Transformative Psychotherapy
A growing collection of articles on the art, craft, process and philosophy of psychotherapy, and occasionally other things. Transformative? Because good psychotherapy is alchemical; it changes you, using the ingredients of what is already present in the unconscious and the conscious with the addition of insight, creativity and choicefulness, as well as tools for continual transformation.
Tuesday, 6 January 2026
Connecting Across Species by Dr Elizabeth McCardell, M. Couns., PhD
Sunday, 21 December 2025
Border Country by Dr Elizabeth McCardell, M. Couns., PhD
January 2026
We rode a dog sled driven by seven working dogs, the seventh a young dog in training, and a man standing on the sled behind us taking us through the icy landscape of Kirkenes, that borders Russia and Finland in Norway’s far north. It was freezing cold, fast and incredibly beautiful: frozen lake, rolling snow covered hills, bare trees, and a sliver of pink sky. The last two dogs seemed to argue a lot and one kept turning around and looking at us, as if to say, “See, I’m right and he is wrong,” or something.
There is nothing sedate about dog sledding, nothing gentle. It’s heart pumpingly scary as one whizzes around tight corners. A couple of times, I thought I’d be flung off into the snow. My face hurt with the pain of cold, but I absolutely loved it and I loved the countryside. It reminded me of the landscape of my family and I felt at home in this border land.
As we crossed the solid lake, I remembered the Ukrainian composer, Prokofiev’s opera Alexander Nevsky, the 13th century Prince of Novgorod, about a battle fought and won on the frozen lake between the Teutonic knights (Germans) and the Russians, a lake that borders Estonia and Russia and the lands of my mother’s family. My mother was Russian, born in Pskov (on the lake’s edge that borders Estonia and Russia, mentioned in the opera), her mother was Russian, her father, Estonian and originally Baltic German. The land they lived was historically disputed as a site for conflicting ideologies and language (just like the war in Ukraine and Russia at the moment). I note here that Prokofiev is claimed by the Russians as a Russian composer! Kirkenes had this quality, of being between places. It’s disputed territory, and interestingly, these days, Russians and Norwegians can freely move across the border, at least within the fairly tight parameter of forty kilometres. What are borders anyway, but a human construct, and we are all humans claiming “mine versus yours” stuff, just like the two sled dogs.
I found the whole thing of being here deeply moving, stirring something profound within me. It was against this backdrop of deep remembering that I met a few of the little puppies who begin training to pull sleds at a young age. One little guy and I totally fell in love. We nuzzled each other and held hand in paw and I wanted to take him home to Australia, but, of course, I couldn’t.
Back home, I have much to think about. Our Norwegian journey was only two and half weeks long and most of it was done travelling on a Hurtigruten ship from Bergen to Kirkenes. In some ways, the trip was far too short, but perhaps not. It was quite restful not having to do much at all. The ship stopped often, mostly merely to collect mail, but sometimes we could disembark and wander new streets, but unfortunately never to do anything but scratch the surface of any place. I guess, it was because dog sledding had a dangerous quality to it and that physically engaged us in that experience that this felt the most real of the entire journey. Everything else became much like drifting through time and space as nothing more than a tourist with a camera.
One place that my friend and I stopped at enroute from Oslo to Bergen, where we boarded the ship, was Flam in the fjords. The landscape was magnificent: mountains, cliffs, rock formations that blew our minds, but the hotel we stayed at was a theme park. Their restaurant was set up like a pseudo-Viking feast house, complete with tall blond Viking man with a suspiciously northern English accent (!) who would sell his grandmother at the drop of a hat, animal hides, carved wooden chairs and tables, a booze bar, etc etc. I felt almost sick with the silliness of it; a museum piece designed for tourists. If this is what travel has become, I’m not sure I want any part of it.
I suppose what I gained most from my journey was connection with my familial history of border countries/cultures, meeting and loving the dogs, and understanding what matters most to me. The rest can be forgotten.
Friday, 21 November 2025
Hypnosis in the Treatment of Dental Anxiety by Dr Elizabeth McCardell, M. Couns., PhD
December 2025
I first came upon the idea of clinical hypnosis when sitting in a dental chair in consultation with my dentist some dozen years ago. As we always did, he and I got talking about shoes and ships and sealing wax and cabbages and kings and the subject of hypnosis came up. My dentist disappeared into another room and came out with a book on the history of the use of hypnosis in dentistry in Australia and invited me to borrow it. My interest was sparked.
Yes, I knew about hypnosis from my studies in psychology decades previously, and yes I knew about hypnosis as entertainment, but that was it. It really hadn’t entered my consciousness very deeply until now. So I got to thinking, incorporating hypnosis into my psychotherapeutic work would be very useful. I set about looking for decent courses in clinical hypnotherapy and found one down in Sydney. This course was spread over several months and required me to fly down to Sydney every month, find a place to stay and immerse myself in the theory and practice of this art. It also required me to write essays, record my sessions with clients, and the like. We had a mountain of stuff to read, to critique, and to incorporate into our practice. It was a good course, and I came out with a Diploma of Clinical Hypnotherapy, which with my Master of Counselling degree has proved very useful.
I see people with all sorts of issues for hypnotherapy, as with non-hypnotherapy clients, but the most frequent issues are sleep disturbances, smoking, fear of heights, fear of falling, of flying, self confidence issues, etc. One client needed hypnosis because she had to undergo bone scraping under local anaesthetic because she’d had too many full anaesthetics for the same procedure and the surgeon was concerned that her recovery rate was too compromised by full anaesthesia. The bone scraping was to stimulate healing. She’d been in horse riding accident and had nearly torn her foot off. The injury had become infected. A truly horrible condition. And so I was called in to hypnotise her, which I did and her recovery was hugely improved.
It is very interesting to me that it is only now, nearly 13 years later that I have my very first client receiving hypnosis for dental anxiety, particularly since I began with this as one of the reasons I chose to learn hypnosis in the first place.
Dental anxiety refers to fear of dental procedures and a reluctance to seek dental care, even when the person has major dental issues. According to the literature, the prevalence of dental anxiety is anything up to about 58% of people, but gauging real numbers is difficult. If someone is avoidant, are they going to own up to it? Avoidance of dental care can lead to significant health issues, including heart disease. The oral cavity can become septic and then the person is in grave danger, beyond just losing their teeth to chew efficiently. So avoiding dental care through anxiety worsens dental problems and that creates even more anxiety and more dental issues.
And then there’s the problem of pain. In the context of dental fear and anxiety, one can never ignore the topic of pain. Although pain has a clear physiological process which is the pain pathway, it also has a strong cognitive component. This means that a person who already has dental anxiety may have an exaggerated pain perception and experience, sometimes to the point of fainting. This is where hypnosis is very useful. The dentist can numb the physical pain, but the hypnotherapist can switch off the psychological fear.
So, if you have dental anxiety consider hypnotherapy for helping you overcome it and give you the means for attending important dental appointments. Hypnotherapy is very useful for many things, and this is there among them. Your overall health matters.
Please contact me via dr_mccardell@yahoo.com to make an appointment.
Monday, 20 October 2025
Incorporation and Utilization in Hypnotherapy by Dr Elizabeth McCardell, M. Couns., PhD
The other day I did a hypnotherapy session with a client coming for dental anxiety. During the session, a neighbour started drilling a wall (there’s always some building going on around me here), so I incorporated that sound into the hypnosis. Afterall, here was the perfect arising and I, anyway, work on the principle that we can be aware of a multitude of things and if we have previously only concentrated on our problems, bringing awareness to the multiplicities shifts our consciousness to whatever happens around us and not be fixated anymore on just the perceived issue.
Incorporating the sound of drilling is a neat example of incorporation in therapeutic practice. I could’ve totally ignored the sound and made no reference to it, but it was very loud and present – and quite funny, really, given what we were working on. Something that the client referred to at the end of the session. The sound, and my reference to it as one of many sounds, served usefully as a reinforcing tool, given that I was emphasizing that one’s attention can be on anything, and nothing at all.
The art of incorporation is central to Ericksonian hypnotherapy, as is its counterpart, utilization. What might otherwise be seen as interruptions are actually very useful opportunities.
The principle of incorporation is using the sounds, sensations, perceptions that arise during a session. Sounds of drilling, perceiving the texture of the rug draped over the client’s legs, the softness of the cushion behind their back, how it feels to put one’s feet on the floor, etc, can all be used to deepen a person’s trance.
The principle of utilization is similar, but refers to anything the client does: movements, words, facial expressions, breathing patterns (even breath itself), cognitive and emotional processes. All can be woven into the hypnotic language employed.
I always employ awareness of breath into the hypnoses I do, because it is already a gift. While we live, we breath and we can use our awareness of our own breath whenever anxiety, or whatever, arises. Some hypnotherapists suggest deep breathing, but I find such a suggestion can actually cause a lot of problems. Getting someone to take deep breaths can made a person ultra self conscious, and create thoughts long the lines of, “Am I doing it right” as well as possibly inducing hyperventilation. Awareness of an ordinary breath, on the other hand: breathing out and letting go and feeling more and more relaxed, pause, and breathing in the new is always available to our awareness, and without stress. And, of course, the beauty of it is that breathing is occurring whether we are awake or asleep and we can be aware of it, or not, and whether we are is a matter of choice. Just like anything else in our consciousness, problems included.
I also often refer to the thoughts and memories that are likely, and most probably, arising as I’m doing a hypnosis and I’m likely to say, “Isn’t it interesting that you can have this thought, or that thought, or that… and they keep coming and going like clouds in the sky, taking shape and form, and evaporating.” This technique I employ is quick in inducing a trance state. As the reader may notice, I use utilization and incorporation all the time when doing a hypnosis, and it use it in a rather confusional way. The point of this is that awareness is shifting all the time in ordinary life and when we pay attention to such processes our fixations on problems shifts. It’s hard to hang on to a single iterative thought when we become aware of the multiplicities of sensations, perceptions, thoughts, and feelings that arise.
Milton Erickson, the father of the branch of hypnotherapy that I practice, saw the techniques of incorporation and utilization as central to the creative process of hypnosis, and they are. The old idea of swinging a pendulum in front of a person’s eyes and making them focus on just that and ignoring all which is going on around them is unhelpful, in my view. I’m far more interested in bringing awareness to complexity than trying to control the person. It is in the awareness of complexity that we are able to choose what we attend to, which seems to me to be the whole point of therapy. We are free agents when we become aware of such things.
Please email me on dr_mccardell@yahoo.com if you are interested in receiving clinical hypnotherapy. It’s all done online, which works well.
Wednesday, 20 August 2025
Delayed Emotion after Trauma By Dr Elizabeth McCardell, M. Couns., PhD
September 2025
One of my first clients years ago when I was starting out as a therapist was a Vietnam veteran. He had just retired as an aircraft mechanic when he came to see me in a state of deep anguish. He had been a helicopter pilot during that war responsible for picking up broken bodies in Vietnam jungles. He said that at the time he just did his job, just got on with it. Didn’t feel much. After he returned home from the war, he settled into his job with a couple of airlines: went to work, came home, showered, cooked dinner, watched a bit of television, and went to bed. Same thing day after day for decades. No hanging out with friends, no intimate relationships. And then he took early retirement and suddenly found himself standing on a bridge about to throw himself in. Instead he went to his doctor and, after that, came to see me. Suddenly he was feeling all those emotions that he cut himself off from for all of his working life.
I get this. In the past month or so I’ve been suddenly feeling the deep sadness from nearly dying this time last year when I was hospitalized with blood poisoning that damaged my kidneys. Suddenly sad, coupled with recurring iterative memories of being in three hospitals with tubes in me for blood transfusions, temporary dialysis and other indignities.
I feel for those in the Northern Rivers, and particularly Lismore, who lost their houses, livelihoods and animals after the 2022 floods. I was lucky, living as I did in Lismore Heights above the devastation. The floods and aftermath are one reason I returned to my hometown of Perth, Western Australia where flooding doesn’t happen. The trauma felt, I know, was not immediately felt by all and many, I’m sensing, are feeling it now. I must admit that I’m feeling the feelings now delayed as well.
Why are feelings sometimes delayed for so long? You’d think that in the face of immediate catastrophe that feelings would be running high. They are for some, but not for others. Our immediate reactions in the aftermath of trauma are complicated and shaped by our life experiences, culture, coping skills, and community support. Coping styles are individual and variations in how a person copes (including those who just get on with life, without feeling much) is not a sign of psychopathology. There is no “normal” response to trauma. The realization of this is relatively new to those who study trauma. When I was studying for my Master of Counselling degree this wasn’t really talked about and the advice given to us was to encourage the person to talk about their experiences at the time of the traumatic event. A person like my Vietnam vet client, or me, for that matter, would not be helped by this approach – until they were ready to feel their emotions; emotions have to be felt in their own good time.
Coping styles vary from action oriented to reflective, from emotionally expressive to reticent. There are those who just get on with life, and there are those who are left exhausted, confused, sad, anxious, agitated, numb, dissociated, confused, in emotional and physical pain, and feeling nothing much at all. Of course, these feelings can become crippling and lead to long term distress: nightmares, sleep disorders, iterative thoughts, flashbacks, anxiety and depression, suicidal thoughts, as well as avoidance of emotions that are associated with the trauma.
Delayed emotional responses are not inevitable. Why this is so, is poorly understood. It could be that the event is not felt life threatening, or perhaps it is familiar to some lucky people. The thing is, though, that we cannot assume that if a person who has been in a horrible event is not showing much emotion is ok. Care and support is necessary whatever the person exhibits, or doesn’t.
Creative arts, therapy, mindfulness exercise, watching the breath, and sometimes medication helps. What doesn’t, is self medicating with drugs and alcohol. The thing is, be gentle and practice self care.
Thursday, 26 June 2025
Hypnosis as Everyday Trance by Dr Elizabeth McCardell, M. Couns., PhD
July 2025
Quite a lot of people are frightened of hypnosis. They immediately think mind control and stage performances where people are made to do bizarre things, but clinical hypnotherapy is no more threatening than reading a book, walking on the beach, watching a movie, listening to music. It’s just an extension of a common, everyday trance state.
You know the sort of thing I mean here: you’re in the zone, you’re not really aware of what’s going on around you even though you can still hear extraneous noises (a dog barking, the wind in the trees), you are aware of passing thoughts, but – like clouds in the sky, they arise and depart; your focus is on reading the book, listening to the song, the rhythm of the walk. You are in connection with the process of where you’re at.
As a hypnotherapist I’m uninterested in attempting to persuade you to do anything at all. That strategy would, anyway, lead to a massive resistance on your part! Instead, I invite you to explore your own experience and inner resources to resolve the thing that is bothering you. Hypnosis isn’t a violence against you, but a gentle exploration. It is felt as deep, supportive, safe relaxation.
Hypnotherapy can have immediate results, or you can notice change happening over time. You may feel different or you may just notice that trepidation, or intrusive thoughts, or feeling compelled to do something habitual has evaporated.
I worked with a woman with a fear of flying. She had a planned a trip to Bali but was really worried about getting on a plane. I discovered through the first session (usually about three one hour sessions are what is minimally required) that she used to do really exciting things like scuba diving and motorbike riding. Given that I also have done these things I know the excitement. I know, also, that the body perceives excitement and fear in about the same way (a rush of adrenalin) and thus feeling afraid to fly can be experienced not as fear, but as excitement. By this suggestion alone, when my client flew she was happy and delighted by the whole experience.
Intrusive sounds, can likewise evaporate under hypnosis and be translated into the spaces where they used to be a massive bother. Several years ago, I had a client having to use a dialysis machine at night that made a particular intrusive noise while he was trying to sleep. Instead of trying to persuade him not the hear the sound (have you ever been successful not thinking about the elephant in the room), I encouraged him through hypnosis to listen to the sound in the same way as he heard the wind in the trees outside his bedroom window, or voices in the street, or anything else going on in the night. In this way, no sound dominated and he was able to sleep.
A woman came to me with a fear of falling and was planning a hiking trip through the Grand Canyon. I discovered in her first session with me that her birthday is in January, like me, and I commented that we were both goats. And thus the hypnotherapy sessions were about the magnificence of mountain goats and how they/we are able to climb mountains with great agility and ease. There is caution, carefulness, and confidence in distributing weight and movement. And so my client had a wonderful hike.
The process of hypnosis is an interesting one. Brain wave research shows that in a hypnotic trance state a person brains exhibits deep alpha and theta brain waves. Alpha is associated with imagination and theta, with meditation. When the therapist’s brain waves are measured while doing a hypnosis, both alpha and theta are also present, but with the addition of beta waves. Beta is connected to conscious thought. So, in other words, the therapist experiences what the client is experiencing, with the addition of conscious thought in the presentation and shaping of the hypnotherapy session. You can see why, receiving hypnotherapy feels so good and why I enjoy doing it.
I offer hypnotherapy online, which works very well. Contact: dr_mccardell@yahoo.com for more information.
Wednesday, 4 June 2025
Online Therapy by Dr Elizabeth McCardell, M. Couns., PhD
June 2025
As most of your already know, I moved to Western Australia a couple of years ago and yet I continue writing for The Nimbin Good Times, as I’ve done since March 2009. Why, you may ask? The reason is that as I’m mostly working online these days, it doesn’t matter where I live. I’m also still very much connected to the people of the Northern Rivers and consider your part of the world my second home. I lived there, after all, in Lismore, 14 years.
I returned to my home town of Perth for a few reasons, including the realization that I was missing my beloved Indian Ocean too much and I was getting home sick.
As the covid pandemic taught us therapists, counselling and doing hypnotherapy online works. In the case of the latter, after all, the hypno is done with the client lying down with their eyes shut and my voice drifting across the ether wherever you or I am. Computer technology is so sophisticated these days that we are generally very comfortable talking to the person at the other end as if we were all in the same room.
There are many therapists working exclusively online nowadays. I do see people in person here in Fremantle, where I’m living, as well as online. This is obviously only an option if you’re here in the West. For everybody else, it’s online therapy that I’m offering. I have clients, these days, spread across the whole of Australia, which is really quite nice. I advertise in Psychology Today, which, like most things these days, is predominantly an online journal.
I follow the lives and politics of what’s happening around the northern rivers region of New South Wales as I do back here. You matter to me. If you wish to contact me, the best way is by emailing dr_mccardell@yahoo.com
It’s interesting how readily we humans have taken to online communication. It doesn’t generally feel very odd at all. Online therapy, also called teletherapy, has been found to be just as effective as in person therapy. It’s better than doing sessions on the telephone as we are very visual creatures. We connect better with each other when we can see the other person.
Online therapy, and I use WhatsApp, Messenger, and doxy.com usually, allows for great flexibility as clients don’t have to drive to a designated place. We can do it from the comfort of our own homes. This opens the way to good therapy for clients living outside towns and those who are disabled in some way. Time constraints are also more easily managed for online sessions.
There are downsides to online therapy and these include dodgy internet connections, difficulty making sure the sessions are private (you need, ideally, to have your living space to yourself for your sessions), incomplete visual clues (we therapists learn a lot about our clients through careful observation), and some psychological issues are not well cared for by this mode of communication. Severe psychiatric crises are best treated by somebody in person.
One thing that is as true for online therapy as in person therapy is the need for quiet contemplation before and after each session. Such time allows the person to reflect and prepare for what is to come and to make notes as felt necessary. You might follow up a session with a hot bath and lovely essential oils or sit down to a delicious meal or just head off to the garden. Prospects that don’t include car travel. Not bad, really. The important thing is that you don’t throw yourself into the rigors of work and stress straightaway but give yourself a bit of space around your therapeutic sessions.
Online therapy is a matter of personal choice. If you prefer in person sessions, then find a therapist for that; if online suits you best, and you’re interested in my work, contact me, please.
