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Orientation in Time: Implications for Psychopathology and Psychotherapy Thomas A. Blakely Jr. Ph.D. Published online: 21 Sep 2011.

To cite this article: Thomas A. Blakely Jr. Ph.D. (1991) Orientation in Time: Implications for Psychopathology and Psychotherapy, American Journal of Clinical Hypnosis, 34:2, 100-110, DOI: 10.1080/00029157.1991.10402969 To link to this article: http://dx.doi.org/10.1080/00029157.1991.10402969

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AMERICAN JOURNAL OF CLINICAL HYPNOSIS

VOLUME 34, NUMBER 2, OeroBER 1991

Orientation in Time: Implications for Psychopathology and Psychotherapy

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Thomas A. Blakely, Jr. Portland, Oregon Considerations derived from the fields of physics, philosophy, anthropology, and psychology suggest that our popular conception of time as a unidirectional and uniform flow may not be an adequate description of the human experience of time. Indeed, other dimensions of temporality may constitute important aspects of human phenomenology with respect to both adaptive and maladaptive or psychopathological mental states. Exploration of the temporal aspect of experience and temporal reorientation may be helpful psychotherapeutic maneuvers that are greatly facilitated by hypnosis.

derstanding of these conditions and for the development of effective intervention strategies. A brief review of some general concepts of the nature of time may facilitate the understanding of this problem. In the seventeenth century Leibniz's (1965) view that reality is composed of "windowless monads," each having its own time, was superseded by Sir Isaac Newton's conceptualization of time as a laminar flow:

Although time is a ubiquitous aspect of virtually all human activities, there has been little attempt to understand how the phenomenology of time relates to the mental anguish that characterizes posttraumatic stress disorders, depressive states, and other forms of psychopathology, or to effective psychotherapeutic treatment of these conditions. Even when time-regression techniques are used therapeutically, time itself has seldom been regarded as a variable of interest in its own right. It seems likely, however, that such a consideration may sometimes be of central importance for the thorough un-

Absolute, true and mathematical time, of itself, and from its own nature flows equably without relation to anything external . . .: Relative, apparent, and common time is some sensible and external measure of duration by the means of motion which is used instead of real time. (Newton, 1952, p.8)

For reprints write to Thomas A. Blakely, Jr., Ph.D., 16016 Boones Ferry Road, Lake Oswego, OR 97034. Received December 3, 1990; revised February 15, 1991; second revision May 23, 1991; accepted for publication June 4, 1991.

Although this conceptualization of time seems to be true intuitively and is certainly the reality on the basis of which most persons organize their lives, further developments in the physical sciences have

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shown that it does not explain all of the observable phenomena related to time. Einstein (1961), for example, has demonstrated that the passage of physical time depends upon the perspective of the observer (i.e, it is subjective as opposed to the Newtonian concept of absolute time); the amount of time which passes between two successive ticks of an absolutely accurate clock is a function of a number of factors, including translationalvelocity and gravitational fields. Although the effect of velocity is small at speeds achievable by current technology (the astronauts who went to the moon came back .005 seconds younger than they would have been had they stayed on earth (Shallis, 1982)), the progression of time is clearly not absolute. There is not one time, but there are many times; for example, time passes more slowly on Jupiter (which has a stronger gravitational field) than it does on earth. The relativity of time at a psychological level is also clear in several ways. For one thing, it is a common observation that time seems to pass much faster with increasing age. It may be that, as with most psychophysical functions, duration obeys Fechner's law' (Boring, 1929; Moiseeva, 1988; Guay & Salmoni, 1988); that is, clock time (the estimation of time from uniform motion) exists on a linear scale with psychological time existing on a logarithmic scale. The ability to judge accurately the passage of time deteriorates rather markedly in certain forms of drug intoxication (Anonymous, 1969; Pahke & Richards, 1969) and in persons living for prolonged periods in subterranean chambers without contact with the outside world 'Fechner's law with respect to time may be expressed by: t' = k 10glO t, where t = clock time, and t' = psychological lime.

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(Mills, 1964; Weaver, 1979). At times when decisive action is required, as during certain athletic competitions, time seems to slow rather markedly. Furthermore, at certain points during a game, ballplayers have described the experience of knowing the flow of play before it develops (Toomay, 1974). It, therefore, appears that psychological time is an intensely personal experience that transcends clock time in certain ways. It also appears that time differs rather markedly as a function of cultural factors. The Australian aborigines (Elkin, 1964), for example, distinguish between time as ordinary chronology and the "great time" or "dream time." In the latter, past, present, and (to a certain extent) future seem to exist simultaneously, and the mythological heroes continue to live and to perform their great deeds as they did in the primordial past. The dream time is said to be experienced on certain ritual occasions, and this is probably facilitated by frenzied dancing and other activities. The Indians of Mesoamerica seem to hold a similar "vertical" view of time (Augur, 1954) in which the past is, conceived as being round about us instead of behind us in a "horizontal" sense. Such a view is also implicit in the words of Chief Seattle: Every part of this country is sacred to my people. Every hillside, every valley, every plain and grove have been hallowed by some fond memory or some sad experience of my tribe. Even the rocks, which seem to lie along the silent seashore in solemn grandeur, thrill with the memories of past events .... (Seattle, 1854)

The concept that the past exists eternally and may be experienced as some sort of a mystical unity with the present moment is reminiscent of some of the conceptualizations of medieval alchemy and of some forms of religious mysticism. This orientation is perhaps nowhere

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better expressed than in the writings and sermons of the fourteenth century theologian and mysticMeister Eckhart, whoseview on time can be summarized as follows:

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Eternity is not simply time extended indefinitely into the past and future. It is the fullness of time, an everlasting instant where experience is not divided . . . by the succession that vitiates temporal existence. The temporal distinction between an action going on and an action completed has no meaning in eternity. (Tobin, 1986, p. 62)

This eternal or mystical time and the aboriginal dream time are, in a certain sense, similar to the idea expressed by Dunne (1927, 1934) who believed that it is important to try to understandour dreams not just because they reflect subconscious motivations, but because they are direct reflections of eternal time. Theorists, such as Dunne (1927, 1934) and Priestly (1964), have held that time exists at three different levels: Time I is ordinary chronology, Time II corresponds to Eckhart's eternal time, and Time III consists of the totality of all existential possibilities which were never actualized in Time I. Although the implications of time III are fascinating, development of this concept is beyond the scope of the present discussion. If, then, we can assume, at least heuristically, that time II is in some sense "real," is there a way in which such a concept could be used therapeutically? In this context it may be argued that the timeless quality that seems to be present in certain works of art, music, and literature has long been used as a sort of "cultural psychotherapy." The efficacy of this process must surely lie in the capacity of such creations to allow time II to be divined through the ongoing and unrelenting flux of time 12 • If hypnotic procedures 2S uch a viewpoint may well render explicable

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aimed at accessing time II could be developed, one would think that such techniques would be extremely effective. This writer is, however, not aware of any systematic attempt at doing this within the psychological or biomedical community. It may be true that certain forms of religious healing have traditionally used this principle, but this possibility is hard to evaluate because the descriptive tenninology that is generally used in this area does not readily lend itself to the type of logical analysis that is meaningful at a philosophical or scientific level. Time and Psychopathology The timeless nature of the unconscious was recognized early in the development of psychoanalysis, but little was done to further develop or refine this concept. Freud (1933) states: "It is consistently being born in upon me that we have made the meaning of certain fairly extraordinary works of literature and lines of verse. For example, part of the magic of Hermann Hesse's (1963) work is undoubtedly the masterful way in which some of has characters seem to go in and out of chronological time. Whereas the aging Steppenwolf does experience the infirmities of age, his encounters with the mysterious Hermine and finally with the "magic theatre" make it clear that he is, in a sense, ageless. Another example is to be found in the climatic lines from Keats' "Ode to a Grecian Urn"; Beauty is truth, truth beauty - that is all Ye know on earth and all ye need to know

As MacLeish (1961) has so ably observed, it is by participation in the poetic creation that beauty is conceptualized and becomes a transcendent truth through which "the imagination, the only weapon men possess in their struggle with time and their own mortality - the flowing away of the world - has proven itself as powerful as time . . . . To face the truth of the passing away of the world and make a song of it, make beauty of it, is not to solve the riddle of our mortal lives but perhaps to accomplish something more." (p. 199)

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too little use of our theory ... that the repressed remains unaltered by the passage of time. This seems to offer us the possibility of some really profound truths. But I myself have made no further progress here." (p. 105) The concept that the unconscious representations of past events remain current indefinitely explains the lasting effects that such past influences have upon ongoing behavior. It may also explain why many patients seem to have a morbid involvement with the past that may more or less obviate effective orientation toward the future as well as meaningful involvement with ongoing activities. This difficulty is probably central to the phenomenology of many forms of psychopathology, and it undoubtedly accounts in large part for the observed incapacity of many patients to function effectively in most reality-oriented activities. When accompanied by strong feelings of guilt or remorse, it may give rise to self-destructive behavior. In addition to the effects of repression and of certain other psychodynamic factors, certain of the existential therapists and writers have emphasized the potentially anxiety-provoking nature of man's relationship to chronological time. This view is possibly most lucidly expressed by Tillich (1948): Mankind has always realized that there is something fearful about the flux of time, a riddle which we cannot solve .... We come from a past which is no more, we go into a future which is not yet; ours is the present .... But what is the present itself? If we look at it closely we must say: It is a point without extension, the point in which the future becomes the past; when we say to ourselves, "This is the present," the moment has already been swallowed by the past. The present disappears the very instant we try to grasp it. The present cannot be caught; it is always gone. So it seems

that we have nothing real; neither the past or the future, nor even the present. (p. 35)

Such phenomenological descriptions of the nature of temporality are not just academic speculation. On the contrary, statements that "time is running out," that regrettable past events leave little that is pleasant to look back upon, or that the future holds only the promise of futility, are commonplace among distressed persons seeking psychological consultation. More insidious is the expressed feeling of affectual alienation from the entire process of living. For example, a highly intelligent female university student once requested consultation complaining: "I have the vague uncomfortable feeling that time is passing and things are happening, and (although I am going through the motions of doing things) I am not really involved or a part of it." To treat such cases effectively it may, at times, be advisable to shift from a conventional (psychodynamic or behavioral) orientation to a more subjective, phenomenological or existential frame of reference. In the case mentioned above, for example, the young woman's complaint is not seen as symptomatic of depression (or some other standard nosological entity) but as the focus of a therapeutic intervention aimed at effecting an alteration in her time-orientation. The Manipulation of Time in Hypnosis Techniques designed to manipulate time in various ways are among the most dramatic and effective of hypnotic methods. The purposeful manipulation of time in hypnosis has traditionally taken several different forms, including time distortion, time regression, and future orientation (pseudo-orientation in time). The effective use of such techniques requires con-

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siderable skill, as well as adherence to Erickson's (1967a) dictum that, since each patient presents a unique psychotherapeutic problem, treatment strategies must be conceptualized in such a manner as to fit those unique features. Time distortion was first investigated systematically by Cooper (1948) and by Cooper and Erickson (1950). In their preliminary inve stigation they noted that through the use of special hypnotic techniques subjects were able to hallucinate activities requiring up to 30 minutes within very short intervals of clock time; for example, a 30-minute automobile ride was experienced within only 10 seconds. To achieve this surprising result, a learning technique was used in which the amount of clock time allowed for a hallucinated activity was gradually reduced. Hallucinated activities requiring 10 minutes could be hallucinated within as little as 3 seconds, but it did not seem possible to compress this process further. Although this phenomenon probably relies on the same mechanism as does the condensation phenomenon that occurs in nocturnal dreams (Freud, 1913), the subjects did not experience the hallucinated experiences as qualitatively identical to dreams, but rather as being more realistic. Some practical implications of this technique were readily apparent; for example, a professional violinist found that she could review either an entire composition or a difficult passage within a few seconds a procedure that greatly facilitated her actual practice and performance of the composition. Erickson (1954) proceeded to use this technique to effect some very remarkable therapeutic results. Probably the most surprising of these involved an accomplished artist who had wanted for some time to paint a "circus picture," but had for some reason been unable to get started

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on it. Although he estimated that it would take him 70 hours to paint such a picture, he was able to complete the work in a single aftemoon in a trance state for which he was later amnesic. The work was of high quality and won acclaim from art critics. The technique also proved very useful for reorienting patients to threatening, unconscious memories and other significant material. When using the technique for this purpose, Erickson would often review selected portions of the history and would then instruct the person to have a dream dramatizing the significance of the preceding material, allotting a very short interval for this activity. Time or age regression is a more familiar technique that is well described in a number of standard works (Cheek & LeCron, 1968; Hilgard, 1965). An imaginative and useful method that uses both a confusion technique and the suggestion of amnesia for the entire time interval subsequent to the approximate target date of the regression procedure has been described by Erickson (1980). Once regression has been accomplished the subject may view himself living through a certain life experience or may actually believe that he is his younger self (revivification). The technique of pseudo-orientation in time (Erickson, 1967b) is, in a certain sense, the antithesis of the revivification procedure. This technique involves the orientation of the patient into the future such that some anticipated future event is experienced as if it has already occurred. In this manner, a person who is contemplating some kind of an event or change can develop increased insight into the consequences that are likely to occur. This technique is very useful in evaluating the desirability of any major life change (marriage, change of job, elective surgery, etc.). It can also be used in com-

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bination with desensitization procedures to prepare a person for making a speech, taking an examination, or participating in an athletic competition or any other activity in which the development of excess anxiety might be counterproductive. The use of techniques such as those described above, in combination with analysis of the patient's time-orientation at a phenomenological level, constitutes a powerful therapeutic approach that may sometimes be a useful adjunct to more conventional approaches. The use of such techniques requires considerable skill; it should probably be remembered that the ability to place oneself within a phenomenological or subjective framework, while remaining cognizant of the formal structural nature of the treatment process, is a very useful (and perhaps essential) skill for the use of this type of treatment paradigm. Many experienced therapists report having had profound subjective experiencesduring hypnotic work and have reported that such experiences have provided valuable insight. There is currently no literature that treats systematically such logistical variables as indications, contraindications, or dangers involved in this type of therapy. However, it seems self-evident that, because time-orientation constitutes an essential aspect of an individual's subjective reality, therapeutic manipulations that significantly alter the constancy or meaning of personal experience over time may be illadvised in patients having severe personality decompensation. In contrast, such techniques may often be extremely helpful when used with more intelligent individuals who have a tendency to be introspective, with a sensitivity to their own subjective experience. Furthermore, in persons having adequate ego-functions the presence of serious behavioral pa-

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thology is not necessarily a contraindication. Although other well-known techniques, such as guided imagery or associative anamnesis, may sometimes achieve similar results, time manipulation often has the potential to achieve these results in a manner that is more systematic, more rapid, and probably more profound in its experiential and emotional impact. Clinical Applications of Time Manipulation Many examples of the clinical use of time-manipulation could be given, but excellent presentations of this type are available elsewhere (Rossi, 1980; Erickson, 1967b). Accordingly, the present discussion will conclude with only three brief case reports, each one of which demonstrates a specific principle of time manipulation.

Case 1 (Bernadette). The use of time distortion to facilitate study for an important examination. This subject was a 32-year-old master of social work. She held a full-time salaried position at a psychiatric hospital, was involved in a private counseling practice, and was pursuing further graduate study. As a result of her rather hurried schedule, effective use of her time was a factor of major importance to her. She sought help because her hospital duties had not left her adequate time to prepare for the final examination in one of her courses. She stated that she had managed to reserve a block of time (about 3 hours) on the afternoon of the same day, but she did not see how she could possibly organize herself to study the necessary material in that length of time. In the hypnotic state I asked her to vis-

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ualize an outline of the various topics covered during the term. I then asked her to visualize reviewing thoroughly and effectively for each topic, and I suggested that she would find the material intensely interesting. She would be so intensely absorbed in the study material that she would scarcely notice the passage of time, which would, in fact, seem to be moving very slowly. Finally, I asked her to visualize herself having successfully completed the examination. Subsequently, she reported that she had had adequate time for study and had not felt rushed. She had managed to master the material, with a good performance on the examination. Comment: This case shows how a relatively simple intervention involving posthypnotic suggestion can successfully maximize the use of a specified time interval. In this case the subject already knew effective techniques of preexamination review. As an experienced clinician, she was also familiar with some of the literature in the area of clinical hypnosis. All that was really necessary was to alleviate her counterproductive anxiety regarding the impending examination and to convince her (at the unconscious level) that she could use a hypnotic process to condense her review into a time interval that was shorter than usual.

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enrolled in a prestigious conservatory of music only to drop out largely as an expression of spitefulness toward her aristocratic mother with whom she was in constant conflict. She subsequently enrolled in a nursing curriculum in which her access to restricted substances was the beginning of a long-term history of drug use that became intense and self-destructive. Her children all had serious psychological difficulties and two of them had been involved in various ways with the juvenile authorities. Her older son was born with a deformed hand, possibly as a result of gestational drug abuse. Sharon sought assistance in an attempt to break her long-standing pattern of "getting loaded" whenever she felt overly stressed. She stated that she was now enrolled in a college curriculum that she hoped would lead to a social work degree. She wanted to do this to help others with drug-relateddifficulties. However, the urge to "get loaded" often seemed virtually irresistible, and she knew that if she gave in she would lose everything for which she had been working. Sharon proved to be an excellent hypnotic subject and she very quickly developed a profound somnambulistic trance. I related a brief review of her history to her. I then told her that she could enter a dream state, similar to nocturnal dreaming, and that her dream experience would, in some manner, summarize all of the relCase 2 (Sharon). The use of dreamevant feelings and emotions of her entire condensation in the treatment of life. Although a period of about 20 seccompulsive drug abuse. onds was allotted to do this, it was necSharon was a 42-year-old woman and essary to extend the time somewhat the mother of three children. Her history because the experience was accompanied of the progressive deterioration and es- by a reaction of intense terror. When she cape into narcotic abuse of a person with was able to do so, Sharon related that she high intelligence and extraordinary talent had had the very vivid experience of being is one that is all too familiar to many cli- in a dense forest on the shore of a lake. nicians. Following high school, she had She' was aware of holding something in

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her arms, and as she looked down, she realized that she was holding her own dead baby! After she recovered her composure, Sharon was able to relate how her intense feelings of self-condemnation and guilt, which were rooted largely in her relationship with her own mother, had undermined her entire life, how she had progressively sought to escape through drug intoxication, and how all of these influences had finally eventuated in an overwhelming and irrational feeling of selfcondemnation - the subconscious belief that she was guilty of the deaths of her children", The fairly brief dream experience served not only to elicit the anamnesis described above, but it also served as a stimulus for a brief didactic discussion of drug-induced teratogenesis and for subsequent reinforcement of her preexisting tendency to displace the rather violent energies involved in her self-condemnation into her desire to excel and to help others. Two years later, Sharon called to report that she had remained entirely drugfree and had graduated with honors from a major state university. Comment: The successful treatment of this patient used the clinical method developed by Erickson (1954) in which the patient is told to condense all of the relevant aspects of a certain problem into imagery lasting only a matter of seconds. The timeless nature of the primary process can also be noted here in that, although the events that gave rise to Sharon's powerful feelings of guilt had occurred some years ago, these feelings were still very current. The imagery that she produced is significant in that it provides insight into the nature of the subconscious process in"The possibility that the dream involved a fourth child which had been stillborn or had died postpartum was investigated and ruled out.

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volved in her self-destructive behavior. Although Sharon had not "killed her children," the possibility that some of their difficulties were due to a drug-induced teratogenic process was very real and could be neither confirmed nor ruled out at a biomedical level. She could escape from this realization either into drug use or into a new constructive lifestyle. The choice was hers. All that the hypnotic therapy could do was to clear away the impediments to the choice that she had already made at an unconscious level.

Case 3 (Angela). The use of regression and altered time II understanding in the emergency treatment of life-threatening symptom. This subject, a 13-year-old girl, was referred on an emergency basis by her primary care physician who related that over a period of several months the patient had been sleepwalking virtually every night. Sometimes she would cry out frightfully during these nocturnal episodes, and sometimes she would walk on out into the street. Because the family lived on a busy thoroughfare, he was very concerned for the girl's safety and wanted to know if she could be seen immediately. Accordingly, I made arrangements to see Angela on the subsequent afternoon, with a 2hour block of time being allotted for this purpose. Angela was accompanied by her mother who again related the girl's difficulties with an expression of concern and perplexity. Her history revealed that she was being raised by her natural mother and a stepfather and that she really did not feel very close to either one of them. The only adult with whom she could describe ever having had a close and supportive relationship was her grandmother, who had served to some extent as a surrogate parent fol-

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lowing her parents' divorce. When this grandmother had died several months ago she had been left with an unbearable feeling of emptiness and confusion. Although she continued to function (to some extent) by attending school, her marks had suffered and her interest in the usual adolescent activities had markedly declined. Her most profound symptom, however, was the somnambulism, which seemed to occur virtually every night. Often she would walk from her second-story bedroom down into the living room where she would confront her grandmother's picture with a fixed stare. She would then scream or would proceed out into the front yard or street wandering in an aimless fashion. As would be expected, she appeared to be totally amnesic for all of these episodes. Angela was an excellent hypnotic subject and rapidly entered a deep somnambulistic trance state. Because answering questions orally seemed difficult for her, I used the familiar device of ideomotor finger signals during a portion of the procedure, but she was also instructed to answer questions orally at certain points. I then attempted to establish orientation to the present point in time and to the future. I did this by explaining that she is now 13 years old and is attending the seventh grade and that as she continues to grow older she will progress further in school, meet new people, participate in sports and music, go on dates, and so forth. (I suggested a lengthy list of activities taking her up through high school and young adulthood.) Significantly, as I told her to visualize this normal kind of temporal agerelated progression, her "no" finger remained elevated. She simply would not or could not orient effectively to the future or to the reality-oriented demands of the present. In addition, she felt con-

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vineed (at least in terms of a certain kind of subconscious "trance logic") that her further progression through life had been obviated by her grandmother's death. At this point, I suggested time regression, using a familiar technique (Cheek & LeCron, 1968), and she was told that somewhere in the past of her childhood she could experience a spring garden and sense her grandmother's presence, and that her grandmother could be there and was there. The procedure evoked a response of very apparent relaxation and subjective comfort. I told her that the image of her grandmother and the garden was a part of her; it would go with her everywhere; it would always be hers and no power on earth could remove it from her. Finally, I gave her the following explanation: "In a manner which none of us fully understands, there is a part of you for which this experience and this relationship are always present." When asked if she understood, she responded by moving her "yes" finger. I then reoriented her to the present and told her that as she continues to grow older she will progress further in school and so forth. Her "yes" finger was raised in response to all of the same suggestions of further growth and development that she had previously negated. Finally, I gave the suggestion: "Now that you have gained increased understanding, I think that you can experience and appreciate sound and entirely restful sleep tonight and the following night and for as many nights in the future as you can imagine." On follow-up after 3 weeks and again after 2 months, she had no further difficulty with her somnambulistic symptoms. Comment: In this case, I made a deliberate attempt to place the patient within a Time II frame of reference through suggesting that the emotional, symbolic, and spiritual aspects of the relationship be-

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tween this girl and her grandmother might be stronger than chronological time and might preempt even death - the "flowing away of the world." Such a timemanipulation was made more difficult by the necessity of using language and explanations comprehensible to this very sensitive preadolescent child of somewhat above average intelligence. Because the rather intensive therapeutic manipulation was directed entirely toward the immediate presenting problem, it was possible to produce remission of a potentially lifethreatening symptom with a single session lasting approximately 2 hours. I made no attempt to deal with longstanding interpersonal problems with the family and other difficulties, although the mother was apprised of the availability of counseling services should they be needed. Summary and Conclusions Considerations related to the nature of time have been derived from a number of different fields of inquiry, and an attempt has been made to show that this dimension of human experience is central to the understanding of both normal and pathological mental states as well as of the human condition in general. I have reviewed a number of time-manipulation techniques, including one (the utilization of the time II mode of subjective experience) that, as far as this author is aware, has not heretofore been described in the psychological literature. Some illustrations have been given of the use of these techniques in an attempt to show that they may indeed constitute effective and powerful forms of therapeutic intervention. I hope that the foregoing discussion will serve as a catalyst for the further investigation of this fascinating topic.

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Orientation in time: implications for psychopathology and psychotherapy.

Considerations derived from the fields of physics, philosophy, anthropology, and psychology suggest that our popular conception of time as a unidirect...
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