessions.

Can you teach the caregivers to tap as surrogates, perhaps write on an index card some suggested phrases for negative feelings/events and then for positive choices?

Good luck, -edith.

Interestingly, I did not ask the client about what "they" would need to feel safe, however, I did ask the client what it would take to make #1 happy or peaceful. Clients reply was "For Jeffrey to be happy, he needs to get his own way, when he doesnt get his own way, he gets angry". when there is a disagreement with another family member, "Jeffrey" tells client, 'see, this is what I am talking about'  It appears that Jeffrey is building the case for client that it is in the clients best interests to "eliminate" the family so that Jeffrey can always have his own way.

 all of your comments in para. 4, I believe are on target. Not for one moment in his life has this young man felt safe and secure. Mother also has schizophrenia and only recently appears more stable due to medication management, so not much support there. Mother is very fragile herself and am not sure how much help she can/will be. I have only met her one time as well.

I do have a DES scale I can have the client fill out. he appears very bright. one would never expect he struggles with this debilitating issue.

Thank you for your response. I am learning a great deal and getting a better perspective on how to proceed....with caution and care!

respectfully, Clair 

Please elaborate as much as you are willing. I have already started surrogate tapping for him daily since I saw him.

 Respectfully, Clair

Hi Edith

Thank you for responding to my post. I have started surrogate tapping for this client. However, I will take your suggestion and tap on the shame, scariness and fear.

 One question I have for you is, if you could do it all over again how would you proceed? Would you do anything different?

Mother also has Dx of schizophrenia and will not be of much help, I believe. She, just recently started on meds which are starting to help. She is fragile. I did tell her about EFT though and she is VERY interested. I just dont know yet how capable she is in following through and assisting her son.

Thanks, Clair 

Hi Clair

According to Gary C. emotional issues can manifest anywhere in the body in the form of pain and that tapping for the pain can clear the emotional issues.  Does this child have any pains of any kind?  I just thought this might be a way to get around the other two protectors and start clearing "the trees in the forest".

Linda

Hi Linda,

 Thank you for the reminder. I have used that in the past but didnt think of it in this situation. He has not reported any pains of any kind but that is something I can explore

Thanks, Clair 

possibly really imortant to not try to get around any of this kids "friends" or parts, or energetic aspects within himself. Betrayal or the experience of same can so easily put the system on the equivalent of high alert of lockdown

Hi Claire

I have had several experiences working with Schizophrenic young people.  I wonder could you ask your young client to explain 1 and 2's purpose in his life. Gain a detailed insight into their individual roles.  This will assure him of your acceptance.of their existance.  Imagine that you are the young man, everyone else is busy giving him a label yet, these other ego's are present, for him, for a specific reason. Working in the hear and now ask him is he able to explain why 1 and 2 are here in the moment you are with him.  I hope you have time to build rapore with them all.  

You are doing a wonderful piece of work.  Your client is very very lucky to have you.

Respect

Lorraine