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Monday, January 24, 2011

TO SLEEP, PERCHANCE TO WAKE

Dr. James Moultan, a clinical hypnotist, noted in his journal the curious case of Annelle Pendleton. She had been referred to him by Doctor Alton, at the clinic where they specialized in sleep disorders. Ms. Pendleton not only slept 24 hours a day, she was a sleep walker for twelve of those hours. She was able to do what most waking people do, while sleep walking. she got up in the morning, had breakfast, brushed her teeth, and went to work, and yet, she was still asleep. At work, she was noted as a reliable person, who got things done, and was even Employee of the Month three times. The thing about Annelle Pendleton, was that she did all this while asleep, and sleep-walking. What follows, is the account of Doctor James Moultan, regarding his work with Annelle.

CASE # 379, ANNELLE PENDLETON

This recorded transcription is an accurate account of my use of hypnotherapy to both explore and understand, the
characteristics of Annelle Pendleton's unique presentation of an unusual sleep disorder syndrome not seen or written about before in the literature of the field.

Jan, 8, 2010. Initial Session with Annelle Pendleton. (Notes)

In my first meeting with Annelle, I was impressed at how perfectly normal she appeared. How awake she appeared. Her eyes did not display the kind of blank glassiness so typical of sleep walkers, nor was there any slurring or slowness of speech, as one might expect, and even predict, as typical of the common and classical form of the disorder. She was, in fact, quite articulate in describing to me her experience of her unique condition. She had been asleep now for three years. During that time, little about her life had changed. She still kept a tidy house, went shopping, maintained her excellent standing in the work place, went to bed at a normal hour and got up as usual in the morning. The only thing that really changed for her was an inner awareness that, while it seemed she was getting out of bed, getting dressed for work, having breakfast over the morning news, and so on, she knew she hadn't awakened at all. She was still asleep, but going about her usual life. Being aware of this led her, in a misguided self help sort of way, to try to wake herself up. In our next session, we will review some of these efforts.

Jan 15, 2010. Session 2

Annelle, recounted her determination to wake herself up. She had tried purchasing a loud alarm clock. Then multiple alarm clocks. She says, as of this date, she has well over a dozen. None of them seemed to shake her from her endless sleep. Several of them were so loud and annoying, her neighbors in the next apartment had complained about them. Then she spoke of a day when, she was standing in the kitchen, and she suddenly charged angrily straight into the refrigerator, and knocked herself out. When she came back around moments later on the kitchen floor, she was disappointed to discover that she was still asleep. She reported that the collision she had attempted, did little more than than to create a slight red goose egg on her forehead encircled by a pale bruised halo of a deepening blue and purple. She said that she realized in that moment, picking herself up from the floor in tears, and rubbing her throbbing forehead with her palm, that she needed help. That she was getting increasingly desperate to wake up.
She had thoughts of hurting herself into wakefulness, even if only to awaken screaming in pain. Or stepping out in front of a fast-moving car to her death, if just to have a moment of waking clarity before dying.
"So, that is why I am here today, doctor." she said, finally raising her head from her fixed gaze down at the floral pattern of her dress across her legs. She swept her palms over her thighs several times, as though smoothing it, as she looked into my eyes. I nodded, looking at her, her eyes revealing nothing but an urgent dark question mark.

I glanced at the clock on the wall.
"In our next session, Annelle, I'd like for you to take me further back in your life, so I can begin to better understand your inner dynaics."
"What do you mean when you say my inner dynamics?" she said, standing to leave.
"Well," I replied, "It means basically the stuff you are made of; the stuff that moves one purposefully through life. We'll walk through it together next time, Annelle. We'll take it slow and easy, and perhaps we both will get to understand you more in time. You see, we have no predictabilityy about life, without first understanding it. And without predictability, there is no possibility of control. It all starts with understanding. Do you understand?" I opened the door for her.
"Yes, doctor. I understand." she said, waving goodbye as she walked toward the stairs.

Jan 27, 2010 Session Three

Annelle sat on the red leather arm chair by the window, as usual. She stared out the window, looking down at the busy street thick with city buses, and yellow cabs. People rushing along the city sidewalks, in all directions.
"You know what's funny, doctor?" she said. " People are always wishing they could live in a dream. If only they knew what it was really like."
"Are you living in a dream, Annelle?" I asked.
"Mm hmm," she replied. "A very long dream."
"I'd like for you to take me back, Annelle. Back to when your very long dream first began. Can you do that?" She nodded,
"I will try. It was in the Winter of 2006. There was a lot of snow that year. I was 23 in the Spring of 2007. That's when it all went out the window." I leaned back in my swivel chair, looking at her as she fell into silence, and simply stared out the window. I knew from her records, that long before 2007, she had been seen by clinicians for narcoleptic seizures, that were brief, but with a sudden onset. These had begun when she was about 10 years old.
"That's when what all went out the window?" I asked quietly. She turned her head to look at me with a startled expression.
"I'm sorry, doctor. What did you ask me?"
"You just said 'that's when it all went out the window' ."
"I did?" she said. I don't remember saying that.
"Annelle, I'd like for you to think back even further. To 1987. You were 10 years old that year. Do you remember? " She nodded.
"I wish I could forget it. Doctor, I really need to leave early today." she said, wringing her hands. "Can we do all this another time?" I nodded,
"Sure." I said, sensing her discomfort. We had touched, even if only on the murky surface, upon two periods of her life. Periods of time that were deeply significant in some way."

Sessions Four and Five, Summary of notes.

Over the next two sessions, we were able to identify the co-incidence of the emergence of various symptoms of sleep disorder, with times in her past where she had experienced great loss. At the age of 10, and, in fact, on the very day of her 10th birthday, her father did not come home. He had been tragically killed in a commuter train wreck, on his way home from work. By the time the news reached her that evening, she was dancing and having fun with a living room full of girls her age, celebrating her birthday. In the years that immediately followed, her life went reeling off-balance. She was having bouts of insomnia, wetting the bed, and having sudden narcoleptic episodes. These symptoms seemed causally tied to the trauma of her father's death. While things improved through high school and college, it could have been predicted even back then, that what happened years later in 2007, could have thrown her into the dark hole of endless sleep and dream, where she remains today.

Session 6

Annelle laid down on the couch and rested her head on the pillow.
"Comfortable?" I asked, as I pulled my chair up near the couch, just out of her field of vision.
"Yes" she replied.
"I want you to feel comfortable and relaxed. You have been sleep walking through our sessions, haven't you? I said in a soft voice.
"Yes." she replied.
"Just as you have been sleep walking through the last three years of your life." I said.
"Yes." she replied.
"And you are wishing and wanting so much to actually wake up." I added.
"Yes." she replied.
" I want you to do something, Annelle. I want you to close your eyes and take a long deep breath....10... I want you now, in your present state of constant sleep, to imagine or dream, that you are not really asleep at all....9.....that you are actually awake....8.....Are you awake, now, Annelle?"
"Yes" she said with a yawn, as she began to slip into a trance state.
"Good. Awake and relaxed....7.....now, I would like you to close your eyes.....6....and go to sleep....5....very peacefully sleeping...4......peacefully sleeping......deeper and deeper asleep....3.....and when you hear me softly call your name....2.....you will awaken from your long dream....1....

I got up quietly and walked into the kitchen and poured myself a cup of coffee. What happened to Annelle in 2007 involved a man who hurt her deeply. So deeply, that she had retreated into an extreme state of emotional insulation. A state of mind and feeling that no longer allowed the world with all it's shock and pain, to touch her. She became so removed, that the real world didn't seem real at all, but more like more like a long dream. And sleep for her became the only possible reality. Over time, she came to actually believe that life really was a dream. Finally, she awoke one morning, but without really waking up. She had begun to believe she was sleep walking, rather than actually getting out of bed. Her protective detachment, and insulation had engulfed her. Swallowed her. She was not living a dream at this point, the dream was living her. And so, for the past three years she has been sleep walking through a world in her mind, a world that was but a dream. A dream that possessed her. I made a few notes before continuing with the procedure.

Note: "The procedure I used, to, in effect hypnotize her in her own self induced trance, is relatively new. Whether, it has worked here with Annelle or not, remains to be seen. In asking her, in her sleep walking state, to pretend or imagine she was awake, I was hoping that I had, in effect, entranced her own self-imposed hypnotic trance. When she answered that yes, she was awake, she was in fact, really awake for the first time in three years. It was as though I had psychically flipped her delusion like a pancake, and put reality face up once again. When I asked her to return to sleep again, I was basically putting this conversion of her state of mind into a normal sleep-wake cycle. Finally then, as she returned to sleeping, I gave her the suggestion that when I called her name next, she would awaken into reality."

I returned to my seat and looked at her. She was breathing slow, deep, calm breaths, peacefully asleep.
"Annelle?" I called quietly.
"Yes." she mumbled sleepily.
"Are you waking up now,?"
"Mm hmm," she said. I watched as she turned onto her side and snuggled the pillow beneath her head. She blinked her eyes several times, then rubbed them with her fist. "I guess I fell asleep." she said, with a yawn.
"Yes, I guess you did." I answered with a smile. She pushed herself up on one elbow, and then slowly sat up. She gave a funny laugh and said,
"I had the craziest dream."
"Really? Tell me." I said.
"Uh huh, it was so crazy. I dreamed that I had gone to sleep, and slept for three years! It was like I was Rip Van Winkle, or something. So crazy." I smiled.
"So, how are you feeling now, Annelle?"
"Happy" she said. "Happy it was just a dream. A long, long, bad dream."
"Yes, Annelle. A long dream. But it ended, didn't it?"
"Yes", she nodded. "I am awake now."

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