The Art Of

Indirect Hypnosis
The Training Manual for the Free BHR One Year
International Online Certificate Course in Indirect
Hypnosis, Ericksonian Hypnotherapy and NLP.
By Stephen Brooks
Edited by Dr Colin Baron & Dr Andrew Bradford
Copyright Stephen Brooks – 1992 /2008
British Hypnosis Research
Copyright and Distribution
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Stephen Brooks has a lifetime’s experience of using indirect hypnosis
with severe problems and difficult patients. Inspired and encouraged by
top American Psychiatrist Milton H Erickson, he was the first person to
introduce Ericksonian Hypnosis into the UK in the mid 1970's. Since
then, his own innovative indirect therapy techniques have had a major
influence on the health professions both in the UK and Europe and have
changed forever the perception of hypnosis and how it should be used
within therapy.
He is founder of British Hypnosis Research (1979) and the British
Society of Clinical and Medical Ericksonian Hypnosis (1995), both major
training bodies for the caring professions. His two-year Diploma courses
became the standard training for thousands of health professionals and
over a period of 15 years he taught indirect hypnosis courses in over 27
major British hospitals. His Diploma courses also became the standard
training for hypnotherapy associations and organisations in France,
Belgium, Spain, Ireland, Malaysia and Singapore. In 1991 he was
awarded special acclaim when archive recordings of his work were
preserved in the British National Sound Archives.
He specialised in innovative approaches to Indirect Hypnosis with an
emphasis on demonstrations with real patients during his training courses,
something that many trainers are still afraid to do. A common thread in
Brooks’ work is his humour, compassion and creative approach to
therapy and his deep respect for the unique needs of the patient. He
treated problems by spontaneously doing what is most unexpected but
always most appropriate for the patient at the time, quickly tailoring each
therapy session to the patient.
He is now responsible for the design and teaching of the British Hypnosis
Research online academic hypnosis course which is available to serious
students of hypnosis free of charge. He also teaches internationally in
several countries.
For further information about training in Indirect Hypnosis please contact
British Hypnosis Research.
The Art of Indirect Hypnosis
By Stephen Brooks
Edited by Dr Colin Barron and Dr Andrew Bradford
Acknowledgements
Foreword
Introduction
Part One - Opening the Door
Open communication
Define the problem
Develop trust
Root cause
Secondary gain
Observe non-conscious responses
Part Two - Digging Deeper
Subjective interpretations
Negate negative interpretations
Be one step ahead
Look and listen but mostly look
Verbal and non-verbal metaphors
Congruency and insight
Organic Metaphors
Chapter 3 - The Nature of the Beast
‘Trying’ is not succeeding
The relationship between cause and symptom
Non-conscious commentaries
Words are not meaning
Challenge negative nominalisations
Therapeutic nominalisations
Chapter 4 - Building Empathy
Rapport building
Breathing in harmony
Reflective speech
The agreement set
Positively Framed Suggestions
Reverse Frame Suggestion
Tag Questions
Response attentiveness
Matching predicates
Sensory re-presentation
Sensational representation
Chapter 5 - Motivational Perception
Well formed outcomes
1. What positive change do you want?
2. How will you know when it has happened?
3. What has stopped you from changing so far?
4. What do you get out of what you're doing now?
5. Do you want this change in all contexts?
6. What could go wrong?
Polarity responses
Responding to Polarity Responses
Accessing resources
Chapter 6 - Visible Trance
Deeper trance states
Minimal Cues
1. Eye fixation
2. Pupil dilation
3. Change in blink reflex
4. Rapid Eye Movement
5. Eyelid Flutter
6. Smoothing of facial muscles
7. Slowing of respiration
8. Reduction of the swallow reflex
9. Body Immobility
10. Inner absorption
Everyday trance
Utilisation
Tailored therapy
Chapter 7 - Therapeutic Strategies
Therapeutic structures
Therapeutic metaphors
Symptom substitution and resolution
Sensory dissociation techniques
Scrambling symptoms
The Swish Technique
Chapter 8 - Artful Suggestion
Patterns of suggestion
Serial suggestions
Dependent Suggestions
Adjunctive Suggestion
Passive Response Suggestions
Open Ended Suggestions
Double Entendres
Illusions of choice
Binds and Double Binds
Chapter 9 - Trance Phenomenon
Non-conscious signalling
Anchoring
Abreaction and Trauma
Chapter 10 - Multiple Mirrors
Multiple dissociation
Crystal gazing
Distorting time
Chapter 11 - Snowballing Effects
Future planning
Future Pacing
Pseudo-orientation of time
Steps for Pseudo-orientation in time
Lingering suggestions
Trance recall
Chapter 12 - More Indepth Approaches
Teaching your Patient Self Hypnosis
Hypnotic Amnesia
Hypnotic Anesthesia
Pain Control
Self suggestions and dissociation
Part Two: The Sussex University Therapy Session Transcript
To purchase the double DVD training set based on this therapy session,
with a running commentary plus interviews, please go to the BHR online
shop: British Hypnosis Research.
Acknowledgements
Many people have contributed to my life, and therefore, indirectly to the
writing of this book. So I would like to express my thanks to everyone
who has supported me.
In particular, I would like to thank the following people who have shaped
the way I work. Dr Milton H Erickson and Dr Ernest Rossi in the 1970’s,
Virginia Satir for showing me how to love my patients, Ajahn
Buddhadasa for teaching me non-attachment, the Shamans of Chiang Dao
for teaching me to navigate the spirit world, His Holiness the Dalai Lama
for teaching me humility, gratitude and how to walk on water, my
patients for their trust, my trainers and staff at British Hypnosis Research
and the international hypnosis organisations who have promoted my
courses with such enthusiasm, Dr Andrew Bradford and Dr Colin Barron
for giving up their valuable time to edit this book. Lastly, I would like to
thank those closest to me for their unconditional love in giving me the
space to live my minimal lifestyle. True wealth consists in being content
with little.
Stephen H Brooks
Foreword by Igor Ledochowski
Stephen Brooks is a pioneer in the field of indirect hypnosis. It all began
in the 1970's. The UK was still dominated by schools of hypnosis that
had been spawned from the work of stage hypnotists. Milton Erickson's
revolutionary ideas about hypnosis and psychotherapy were making big
waves in the USA but were practically unheard of in Europe.
Stephen originally learned his craft at one of the old schools. He was
bright enough to realise the limitations of the old system and, dissatisfied,
he sought better alternatives. After much searching, he eventually found
the legendary Erickson and began to learn new ways of using hypnosis to
transform people. Stephen became very good with people. His practice
filled to cover six different towns.
In time he mastered his craft. Like every other true master, he then started
to develop the field of indirect hypnosis in exciting new directions. Many
people, including health care practitioners from around the globe, came to
learn from Stephen. His Diploma Course in Indirect Hypnosis became the
gold standard in six countries.
His series of ebooks, audio lectures and workshops covers Stephen's
patterns and discoveries in indirect hypnosis and minimal therapy. They
cover over thirty years of experience in clinical hypnosis. His
publications belong in every therapist’s practice for two reasons:
Firstly, his archive of training materials is one of the most comprehensive
sources of material to cover all of the technical aspects of indirect
hypnosis as applied to therapy. It covers more than the technical aspects
of inducing trance, it shows you how the pieces fit together in a
therapeutic context.
Secondly, you will find within his material a way of being with your
patients that is both respectful and powerfully effective. Stephen has
drawn on his experiences of Buddhism and a deep respect for nature to
shed light on our human nature. His approach is pragmatic, humanistic
and in many ways deeply spiritual. His philosophy is at once
sophisticated and simple, like his lifestyle: people are a part of nature and,
like all natural systems they will find balance and harmony as soon as
they get out of their own way for long enough to allow their nature to
express itself unhindered.
While the structure of therapy is illustrated by the technical information,
Stephen also gives numerous case histories that bring the spirit - or
perhaps more accurately the spirituality - of his life's work to life. You
will no doubt find these case histories at once charming, illuminating,
inspiring and thoroughly absorbing. As good as these are, they do not do
full justice to Stephen Brooks and the way he finds a roadmap deep into
his patient's non-conscious minds. To experience that you should really
see Stephen in action.
Igor Ledochowski
Author of “The Deep Trance Training Manual”
Introduction
The Art of Indirect Hypnosis has been written for people wishing to learn
practical covert hypnotic skills that can easily be applied professionally
and personally in a simple, non-intrusive way. Despite the advances that
have been made in the field of hypnosis over the years most people are
unaware of the vast array of skills that lie behind the process of indirect
hypnotic induction. This book is the result of the author’s early work into
the covert use of hypnosis in medical and psychotherapeutic settings.
As the name implies, indirect hypnosis is the opposite from the direct
authoritarian approach to hypnosis used by most therapists during the 20th
century. The indirect form of hypnosis and psychotherapy taught in this
book allows the therapist to by-pass the patient’s normal conscious
resistance to suggestions. Because this approach is so indirect, therapists
can now use hypnosis effectively in areas of the caring professions
previously unfamiliar with hypnosis. Through the work of Stephen
Brooks in the UK, indirect hypnosis is now widely applied in the social
services, nursing, counselling and psychology in addition to the more
traditional contexts of medicine and dentistry.
When Brooks wrote this book he was teaching at various hospitals in the
UK and this book became the standard training manual for those courses.
He was working in a minimalist style using indirect hypnosis with some
additional NLP. This book contains the results of that integration. Brooks
had not fully developed his principles of Minimal Therapy at this time,
although his work was always brief and simple. The first part of this book
introduces the various principles and techniques of indirect hypnosis. The
emphasis is on the application of indirect hypnosis in therapeutic settings,
however the concepts and skills taught will be of interest to all serious
students of communication and influence. So persuasive are the indirect
hypnotic techniques taught, that the author stresses the importance of
applying the skills only for the benefit of others and suggests that all
serious students acquire professional training before using the skills with
patients. This emphasis on integrity runs through all of Brooks' work and
for the serious student of indirect hypnosis, this book should ideally be
used as an adjunct to actual attendance on a training course.
A transcript of an indirect hypnosis therapy session with a commentary
by Brooks is featured at the end of this book. The demonstration is also
available separately on DVD and readers are recommended to acquire
this if possible to refer to while reading the transcript and author’s
commentary.

Chapter One - Opening the door

Open communication
When two people meet for the first time they know nothing about one
another. It is the therapist's job to be observant and ask questions to start
things rolling. It is important to ask open-ended questions that elicit
relevant information. Open-ended questions cannot be answered with a
‘yes’ or ‘no’ and usually start with ‘who, what, where, how, when etc’.
Questions such as "What made you decide to see me?" will elicit a
relevant, content rich response. This can be used to help understand the
patient's problem and build rapport. Good rapport between the patient and
the therapist enables more open discussion and is itself therapeutic for the
patient. Therapeutic intervention does not require detailed knowledge of
the patient’s problem and sometimes the patient may be reluctant to
discuss their problem openly so early in the therapeutic relationship.
Define the problem
Every symptom or problem behaviour has a beginning, a middle and an
end. Attempt to identify any triggers and the subsequent sequence of
events experienced by the patient. By recognising the sequence of events
experienced as feelings, pictures, sounds or actual experiences the
therapist gains valuable insight. Identify the date or the time in the
person's life when the problem first started. This includes significant
times in the person's life when the problem has been at its worst. It might
also be useful to identify any times prior to the problem starting when the
patient felt similar feelings. Identify the frequency of the symptom or
behaviour. You might also like to identify where it occurs and with
whom. You need to know how long the symptom or behaviour lasts.
You should also identify any other events, happenings, experiences or
traumas that have occurred at about the same time that the problem first
started or developed. Maybe one of these events has indirectly triggered
or started the problem. Therapy should also attempt to identify how
family and friends view the patient's behaviour or symptoms. The
symptom may only occur in the presence of certain family members. By
identifying the relationships between the patient and the people around
the patient the therapist will gain a deeper understanding.
It is equally important to identify the times in the person's life when they
have not had the symptom. This is especially important when the person
had expected to have the symptom or problem and it did not occur. The
patient's subjective understanding of the problem will often be vague and
they will often be unable to say specifically why the problem exists, so
you need refined and unobtrusive questioning skills.
Develop trust
A patient needs to trust you before sharing personal information. One
way to develop this trust indirectly is for you to share personal
experiences in an informal and friendly way, this builds rapport. It is
unwise to share information about any personal problems that you may
have as this will reduce your patient’s confidence in you. However, you
can share personal strategies or resources used to overcome a problem.
Towards the end of the information gathering stage it is always useful to
go over the important points raised. You can build rapport by re-capping
on the information shared and reflecting back your own understanding of
your patient's problem.
Some patients will want to know why they have their problem. Your job
is to help your patient overcome their problem and this is often done
without really knowing why the problem started. If your patient insists on
knowing "why", then first consider whether there is any possibility of
identifying the real cause, but this is not always possible or necessary.
Your patient should be reassured that overcoming the problem is the
primary concern and that identifying the reason why they have it can be
addressed later.
After summarising, identify outcomes that your patient wants from
therapy. Sometimes your patient’s outcomes are not the same as your
own. You can try to achieve both outcomes if they are compatible and
both beneficial. Usually you both can agree on the same outcome.
Throughout therapy and especially when you are interviewing the patient
for the first time, you should keep your mind open to other possible
problems that may lie behind the presenting problem. If you feel there is a
secondary problem then you should ask open -ended questions and not
suggest in any way to the patient your suspicions about other possible
problems. Remember, your patient may need time before they are willing
to talk about their real problem. If they have an undisclosed problem, and
if you try to rush them, they may clam up altogether and you may never
see them again. Whenever possible you should let the patient set the pace,
especially at the beginning of treatment.
Case Example
A forty year old woman came for therapy to lose weight. She was
reluctant to talk about herself and her problem. She was overweight and
looked drab. Her weight problem had apparently started in her teens, yet
none of her family had been overweight. She had three brothers, one
sister and a psychotic mother and she was no longer in contact with her
father. She was seen for a number of sessions over a period of six weeks
and despite a few pounds weight loss during the first week she did not
respond to any intervention with hypnosis. Despite her failure to lose
weight she remained confident and kept all of her appointments.
After about ten sessions of unsuccessful therapy she ‘mentioned’ that she
had been abused as a child by her father. During the next six sessions she
worked on her feelings about her father and the abuse. The weight
problem was never mentioned again, yet slowly, as she seemed to come
to terms with her feelings about the abuse, she stared to lose weight. She
started to take pride in her appearance. It seemed that by becoming
overweight as a teenager she had discovered a way of making herself
unattractive, which stopped her father abusing her. Her fear had
generalised itself to all of her relationships with men and she was never
able to lose weight because of her non-conscious fear of being abused
again. As soon as she was able to learn how to trust men, initially by
trusting me, she was able to lose weight.
Root cause
Sometimes, when patients enter therapy, they may be afraid to talk about
the problem they are most concerned about. Instead they talk about some
other peripheral problem that is affecting their lives because they are too
embarrassed to talk about their main problem. Often they dare not risk
presenting the problem immediately because they are afraid that if
therapy is unsuccessful then all will be lost. Sometimes they may want
you to test your skills on a less important problem to check out your
ability to help or to see if they, as a patient, can respond to treatment.
Successful treatment of a peripheral problem is a good way of ratifying
your skills before the serious work begins.
You are compromised if the patient withholds very relevant information.
Problems rarely exist in isolation and where more than one problem
exists, they are usually associated with each other in some way. It is
important for you to know about all aspects of a patient's problems and to
see how they are related and may be reinforcing one another.
Sometimes a different problem is the root cause of the presenting
problem although the patient may have no conscious awareness of this.
Any attempt to suggest this to the patient will usually result in some kind
of resistant behaviour. Most problems have some underlying cause. The
cause may no longer exist in the person's everyday life. The cause may
have only existed in the person's childhood, however the symptom
continues in everyday life. Sometimes problems can be solved simply by
working on the symptom, because the cause has burnt itself out many,
many years earlier. When the cause still exists in the person's life then the
cause has to be dealt with along with the symptom.
Secondary gain
A secondary gain is a benefit that arises from having the problem. A
patient may get used to the attention from family members when they
have their symptoms. Sometimes making the problem disappear means
losing the attention that has been gained because of the problem. The
secondary gain has hitch-hiked itself onto the presenting problem. When
helping a patient solve their presenting problem you should attempt to
identify secondary gains and deal with those at the same time. You
should meet the needs of the secondary gain in some other way.
At this point you are still gathering information and with such little
information you should not be giving advice to the patient. Any solutions
can be given in the form of metaphors, analogies, tasks or with indirect
suggestions. Advice or interpretations given too early in therapy will
probably mismatch the patient's beliefs or needs. When attempting to
identify a solution you should look for patterns. By taking in as much
information as possible identify patterns regarding dates, behaviours,
actions, etc. Avoid repeating the word "problem" to the patient. The word
"problem" has negative connotations. Instead, emphasise positive
changes in the person's life. Always be optimistic and confident in the
patient's ability to change.
Observe non-conscious responses
When patients communicate they communicate on two levels:
consciously and non-consciously. They will often say something and at
the same time they will use non-verbal gestures, expressions or
behaviours that sometimes conflict with the words they're using. An
example of this is a patient who says something whilst covering their
mouth with their hand. Another example would be someone who literally
digs their heels in when being asked to respond to a particular question. A
third example would be a patient who shakes their head when saying
"yes".
When patients enter therapy they expect action. It is better to avoid
therapy based on the patients understanding of the problem, but rather
focus on their non-conscious behavioural responses. If possible you
should attempt to get an example of the symptom. You need the raw
materials of the problem to work with. If you have good materials you
can do good therapy. So for example, if a patient admits to a fear of
spiders, you should ask them to close their eyes and consider imagining a
spider and notice the response that follows. This will give you an
example of the physiological change that occurs when the patient has the
problem. If the patient's presenting problem is a fear of meeting people
and being asked questions then the therapist should attempt to evoke the
response in the patient. A clear explanation of this process whilst
attempting to evoke a symptom will maintain good rapport with your
patient.
Summary - Questions to ask and principles to remember
- When did the problem first start?
- How often does it occur?
- How long does it last?
- When it does NOT occur?
- What is the sequence of steps in the symptom or problem
behaviour?
- What other events occurred around the time of the start of the
problem?
- What are the family circumstances?
- What are the general beliefs about the problem?
- Summarise the problem and establish an outcome.
- Remember the presenting problem may not be the real problem.
- Your patient may not be aware of any other underlying problem if
one exists.
- Sometimes patients have a need to hold onto a problem.
- If appropriate, attempt to elicit the problem behaviour or symptom
or evoke the feelings.
- Avoid placing emphasis on the word "problem" by repeating it too
often.
- Avoid giving advice, interpretations or solutions at this stage.
- Look for conflicting non-verbal behaviour.
Chapter 2 – Beneath the surface
Subjective interpretations
When patients enter therapy they may often try to expound on their
beliefs about the cause of their problem with information based on either
fact or fiction. Patients interpret their symptoms and behaviours in many
ways. Patients may make subjective interpretations about why other
people have problems. For example a husband may interpret his wife's
behaviour purely from his own subjective understanding, whilst the real
causes is totally different. This ‘mind reading’ on the part of the patient
can contaminate the therapeutic process. It is important for the therapist
to acknowledge the interpretations that patients make about their own and
others behaviour, even though many of these interpretations are not
useful to the therapist. It is often unnecessary for you to understand these
subjective interpretations. It is often easier to work therapeutically with
actual behaviours rather than subjective interpretations.
Patients will often discuss a lot of irrelevant details. Often you will need
to intervene and interrupt irrelevancies. Suitable questions might be; "yes
but how is this relevant?" Avoid being drawn in to your patient's own
understanding too much as you may even end up being just as confused
as your patient. If you discover yourself going off on some tangent or
other, you have probably been influenced by some subjective report given
by the patient.
There are a number of different subjective interpretations offered by
patients, here are twelve classic forms of interpretation:
Examples of subjective interpretations
- Hereditary interpretations: "my mother had the same problem".
- Prediction interpretations: "he will say the same thing next time"
- Cause and effect interpretations: "she feels depressed when our
daughter forgets to phone".
- Biological interpretations: "it's my hormones".
- Personality interpretations: "that's just the way he is".
- Casual interpretations: "she acts just like that girl did in that play
about depression".
- Medical interpretations: "the doctor says I am depressed and it
could last for years".
- Cognitive interpretations: "he's thinking about his work all the
time".
- Nominalised interpretations: "she's confused, her expectations are
preventing us from communicating".
- Judgmental interpretations: "people shouldn't behave like that,
should they?"
- Emotional interpretations: "I have always been up tight, it's my
nerves
- Motivational Interpretations: "she's trying to punish me for
forgiving my mother".
- New Age Interpretations: "my inner child lost her shamanic
healing crystal in a past life".
Negate negative interpretations
Although patients often come into therapy with a firm belief about what
caused their problem, many therapists tend to jump to conclusions
utilising past experiences as a reference. Remember that every patient is
unique. Some patients believe that their behaviour is out of their control.
If your patient states a negative belief then look at it objectively and if
appropriate, cast doubt on it. Ideally, play down negativity in favour of a
more neutral stance. Whenever a patient gives an example of a problem
behaviour or symptom, it is often useful to give a neutralising counter
example. For example, offer an anecdote about another patient who had a
similar symptom but who did not find it a problem or alternatively an
anecdote about a patient who overcame the problem with great ease. Also
play down over-ambitious positive beliefs. Persistent negative remarks
should be acknowledged but ignored. Gently guide your patient in a
positive direction.
Be one step ahead
Anticipate and then normalise the patient's objections, complaints and
exaggerated accounts. An ideal strategy for any therapist is to anticipate
irrelevancies, judgements, negative beliefs, patients' examples, and
negative remarks. By anticipating them the therapist can ‘re-frame’ in
advance. By neutralising these negative comments by the patient, the
therapist is one step ahead. By being one step ahead the therapist has the
opportunity of neutralising all of the patient's potential negativity.
Examples of challenges:
Negative subjective interpretations can often be cut short by simple
questions. For example:
- Have you got evidence of that?
- How do you know that?
- How is that relevant?
- Does it really matter?
- Well you could be right, you could be wrong - we can't be sure.
- The opposite could be true.
- I'm sorry, I don't understand.
- How realistic is that?
- Yes, I have many normal friends who behave the same way.
Summary - Dealing with subjective interpretations
- Always pursue relevance.
- Suspend judgement.
- Acknowledge but ignore negative remarks.
- Cast doubt on negative beliefs with counter examples and
anecdotes.
- Anticipate negative standpoints.
Look and listen but mostly look.
Thoughts evoke both an emotional and often a physiological response.
Patients verbally commentate on thought processes but there is also a
direct observable physiological response or body language. When
patients talk about their problems they often "give away" information
about possible causes of their problems. They do this verbally and nonverbally.
Non-verbal communication is made up of gestures, facial
expressions, postures and changes in autonomous processes like
breathing. Training yourself to observe any mismatch or incongruity
between the verbal and non-verbal communications will give you further
insight into your patient's non-conscious knowledge of the causes of the
problem. Even though your patient may not know the cause of the
problem at a conscious level, communication of non-conscious
understanding will occur indirectly through the things they say and do.
Verbal and non-verbal metaphors
Sometimes patients may use metaphors. These are stories to help the
therapist understand their problem. Patients also use a different kind of
metaphor. This is called a non-verbal metaphor. They use this kind of
metaphor without realising that they are doing it. Non-verbal metaphors
are stories told with gestures, facial expressions, changes in voice tonality
etc. Non-verbal metaphors express the patient’s non-conscious responses
at the time.
When a patient makes a statement that appears to contradictory to nonverbal
cues, you should mentally note this incongruity and look for
subsequent repetitions. Only one example of an incongruity is rarely
enough for you to determine the course of therapy for the patient. Identify
patterns in your patient's behaviour that indicate a mis-match between
what your patient is saying and what is happening at an non-conscious
level. It is your responsibility and obligation to develop your own
observation skills so that you can easily recognise your patients nonverbal
metaphors.
Therapists may use metaphors in therapy. Verbal metaphors are stories
that parallel life situations. Stories are normally verbal accounts of chains
of events and a verbal metaphor is story where the chain of events reflects
a real life situation. Stories that parallel the patient's problem but then
suggest a therapeutic outcome are called ‘Therapeutic Metaphors’.
The American comedian Woody Allen is one of the most observant
commentators on non-verbal behaviour. As a director he has developed
his ability to recognise slight changes in facial expression that can change
a verbal statement from positive to negative. He uses his observation of
non-verbal metaphors to coach his actors so that they can model these
subtle meta-communications. Many people remember a clever scene from
his film Annie Hall when the two actors were exchanging comments yet
simultaneously thinking the opposite of what they were saying. Allen
illustrated this by putting the contradictory thoughts into sub-titles.
Congruency and insight
In therapy we are looking for both congruency and incongruity.
Congruent responses are more trust worthy, whilst incongruent responses
cast doubt on the accuracy of the account. Often the patient will make a
gesture, expression or movement of some kind when talking about a
particular topic. These physical behaviours relate to what is being said.
For example; people usually nod their head non-consciously when saying
the word “yes”. Even if you draw their attention to it, it is quite difficult
for them to stop, because it is such an automatic response. In this
instance, non verbal behaviour is congruent with the verbal
communication. Head shaking when saying “yes’ would be incongruent.
Incongruity occurs because there is an non-conscious disagreement with
the patient's conscious account of the problem. The non-conscious mind
disagrees with the verbal account and offers more honest communication
about the patient’s problems. This occurs because it arises from much
deeper experience than the patient has at a conscious level. Non-verbal
metaphors, once recognised, are very easy to recognise time and time
again. The next case example is an account of a very successful series of
therapy sessions with a family and it illustrates the importance of nonverbal
metaphors in deciding a therapeutic course of action.
Case Example
Joseph was a friendly yet slightly nervous teenager with bright red hair
that he had dyed himself. He looked as though he should have been
fronting an Irish punk group. His immaculately dressed middle aged
mother wouldn't have looked out of place alongside an American
President. She had dragged her son in for therapy because she believed
that he was mixing with the wrong people. She wanted me to use
hypnosis to make him dislike his friends and "come to his senses”. When
Joseph first came to me he had great difficulty answering questions
without first looking at his mother for approval. Towards the end of the
first session when his father came into the room Joseph couldn't make
any decisions at all. He preferred to look at the floor for most of the time.
Whenever he was reprimanded for not answering my questions, by either
his father or his mother, he would look from one parent to the other for
approval before answering.
Despite his difficulties with responding he did remarkably well in
therapy. Within 5 sessions he had moved out of the family home and got
himself a job. He had cut his hair and had dyed it dark blue. Both of his
parents were surprisingly relieved that he had left home, if a little nervous
of his ability to cope, and over the following months slowly ceased to be
so controlling and dictatorial in their communications with him.
Joseph had led a life of confusion and uncertainty by being told one thing
by one parent and often the opposite by the other parent. Not knowing
what to do to please both parents, he did whatever he was told at the time
according to whichever parent was in front of him. He would then do the
opposite if another parent took charge. Many times he had been punished
in turn for not obeying either parent and had not learnt to have faith in his
own ability to make decisions. The therapeutic outcome for Joseph was to
get him out of this triangle as quickly as possible. The problem was that
he was unable to decide whether to leave home and how he would handle
it if he did. His mother wanted him to stay for his own safety and was
concerned that if he did leave that he would mix with the "wrong sort".
His father wanted him to leave so that he could be more independent but
preferred him to stay a while longer so that he had more time to find the
right job.
His therapy worked well. I think that he had been planning his escape for
some time and that all he had really needed was a caring yet responsible
therapist to give him permission to flee from the grasp of his well
meaning parents. The therapy kept his parents back from sabotaging his
efforts at independence. He did remarkably well, yet throughout the
therapy he hardly spoke. His parents did nearly all of the talking whilst he
stared at the floor nodding and shaking his head in non-conscious
agreement or disagreement at what was being said. His head movements
seemed to be out of his awareness. When he did speak he continued to
communicate with his head movements even though often they would
directly contradict what he was saying verbally. Careful observation of
his non-verbal communications gave insight into the dynamics of the
relationship between the three family members and helped design a task
that would create an opportunity for Joseph to leave home and start to restructure
his decision making abilities. During the sessions, whenever he
verbalised a response, it would match whatever he believed his parents
wanted to hear at that time. But his non-verbal response always matched
his true inner wishes. His non-verbal communication was a guide
throughout Joseph's therapy.
Whenever there is incongruity, pay attention to the content of the verbal
communication at that point. The verbal content, whether it is about the
problem itself or something seemingly unrelated to the problem, is
important at this stage in therapy. The patient is emphasising, by his
incongruity, that his non-conscious mind contains conflicting information
to what is being said.
Organic Metaphors
Patients will often include, gestures, movements or "throw away"
comments about physical symptoms when talking about their problem.
The patient will usually be unaware that there is any connection between
the gesture or comment and the content being talked about. For example,
a patient may make a "throw away" comment about the muscular tension
in his shoulders as he is talking about having taken on a new job which
"carries" additional responsibility. The patient is saying indirectly that he
is carrying the weight of the world on his shoulders at work and that this
is producing physical tension in the shoulders.
The patient may not recognise the relevance of the comment about his
shoulders as he talks about his work. Alternatively, rather than
commenting on the tension in this shoulders, he may just rub or massage
his shoulders for a few moments as he is talking about work without
realising it. The pain in his shoulders is called an organic metaphor. It is a
symptom of the problem and the patient is using the commenting or
massaging as a way of communicating a message to the therapist which
says; "I am having difficulty carrying all of this responsibility at work".
Case Example
Jean, who with her hair tied in a French knot on top of her head, looked a
little like a 1960's French film star, wore a white button up collar blouse
and pleated navy skirt. She first sat on the edge of her chair but soon repositioned
herself more comfortably as the session progressed. The day
before, she had telephoned me requesting an urgent appointment. During
her visit she complained about her work. As she complained about her
workload and fellow workers she appeared to be in control of her feelings
and she sat in what appeared to be a comfortable posture and made
appropriate yet relaxed gestures that matched what she was saying. She
appeared to be congruent in what she was saying in that she clenched her
fists when talking about her frustration over a certain deadline she had to
meet and she relaxed back in the chair when she thought of having
completed it in near future. It would have been very easy for any therapist
to have been fooled into thinking that her problems with stress were
related to pressure at work. When asked her how she felt about reducing
her work load or changing her job she adamantly refused to accept any of
these possibilities stating that she lived for her work. This gave a clue to
where the cause of her problems lay.
When asked her about her home life she took on a rather rigid, posture
attempting to look comfortably relaxed, brushing her hand back through
her hair, looking up and smiling and then picking bits of cotton off of her
skirt. Her verbal report about her home life was positive. She talked about
how there had been some difficult times in the past but that these had now
been resolved and that she felt very positive about things. Her language
was vague yet positive with an emphasis on how things were now "better
than ever before" and that she "couldn't wish for a better life".
It was obvious that she was consciously trying to look at ease but was
giving her true non-conscious feelings away through her nervous nonverbal
behaviour, her vague language when talking about the past and her
emphasis on "things being better. When asked what "things" had been
like in the past before they had got better she casually said "oh, you
know, the things that happen when you first get married". When pushed a
little further, she said “well that's in the past now” and gave one of those
"let's drop this shall we!" kind of looks.
When asked about her life at the present, she looked more relaxed, but
when approached about her marriage, she casually yet quite firmly started
massaging the back of her neck as she talked about her ‘supportive’
husband.
She seemed unaware of her behaviour (commentating on her nonconscious
communications may have lost the therapeutic advantage
gained in the session). When asked about the physical symptoms of her
stress, she complained mainly of the pain in her neck that seemed, to her,
to come and go for no apparent reason. Further questions about her
husband elicited more neck massage, of which she was unaware.
Although she never ever got as close as saying that her husband was a
pain in the neck, it was obvious that her massaging of the area of tension
in her life was an indirect non-conscious communication that the cause of
her problem lay with her relationship with her husband. Of course, it
could also have been possible that her work or any other relationship
difficulties or concerns.
It turned out that her husband had had a number of affairs when they had
first got married and had told her about them each time afterwards.
Although they were both older now and he had claimed to have changed,
she had never been able to trust him. As she was so busy at work she had
been unable to pay as much attention to her husband and she was worried
at an non-conscious level that he might start straying again. In fact she
later said that she had felt (although she had dismissed it) that he had had
several affairs since he had first promised that he would remain faithful to
her and that her work took her mind off of her problem.
Case 3 illustrates how a combination of non-verbal behaviours indicated
non-conscious unease about the patients relationship with her husband.
First there was the incongruity between the fact that she urgently
requested an appointment and her actual account of her problem when
she attended the session. During the session there was a lack of
incongruity when she spoke of her stress at work. She appeared so
congruent and believable that she seemed to be covering something up.
Her behaviour was incongruent with the context. The incongruity was
really between the way she described her problem and its perceived cause
as being work related and her absolute urgency to seek therapy. The
problem was not simply work related because her description of her
problems with work just did not match the urgency with which she
requested an appointment.
Secondly, there was the verbal incongruity between her account of her
problem as being work related and her statement that she lived for her
work. If she were telling the truth, how could she could on the one hand,
complain so bitterly about her work yet state that she lived for it? Any
attempt to get her to reduce her workload or change job on the
understanding that her problem was work related would have failed. She
really did live for her work, it was her escape from the worries of her
relationship and the more overworked she was the easier it was not to
think consciously about her husbands possible infidelity. Thirdly, there
was the incongruity between her apparent relaxed posture as she talked
about her home life and her nervous gestures and fidgeting. This was
paralleled by the mismatch between her verbal emphasis on everything
being positive and her avoidance of talking about the past.
Lastly there was the incongruity between her statements about her
husband being wonderfully supportive and the organic metaphor of her
intense massaging of the back of her neck. The fact that her main physical
symptom of stress was a pain in the neck suggested that her problem was
related to her husband in some way. It was only later after much more
questioning that she was able to identify for herself that her problem was
caused by a fear of her husband's potential infidelity. This insight she
discovered for herself.
She had put herself into a ‘double bind’ by working harder to avoid the
anxiety of thinking about her problem but this had prevented her from
consciously keeping an eye on her husband's behaviour. This then created
more anxiety which eventually drove her to seek therapy in such an
urgent manner.
Summary – Non-conscious communication
- Patients give conscious information about the possible causes of
their problems.
- Patients communicate verbally and non-verbally.
- Patients comment non-verbally on what they are saying.
- Non-verbal communication is usually non-conscious.
- Observe verbal and non-verbal metaphors.
- Observe organic and symptom based metaphor
Chapter 3 - The nature of the beast
Trying is not succeeding
It is only natural for us to try and make ourselves better, but the act of trying often
only reinforces the problem. Patients should be reassured that they are doing their
best. The word "try" implies difficulty, so often the harder we “try” to solve our
problems the more difficult it becomes. By "trying" at a conscious level only
conscious resources are invoked. For example, when ‘trying’ to lose weight by not
eating a particular food, the very thought of ‘not eating’ indirectly reinforces eating
the food.
Often patients put themselves into situations which leave no room for success.
They
put themselves into a situation whereby any decision brings about a negative
outcome. A patient will try to solve a problem the same way over and over again,
even if it fails. Because the problem takes all of the patient's attention, the patient
is
often unable to step outside of the problem and look at it objectively. This
saturation
of subjective experience tends to severely limit the patient's awareness. In the same
way, if you lose your keys you may return to the same place many, many times to
look for them rather than looking somewhere totally new.
When patients saturate themselves with their subjective understanding of their
problem they are unable to stand outside of their problem and look at it objectively.
Often, when patients realise how they have been trapping themselves, they find it
very funny and sometimes this realisation can be therapeutic.
Rarely is this enough for the patient to make the desired change, because the
patient
requires new behavioural strategies. The therapist must offer such alternatives to
enable the patient to behave in a different way. Alternatives can be offered in the
form of tasks or new strategies. Alternatively the therapist can utilise indirect
suggestion to encourage the patient’s non-conscious to facilitate this process.
Summary – How patients trap themselves
- Problems often develop at an non-conscious level.
- Patients often maintain them by trying to solve them.
- Patients are usually unaware of how they maintain their problems by -trying to
solve them.
- Patients often trap themselves in no win situations.
The relationship between cause and symptom.
There is an assumption that psychological problems have an underlying cause
which
produces a symptom, rather like cascading dominoes. The first domino is knocked
down and thereby knocks down the second domino and thereby knocks down the
third domino so producing a chain reaction. However, human experience is very
complex and behaviour is modified by experience. Consider a patient who has had
a
frightening experience as a child, such as being bitten by a dog. Later, upon
meeting
a dog the patient may once again be frightened, triggered by the memory of the
earlier biting experience. This may occur even if the previous biting experience is
unavailable for conscious recall. On occasion the patient may experience a
kinaesthetic sensation of fear without a rational explanation.
Subsequent experiential encounters with a dog will be influenced by the
summation
of previous encounters, for example a combination of the first and the second
experience. Thus the quality of the first experience may change. It no longer is a
simple biting experience, added to this are all of the psychological aspects of the
second experience. The patient starts to look out for dogs so as to avoid them. They
now give even more attention to the fear, which is feeding back the fear into itself;
effectively putting fuel on the fire of experience. The simple domino theory of
‘cause
and effect’ does not apply. Previous experiences are not necessarily ‘fixed’ back in
the past but continually evolve and move ahead with the patient as they get older.
In
fact the cause and the symptom are the same thing. In the same way an iceberg
only
has a small tip sticking above the water. The "cause" of the tip of the iceberg is
hidden, yet they are one and the same. The only thing that separates them or makes
them separate parts is the perspective of the observer.
Non-conscious commentaries
When patients communicate they give non-verbal signals related to the content of
their verbal communication. You should learn to pay attention to the non-verbal
communication as often this information will give you important clues about the
nature or cause of the patient's problem and how it is being maintained. You may
have heard someone saying of another person "Oh he's a dead give away" or "I can
read him like a book". These are phrases that describe a person who is totally
unaware of their non-verbal communication to the extent that they have no control
over it and others can see what they are really trying to say. These people usually
have difficulty lying because their non-verbal communication does not match their
verbal communication.
Think of the non-verbal communication almost as a running commentary on what
the
patient is actually saying. A positive phrase or statement accompanied by a
negative
facial expression demonstrates incongruity between thinking at conscious and
nonconscious
levels. Think of the non-verbal aspect almost as a subscript to the main
communication. You can learn to recognise incongruities by watching for repeated
gestures or movements. Sometimes it may be an aggressive voice tonality that is
repeated or even a kind of facial expression that seems wrong. You need to see at
least two examples of it occurring before you can call it a pattern. Then keep a
mental check to see when and how often it occurs. Often it will be triggered by
some
part of the verbal communication. These non-verbal signals can be metaphors that
may tell you how the patient really thinks about the subject they are discussing.
Case Example
A patient kept putting her hand over her mouth every time she talked about her
husband. It became so obvious that it eventually became quite funny. It was quite
subtle and few people would have noticed it. She was totally unaware that she was
doing it. In fact she was saying "I don't want to talk about this". Covering her
mouth
was an indication that she didn't want to talk about her husband and that her
husband
was connected to the problem in some way. This was one of her ways of
communicating non-verbally. Of course you shouldn't get carried away and think
that
all non-verbal signals are an non-conscious message. A hand covering the mouth
sometimes is a way of covering an embarrassing smile. A patient sitting with their
arms folded might mean they are cold (not defensive as many non-verbal
communication books suggest). All non-verbal communication should be
interpreted
in context to be understood properly.
Whenever there is incongruity, focus on the non-conscious non-verbal component
of
the communication rather than the verbal component. The patient may consider
that
he has full conscious understanding. However, his non-conscious mind knows
different (and usually better). Patients reveal their inner feelings so well with
nonverbal
communication that it is often possible to identify what a patient is feeling or
even thinking simply by paying attention to their non-verbal cues. By noticing a
patient's facial expression when they're talking about positive things and their
facial
expression when talking about negative things it should be possible for the
therapist
to identify whether the patient is thinking positively or negatively in the future
simply by watching their facial expression.
Other techniques such as ‘ideo-motor signalling’ and ‘automatic writing’ are
hypnotic techniques for evoking non-conscious communication and are also
nonverbal
communications. The only difference being that they are deliberately induced
by the therapist rather than presented naturally by the patient although both classes
of
these hypnotic phenomena can appear spontaneously during trance.
Case Example
A patient complained about being depressed. She was very unkempt and looked as
if
her hair hadn't been washed for weeks. She used very foul language and
throughout
the session she seemed unable to be specific about what was troubling her. She
spent
most of the time looking at the floor. Whenever she spoke of her depression she
would pick and scratch an unpleasant sore on one of the fingers of her left hand.
When she spoke about men she would literally dig her heels into the carpet.
Questions about sex or violence would produce more picking of her sore and
digging
in of heels. After about an hour of hardly any verbal responses to my questions I
decided to challenge her "Why don't you tell the fucking bastard to get the fucking
hell out of your life?" She suddenly burst into tears and said "Because I love him,
the
fucking bastard".
Her husband had regularly physically abused her. She wanted to get rid of him but
was still in love with him. She had removed her wedding ring some months before
but still felt that it was there on her finger. Her sore was caused by the continual
picking of the place where her ring used to be as if it were still there The digging in
of her heels could have either been a sign that she was scared to talk about her
problem or that she was frustrated with her dilemma.
Words are not meaning
Some words are used to describe processes, subjective experience and concepts.
The
word combustion describes a process. As long as everyone knows the meaning of
the
word then it can be used over and over without the need for long technical
explanations. This process is called nominalisation. Communication has developed
its own nominalisations, the word communication being one of them.
Nominalisations have developed out of the need to shortcut or generalise
communication.
Patients will often used nominalisations to describe their experience. They may say
"This problem really bothers me, my arm won't move and I am in agony" rather
than
"When I lift my arm it won't reach any higher than my chest and I feel pain in my
right shoulder." Their communication is often non specific because they assume
that
the therapist knows what they are talking about. When a patient says that they are
depressed they believe that you understand them. When they say that they are
anxious they assume you know what this means. There are many well meaning
therapists who nod their heads in agreement when a patient describes his problem
in
this way and they never challenge the communication.
Take this as an example: At home I have a vase with a flower in it. Can you picture
what kind of vase it is? Can you see the flower? How accurate do you think you
are
with your guess? The chances are that you are wrong. Therapists often base their
therapeutic approach on conclusions formed by the same kind of guesswork.
Challenge negative nominalisations
Listen for words that describe a process but lack specific content. Look at the
following:
" I am unhappy, I can't communicate with people, I am anxious and worried about
my depression getting worst, I just can't concentrate on resolving the issues in my
life."
What on earth does it mean? The person is clearly not feeling good but is not
saying
anything specific. Let's break the communication down into specific chunks that
can
be analysed and hopefully utilised in therapy. What does the patient mean by
"unhappy'. When and where does it happen? Is it all of the time, even when asleep?
What does it feel like? Where is it felt? - the patient’s whole body, the chest, the
big
toe?
Just look at these words (unhappy, communicate, people, anxious, worried,
depression, concentrate, resolving, issues, life) and ask yourself what questions
would evoke more information if these words were challenged. If you start each of
your questions with a "where, when, what, who, how, and, if you must, why, you
will
start to get specific information. Bear in mind that by asking "why" you may just
get
another string of Nominalisations. Just look at how many different questions you
can
ask about the word "anxious":
- Where are you anxious?
- In what context?
- In what place geographically?
- In what part of your body?
- When are you anxious?
- Daytime or night time?
- All the time?
- Does it come and go?
- How long does it go for?
- How long does it last when it's here?
- Have you felt this before, where, when, how long for etc.?
- What does it feel like?
- Does the feeling change?
- What is the sequence of feelings?
- What happens first, next, last?
- Who knows about this?
- How do they deal with this?
- How do you feel about them?
- How long have you felt this?
- How did it start?
- How do you deal with it?
You may discover that the patient only feels anxious in a certain place and that this
then only happens when they have to communicate to a specific person. You may
establish characteristics of a person that relates to the cause of the anxiety. Specific
information will reveal the patterns in the patient's life. The problem is created and
maintained by the patient’s specific patterns of thinking and behaviour and it is
important to understand them. At all times keep your eyes and ears open to two
level
communications that come from the patient.
Therapeutic nominalisations
Nominalisations are very useful in therapy as they offer a medium to communicate
in
a non-specific way e.g. communication, development, integration, discovery etc.
Such words when given to a patient, especially under hypnosis, create an inner
search for meaning at an non-conscious level. The therapist does not need to offer
an
explanation but can allow the patient to find a subjective interpretation. This inner
search occurs usually without the patient's conscious awareness.
Therapeutic Nominalisations are useful when therapist lacks information about the
nature or the cause of the patient's problem. The non-conscious mind can be
encouraged to facilitate the healing process. The therapist can ask the non-
conscious
to search for resources at an non-conscious level and apply these resources to the
problem. The application of therapeutic Nominalisations in therapy is possibly the
most ‘open-ended’ approach to helping patients. Suggestions can be offered by the
therapist without any knowledge of the nature of the problem. The therapist is in
effect saying to the patient "you have the resources to help yourself. I'd like your
non-conscious mind now to go and get on with the job."
Summary – Assumptions and nominalisations
- Sometimes patients are artfully vague when they communicate.
- Listen out for nominalisations.
- Specific information will help identify the patient’s cognitive and behavioural
patterns
- A therapist must never assume.
- Therapeutic nominalisations are process words.
- Therapeutic nominalisations create an inner search.
- Therapeutic nominalisations should have a positive orientation.
Chapter 4 - Building Empathy
Rapport building
When two people are getting on well together they naturally tend to adopt
the same posture. This can be seen in social situations. When people walk
down the street together, as long as they are the same height and build,
they tend to walk in step with each other. Observing and reflecting a
patient’s body posture is an important part of building rapport. Likewise,
deliberate mis-matching of body positioning will break good rapport.
There are three types of matching.
Mirroring: the therapist deliberately and identically adopts every posture
and movement made by the patient. The therapist’s movements are like
those of the patient’s reflected image in a mirror. This is useful when
learning how to observe body language and for stationary postures but
such ‘mimicry’ is not usually natural and may quickly become obvious to
a patient.
Matching: the therapist’s movements are harmonised with the patients but
are not necessarily identical. For example a movement of the patients left
arm may be matched by a movement of the therapist’s right hand when
sitting opposite each other.
Cross matching: the therapist identifies a patient’s behaviour, for example
the patient's breathing. The therapist then identifies some way he can
match the pattern or rhythm in the patients breathing without actually
using his own breathing. For example by swinging his own leg in rhythm
with the patient's breathing, or gently swaying or nodding the head.
Obviously movements such as swaying or nodding the head can
sometimes be interpreted by the patient as messages or indications of
states. Nodding the head could be interpreted as agreement with what the
patient is saying and swaying could be interpreted as nervousness on the
part of the therapist. So cross-matching should be "content free" to avoid
misconception. For example the therapist can gently move his finger in
time with the patients breathing.
Exercise
Choose a partner and hold a conversation during which each of you
speaks for a few minutes on several occasions. Take it in turn to speak.
The ‘listener’ mirrors all of the postures made by the ‘speaker’. Each
takes it in turn to be the listener. Both partners should make a mental note
of the feelings and the qualities during the exchange of communication.
Take a few minutes to share experiences at the end of the exercise.
Repeat this process, however this time the listener should deliberately
mismatch all of the speaker’s postures. Take it in turns and give each
other feedback. Play with the exercise, make mirroring or mismatching
postural changes when either speaking or listening or simultaneously try
to deliberately mis-match posture during the discussion
Most patients are totally unaware of their own or other peoples body
movements. It is only when the therapist matches in a very overt way
does the patient notice that a ‘technique’ is being applied. An observant
patient will quickly notice that you are mirroring their posture and will
find this uncomfortable and strange. Mirroring of any overt hand
gestures, for example, would be recognised consciously by the patient. In
therapy you should attempt to match the patient as much as possible. This
should continue throughout the therapy until the end of the session.
Utilise a combination of matching and cross matching posture to enhance
and maintain good rapport. Match the rhythm of your patient’s
movements rather than just the content.
Breathing in harmony
Pay attention to your patient's breathing. By matching the breathing of
your patient you will maintain a deep level of communication with your
patient, creating an non-conscious sense of ‘harmony’. By matching the
breathing in this way you can start to slow down your patient’s breathing.
By slowing down, you will help your patient’s breathing to slow down.
This indirectly helps them to relax at an non-conscious level. Naturally,
the therapist shouldn't match a patient's breathing if it is unusual or
problematic in any way. For example if the patient is asthmatic and
breathing in an accelerated or difficult fashion. Matching a patient's
breathing is essential when inducing hypnosis. When patients go into
trance they like to maintain contact with the therapist in some way. In fact
the trance experience is exclusive for the therapist and the patient.
Talking back
In addition to matching posture you can also match your voice of the
patient. You should pace exactly to what degree you match the quality of
the voice of the patient. Matching the voice tonality, tempo, pitch and
volume of the patient serves the same purpose as matching the breathing.
The patient non-consciously feels safe with the therapist. In this way the
therapist is saying that it's OK to be the patient. This is important when
some patients come in troubled and concerned about their own self image
or personality. It's reassuring for the therapist to feed back these minimal
cues. It normalises the patient's problem to a certain extent. Obviously
matching the voice to extreme can lead to mimicking which breaks
rapport.
In addition to breathing, voice tonality, tempo, pitch and volume, the
patient also demonstrates many other non-verbal changes. These nonverbal
changes are known as minimal cues. Some minimal cues can be
more difficult to spot than others. The most obvious minimal cues to look
out for are change in muscle tone. This can be observed in the facial
muscles. You will often see a patient’s face "smooth over" when talking
about pleasant memories. When the patient conjures up unpleasant
memories increased muscle tension can also be observed. You should
identify these minimal cues and match them if appropriate. By doing this,
you will demonstrate recognition of your patient's needs and maintain
rapport at an non-conscious level. This occurs because the patient’s nonconscious
identifies with the therapist’s response. This non-conscious
communication is in fact occurring all of the time in every day
interactions. Important minimal cues to look for include: pupil dilation,
sweating, eye watering, changes in blink rate, changes in skin colour,
changes in pulse rate, changes in head position, eye movements similar to
eye accessing cues and swallowing. These often accompany shifts in
sensory awareness from external to internal reality similar to the
experience of day dreaming.
Summary – Matching and rapport
- Matching a patients body posture will enhance rapport.
- Cross matching is the indirect mirroring of behaviour in another
system or part of the body.
- Mis-matching the patient's body posture can break rapport.
- Matching voice tonality, tempo, pitch and volume enhances
rapport.
- Matching on a minimal level enhances rapport.
The Acceptance Set
Positively framed suggestions
A person who is positively motivated in a therapy session will offer less
resistance to change. Getting a patient to say "yes" a number of times will
help develop a positive acceptance for you as a therapist and the ideas
that you suggest. These suggestions can take the form of straight forward
questions, such as "So this is your second visit John?" The patient has to
answer yes. Questions should be relevant and based on the therapy. Use
questions which invoke only positive responses and for which you
already know the answer. Often on an initial visit the therapist has little or
no information about the patient, the therapist may find difficulty in
asking questions for which the answer should be "yes". So it is important
that you start by asking open-ended questions to build up information
about the patient on which to base your ‘positive frame suggestions’.
Reverse frame suggestion
Obviously if you keep asking questions that elicit ‘yes’ responses, your
patient may become suspicious. So every now and then it's important to
put in a ‘reverse frame suggestion’. This enables your patient to answer
"no" but retain agreement. For example: "Tell me John, you wouldn't
expect to go into a deep hypnotic trance before you have sat down in the
chair would you'?" Here John has to answer "no" but what he's actually
saying is "I agree with you". This maintains the agreement set but gives
the patient a chance to actually put in a negative. This then neutralises
any uncomfortable feelings that the patient may have had by having to
continually say "yes".
Tag Questions
Negative suggestions or ‘tag questions’ offer both agreement and
negative suggestion simultaneously. They are too complex for the
patient's conscious mind to figure out. So the patient just finds themselves
agreeing or nodding or saying "yes" without really having time to think
about it. For example: "So John you would like to go into a trance today,
would you not?" Here the "would you not" is the tag question. Other
examples are: "You can, can you not?" "You are, are you not?" "It is, is it
not?" "I am, am I not?" When a patient hears one of these tag questions
they find it very difficult to resist. This is possibly because the tag
question contains in itself a negative. As this negative is said by the
therapist, it possibly neutralises some of the active positive agreement.
Negative suggestions shouldn't be used too often. They should only be
used at special times when the therapist really wants commitment from
the patient.
Response attentiveness
You can usually tell good hypnotic subjects by observing for their
minimal cues. Within the context of a group conversation you can usually
identify the most responsive hypnotic subjects by watching for a
combination of pupil dilation and head nodding. Pupil dilation is a good
indicator of trance responsiveness. The person with the largest pupils who
is also appearing to listen intently by nodding their head is the most likely
hypnotic subject. The term "Response Attentiveness" describes the
collective minimal cues of trance. In the context of a therapy session you
will see the patient "drift off" from time to time during the conversation.
This is usually accompanied by a shift in the facial expression, a
softening of the facial muscles, sometimes looking away, de-focusing and
a slowing of the respiration. When you see this special combination of
cues you can encourage trance to develop further. This can be further
facilitated by adopting a "trance style" of communication. The patient
will associate your shift in communication style with their shift into an
altered state and its associated minimal cues.
Hypnotic Induction Exercise
Eye Fixation Induction
Ask a partner to focus their eyes on a spot or a certain place in the room
just above eye level. Ask your partner to notice three objects that can be
seen. Then ask your partner to notice three sounds that can be heard and
then ask your partner to notice three feelings that can be felt at that
moment. Ask you partner to say each one (for example: “I can see the
wall, I can see the door, I can see the floor; I can hear the clock, I can
hear the central heating, I can hear the birds outside; I can feel the chair
beneath by thighs, I can feel the carpet on my feet, I can feel more
relaxed…etc.). After vocalising each of the sensory experiences repeat
the process without interrupting your partner’s concentration. Observe
your partners responses.
Eventually your partner’s conscious mind will grow tired of the external
search allowing the non-conscious state to facilitate a trance induction.
The upward tilt of the eyes induces eye fatigue and hence eye closure.
Narrowing the focus of attention reduces the amount of available external
stimuli. The focus of attention will be directed internally as the conscious
mind searches both external visual and auditory sensations and then for
internal ‘feeling’ states (e.g. “I can feel sleepy”).
Matching predicates
We use our senses in order to understand and make sense of the world.
We take information in through our senses and we process information
internally inside our head, in our sense systems. We have developed
descriptive vocabulary to describe our sensory experiences. A predicate is
the term given to a particular word that is sense orientated. For example
the visual sense offers the predicates: to see, to view, to look, etc.
Examples of predicate based statements:
Visual:
- It looks good to me.
- I can picture it.
- From my perspective.
Auditory:
- It sounds good.
- It's as clear as a bell.
- I ask myself.
Kinaesthetic:
- It feels right to me.
- I can handle it.
- I am under pressure.
As you can see from the above examples people use sensory specific
predicates in every day conversation. Here are some examples of other
sensory based predicates in visual, auditory and kinaesthetic systems.
Listening for these predicates offers the therapist a further opportunity to
enhance rapport. When a patient talks about his experience and uses
specific predicates such as “I see” or “I hear”, then the patient may well
be actually thinking in pictures and/or in sounds that relate to the
predicates being used. By feeding back these words the therapist aims to
convince the patient at an non-conscious level that he also is seeing and
hearing in the same manner. This simultaneous seeing and hearing
suggests to the patient, that both parties are in rapport with each other. It
is difficult to tell whether the feeding back of predicates and the
subsequent rapport that follows is the result of matching of ways of
thinking, or simply the matching of language.
Patients who have a limited vocabulary and who are unable to express
themselves in all of their sense systems may be stuck in a particular sense
system. For example a person who can talk only in auditory terms may be
stuck in this particular mode because of an inability to communicate or
think in other ways (senses). For example a person talking in mainly
auditory predicates may not be able to visualise particularly well. One
approach commonly used in NLP (neurolinguistic programming) is to
help the patient experience the problem in other sensory modalities. By
taking a different viewpoint, by talking it over or by feeling in a different
way, the emphasis is shifted from one sense system to the other. In this
way the patient can learn new insights into why their problem exists.
These new insights help the patient learn to change by giving them more
choices on how to behave.
Certainly it is true that some patients are able to associate or dissociate
from their problem depending on their visual ability. We could also argue
that some patients may appear to be limited in their vocabulary not
because of their inability to access a particular sense system but because
of their education or because of the way that they have been brought up,
e.g. a child who’s father thought primarily in an auditory modality.
Here are some examples of other sensory based predicates in visual,
auditory and kinaesthetic systems.
VISUAL
See, Picture, Imagine, Bright, Sparkling, Perceive, View, Focus,
Shimmering, Clear, Clarify, Hazy, Blurred, Bleak, Dull, Image, Misty,
Fuzzy, Foggy, Speculative, Hue, Hindsight, Obscure, Reveal, Panoramic,
Magnify, Glassy, Huge, Minute, Steamy, Colour, Dim, Shady, Cloudy,
Stormy, Precipitous, Distant, Brilliant, Radiant, Blinkered, Blindfolded,
Gloom, Doom, Starry-eyed, Tunnel-vision, Outlook, Transparent,
Translucent, Opaque, Fluorescent, Glaze, Small, Big, Glimmer, Rainbow,
Vision, Vista, Hallucinate, Dream, Perspective, Visualise, Landscape,
Deep, Bleak, Light, Dark, Perceptive, Flash, Proportion, Reveal,
Telescopic, Kaleidoscope, Shimmer, Shine, Glossy, Huge, Bright light,
Bright spark, Flash of inspiration, A flicker, I see red, Seeing ahead, I've
gone a blank, See through, Draw back the curtains, Rose coloured
glasses, See the horizon, Blind spot, Draw up agenda, Sketch out/Map out
my future, Clear as crystal, Looks like...., To reflect, To mirror, Mirror
image, Eyeball to eyeball, A sight for sore eyes, Black and White, Visual
aid.
AUDITORY
Hear, Sound, Pitch, Tone, Volume, Noisy, Buzz, Raucous, Ringing,
Loud, Soft, Listening, Whisper, Speak, Whistle, Hum, Drumming, Bell,
Rattle, Song, Lilt, Band, Music, Orchestrate, Crescendo, Crashing,
Musical, Harmony, Still, Echo, Rustle, Resonate, Twang, Jingle, Jangle,
Clatter, Pitter-patter, Chord, Amplify, Scream, Bellow, Roar, Screech,
Yell, Squeal, Silence, Thunder, Drone, Reverberate, Discord, On the
wavelength, Announce, Broadcast, Talk, Tick, Crying Shame, Interpret,
Click, Clear, Bang, Beat the Drum, Tune in, Fade, Note, Rhythm,
Whisper, Crack, Moan, Clarity, Whine, Shriek, Quiet, Overtone.
KINAESTHETIC
Feel, Pressure, Stress, Settled, At ease, Relaxed, Cushioned, High,
Oppressed, Under the weather, Oh top of the world/things, Up in the air,
Flat on the Floor, Down in the dumps, High as a kite, Ecstatic, Away with
the fairies, Touched, Detached, Tired, Tread the boards carefully,
Walking on eggshells, Delicate, Fragile, Robust, Determined, Fidgety, In
bits, Hurt, Cold, Over the edge, Low, Sharp, Feel Beaten, Tender,
Succulent, Soft, Clingy, Funny, Back to the wall, Burdened, Trapped,
Hemmed in, Heavy handed, Swamped, Drowning, Dependent,
Abandoned, Gutted, Fighting fit, Tight, Fragmented, Drifted, Sexy,
Things are moving, Pain in the arse, Raises my hackles, Empty, Slimy,
Flip my lid, Heavy, Touch, Caring, Sick, Dull, Pressure, Wound up,
Drag, Rushed, Intense, Heavy as lead, Spacy, Feel grey, Tight, Centred,
Closed, Handy, Thick, Put upon, Tense, Twitch, Anxious, Jumpy, Angry,
Moving, Floating, Light, Elated, Show, Cool, Happy, Excited, Stuck,
Sharp, Overwhelmed, Sensitive, Blunt, Cracking up, Breaking apart, Up
tight, Falling to Pieces, Over the edge, Snappy, Feeling high/low,
Flexible, Under par, Drained, Exhausted, Depressed, Out of/In hand,
Burdened, Out of control, Sick of it, Makes me want to throw up, Gut
feelings, Makes my flesh creep, Electrified, Sets my teeth on edge, Grates
on me, Makes me feel creepy, Slide into things, Collapse, Break down,
Feels empty, Things are a bit slow, Feel cold inside, Slippery slope,
Mixed up.
Summary - Predicates
- Patients use sensory based words that represent the way they are
thinking at the time.
- Therapists can feed back predicates to build rapport.
- The patient can sometimes become stuck in a particular sense
system.
- Predicate identification can help in diagnosing a patient's
limitations and/or resources
Hypnotic Induction Exercise
The Staircase Induction
Explain to your patient or partner that you will be taking them on a
journey along a staircase. Determine whether your patient would find it
easier to go into trance by descending or by climbing such a staircase. If
you are counting, then each number that you count should be associated
with an exhalation. By telling your patient they can go deeper with each
number, indirectly they will be helping themselves to go deeper simply
by breathing. You do not have to count with each breath, you may prefer
to count every' other breath. This will give you the opportunity to
intersperse suggestions along with the counting. As your patient/partner
exhales, give suggestions for going deeper into trance. By counting and
pacing your suggestions with the patient's breathing you will be
reinforcing rapport.
Because your patient experiences hypnosis with his visual, auditory and
kinaesthetic sense, your induction should have visual inputs, auditory and
kinaesthetic inputs. The staircase induction consists of a journey, one step
at a time, along a flight of twenty stairs. Encourage your patient to
experience this induction in all three sense systems; to hear the sound of
your voice, see each stair in front, feel each stair underfoot. At the bottom
of the stairs ask your patient to see a door, this door could be to the left, it
could be in the centre or it could be to the right. Ask your patient to
notice where the door is. By asking, your patient will become more
absorbed in the experience. Behind the door there is a room with a
comfortable chair in which the patient sits down. In front, is a small
cinema screen on which appears a very relaxing scene.
These changes should occur gradually as the induction progresses. The
therapist starts the induction at normal volume and tempo etc. At the
deepest part of the trance the therapist should have the maximum
alteration to his voice. By changing his voice in this way the therapist is
matching the patient's experience of going deeper into trance. This also
helps the patient anchor the trance experience to the therapist's voice. In
future sessions the therapist need only talk in this special way and the
patient will start to go back into trance again.
As you are pacing your suggestions and counting with your patient's
breathing it will be difficult for you to rush. It's very important that you
give the patient as much time as is necessary to experience the trance
state. When you talk to your patient you should appear confident and
knowledgeable. If you communicate doubt through hesitation or lack of
confidence then your patient may pick this communication up. This will
cause a loss of rapport and a lack of trust. So always appear confident and
take your time.
When you decide to bring your patient out, usually after about five
minutes, ask your patient to watch the picture on the screen and then to
experience standing up from the imaginary chair, walk out of the room,
out of the door and slowly come up the stairs. As your patient comes up
the stairs, count backwards from twenty to one. Remember that when
there are twenty stairs the therapist counts from one to twenty to go down
into trance and from twenty to one to come out of trance. As you count
from twenty to one, bring the patient out of trance by timing the numbers
with your patient's inhalations. Likewise alter your tonality, pitch, volume
etc. in accordance with the depth of trance as your patient comes out.
Your voice should get louder, the tonality should harden, the pitch should
rise until the voice sounds perfectly normal as in everyday conversation.
When the trance has been terminated thank your patient and ask for their
experiences.
Summary – The Staircase Induction
- Time your suggestions to your patient's breathing.
- Utilise all of your patient's sensory systems.
- During the induction you should slow down your voice, lower your
volume, lower your pitch and deepen your tonality
- Appear confident and take your time.
- Bring the person out of hypnosis by reversing the induction
procedure.
Sensory processing
All information that passes from our external reality to our internal reality
has to pass through our sensory systems. Without an ability to see and
visualise internally it would impossible to think with pictures. Likewise it
would be impossible to talk to yourself if you were unable to hear
language internally. Much of our thinking is processed this way.
Our experiences are mostly internal and only represent the ‘reality’
occurring outside. Reality is ‘re-presented’ in our brain and body. Many
problems are ‘re-presented’ by patients in their sense systems and this is
why it is possible to change a person's beliefs by changing the way they
represent their beliefs with their senses.
NLP has suggested that people who are visualising tend to change their
physiology in the following way: their breathing appears to be higher in
the chest; their voice is higher, faster with a somewhat breathless quality;
they draw pictures in the air with their hands as part of their gesturing;
their posture is upright sometimes with tension in the shoulders and their
skin appears often pale with a tightness around the mouth. People with a
predominately auditory modality: breath more in the middle of their
chest; speak evenly and rhythmically; hold their head often resting on a
hand with their head tilted almost as if they were talking on the
telephone; hold their posture often asymmetrically with normal skin
colour. People who are kinaesthetic breath low in the stomach with a
voice, which is deeper and slower with gestures that are solid, holding or
gripping; their posture is often down sometimes round shouldered with
muscles relaxed; the skin colour often appears flushed. Observation of
these particular shifts in minimal cues can help the therapist gather
information about the particular sense system that the patient is accessing
at a particular time.
Sensational representation
NLP has suggested that people move their eyes in certain directions
related to the sense system they are using at the time. It has been
suggested that when people look up to their left they are visualising
memories. When they look up to their right they are constructing pictures.
When people move their eyes down to their left they are talking to
themselves internally. When they move their eyes down to their right they
are experiencing internal feelings. These four primary positions are
known as ‘eye accessing cues’
NLP has suggested that by observing the patient’s eye movements and
dialogue as they communicate, the therapist can identify the particular
sense system the patient is operating in. For example if the patient is
talking about a particular experience and is looking up to his left the
therapist can conclude that the patient using visual memory. If the patient
is looking down to his right whilst talking the therapist can conclude that
the patient utilising internal feelings.
In addition to these four primary accessing cues, additional accessing
cues have been observed as follows: looking straight ahead usually
suggests that the person is visualising but not in any specific past or
future context. Looking to the immediate left suggests that the patient is
hearing sound with a past orientation. Looking to the immediate right
suggests that the patient is imagining sounds from a future context. In
addition to this it is suggested that people who spend most of their time
looking upwards either left or right or defocused ahead, are visualising.
That people whose eyes move from left to right whilst communicating are
auditory. And lastly that people who spend most of their time looking
down to their right whilst talking are primarily kinaesthetic. General
observations do not apply to all individuals. It is interesting to observe the
relationship of an individual’s eye movements and their internal sensory
coding. Once simple associations have been identified, an individual’s
entire sensory experiential strategy can be observed and utilised for
therapy.
Whilst there maybe some people who have a preference for one system
over another for most activities, most people seem to be able to shift from
one sense system to another depending on the topic of conversation and
the context in which they find themselves. People generally utilise all
sensory systems to a greater or lesser degree: artists will talk about how
they feel about their work as will musicians. Certainly skills, traits or
strategies learnt from childhood tend to dominate throughout life. One
could argue that an artist may have developed a certain kinaesthetic
preference over other senses through every day life experiences from
childhood long before they acquired the skills of an artist. This would
certainly lead to the individual being able to process kinaesthetically the
experience of art.
Observation of sensory preferences at given times during an interaction
can allow the therapist to learn more about the patient and the problem,
for example:
- To identify the sensory coding used by the patient at the time and
therefore gain a deeper understanding as to how the problem being
discussed and processed.
- To recognise incongruity in the way the patient represents the
experience.
- To feed back relevant sensory based predicates to the patient to
enhance rapport.
Summary - Sensory Representations
- People often 'think" using their sense systems.
- Sense systems can be viewed as representational systems.
- Representational systems can be recognised by watching people's
eyes movements.
- Representational systems can be recognised by watching people's
postures, gestures and minimal cues
Chapter 5 - Motivational Perception
Well formed outcomes
The following sent of questions are useful for therapeutic interactions. By their
nature they often evoke an non-conscious response by the patient. The answers
they
evoke will provide useful material on which to structure your therapy.
1. What positive change do you want?
When patients enter therapy they are not always certain about the outcomes. Often
patients think of what they want to stop happening rather than what they want to
achieve. For example a smoker might want to stop smoking rather than to be
healthier. It's important to frame the outcome positively. By asking the patient
“What
positive change do you want?" you are directing the patient towards identifying a
positive outcome rather than a negative one. It is a lot easier for a patient to look at
positive outcomes rather than to look at stopping a behaviour. If the patient wishes
to
stop doing something he first has to be aware of what it is he is trying to stop. The
awareness of this activity or behaviour often reinforces the activity or behaviour. If
someone wants to stop eating chocolate they often tell themselves to not eat
chocolate. On the surface this seems to be fine, however, the very act of trying to
not
to eat chocolate involves first thinking about it in order to negate it. Always keep
your patient directed towards positive outcomes.
2. How will you know when it has happened?
Many patients enter therapy, get better and yet not know that any change has
occurred. A patient needs to know how things will be different when they are
better.
If a patient makes changes yet has no way of identifying that these changes have
occurred, they will never know that they have got better. So it is important for the
therapist to help the patient identify some way of knowing when they have reached
their outcome. Often this will be a change in the way they feel. It might also be a
change in the way they see things. It might also be a change in the way they look.
It
is very important to identify how the patient will know that changes have occurred.
Some people become "professional patients" in that they seem to spend their whole
time going around from one therapist to another. Although, for some this is a way
of
getting attention or building up a network of "caring friends", for many it is
because
they cannot recognise the changes that are happening to them.
Case Example
I knew of one patient who had lost weight so successfully with a colleague of mine
that she had told all of her friends about her wonderful "cure". I was horrified when
I
saw her because she was very thin. Her friends had told her that she would become
Anorexic but she didn't understand. She had lost weight and that had been her plan.
The trouble was that she had gone too far and had passed beyond her healthy
weight
because she hadn't specified her goal to start with. If her therapist had asked her to
state her desired weight before the treatment began he would then have realised
that
her problem was one of obsession and not obesity. He could have then added some
clause to the therapy contract whereby she agreed to receive help with her
obsessive
dieting in addition to her perceived eating problem.
3. What has stopped you from changing so far?
By asking your patient to identify the things that have stopped them from making
the
changes they require you are asking your patient to go on an inner search through
the
past strategies that have sabotaged their attempts to change their behaviour. It may
seem strange to think of patients actually trying to sabotage their recovery, but it is
a
real phenomena that has to be appreciated and dealt with. Patients are not used to
identifying the things that stop them from achieving. They are usually more
familiar
with just not being able to achieve. By asking them to go back one step, you are
helping them to see the cause and effect relationship between their problem and the
possible cause. In addition to this you are also identifying potential situations or
behaviours in the future that might prevent the person from changing.
When you ask "What has stopped you from changing so far?" the answer is rarely
available at the conscious level. This is because answers of this nature are not in
the
patient's conscious frames of reference. If they were already able to identify what
has
stopped them from changing so far they would have already made use of that
information and started to change by themselves. The therapist's role is to tease out
the non-conscious processes that lie behind the problem and then re-model the
strategy or "problem maintaining pattern" so that it no longer occurs.
Case Example
I had a patient who wanted to be a little healthier and work out at the gym but who
just couldn't get motivated. I asked him what had stopped him from going to the
gym
in the past and he thought hard but couldn't answer the question. So later when he
was in trance I asked him the same question again and then he said "Oh I tell
myself
that I will never make it as a body builder".
So, although on the surface (at the conscious level) he was telling himself that he
ought to work out. At the non-conscious level he really saw himself as a would-be
‘Mr Universe’ but knew that he would never make it. So he had sabotaged his
visits
to the gym every time by finding some "very urgent work" that needed doing
instead.
Sometimes the effort of having to get better is too much for some patients. They
feel
that it is easier to hang on to their problem than to go through the anticipated effort
or
pain of trying to change (many patients think that therapeutic change has to be
painful, this is not the case). These patients lack motivation and even though they
present themselves for therapy they find all kinds of devious ways of getting out of
actually having to do something that will actually help them. You have to be very
artful with these kinds of patients. You have to be more artful than they are.
Usually
they are not aware of their patterns of sabotage so direct confrontation is often of
no
use because they usually go on the defensive if you confront them with your
observations.
There are two ways you can get these patients to change. One is to work with them
indirectly reframing all of their “yes-but’s” with indirect suggestion and metaphor
to
slowly chip away at their old belief system and then ease them off of their
backsides
and guide them into action. This may take many sessions. Alternatively you can
motivate them from the inside by creating a context that will ideally catapult them
out of their chair and into action. The later is a faster process but carries more risks.
To get a patient to sit up and really take notice you might have to be quite
provocative but not confrontational (unless that is your usual successful style). You
should be careful to maintain rapport even if you are challenging them.
Case Example
In the South of England there is a famous stretch of white cliffs called Beachy
Head.
It's quite a drop to the sea below. Sometimes if I had a really stubborn patient who
sabotaged all my reframes I would say to them, "If I were to take you to Beachy
Head right now, stand you on the edge and give you a choice of either working
together with me on your problem or you going over the edge - what would you
choose?" This usually put things into perspective for them.
Metaphor
There was a frog hopping down the road and he came across another frog caught in
a
rut. So he tried to help him get out of the rut. Somehow the harder he tried the
more
tired the trapped frog became and just couldn't get out. Then the trapped frog said
"I
have an idea, why don't you hop down here and then I can climb on your back and
get out". "I don't like that idea much," said the other frog, "because then I will be
trapped and I have far too many things to do today, so I will leave you to find some
way out yourself". Well, the frog went off on his way and when he was about 50
metres further down the road he heard the other frog close behind him. "Hev how
did
you get out! I did everything I could to help you but you just couldn't get out. What
happened?" Well, said the frog. "there was a truck coming."
It is important to remember that there always comes a time in therapy when
patients
should get off their backsides and do something different. Good therapy is not
about
talking about change, it is actually about changing. Even so, you may still find that
some of your patients are only window shopping. If they really don't want to
change
you may have to let them go. Even the great Milton Erickson admitted that he had
to
refer some of his patients on.
4. What do you get out of what you're doing now?
When answered consciously, most patients will say that they get nothing out of
what
they are doing now. However most problems have a function of some kind. A
person
who shakes involuntarily in public might be creating a symptom that prevents him
from going out and so will be protecting himself from possible humiliation or
embarrassment in front of others. A patient who wets the bed may well be getting
attention from others. By asking your patient to identify what they're getting out of
what they do now you are also starting to recognise possible secondary gains.
Secondary gains are the benefits that patient get from having a problem. They often
reinforce the problem because they make having the problem more bearable and
sometimes even desirable.
Case Example
A patient worked in a pub and was very concerned about being overweight. He was
always being bought drinks by his customers. His wife worked in the bar also but
had
learnt how to say no. He felt obliged to say “yes” because he didn't want his
customers to be offended. The fact that his wife usually said “no” made him feel
even more obliged to say “yes” to a couple of drinks each night. He then
discovered
a curious problem developing. He found that he would blush very easily whenever
he
was offered a drink. This seemed to coincide with his increase in weight. The
problem became so severe that eventually he felt too embarrassed to work in the
bar
and spent most of his time in the back. This was about the time he first visited me
with his problem. I listened carefully and asked to see his wife also. She said that
she
was happy with him working in the back as he was out of her way and they had
employed younger staff who were bringing more younger people into the pub. She
would like him to get over his blushing though because it was affecting his
confidence. I listened vary carefully and concluded that I need not do anything and
that the problem would probably disappear by itself. I taught him a relaxation
technique which he dropped after a few days. Within one month the problem had
disappeared. The secondary gain of staying in the back of the pub so as not to have
the conflict of either offending his customers or putting on weight was brought on
by
the blushing.
Because he no longer worked in the bar his original conflict disappeared and the
blushing was no longer needed to supply the secondary gain. His wife was happy
and
the pub made more money. If only all therapy was like this! Sometime you will
discover that the best action to take is no action. In fact, quite often, the less action
you take the better. Your role as a therapist is to guide your patient and create the
right context for them to get better by themselves.
5. Do you want this change in all contexts?
Generally speaking it is usually desirable for patients to have their changes occur
in
all contexts. However there are exceptions to this. For example if a man wishes to
be
more assertive at work you may well be able to help him achieve this, but unless
you
put constraints on the contexts in which he is assertive, he may well also be
assertive
at home. This new assertive behaviour may lead to a break-up in his marriage. It is
important for therapists to identify all of the contexts in which the patient requires
his
new behaviour and only help him achieve this in all contexts if it is ecological to
do
so.
Case Example
One of my sons was taught by his Nanny to hit one of his toys the wall or the floor
with his fist if he tripped up. Blaming the floor for his fall was her way of
distracting
him away from the pain or embarrassment of falling over. I was horrified to see
him
doing this because I didn't like the idea of him being taught to blame others for his
own mistakes. Very shortly afterwards he started hitting his friends or his parents
whenever he made a mistake or fell over. I quickly stepped in and corrected his
behaviour by threatening to sack the Nanny. She soon put him right and he has
now
forgotten that he used to do it.
Her attempts to help him in the context of that particular time frame were fine, but
she never looked at how that behaviour could affect him within the context of
relationships or within the context of adult life. So when you consider the other
contexts in which your patient has to live do not only think of the contexts that
exist
at present. You should also consider your patient’s future contexts as well.
Future Pacing is the name given to the principle of getting your patient to step into
their imagined future and try on their new changes. The patient is asked whether
the
changes seem to "fit" and whether any adjustments need to be made. Future Pacing
can in fact be applied at any time throughout therapy as a way of checking that the
intended therapeutic outcomes are congruent with future contexts. Usually ‘Future
Pacing’ is done at the end of the therapy session to check whether the patient feels
that the therapy has worked. However it also fits in well with this particular
questioning skill.
6. What could go wrong?
This may seem like a negative question. However we are not actually suggesting
that
things could go wrong, we are attempting to recognise, ahead of time, any
situations
that might trigger a re-occurrence of the problem. This question is very similar to
the
question "What has stopped you from changing in the past?" the main difference
being that this new question is future orientated. Because it is about the future,
Patients often find it easier to answer because they don't have to remember the
nonconscious
ways they used to sabotage. Here they are being asked to be creative and
imagine how things could go wrong. However, both questions will often bring up
similar answers because their imagined responses are usually based on how they
did
it non-consciously in the past.
When you ask this question you are attempting to identify patterns of sabotage. By
recognising these possible occurrences ahead of time, the therapist can plan ways
of
either avoiding the situations which allow sabotage to happen or giving the patient
resources with which to handle the situation in a better and healthier way. If this
question is asked a second time at the end of therapy (as a kind of future pacing
question) the answers will most likely be different from the first time because the
patient will then have, ideally, the resources to prevent any sabotage.
You might be surprised at first by how many different ways patients have of
sabotaging therapy. Asking "what could go wrong?" usually brings up a whole list
of
ways they might prevent themselves from getting better. Usually they don't
recognise
that these ways of preventing success are of their own making. They will usually
blame other people or contexts. It is your job to make them realise that these
"events"
that seem to suddenly step spontaneously in the way of success are in fact attempts
on their own part to allow their own success to be sabotaged. patients sabotage in
two
ways. They either do something directly that gets in the way of success or they do
it
indirectly by allowing something or someone else do it for them and then deleting
their awareness of how they have in fact created the situation.
For example, a patient wanting to lose weight might sabotage directly by going to
the
refrigerator in the middle of the night. Or they might sabotage indirectly by
creating
a context where someone else feels compelled to buy them chocolates and they,
therefore, are obliged to eat them or risk offending their ‘accomplice’. When
patients
are able to generate lots of alternative ways of sabotaging therapy or excuses for
explaining why they cannot get better you should investigate their secondary gains
more closely. When patients have problems they try and cope which creates
secondary gains. Sometimes patients even invite the problem into their lives in
order
to have the benefits of the secondary gains. You should look closely at their level
of
motivation in association with their degree of secondary gain (see "what has
stopped
you from changing so far" and "what do you get out of what you are doing now -
above), because secondary gains reduce the level of motivation for therapeutic
change. You have to either change the secondary gains by finding equally
rewarding
substitutes or remove them by re-framing the patients beliefs about the value of the
secondary gains. When patients create lots of examples of how they cannot get
better
you will notice that some examples may seem quite ridiculous. For example a
patient
sabotaging a diet might say "When my children can't manage to eat the cakes I
have
bought for them I just have to eat them myself because it would be such a waste of
money to throw them away". The possibility of saving the cakes for the next day or
simple buying less cakes doesn't seem to occur to the patient. This is an example of
indirect sabotage where the patient deletes their awareness of their own sabotaging
strategy.
Summary - Well formed outcomes
- What positive change do you want?
- How will you know when it has happened?
- What has stopped you from changing so far?
- What do you get out of what you're doing now?
- Do you want this change in all contexts?
- What could go wrong?
Polarity responses
Some patients have an in built strategy that makes them do the opposite
from what you tell them. This kind of patient has a polarity response.
This kind of response is often learnt in childhood either through
modelling a parent or created by the child as a defence or coping
mechanism. Also a child may see the parent as too weak and unassertive.
The child senses the parent's difficulty with control in communication
and develops the opposite strategy and often one in which they over
assert themselves through a process of denial.
When some children are put into a tight corner by a parent or sibling they
feel trapped. Some children develop a polarity response as a way of
freeing themselves from this sense of entrapment. A polarity response
will guarantee for the child that the other person is always wrong and so
make the child always right. Often arguments between children and their
parents are based on a child's polarity response. This is especially true in
adolescents when the child is starting to become more independent and
the parent has not yet recognised the child's ability to manage without
them. It is only natural for a caring parent to want to help the adolescent
but, of course, the adolescent perceives this help as interference. So often
the adolescent will "rebel" or do the opposite from what they are told. If
this works particularly well for the adolescent it can become part of the
repertoire of communication strategies. When the adolescent becomes
more mature they usually lose the strategy because the awareness that
accompanies maturity usually makes them realise that their polarity
response is inappropriate for most contexts. Other less mature and selfaware
"grown ups" continue with their strategy as they are unable to
develop an alternative way of getting what they want.
Responding to Polarity Responses
When the therapist states a fact or makes an observation the polarity
responding patient will often deny it or find a counter example often
without any rationale. To counter this behaviour the therapist needs to
learn how to phrase statements negatively so that the polarity responder
rejects the negative bias in the therapists statement and so moves in the
direction desired by the therapist. For example, if a patient always
sabotages the therapist's attempts at trance induction, the therapist could
start a session by stating. "I was going to suggest that today we do some
therapy with hypnosis but then I thought that you might sabotage it". A
true polarity responder would respond with "I don't think I would
sabotage it!”
Later in the session, when the therapist starts the hypnotic induction, the
patient has to enter hypnosis to prove that they will not sabotage. The
polarity responding patient has to be right and will go out of the way to
prove that they are right, even if it means agreeing to something now that
they earlier may have refused. Whether they keep to their original denial
or change to the new denial depends on the benefits and losses associated
with each choice. Whichever gives them the greater benefit or the least
loss will win. Of course this non-conscious choice is also influenced by
their personality orientation. If they normally reduce their anxiety by
avoiding loss then they will chose a choice that accomplishes that
outcome. If, however, they reduce their anxiety level by achieving
benefits then they will base their choice on that criteria.
Let us imagine the polarity responders response had we asked the above
question in a slightly different way. If we had said: "I was going to
suggest that today we do some therapy with hypnosis but then I thought
that you might sabotage it, like last time". Here the patient can chose to
respond negatively to either of two components in the statement. They
can either respond as before or they can say "I didn't sabotage last time".
Given that polarity responders are very quick and observant, they will
usually pick up on that part of the therapist's statement that can be denied
without compromising themselves. So it is very important that the
therapist's language is clean, specific and does not offer any choices that
could be used by the patient to break rapport or sabotage therapy.
Severely depressed patients seem to have a homing device installed in
their subjective
perception that seeks out negative interpretations and then latches onto
them. They usually negate any positive suggestions offered to them by
the therapist and agree with any cleverly designed anti-polarity strategies
the therapist may have dreamed up. So the above strategy for dealing
with polarity responders rarely works with severely depressed patients
because they tend to agree with any opposing or negative comments that
the therapist makes.
Summary - Polarity Responses
- Some patients have an in built strategy that makes them do the
opposite from what you tell them
- Polarity responses are sometimes learnt through role modelling.
- Polarity responses are sometimes learnt as a way of coping with
difficulty.
- Therapists have to develop a therapeutic strategy to be able to build
rapport and negotiate with the polarity responding patient.
- Precision with language is important when working with polarity
responders.
- Severely depressed patients may appear to have a polarity
response.
Accessing resources
Most patients have within them the resources to be able to change.
Whenever possible we must attempt to identify these resources, if
possible, before therapy starts. Your job is to help the patient apply their
own resources to their problem. Resources should be stacked whenever
possible. Stacked resources are a series of good feelings literally stacked
one upon the other. You should continue stacking positive resources until
the positive feeling is stronger than the negative feeling.
Patients often are not aware of their resources because they are hidden at
an non-conscious level. Patients try to get better by applying their
conscious resources to solving their problem but this is not enough and
this is why they usually enter therapy. Because "trying" occurs at a
conscious level the patient usually only has conscious resources available
for problem solving and any non-conscious resources become more and
more elusive because of the conscious effort of trying.
There are a number of different ways of accessing resources. Review any
‘exceptions to the rule’. These are times when the problem did not occur
even when the patient expected it to. The therapist asks the patient to
remember such times and then investigate what was different on that
occasion. Another approach is to look at contexts. The therapists attempts
to identify a context where the problem could not happen. Either because
the patient would not allow it to happen or because he would be unable to
experience it happening. Another approach is to ask the non-conscious to
identify the resources and apply them to the problem. This can be done
without the patient knowing what the resources are or how they are being
applied to the problem. Patients may find that as a result of carrying out
an ambiguous task that they remember skills and talents that they had
long forgotten. They remember positive life experiences. Sometimes the
task itself can lead the patient to experience resourceful experiences that
they never thought possible.
Case Example
I had one patient who had a compulsion to drive her car into the middle
of the road. Whenever she was driving her thoughts would become more
and more drawn towards the centre and she found it really difficult to
control her hands. She was immaculately dressed, with beautiful finger
nails. I remarked on her appearance and especially her nails which were
really rather beautiful. She said that they were her pride and joy and that
"she would just die if anything happened to them. When I questioned her
about her strange driving problem she said that she just felt intuitively
that she was going to have an accident sometime and that her hands
seemed to turn the wheel by themselves. I asked her what she had done to
try and help herself and she told me that she had been to more hypnotists
than she could remember but it had never worked. When I asked her why
she had visited me she said that she had once been hypnotised during a
stage demonstration and that she knew that she was a very good hypnotic
subject. She said that every time she was hypnotised she had amnesia and
experienced a very deep trance. So she still believed hypnosis could help.
I hypnotised her and asked her to recall every trance she had experienced
with some five different hypnotists. She was able to recall in trance what
they had told her. She said that each one had said more or less the same
thing. They had told her that if she drove into the middle of the road she
would surely kill herself so she must always tell herself to "not drive into
the middle of the road". One hypnotist had told her that this thought
would play on her mind and so would stop her from killing herself. I told
her that I didn't want to speak to her mind, that I didn't even want to speak
to her. I wanted to speak to her hands instead. I then asked her hands
whether she had ever broken a finger nail and felt embarrassed about it.
She nodded. I told her that when she came out of trance she would feel as
if one of her beautiful finger nails had broken and that she would feel
very upset and self conscious. I told her that the more she tried to cover it
up the more she would feel that I could see it and that she would feel even
more compelled to cover it up. I told her that as her feelings got worse
she would feel more and more like she wanted them to stop but that the
more she wanted them to stop the worse she would feel and so on until I
did something "dramatic" to stop the feeling for her.
When she came out of trance she responded exactly as I had asked and
became very fidgety all the time playing with her hands. I asked her what
was the matter but she didn't want to tell me about her nails. I said to her
"It seems like those hands are driving you crazy". She didn't appear to
hear me as her mind was totally focused on her hands. I then shouted
"LOOK OUT!" and she suddenly jumped out of her chair and looked
totally confused. I put her back into trance and asked her to review the
whole experience in relation to her driving and to make a commitment to
do something positive.
After a while she came out of trance with amnesia for the whole
experience. One week later she telephoned to say that her driving
problem had disappeared and that she thought that she had left something
in my office but just couldn't think what it might be. I told her not" to
think about it because one day she would remember and be delightfully
surprised. I told her to look after her nails and she said "Did I ever tell
you they are my pride and joy?"
Chapter 6 - Visible trance
Deeper trance states
In hypnotherapy there is a pre-supposition that the patient has a conscious
and an non-conscious mind. Of course this is only a model. Sigmund
Freud believed that the non-conscious mind was a cesspit of repressed
sexual memories. Nowadays the non-conscious is believed to be a
storehouse for positive resources. In hypnotherapy we take account of
both of these views. The non-conscious minds functions as a security
guard – protecting the conscious mind from traumatic emotions. It may
hold back unpleasant memories to protect the patient from pain. It also
stores and sorts positive memories. It is from this "store" that the therapist
takes his ideas for therapeutic interventions. The non-conscious mind also
oversee the body’s autonomic processes and healing mechanisms.
Therapists prefer talking to the non-conscious (rather than the conscious)
mind. The conscious mind contains the patient's learned limitations which
often get in the way of successful therapy. After all, if the patient knew
how to get better consciously they would not need to come to a therapist.
Despite this obvious revelation many patients like to participate
consciously in their own treatment. Patients often like to help themselves
through conscious effort so the therapist has to educate the patient about
the functions of the conscious and non-conscious minds and play down
the former whilst praising the latter. Analogies about the patient "taking
for granted" abilities such as being able to write their name without effort
or tie a shoelace without thinking serve to highlight the enormous
competency and dexterity of the non-conscious mind.
Some patients have difficulty with the concept of mind. As the mind has
no physical form it is often hard for them to accept it as a reality. Of
course they are quite justified in doing so as it is only a model. With some
patients it is useful to talk about the mind in terms of the brain. The brain
has two hemispheres. The two sides of the brain have different functions.
The right brain is the creative, dreaming and imaginative brain whilst the
left brain is the analytical, logical and reasoning brain. Because the
“wiring” from the brain’s two hemispheres crosses to the opposite side of
the body we can surmise that one side of the body (the left side) is more
closely linked via the right brain to non-conscious processes. The reverse
is true for the conscious mind which is connected via the left brain to the
right side of the body.
Most of the language skills we use in indirect hypnotherapy are designed
to appeal to the non-conscious mind. We often tell the conscious mind to
"go and do something else" while we work intimately with the patients
non-conscious. By working more closely with the patient’s non-conscious
mind we hope to bypass the conscious resistance or sabotage sometimes
caused by the patient's doubts about treatment. Only by developing an
honest relationship with the patient's non-conscious mind can we hope to
work therapeutically without interference from the part of the patient that
is responsible for the problem .
Minimal Cues
When people go into trance many physical changes occur. These changes
– which are called “minimal cues” - are the observable signs of hypnotic
trance. These changes do not happen in every hypnotic subject but most
will be seen at some time during the trance experience.
1. Eye fixation.
One of the main principles of hypnosis is capturing the subject’s
attention. If you are telling a compelling story or are using direct eye
contact the subject will often defocus their gaze and fix their eyes on
either a spot in the room or on your eyes . In these cases you will often
see a lack of blink reflex and open eye catalepsy which is an inability to
blink or close the eyes.
2. Pupil dilation.
When the subject's eyes defocus you may see a relaxing of the muscles
around the eyes and pupil dilation, depending on the amount of
illumination in the room.
3. Change in blink reflex.
Often the subject's blink reflex will start to slow down. This is a sign that
the subject is going into trance. You can utilise this slowing down in two
ways:
You can match the movement of your own eye blinks to that of the
subject and then gradually slow down your blink reflex to non-verbally
suggest to the subject that their eye lids will shut.
You can associate a hypnotic command such as "deeper", "heavier" or
"comfort" to their eye blinks. This will induce further blinking and then
eye closure.
4. Rapid Eye Movement
When people dream their eyes move rapidly from left to right as they
visualise images associated with their dream. The same phenomenon
happens in trance. Often you will see this rapid eye movement (REM)
when you ask the subject to visualise something.
5. Eyelid Flutter
Some subjects develop an eyelid flutter. This is an automatic response in
some people and does not indicate nervousness. If the subject is
concerned about it you can utilise the flutter as a ratification of the trance
by commenting on how this particular phenomena is characteristic of a
good hypnotic subject.
6. Smoothing of facial muscles.
The muscles in the face will smooth out. They will lose signs of tension
in their face and their jaw or shoulders may drop a little. Sometimes
subjects hold on to the tension in their jaw or shoulders and you may need
to encourage them to relax these muscles with some gentle suggestions.
7. Slowing of respiration.
The subject's breathing will usually slow down and may get deeper. If the
breathing becomes too laboured then this suggests that they may have
fallen asleep. If this happens you should gently wake them and start the
induction again. Usually they develop a nice slow comfortable breathing
rate and you can link words like “comfort” and “deeper” to this rhythm to
encourage these feelings. It is better to link these words with the subject's
exhalations as the body is naturally relaxing more on the out-breath.
8. Reduction of the swallow reflex.
People normally swallow about once or twice every minute. In hypnosis
this can stop altogether. It is not unusual to find a subject not swallowing
for half an hour. If the swallow reflex does not stop altogether there is
usually a slowing down of the reflex. If you see an increase in swallowing
it is a sign that the subject may be a little nervous. The increase in
swallowing can be caused by a dryness of the mouth. This oral dryness is
often caused by apprehension or fear and swallowing is generally a
conscious response made by the subject to prove to themselves that they
can still swallow comfortably. Sometimes very nervous subjects get quite
concerned with this difficulty in swallowing. You should re-assure the
subject that it is normal (or desirable) during trance induction.
9. Body Immobility.
The subject will develop a comfortable immobility of the body and limbs.
They may adjust their position once or twice to get comfortable but after
that they usually relax into a comfortable position. If the subject
continues to fidget they may be nervous or perhaps the chair may be
uncomfortable. If they are nervous you can give suggestions that they
need not go any deeper into a trance than is right for them at that moment.
10. Inner absorption.
When people daydream they appear very absorbed in their inner thoughts.
They will often demonstrate all of the above minimal cues. So inner
absorption is a term used to describe the collective cues of trance.
Everyday trance
Most people are hooked on leisure activities. One of the reasons for this is
that these leisure pursuits are often trance inducing. For example, dancing
and sports have a trance component in the same way that watching
television or listening to music have trance components. Because most
people enjoy leisure pursuits they are familiar with the trance experience
associated with them. However patients are not usually aware that this
particular state of reverie is the same one required for hypnosis. By
asking the patient to think about their favourite leisure activity and
informing them that the state associated with this is the one required for
hypnosis the therapist helps the patient to achieve a trance. Thus trance
can be induced by recalling a leisure activity.
The therapist should give analogies about trance experience in everyday
life. Analogies about ensuing trances that happen spontaneously when
one daydreams or watches television can actually re-induce a similar
trance state in the patient. Alternatively, the therapist can direct the
patient to recall one of his own leisure activities. The therapist must
decide whether an explicit request to recall a familiar leisure activity is
the best way to re-induce trance or whether an more indirect approach
based on the therapist's leisure interests could be more effective. What
works for one patient, may not for another.
Trance may be associated with certain activities The same is also true of
hypnosis. When a patient re-enters trance he re-enters the same
psychological and physiological state that occurred the first time he went
into a trance state. By asking the patient to recall a leisure activity he
automatically recalls the state associated with it. Therapists should always
remember this principle whenever communicating therapeutically.
Examples of leisure activity trances:
- Daydreaming.
- Watching television.
- Listening to music.
- Reading a book.
- Concentrating on a task.
- Enjoying a sport.
- Listening to a lecture.
- Dancing.
- Performing music.
- Painting, drawing etc.
Utilisation
One of the most important principals of hypnosis is that of utilisation.
Always utilise your patients response and feed it back to them in some
positive way. This is a very powerful technique and reinforces the level
of connection that you have with your patient. Utilise unexpected events,
noises interruptions to further deepen your trance induction. Utilisation is
also important for therapy as sometimes patients strategies for change are
partially effective and can be utilised to create greater levels of change.
Tailor therapy
Two people never have exactly the same problem. When a new patient
comes in and complains of the same problem as the previous patient it is
never exactly the same problem because it is not the same patient. Every
patient is different. Some of the principles that work with one patient may
be able to be employed with the new patient but not necessarily the same
techniques. People are individual and have different needs. The therapist's
job is to identify those needs and change what he is doing to meet the
needs of the patient. There are far too many therapists trying to pigeonhole
patients. There are therapists who try and get the patient to fit the
model of therapy they are using. Why is this? Maybe because they have
invested time and money in their own training and feel it must be right or
because they are lazy and don't wish to tap into their creative potential.
Techniques are helpful for training but it is also important to realise that
it's OK to not know what to do next, to feel free to go against the theories
taught and develop the flexibility and willingness to change the treatment
modality to meet the needs of the patient.
Leisure Interest Hypnotic Induction
First you would question the subject about various hobbies and leisure
pursuits which you think might be trance inducing. After explaining that
trance is a naturally occurring phenomenon you would ask the subject to
remember a time when they were engrossed in a leisure pursuit and
possibly were in trance . Then you might proceed as follows-
“ So I would like you to remember what it felt like to go sailing on that
lovely Summer day. Perhaps you can remember what you saw ….was it a
sunny day or was it dull?…..what colour was the sky?…isn’t it curious
how the sky can be such a deep blue at its highest point yet so light near
the horizon….were there any clouds?…..were they streaky clouds or
puffy white cumulus clouds?……..what colour was the sea …was the
watter calm or choppy?….were there any white caps or was the water
stil?…can you remember what the boat looked like?……and what did
you hear back then?…..the sound of the waves…..the creaking of the
boat…..the sound of the wind…..and the seagulls…….and what did you
feel?…..the rhythmic motion of the boat through the waves…….the
splash of spray on your face……the wind blowing against your
body….the heat of the sun…..and what did you smell back then?….the
smell of the salt air and the sea…..the smell of your wet clothing….that’s
right just experience that moment with all your senses…..see what you
saw…….hear what you heard…..feel what you felt…….smell what you
smelled…..and as you experience that moment with all your senses …you
may be aware of just how relaxed your facial muscles have become
…..and as your facial muscles relax you can become aware of a growing
sensation of comfort somewhere in your body….and as you become
aware of this feeling…..your may notice just how heavy your eyelids
have become….and as you eyelids become heavier….you can brighten up
the colours in your internal imagery …and as you brighten up the colours
….you can go deeper….and as you go deeper your eyelids can get
heavier…….but I don’t want you to close your eyelids until your nonconscious
mind knows that it is ready to go much deeper into trance.”
Contraindications to a leisure trance induction.
Some people experience trance when driving a car, especially on long
journeys. It is inadvisable for the therapist to use such a naturally
occurring trance as it can be dangerous as the patient may re-enter trance
while driving and crash . In fact patients should be encouraged to rest
before driving home. Everyday leisure activities should only be used to
induce trance when these leisure activities do not involve danger.
Chapter 7 - Therapeutic Strategies
Therapeutic structures
When patients enter therapy they either want to change what they're
doing into something totally new or to alter the degree, duration, or
general experience of their problem state. Sometimes it is more
appropriate to help a patient improve rather than change e.g. if a heavy
smoker requires smoking as a crutch to help relax. A reduction in
smoking (an improvement) may be more appropriate initially than getting
the smoker to quit altogether.
Once the secondary gains that smoking gives the patient, have been
satisfied with something more therapeutic and healthy, smoking can then
be terminated. In some cases it's more appropriate for the patient to
change completely. For example a nail-biter may wish to just stop biting
their nails. As long as there are no secondary gains left unidentified the
patient can be helped to stop.
Case Example
A man came to see me complaining of stomach pain. He had been to a
number of Doctors and the local hospital and they had told him that it was
all in his head. He came to see me because he thought he would try and
"get his head fixed". This man was in his seventies and did not have
enough money to pay me for my services. Neither did he want to come
for many sessions as he was afraid his wife might fin out. I was stuck
with the choice of trying to work with the pain directly or work on what
might be causing the pain at a deeper level. After the first session I
suspected that the problem might have something to do with his wife. As
she wasn't to know about his therapy I couldn't see how I could get her to
come and see me. Besides he didn't have the time or the money. So I
decided to work with the pain directly using Ideo-motor signalling.
First I asked the pain to move down his leg which it did. This confirmed
the Doctors' diagnosis that it was probably psychological. He wasn't a
particularly good hypnotic subject and I concluded that to be able to
move a real physical pain around his body so easily would be very
difficult for someone not trained in deep trance phenomena. On the next
session I then moved the pain to his shoulder and down his arm into his
wrist. On the following session I moved it into his little finger where it
became a mildly irritating throb. Before his next visit he telephoned me
saying that he did not want any more help, that he was happy with the
pain in the little finger and wanted to keep it like that. This patient was
helped through improvement not change. Change would have involved
the removal of the symptom altogether, probably by directing therapy at
the possible source of the problem, his relationship with his wife. I
figured that he had made the right decision to finish therapy when he did.
I believed that if he had taken it further it may have led to a split in his
marriage. As both were in their mid seventies I saw no point in working
on this aspect of the problem purely for the sake of therapy. He still had
his pain but it was now manageable and he still had his wife. Presumably
she still had what she was getting from the relationship too.
Helping a patient initiate a new positive behaviour is a way of giving a
patient something new that didn't exist previously. Terminating an old
negative behaviour is a way of taking away something that existed
previously. The former gives the patient a feeling of gain and the latter a
feeling of loss. Not many people like to lose something yet many patients
enter therapy and ask that something be taken away of stopped. This is
curious because patients usually have a better chance of succeeding if
they think they're getting something new to take away with them.
When deciding whether to initiate or terminate behaviours you should
consider your patient’s own orientation to the problem. For example if
cigarettes are seen as a means of support and maybe even like a friend
then despite wanting to stop smoking the patient is going to feel a sense
of loss when they give up. This will make relapses more likely. If,
however the patient can be made to think of quitting smoking as an
opportunity to feel healthier, more active, and socially acceptable then the
loss will not seem so great.
The problem with this approach is one of maintaining rapport. If the
patient believes that they will be more successful by stopping or losing a
behaviour you will have to pace this and appear to agree with them up to
a point. Often they will have tried many courses of action and will now
be frustrated and so will just want the problem taken away. If you start
telling them that this is the wrong way to think about things you will
probably lose rapport. You should appear to agree with them and then
start to reframe their beliefs. Avoid acknowledging their perspective too
much. Maybe a head nod here and there is enough. You can then get them
involved in discussion about the benefits of stopping whatever it is they
want to stop doing. You can then turn the discussion around so that both
of you are only focused on the achievements and benefits of therapy and
the thought of losing or stopping is no longer relevant.
Some patients prefer to increase their present positive behaviours whilst
some prefer to decrease their present negative behaviours. Once again the
therapist should identify the patient's orientation. Improvement is in itself
a form of change. Change usually becomes contingent upon alterations in
existing behaviours. The decision whether to improve or change depends
on the therapist's skill as an observer. Firstly the patient's orientation has
to be taken into account. Secondly the therapist should choose the
orientation that is the most ecological and therapeutic for the patient.
Thirdly the therapist should choose the orientation that is most likely to
work. Sometimes an improvement is a pre-requisite for change.
Sometimes a change can be made directly. If the patient is unwilling to
commit themselves to a complete change then aim to seek improvement.
This improvement can then lead to a more complete change. Sometimes
patients are happy with only improvement. The improvement can lead to
a snowballing effect whereby the improvement generates further
improvement which eventually generates change.
It should be remembered that patients need motivation to stay in therapy
with a particular therapist. If they feel they are getting nowhere they will
leave. So go for small changes (improvement) at the start if the problem
seems complicated or too big. In these cases always go for the smallest
easily obtainable change for the patient first. You need to convince the
patient that something positive is happening and this has to be a big
enough change to impress them so that they stay in therapy with you. So
you have a conflict here. What change will be small enough to
accomplish easily yet be big enough to impress them? You will know this
answer through experience because it depends totally on your patient,
their particular problem and their resources.
Sometime you may spend all of the first therapy session asking questions.
If your questions are searching ones and open doors for your patient this
may be all you need to do on the first session to impress them. If you
seem to be getting nowhere with your questions then spend the last 15
minutes or so inducing trance you at least let your patient know that you
can do something for them. The aim is to keep them in therapy long
enough for you to help them. It can take a lot of courage for a patient to
enter therapy so they want to see something positive for their efforts. It is
important to impress your patient on the first visit, but for any personal
gain on your part. You shouldn't attempt to give the impression that you
have the answers to every thing or that you are some guru like figure.
You just want them to feel secure in knowing that they have made the
right decision in seeking help. If you don't appear to be able to help them
they will probably leave and may never have the confidence to see any
other therapist again. You have no right to treat your patient in this way.
So do something for them right away and make sure that it's an
improvement.
Therapeutic metaphors
When patients communicate information about their problem they will
often metaphorically describe the cause of their problem. They may not
be aware that they are doing this. The therapist should listen to the kind
of language the patient uses, the phrases, the vocabulary and feed this
back to build rapport. When the therapist creates a suitable therapeutic
metaphor for the patient the therapist can utilise the same statements or
vocabulary. This will help the therapeutic metaphor parallel the structure
of the patient's problem and be more acceptable to the patient. For
example a female patient may talk about letting her hair down. Taken
literally this can imply a relaxing of her attitudes and/or a need to maybe
appear more physically attractive, but both resulting in greater enjoyment.
A patient presenting with a pain in the neck may be making a statement
about themselves or another person. An inability to talk maybe a
metaphor for an inability to express anger. There can be any number of
interpretations and the therapist should avoid interpreting metaphorical
components of symptoms without first having confirmation of repetition
of patterns. If a patient presents a problem of bed wetting and continually
talks about his inability to express himself and about feelings of being
trapped by those around him the bed wetting may be interpreted as a
metaphor for expressing himself in an alternative way.
When given a metaphor, the patient goes on a transderivational search.
This is search through his sensory Systems and representational Systems.
This search happens at an non-conscious level. The patient attempts to
find meaning in the metaphor by going inside into a trance state. Within
the context of therapy the patient attempts to understand why the therapist
is telling a metaphor. The patient realises on one level that the metaphor
must have therapeutic value and so searches for structure or resources in
order to help himself with his problem.
Because the metaphor is given at the conscious level but contains a
deeper structure at the non-conscious level the patient is unaware
consciously of the implications given by the therapist in the metaphor.
For example if the therapist talks about a tree and how a tree can bend in
the wind, the patient may not consciously interpret the metaphor as being
a model for new behaviour. If the patient presented a problem of being
rigid and unable to be flexible in relationships then the metaphor would
be quite appropriate. Ideally a metaphor should make sense at a conscious
level but the meaning should only make sense at the non-conscious level.
If the patient becomes aware of the therapeutic implications within the
metaphor he then has the choice of taking or leaving the therapeutic
implications. He even has the opportunity to sabotage the therapeutic
implications. So at all times the metaphor should be delivered with the
message being covert at an non-conscious level.
When the therapist constructs a metaphor and offers it to the patient, the
therapist may not fully know at that time whether the metaphor is right
for that particular patient. The metaphor will be designed with the
patient's problem in mind. By watching the response of the patient as the
metaphor is told, the therapist will be able to calibrate and identify
whether the meaning in the metaphor has meaning at an non-conscious
level for the patient. This is a very useful way of diagnosing whether the
therapist's assumptions are correct. If the therapist's assumptions are
incorrect nothing is lost. The patient just feels they've been told a nice
story. If the therapist's assumptions are correct then a response will be
evoked within the patient and recognised by the therapist. This is usually
followed by a change in behaviour.
When designing the metaphor the therapist should attempt to create a
story or cast of characters that somehow parallel the structure of the
patient's problem. The difference between the patient's problem and the
metaphor is that the metaphor has a happy ending. The ending of the
metaphor usually suggests new ways of behaving or ways out of the
problem situation. These ways have been calculated by the therapist as
being the most appropriate behaviour or action to take as a way of
resolving the problem. These ways of behaving have usually never been
considered by the patient previously. If given to the patient directly in the
form of advice, the patient then has the opportunity of rejecting them or
sabotaging them. By giving these suggestions or possible solutions to the
patient metaphorically they are received by the patient at an nonconscious
level. The non-conscious mind then utilises these potential
solutions if they are appropriate and brings about change.
Sometimes homework assignments can be given to patients and these
homework assignments or tasks metaphorically suggest action to be taken
by the patient in order to bring about a change in the patient’s problem.
For example a child unable to control his bladder may be told to learn
how to water the garden with a hose pipe, and how to control the flow of
water from the hose pipe by adjusting the tap on and off or squeezing the
hose pipe so that the flowers and the lawn receive only just the right
amount of water to make them grow. The patient in this case carries out
the homework assignment oblivious of the non-conscious message given
to the patient. A task of cleaning out a refrigerator maybe suitable for a
patient who needs to organise themselves. The task of defrosting a
refrigerator might be suitable for a patient who is frigid.
The Four Seasons Hypnotic Induction
Patients are frequently asked to focus their eyes on a spot or some neutral
place and to notice changes in their own physiology as part of the initial
stages of trance induction. Patients are most likely to notice alterations in
the visual and kinaesthetic experience first before auditory, gustatory and
olfactory. Hearing often follows closely behind the visual experience of
trance as mental images are formed creating internal representations of
sounds that are associated with the mental imagery.
With the four Seasons induction the patient has a three dimensional
internal experience of walking through the different seasons of the year.
The patient has to see, hear and feel the experience. This overlapping of
internal sensory experience deepens the trance state. Whenever the
patient has representations of an internal remembered event in all of the
sense systems there is a deepening of trance experience.
The therapist should always endeavour to overlap the sensory experience
of the patient whilst they are entering trance. In everyday life we see, hear
and feel things so why not in trance? It is only natural that a full sensory
imagined experience is going to seem more real that a fleeting imagined
experience. So attempt to give your patient a full sensory experience of
whatever it is they are imagining. However, do not be too specific. You
cannot see what they can see inside their head so do not suggest things
that may not be part of their imagined experience. For example if you
expect them to see a tree. Do not give it a name or describe it in any
detail. The chances are that they are seeing an entirely different tree from
you anyway and a too specific description will break rapport and make
your patient feel that they are not following your instructions properly.
The rule is "be general".
As the four seasons induction involves travelling though the countryside
by the sea up into the mountains towards a welcoming cottage there is
movement on this journey of exploration. Any movement included as part
of an induction will help deepen the trance experience. In fact, depth of
trance can be contingent upon the movement or the journey itself. Each
step can be linked to going deeper and deeper into trance. This, coupled
with the overlapping of internal sensory experiences makes the trance
experience an engrossing and absorbing one. Because each scenario is
different yet progressive the patient will feel as if each trance location
(hill, beach, road, cottage) is a different yet related trance. Each new
trance location is like a trance within a trance. This means that you can
associate certain experiences with each place (or season) and the
experience will then be anchored to that place and time. You can also
suggest amnesia for some place on the journey and then the journey will
be remembered minus the place (and experiences) for which the amnesia
was suggested. Be careful when suggesting amnesia for places or times
that may be an actual part of your patient's reality because your patient
may literally forget these contexts in real life.
The four seasons induction can be used as a metaphor for life. It can be
suggested that as the patient travels through the various seasons of the
year going deeper into trance he can utilise the learning's on this journey
as they parallel his life experiences. As a metaphor this is very nonspecific.
When a metaphor is open-ended in this way the patient can
apply it to their problem or life experience without fear of manipulation
on the part of the therapist. Patients will make sense of metaphors in their
own way.
A metaphor given to a group of people will have a different meaning for
each person. The meaning will come through recognition of parallel
structures identified in the metaphor and each person's life experiences.
When the metaphor parallels the person's life experience he will make
sense of it and maybe use it therapeutically for change. If a metaphor
does not parallel the person's life experience nothing is lost. The patient
just thinks it's a pleasant story or in this case a pleasant induction.
When this induction is also used as a metaphor for life the patient often
sees the experience as a kind of "taking stock" experience. You can
suggest to the non-conscious that it should allow useful therapeutic
learning experiences to happen on this journey so that your patient can
utilise these learning's for himself in some way. When you do this you
should give your patient plenty of time to enjoy the experience (at least
one hour).
Summary – Therapeutic Principles and Metaphor
- Therapy is based on either change or improvement
- Change involves initiating new positive behaviours or terminating
old negative behaviours.
- Improvement involves increasing existing positive behaviours or
decreasing existing negative behaviours.
- Patients often talk in metaphors.
- Patient's symptoms may be organic metaphors
- Metaphors can be applied as a diagnostic tool to test the -therapist's
hypothesis.
- Therapeutic metaphors parallel the structure of the patient's -
problem and lead to solutions.
- Tasks can be given as metaphors.
- Therapeutic metaphors by-pass the patient's conscious limitations.
Symptom substitution and resolution.
The therapist can either create a "designer symptom" for the patient and
then implant suggestions under hypnosis that the symptom occur as an
alternative to the old disabling symptom. Or the therapist can ask the nonconscious
mind of the patient to create an alternative less disabling
symptom. Sometimes this is enough to deal with the problem that is
presented in therapy. If the cause of the problem no longer exists then
alteration of the symptom is usually enough to bring about a change. The
therapist gradually replaces one symptom with another until the symptom
in fact becomes an asset. For example the symptom of psychosomatic
pain could be altered to become an ache. The ache can then be altered to
become an itch. The itch can become a pleasant feeling. The pleasant
feeling can become a friendly sensation of comfort
By gradually changing the symptom in this way the therapist can work on
the symptom a piece at a time gradually changing or transforming its
shape. If the cause of the problem still exists in some way then this
approach will give the patient immediate relief or comfort. Just knowing
that the symptom is changing will encourage the patient to remain in
therapy whilst work on the cause progresses. It's very important to keep a
patient in therapy if the process of change is occurring slowly. Some
patients become despondent. If they can see a definite change in their
symptom they are happy to remain in therapy whilst the therapist works
more therapeutically at a deeper level
Altering the intensity, position or form of a symptom is the pre-requisite
to actually removing a symptom. By moving the symptom from one
location to another in the patient's body the therapist is proving that the
symptom is psychological and that it is open for change. Likewise if the
therapist reduces the intensity of the symptom in some way. If the
therapist is able to actually change the shape of the symptom or transform
it from one symptom to another, this then ratifies the therapist's skills and
the patient's potential for change.
There has long been an assumption in psychotherapy that every symptom
must have a cause. A second assumption is that a symptom cannot be
removed whilst a cause still exists, the result being that a second
symptom (sometimes more severe) pops up in place of the first one. In
effect what we are doing here is utilising this principle or assumption by
offering a designer symptom to replace the disabling symptom. However
to get back to this assumption that a cause must have an effect this
particular model of treatment presupposes that a symptom is difficult to
remove whilst a cause still exists. Some causes to problems of course
may no longer exist at all in that they have since burnt themselves out and
the person is responding habitually to old patterns of behaviour. In such a
case the symptom should be easy to remove. This is the principle behind
a lot of the NLP techniques.
Symptom substitution cannot occur if the cause of the problem no longer
exists. The cause can only be removed if it still exists. We are also saying
that spontaneous symptom substitution can occur if a symptom is
removed without the cause being handled adequately.
Sensory dissociation techniques
Sensory dissociation techniques are useful for dissociating the patient
from any traumatic feelings associated with the memory that lies at the
source of the patient's problem. Because dissociation is a part of every
day life especially in experiences such as shock most people can imagine
seeing themselves as if another person. In hypnosis we capitalise on the
patient's natural ability to accomplish everyday phenomena. In fact the
source of most hypnotic phenomena is in everyday life. Dissociation
removes the patient dramatically from the scene of the trauma and often a
‘cure’ can occur in one session.
The therapist may ask that the patient imagine a disturbing scenario on a
cinema screen. The patient is asked to then see themself sitting in the
cinema watching the cinema screen (second position), usually in the
projection booth. The patient is then asked to watch themself, watching
themself on the screen going through the experience that is traumatic. The
patient is dissociated and is free of the uncomfortable kinaesthetic
response that is normally associated with the memory.
By dissociating the patient to an observational position, it is possible to
‘watch’ without negative feelings and learn that is possible to remember
the experience with out feeling uncomfortable. This new learning is then
carried over into everyday life and more specifically, into the situation in
which the phobia occurs.
Exercise - The VK Dissociation Structure.
- Anchor the resource (comfort) on the shoulder.
- See the younger self immediately prior to the trauma projected as a
still picture on a cinema screen.
- Float out of body into the projection booth and see the self sitting
in the cinema.
- Anchor the dissociation as for the resource (on shoulder).
- Hold the patient's hand and tell them to squeeze it if traumatised.
- Get the patient to watch themselves in the cinema watching -
themselves on the screen in black and white.
- At the end of the movie get the patient to associate with the self on
the screen and run the movie backwards in colour.
- Dissociate the patient back to the projection booth and re-run -the
movie in colour at normal speed re-associating with the self each
time it is run. It is important to give the patient time to accomplish
this particular exercise.
Summary – Symptoms, cause and dissociation
- New symptoms can be prescribed to replace old, more disabling
ones.
- Symptoms can be moved, reduced and transformed into more
manageable symptoms as an initial stage in symptom resolution.
- Symptoms can be resolved when there is no remaining underlying
cause.
- Removing the cause of a problem is important because it prevents
the patient spontaneously substituting another symptom.
- Dissociation protects the patient from feelings.
- The further a patient is dissociated the more remote are the
feelings.
- Dissociation is a natural phenomena.
- The technique can often treat phobias in one session.
Scrambling symptoms
As stated earlier, every symptom or behaviour has a beginning, a middle
and an end. The scrambling technique aims to identify the different stages
in the sequence of a behaviour or problem and then literally scramble the
different stages so that the patient no longer has access to the smooth
running cause and effect relationship inherent within the pattern. The
scrambling process is fairly straight forward; the first step being that the
therapist identifies the first step in the symptom or behaviour. For
example with a problem such as blushing, the therapist identifies the five
stages in the symptom; The first step may be accelerated respiration. The
second step may be sweating palms. The third step may be a tightening in
the upper chest that the patient interprets as panic. The fourth step may be
hot feelings in the face. And the fifth and final step may be feelings of
possible blushing or sensations of redness in the face. If we look at this
particular sequence we can see that step one is a prerequisite to step two,
step two a prerequisite to step three etc., etc. We can see there is a
definite sequence of events that occurs as this symptom develops.
Having identified the various steps in the symptom the therapist has to
associate each step with particular number. This is a form of ‘anchoring’.
The therapist anchors a number to a particular step. So we now have five
distinct steps:
1. Accelerated respiration,
2. Sweating palms,
3. Tightening in upper chest,
4. Hot feelings in the face,
5. Feelings of possible blushing or redness in the face.
Whenever the therapist says number one the patient should be able to go
to the step called number one, that is the patient should be able to recall
the experience of having accelerated respiration. If the therapist were to
say step number four the patient would also be required to recall the
experience of step number four: that is hot feelings in the face. Having
established this cause and effect relationship between the number and the
particular step in the sequence the therapist moves on to the next stage.
This next stage involves the patient re-experiencing the actual internal
state associated with the particular step which has also subsequently been
associated with a particular number. To do this the therapist asks the
patient to experience step number one. As the patient experiences or
recalls the accelerated respiration he also attempts to step into the internal
state associated with this step of the symptom. The therapist is expecting
the patient to induce the kinaesthetic experience of accelerated
respiration. Having established this first step the therapist then repeats the
same process with step two asking the patient to step into the internal
state known as sweating palms. And so on, and so on until the patient is
able to re-experience the internal state associated with each step in the
sequence in the symptom.
Once the therapist has established this association between the internal
state, the number of each step and the actual step itself he can proceed
with the scrambling aspect of this technique. The scrambling aspect
requires that the therapist requests that the patient re-experience whatever
internal state is associated with whichever number he announces. The
therapist then request that the patient experience step number one, he then
asks the patient to experience step number four followed by number two,
number five, number three. The therapist is actually asking the patient to
experience the blushing problem in a new way. He's asking the patient to
experience first the accelerated respiration followed by hot feelings in the
face then followed by sweating palms then followed by feelings of
blushing or redness in the face finally followed by a tightening in the
upper chest. By swapping around the different steps so that the patient
loses the normal cause and effect relationship between step one, two,
three, four, five, the therapist is effectively shuffling or scrambling all of
the steps.
By scrambling these steps the patient finds it very difficult to have the
pattern run through in chronological order as before. The next phase
would be for the therapist to request that the patient experience the
different steps in other random orders. This is continued until the patient
becomes exhausted. After this point the therapist asks the patient whether
they can re-access the original sequence. The patient usually finds it very
difficult to do so. In future situations when blushing should occur the
patient usually finds that the pattern does not run. Simply because the
brain has learnt many other ways of handling the different steps.
Summary – Scrambling
- Symptoms or behaviours have a sequence.
- The therapist can anchor and/or number each step in order.
- Each step is anchored to a different internal state.
- The sequence can be scrambled to disrupt the old pattern and/or
sequence from re-occurring.
The Swish Technique
There is a definite cause and effect relationship between the recollection
of an unpleasant memory and the associated feelings. Usually the picture
is the pre-requisite to the feeling. The mental image triggers the
unpleasant kinaesthetic responses. Likewise patients feel good when they
see a pleasant image. The Swish Technique involves asking the patient to
access the suitable resource required to erase or neutralise the negative
traumatic memory. The patient is first asked to see the behaviour they
want to change and then asked to see and feel the positive resource they
would like as an alternative. It is assumed that the patient can already see
and feel the negative feeling. If the patient does not have access to the
picture responsible for the negative feeling then a different therapeutic
approach should be applied.
The first step involves the patient in accessing the picture of the bad
memory and its associated feelings and seeing and experiencing this bad
memory in an associated state. The patient has to step into the image of
the memory and experience it as if he were there. The previously
accessed positive resource required to neutralise or erase the bad memory
should be in the form of a dissociated picture in the distance. The
therapist then asks the patient to enlarge the dissociated resource picture
bringing it forwards and whilst doing so to push away the associated
negative picture. As the positive picture and the negative picture meet and
superimpose over one another, so the positive element of the resourceful
picture erases or neutralises the negative picture. Simultaneously the
associated feelings also superimpose and integrate.
This swishing process also swishes on a kinaesthetic level. The positive
feelings from the resourceful picture neutralise the negative feelings from
the negative picture so that the patient has difficulty in re-accessing the
original negative feelings. Usually the patient has difficulty in reaccessing
the negative image also. As patients rely on their internal
images of reference in order to make decisions in the future, the new
swished image and related feeling replaces the earlier negative feeling
and image as a form of reference. When the patient approaches similar
events in the future there is only a neutral response.
Exercise - The Swish Technique
Summary of the Swish Sequence.
- Close your eyes and identify a behaviour you want to change and
visualise the moment prior to the behaviour you want to change.
Attempt to feel as if you are actually there in the experience - be
associated. You should notice an uncomfortable feeling associated
with this picture.
- Create a positive outcome picture of yourself doing what you
would rather do as an alternative to the negative behaviour. See
yourself in the picture - be disassociated.
- See the negative picture big and bright in front of you and put the
positive picture into a small space in the bottom corner of the
negative picture.
- Now do the Swish by enlarging and swishing the small positive
picture up behind and through the negative picture whilst pushing
the negative picture away so that the positive picture replaces the
negative picture. You should discover that you shift from
associated to disassociated as the positive picture swishes through
the negative.
- Open and close the eyes to "break state" and repeat the above swish
several times opening and closing the eyes between each swish.
- Test - open the eyes and try' and remember the old negative
picture.
Chapter 8 - Artful Suggestion
Patterns of suggestion
Serial suggestions
Serial suggestions link together specific events from a behaviour that is familiar to
the patient For example the patient may be asked to imagine picking an apple from
a
tree. The therapist then describes in great detail the act of picking the apple: the
experience of lifting the hand, feeling the change in muscle tension… then
releasing
the fingers and forming a shape that can hold on to the apple… pulling on the
apple,
testing the grip and the strength of the apple stem… feeling the apple pull from the
branch as the branch springs back. Hearing sounds and seeing the experience
simultaneously.
When used as an induction the patient enters trance as he becomes more and more
absorbed in the experience of picking the apple - the more real the therapist can
make
it the better. By overlapping all of the sense systems, including smell and taste if
possible, the patient goes deeper into trance.
If the therapist wants the patient to experience achieving something specific, either
in
the future or in the past, he can take the patient a step at a time through the
experience of the specific event or act. For example, if the patient needed to
identify
and utilise a resourceful feeling from the past the therapist could take the patient
through each step of the memory of having achieved that resource using the serial
suggestion technique. Likewise if the patient was having difficulty achieving
something in the present, the therapist could take the patient through each step of
the
behaviour as if it were happening in the future. By filling in all of the specific
details
of the behaviour the patient can then identify more easily with the experience as if
it
were really happening.
The main benefit of this is that the patient gets to rehearse the behaviour in great
detail. This creates the feeling of already having accomplished it. In the future,
when
the time arrives for the patient to actually carry out the behaviour, it is done so
effortlessly because the patient already knows how to do it and that it will be
successful.
Dependent Suggestions
A dependent suggestion can be used to evoke a hypnotic or therapeutic response. It
is
called a dependent suggestion because the response occurs as a result of the patient
carrying out his ongoing behaviour. For example:
- Go deeper into trance as you breathe out.
This suggestion hitchhikes the hypnotic response of going into trance onto the
ongoing behaviour of breathing out.
Dependent suggestions utilise a link word. This usually occurs in between the
suggestion for a hypnotic response and the mention of the ongoing behaviour.
Words
such as "until" may also be used when prefixed by a negative, for example "don't
go
into trance, until, you close your eyes."
When dependent suggestions are used as an induction technique, the therapist
should
observe the minimal cues of ensuing trance and feed them back as dependent
suggestions. For example:
- As you breathe you can feel comfortable.
- When your facial muscles relax you can go into trance.
- Don't go deeply into trance until you know you are comfortable.
All of these minimal cues have to be identified by the therapist before they can be
fed
back to the patient. The therapist acts as a kind of bio-feedback machine reflecting
the minimal cues as they occur. As the ensuing trance is dependent upon the
development of these minimal cues the trance becomes self-generating.
Adjunctive Suggestion
An adjunctive suggestion is an important form of indirect communication. It helps
the therapist to bring about changes in awareness while inducing trance or changes
in
behaviour. An adjunctive suggestion consists of a truism (a true statement which
cannot be denied) followed by a suggestion, although sometimes a suggestion can
be
followed by a truism.
For example the truism: you can see your hand. Can be followed by the
suggestion:
and notice how it feels.
In this example the truism comes first, followed by the word "and", followed by
the
suggestion itself. Here the therapist is implying that by simply looking at the hand
the patient will be able to notice the feeling. Although there is no real relationship
between looking at a hand and feeling the feeling, the therapist uses the word "and"
to introduce a relationship between the seeing and the feeling.
The following example is a suggestion followed by a pause, followed by a truism:
You can experience a happy feeling… pause… everyone has some happy
memories.
Here the suggestion to have a happy feeling is followed by the truism that
everyone
has happy memories. The decision on whether to put the truism first or last
depends
upon the patient’s response to the suggestion. If the therapist notices a better
response to the truism-suggestion format then he should use that particular
structure.
Adjunctive suggestions are so simple and indirect that they can easily be practised
in
everyday conversation. In fact it is good practice to apply all of the indirect forms
of
suggestion in everyday speech so that they becomes second nature. If you are only
practising only one form of indirect suggestion (the adjunctive for example) then
you
may seem a bit repetitive.
Indirect suggestions are most effective when used together. If you really want to
develop a hypnotic personality you should learn to use indirect suggestion in your
everyday conversation.
The word "and" acts as a link between the truism and the suggestion. A pause has
the
same effect as it represents an implied "and". The "and" and the pause both imply a
relationship between the truism and the suggestion though no relationship need
really
exist.
A non sequitur example of an adjunctive suggestion might be as follows:
You want to get better… and… your arm can lift all by itself.
Here there is no real relationship between the truism, "you want to get better" and
the
suggestion: "your arm will lift by itself". However there is an implication that there
is
a relationship.
Indirect suggestions are used for inducing trance but they should also be used for
inducing therapeutic change. An adjunctive suggestion for induction of trance
would
be as follows, "You can notice you're blinking… and feel that heaviness in your
eyelids". An example of an adjunctive suggestion for therapeutic change could be
as
follows;
You have felt relaxed at various times in your past, and this can occur more and
more in your future.
Naturally, the therapist would only give this kind of suggestion if he has
knowledge
that the patient has previous experience of feeling relaxed. A truism cannot be
denied
and is a statement of fact. The truism always ratifies the suggestion. It helps bind
beliefs together. It helps build rapport and helps build trust. Without the truism the
suggestion has no firm foundation.
If the therapist gives the patient an adjunctive suggestion consisting of a truism
about
an undeniable, external, observable behaviour followed by a suggestion for a
possible, yet internal and as yet, unverified behaviour the patient will experience a
shifting of awareness from external to internal reality.
For example in the following adjunctive suggestion the truism is an observable,
verifiable behaviour and the suggestion an internal, unverified experience,
You're looking out into the distance, and, all kinds of memories come to mind.
If the therapist gives a series of these adjunctive suggestions the patient has to
make
a shift in his awareness from an external to an internal reality. This is trance
inducing. So a trance can be induced using only adjunctive suggestions. Each
suggestion should overlap the preceding one and take the patient on an internal
journey from observable truisms to non- observable experiences. For example the
following are a series of adjunctive suggestions that could be used together with
others of the same class for inducing trance.
- You can see your hand - and - feel the texture of your trousers.
- You can feel the texture - and - feel a warm sensation in your body.
- You can experience those sensations developing now - and - remember some
place that was warm and comfortable.
Here we see the first adjunctive suggestion as a truism about an observable
experience - "see your hand", followed by a suggestion about an observable
experience - 'feel the texture of your trousers". This truism and suggestion paces
the
patient's ongoing experience and helps to build rapport as well as directing the
patient to focus internally. It is followed by the observable truism to 'feel the
texture"
and then the non-observable suggestion to 'feel a warm sensation in your body".
This
adjunctive suggestion takes the patient one step closer to trance. It does this first by
pacing their previous experience by stating a truism about their response to the first
adjunctive suggestion. Then by offering the new non-observable suggestion to be
aware of a warm sensation in the body it takes the patient further into trance.
The final adjunctive suggestion offers a truism about a non-observable experience
"experience those sensations developing now" followed by a non-observable
suggestion "remember (see) some place that was warm and comfortable" You
should
notice how each suggestion overlaps and how each subsequent truism picks up on
the
patient's response to the preceding Adjunctive suggestion. The format for this
series
of Adjunctive suggestions is as follows:
a. Observable - Observable
b. Observable - Non-observable
c. Non-observable - Non-observable.
There are two ways in which these series of adjunctive suggestions can be used as
an
induction procedure. Firstly they can be used as above in groups of three. In this
instance the therapist would give three suggestions starting with observable and
finishing with non-observable, thereby directing the patient's attention inward by
repeating the pattern with new suggestions that follow the same structure, the
patient
is taken in and out of trance many times.
Alternatively the therapist can offer many kinds of observable - observable
suggestions, followed by many kinds of observable - non-observable suggestions,
followed by many non-observable - non-observable suggestions. In this case the
patient should gradually go into trance over the course of the repetitions.
The latter may seem a better approach because it always moves the patient in the
direction of trance. The former has the advantage of continually re-inducing trance
over and over again and putting the patient into a double bind. Continual re-
induction
of trance is a deepening process but is also quite tiring for the patient. If patients
pay
strict attention to the therapist's suggestions, they are taken in and out of trance
many
times but never quite deep enough to satisfy them. This creates frustration for the
patient and makes the prospect of trance more compelling. On the other hand, if
they
find the suggestions too tiring they will want to ignore them.
As patients are already fatigued by accepting suggestions, it becomes easy for them
let go and enter trance fully. Normally you would not limit yourself to adjunctive
suggestions alone as an induction procedure. However, it is good practice to limit
yourself to only a few hypnotic tools for training purposes and see what you can
accomplish. Many therapists tend to throw their entire tool box at the patient and
hope that somehow it will all come together. The real art is to apply the right tools
at
the right time with the right patient. This develops with experimentation.
The Uptime Downtime Hypnotic Induction
This induction is based on a shifting of awareness combined with eye fatigue. Your
patient is asked to direct their attention to the external world and focus on one spot
just above eye level. Also ask your patient to listen for external sounds and be very
sensitive to tactile feelings. When you are certain that your patient is directing their
attention externally, then ask your patient to slowly close their eyes once you have
counted from one to three. On the count of three ask them to close their eyes. You
should then ask them to visualise some relaxing scene. Your patient should relax
their muscles and experience the sights, sounds and feelings associated with their
relaxing place.
Once your patient is focussing internally you should ask them to try and open their
eyes once you have reversed the count. You then count backwards from three to
one
and emphasise the difficulty in opening their eyes. Your patient should then be
asked
to try and sharpen up each of their senses in turn. This pattern is repeated with your
patient closing and opening their eyes whilst simultaneously shifting their
awareness
from internal to external awareness and back again until their eyes are too tired to
open again.
Passive Response Suggestions
When patients experience hypnosis they sometimes fidget or talk and become too
actively involved at the conscious level. Passive response suggestions request that
the
patient do nothing consciously. These suggestions emphasise the activity of the
nonconscious
mind. As therapists we do not want our patient interfering on a conscious
level. Sabotaging of therapy is often done at a conscious level so ideally we want
the
conscious mind out of the way. Here are some examples of passive response
suggestions:
- Nothing is important except the process of your non-conscious mind.
Here we see a suggestion that emphasises the non-conscious mind whilst
simultaneously playing down the conscious mind.
- Trance can happen all by itself, you can wonder how it is happening.
This suggestion emphasises the spontaneity of the patient. It actually asks the
patient
to wait to experience an non-consciously generated trance experience. The only
conscious activity suggested is wondering which is itself trance inducing.
- You don't have to try to change that problem, your non-conscious mind can do
it for you.
Here again we see the emphasis on the non-conscious mind's involvement in
problem
solving. As stated earlier in the book, patients often reinforce their problems by
trying to solve them. Here we are suggesting that the patient does not try to solve
the
problem and leaves it up to the non-conscious mind. This developing trust in the
nonconscious
mind is an important part of therapy. Patients should be encouraged to
trust their non-conscious mind more and more. If this trust can be maintained and
carried over into everyday life when the patient finishes therapy then they should
feel
more responsible for their own personal change.
Open Ended Suggestions
Open - ended suggestions offer the patient a number of mutually appropriate
choices.
Open - ended suggestions usually give a number of choices rather than just two.
The
therapist covers all kinds of response in order to re-frame any response as being
appropriate. Here are some examples of open - ended suggestions:
- You can dream, imagine, picture, visualise, any memory you like.
So here we see a suggestion for some kind of internal imaging. It does not matter
which option the patient chooses, whether to dream, imagine, picture etc., he has to
visualise an image of some kind.
- Your hand can lift, move to the left, the right, press down or stay as it is as you
go into trance.
Here we see an open - ended suggestion related to hand or arm levitation. The
patient's non-conscious mind is free to move the arm in whatever way it wishes.
However notice that even no movement is included as a valid response.
- Will you smoke six, eight, three, ten or even two cigarettes a day as you
practice your self hypnosis?
So here we see the open - ended suggestion applied to therapy rather than to
hypnosis. This open - ended approach uses a post - hypnotic suggestion that
appears
to give the patient a choice in how to respond. However there is a presumption that
the patient will cut down on smoking.
Double Entendres
A double entendre is usually the name given to any phrase which has a double
meaning. Suggestive jokes often have this particular structure. Maybe one word or
phrase in the joke can be re-interpreted as being something rude. The effect of the
potential misunderstanding caused by the double meaning in a joke is what makes
it
humorous. Here are some examples of double entendre suggestions.
- Sit in this chair and take a weight off your mind.
Here we see a double meaning in the word "weight". This would be an interesting
suggestion to give to a patient who was obese.
- As you wonder where the feelings have gone in your hands there's no ‘arm
(harm) in looking.
Here we see a play on words. The word "harm" is mispronounced to sound like
arm".
This would be a useful suggestion when attempting to promote anaesthesia in the
arm or a negative hallucination for the arm.
- Your non-conscious mind has a gift for you, you can feel its presence.
Once again there is a play on words . The word "presence" sounds almost identical
to
"presents" and this also echoes the word "gift".
Summary - Suggestions
- Serial suggestions link together specific minimal events from a behaviour that
is familiar to the patient
- Serial suggestions can be used as a trance induction.
- Serial suggestions can be used as therapy.
- Dependent suggestions "hitchhike" a hypnotic response onto an ongoing
behaviour.
- Words such as: "until", "when", "as", link the ongoing behaviour to the -
request for a hypnotic response.
- Dependent suggestions can feed back minimal cues.
- Adjunctive suggestions contain a truism and a suggestion.
- The truism and suggestion are linked by an "and" or a pause.
- Adjunctive suggestions can be used for inductions or therapy.
- Adjunctive suggestions can help shift the patient's awareness from external to
internal reality.
- Double entendres deliver two simultaneous messages, one for the conscious
and one for the non-conscious mind.
Illusions of choice
Binds and Double Binds
Double binds are one of the most effective indirect language skills we have
available
for inducing trance or encouraging therapeutic change. The double bind appears to
give the patient a choice but the choice is only an illusion. The prerequisite to
structuring a double bind is the embedded presupposition that something will
occur.
When the patient is asked to choose between two or more alternatives it is already
presupposed that the behaviour being suggested by the therapist will occur as a
result
of either choice made by the patient. For example to ask "do you prefer tea or
coffee?" is to presuppose that the person is going to drink. Because the question
does
not ask whether the person wants a drink but is more concerned with what kind of
drink the patient wants, the patient answers the question without being aware that
they have committed themselves to drinking something.
1) Binds
These are questions that can be answered consciously by the patient. For example
"do you want to go into trance in this chair or that chair?" The therapist is asking a
simple question which can be answered consciously.
2) Double Binds
A double bind requires that the response or choice be made at an non-conscious
level. For example if you say "are you going deeper into trance as you inhale or
you
exhale ?" then the patient becomes more aware of changes in his own internal
experience. There is a presupposition that the patient is going to enter trance.
In order to answer the question the patient has to pay attention to the changes in his
internal state. These changes can only occur on an non-conscious level so he has to
wait for the hypnotic response before he can answer the question. The experience
of
waiting and focusing attention inward is itself trance inducing.
3) Conscious / Non-conscious Double Binds
Suggestions such as "you can remember certain memories and your non-conscious
mind can remember others, which come first?" require the patient to not only wait
for
an answer at an non-conscious level but to emphasise the difference between
conscious and non-conscious processing. In therapy it is always useful to separate
the
non-conscious from the conscious mind to avoid sabotage by the conscious mind
or
recall of communications directed solely to the non-conscious mind. It also helps
to
promote a structured amnesia for traumatic memories repressed at an non-
conscious
level.
Many of the forms of hypnotic suggestion are designed to dissociate the conscious
from the non-conscious mind.
Examples of binds
- Would you like to go into trance standing up or sitting down?
- Do you prefer to have your hands on your lap or on the arms of the chair to go
into trance?
Examples of double binds:
- Do you begin to feel a numbness in the fingers or in the back of the hand first?
- Will it be the right or the left hand that lifts first all by itself?
Examples of conscious/non-conscious double binds
- If your non-conscious wants you to enter trance your right hand will lift
otherwise your left hand will lift.
- I can talk to you (conscious) and I can talk to you (non-conscious) and you
(non-conscious) can respond without you (conscious) knowing how you are
doing it.
Arm Levitation Hypnotic Induction
One of the most classic inductions is the Arm Levitation Induction. This form of
induction has been used by most hypnotists at some time, however Erickson
refined
it and applied his indirect hypnotic skills, developing it into a utilisation approach.
Previously, the hypnotist would suggest levitation in a direct and authoritarian
manner - unfortunately this gave the impression that the arm levitation was caused
by
the "power" of the hypnotist. Erickson's approach allowed the patient to experience
the arm levitation happening from inside himself as if the response was the result
of
non-conscious processes caused by the association of ideas.
Erickson would often "seed" suggestions for hypnotic phenomena long before he
asked for them to happen . By offering casual anecdotes, analogies and metaphors
about lifting, lightness and levitation he would seed the idea of arm levitation so
that
the patient's non-conscious mind picked up on the indirect suggestion for arm
levitation to occur.
Anticipation and expectancy compound the success of arm levitation. You should
expect the arm to lift whilst leaving a little room for escape in case it doesn't. The
patient will usually pick up on apprehension and doubt communicated by an
unconfident therapist. When you attempt an arm levitation you should pace
yourself
so as to be one step ahead of the patient. You can do this by paying attention to the
experience and physiology of the patient. If an arm is going to lift the patient will
tell
you in their own way either verbally or non-verbally.
First you should draw their attention to any difference between their right arm and
left arm. You should do this in an enquiring way and with an anticipation that there
will be a difference. Your anticipation of a difference will be picked up by the
patient
at an non-conscious level and this will create expectation. Further requests to pay
attention to the difference will compound the sensations in either arm.
You can use almost any difference in sensation as a starting point. Warmth, cold,
lightness, heaviness, numbness, pins and needles etc. As soon as the patient
recognises one sensation in one arm you can imply that they will experience the
opposite sensation in the other arm. You can further suggest that the more one arm
feels one sensation the more the other arm will feel the opposite sensation. So you
work one sensation against the other. Warmth and coolness, heaviness and
lightness,
sensitivity and numbness etc. This is called the law of reversed effect. Obviously if
one hand feels heavier than the other then the other will feel lighter. You are only
capitalising on naturally occurring phenomena. The next step is to lead the patient
into expecting the arm to lift. You can do this by overlapping your suggestions of
sensations to suggestions of lifting in one arm more the other.
Visualisation often compounds the success of arm levitation. Sometimes you might
want to ask the patient to imagine their arm lifting whilst their eyes are closed. This
is a kind of rehearsal technique. However, whilst this sometimes works the patient
may be unhappy with the imagined arm levitation and decline to lift the arm as part
of the hypnotic phenomena. As long as the patient "believes" that the arm has
levitated it does not matter. The arm levitation is a hypnotic induction, it ratifies
trance and can also be used as a physical metaphor for muscle control.
Summary – Bind and Double Binds
- Binds give a patient a conscious choice
- Double binds give an illusionary choice.
- Conscious/non-conscious double binds are the same as double binds but
emphasise the dissociation between the conscious and the non-conscious mind.
Chapter 9 - Trance Phenomenon
Non-conscious signalling
In hypnotherapy, therapists can communicate with the patient’s nonconscious
mind by instructing it to move a finger. A usual pattern is that a
finger of the right hand lifts for a “yes" answer, while finger movement
on the left hand indicates a "no" response to questions directed to the
non-conscious. Ideally there should be no conscious participation by the
patient as they are usually unaware of these finger movements. It is easy
to tell the difference between a conscious and non-conscious response. A
conscious response is a direct, immediate lifting of the finger while an
non-conscious response is a slow, minimal, often jerky movement that
may take some time.
Sometimes the patient may also nod or shake their head without realising
it. Because head nodding and shaking is a part of our everyday life it can
happen quite naturally. However head nods, when non-consciously
generated, are slow and barely noticeable. If a patient nods their head in a
very enthusiastic way then the response is probably a conscious one and
should be disregarded. The same can be said of a foot movement or
maybe a movement of facial muscles. With true ideo-motor responses
there is often a delay before a response is seen and this is usually jerky.
An instant smooth response suggests that the patient is responding
consciously. You may see only a twitching of the muscles in the back of
the hand or a lateral movement of one of the fingers. Sometimes a
movement may occur in different parts of the hand in consecutive
sessions.
Ideo-motor responses are used to communicate directly with the nonconscious,
the part of the patient that knows more about the problem than
they do. The patient usually has their problem because they try to solve it
consciously. By communicating directly with the non-conscious mind the
therapist is able to call upon relatively unlimited non-conscious resources
for problem solving. In this way some negotiation can be carried out
between the therapist and the patient's non-conscious. The patient need
not have any conscious knowledge of the communication. However,
patients will often remember part of the communication.
The patient's non-conscious mind will rarely give an explanation for the
problem. Any attempt at evoking direct answers via finger signalling is
severely limited especially as the fingers can only say "yes" or "no".
When recording information obtained via finger signalling the therapist
should list the questions and answers on a sheet of paper. Sometimes the
responses can be quite confusing and contradictory because the nonconscious
mind has its own sense of logic and these response can be
entertaining and challenging for the therapist. Keeping a clear written
record of the responses as the session progresses will usually help you to
keep track of the non-conscious communication.
Summary – Ideo-motor responses
- An ideo-motor response is evoked at an unconcious level
- Ideo-motor signalling is usually an non-consciously - controlled
movement of a finger
- It can also be an non-conscious movement of the head, foot or
other part of the body.
- There is usually a delay in an ideo-motor response.
- An ideo-motor response can often be a very minimal movement.
Anchoring
Anchoring is an NLP term used to describe a form of classic
conditioning. It involves the setting of a particular trigger, maybe a touch
on the arm, a particular word, or a visual stimulus. When this trigger is
given the patient responds accordingly. Anchoring follows a similar
principle to post - hypnotic suggestion in which the patient responds
automatically to a cue given initially under hypnosis by the therapist. In
NLP we give the patient the initial trigger either indirectly or directly in
the conscious state. Triggers given under hypnosis are usually more
powerful. An example of anchoring would be one where the therapist
touches the patient on the shoulder as the patient laughs about a happy
memory. This should be done several times in order to create an
association between the touch on the shoulder and the feeling of
happiness. Later in the session the therapist can casually touch the patient
on the shoulder - at critical moments in the therapy session - and so evoke
the good feelings associated with the touch on the shoulder. Because most
of our learning occurs in this way through simple stimulus - response
mechanisms most patients are familiar with anchoring though they may
not be consciously aware of it. As anchoring is an everyday occurrence it
is quite natural for the therapist to use this form of association when
helping patients make important changes. To get a good response from a
patient the therapist needs to give an effective and precise trigger and this
should be in the same place every time the patient is anchored.
In therapy it is sometimes quite common practice for the therapist to
touch the patient. However, too much touching or overt touching can be
inappropriate even in a therapy session. Anchoring should be done in a
very indirect or informal way. Ideally the patient should not be
consciously aware that they are being anchored. Conscious awareness of
the anchoring process may allow the patient to sabotage some of the
therapeutic work.
Anchoring can be done in an overt way when the patient requests it or
when the therapist considers that the patient should be made aware of it,
for example in any case where a patient is particularly analytical and likes
to have an awareness of therapeutic processes.
The purpose of anchoring is to evoke a response of some kind. There is
no point in giving an anchor and then just wondering whether a response
has developed. A congruent, definite response must be observed before
the therapist terminates the anchor. There are two stages to anchoring -
the initial placing of the anchor and the subsequent triggering of it. In
both cases anchoring should be precise and continued until a response
develops.
In anchoring we anchor negative feelings and positive feelings. These
positive feelings are called resources. Often patients have very strong
negative feelings so the therapist should make sure that any positive
feelings that are anchored are as strong (if not stronger) than these
negative feelings. The therapist does this by stacking anchors. Stacked
resources are a series of good feelings literally stacked one upon the other
with the same positive anchor. This stacking process reinforces the good
feelings. The therapist should continue stacking the positive resources
until the positive feeling is stronger than the negative feeling.
The Stop Smoking Strategy
This strategy has four specific steps and these have to be followed in
order. Each step involves a different feeling, picture or auditory
component and each step automatically triggers the next.
1. The first step is the trigger.
The first step involves asking your patient to visualise their own hand
reaching for a pack of cigarettes. You should not use the image of a pack
of cigarettes on its own as the strategy may then become generalised to
all contexts in which packs of cigarettes feature like shop windows or
packets in another person’s hands. The idea is that the patient sees their
own hand reaching out for their own cigarettes. Because this is a
universal behaviour for most smokers it should be easy for the patient to
recall. For smokers who roll their own cigarettes the image should be of
their hand either rolling a cigarette or of their hand lifting a cigarette to
their mouth. The same applies to pipe smokers. You can use changes in
sub-modalities if you wish to intensify the image of the cigarettes. For
patients who are poor visualisers you can use the feeling of reaching for a
pack of cigarettes as the trigger.
2. The second step is the aversion.
Now you ask your patient to let the picture/feeling of the pack of
cigarettes fade into the background. Once this has happened ask your
patient to think of the worst consequences of continuing smoking. Most
patients think of a deterioration of health or death as the worst thing that
could happen. Often this is not sufficient because the smoker has already
learned to put a psychological distance between the act of smoking and
death or poor health. Most smokers have not taken this to its next logical
step and considered how it would affect others in their life. Usually when
the therapist suggests how it could affect others (especially children) the
patient experiences quite intense distress. This is exactly the feeling you
want them to achieve at this point. You should anchor this feeling with a
touch on the shoulder, if appropriate, and reinforce the intensity of the
feeling by either describing it in visual, auditory and kinaesthetic terms or
by just talking about how awful it must feel.
3. The third step is the statement.
Your patient says “No” out loud . If this is inappropriate he can say it
quietly internally. Your patient says “No” to the idea of dying and others
suffering. By saying “No” they are pushing the negative picture and
feeling out of their mind. Allow your patient to let his “No" push away
the picture and its associated awful feeling.
4. The fourth step is the positive consequence of quitting.
Your patient is asked to see and feel the benefits of having said “no” to
the negative consequences of smoking. For example they may see
themselves happily playing with their children or even grandchildren.
This implies that they have lived long enough for this to happen.
If you use this approach with a younger person they may have difficulty
accessing an aversion related to death or poor health. The loss of income
or savings caused by an expensive smoking habit may be more
appropriate. You should really ask your patient what they feel would
make them think seriously about quitting. If they cannot think of anything
then a different approach may be more appropriate.
In general it is a bad idea to suggest that a particular patient should be
scared of dying unless you know that is how they already feel. Some
patients are not afraid of death but do fear poor health. Some do not
worry about either but are afraid for others who might suffer as a
consequence. Patients should be encouraged to be unafraid of death and
see it instead as a natural, inevitable process and possibly the start of a
new spiritual journey. By asking your patient to think of the effect their
death will have on others you are avoiding suggesting that they should
personally feel afraid of dying.
Naturally they may also wish that others have the same perspective and
also be unafraid of death. In this case focus more on the loss of social
contact they may have if they kept smoking, or the smell on their clothing
and hair or the loss of self - esteem they might suffer if they were unable
quit.
Summary – Anchoring
- Anchoring is an everyday occurrence.
- Anchoring should be precise.
- Anchoring should be informal.
- An anchor should be reinforced until a response develops.
- Resources should be stacked.
Abreaction and Trauma
Abreactions are sometimes produced deliberately or they may occur
spontaneously. They usually involve a total re-experiencing of an early
life trauma in great detail which can often be dramatic and frightening -
not only for the patient but also for the therapist. Some people are aware
of early traumatic events while others have forgotten them. Amnesia
usually exists when the trauma is so severe that the child blocks out the
experience as a way of surviving. This is particularly true in the case of
multiple personality. Multiple personality, often caused by abuse, is the
experiencing of many sub-personalities caused by continual abuse
followed by dissociation from the traumatic experience. The child learns
to dissociate from the memory and create an amnesia for the experience.
When the child is subsequently abused he follows the same pattern until a
number of personalities exist, each with their own unique experience and
their own personality. These personalities usually have no knowledge of
each other at a conscious level. Once an abreaction has occurred patients
usually remember the event although sometimes a spontaneous amnesia
occurs as well.
In therapy we can work with the raw materials and emotion - which can
be provided by an abreaction - is the rawest material of all. If an
abreaction starts to occur spontaneously the therapist should allow it to
develop. If the abreaction is prevented from occurring it is usually very
difficult to access at a later date. The reason for this is that the patient
now has an awareness of a hidden traumatic experience. The patient is
aware that at any time these feelings could overwhelm. Any attempt to
evoke the abreaction will usually result in intense resistance to any efforts
by the therapist. Once an abreaction does occur it should not be
terminated halfway through. This would only leave the work half done.
Abreaction should be carried through to the very end. By going through
the whole cycle of experience the patient is able to express the feelings
fully. Usually when this is complete the patient experiences a release of
feelings, intense exhaustion, and extreme stress.
As well as being terrifying for the patient abreactions can be frightening
for the inexperienced therapist. Sometimes patients may even become
violent. This is especially true when the patient identifies the therapist as
a participant in the traumatic experience. If a transference occurs so that
the patient imagines the therapist to be an active participant in the early
life memory he can become aggressive towards the therapist. In these
cases, both the therapist and the patient should be protected.. Whenever
possible the therapist should remain calm and detached from the
experience whilst maintaining control of the situation and support for the
patient as they abreact.
After a patient has abreacted they will often have new information about
the cause of their problem. However knowing why a problem exists does
not usually solve it. When patients abreact they release energy which was
previously used to repress the traumatic memory. This new release of
energy can be applied and directed into future positive outcomes.
However the release of energy is not itself a cure. At the end of an
abreaction the therapist should start to consider various options for
healing the patient. At this time more than any other the patient feels
vulnerable. It is very important for the therapist to utilise the patient's
experience at that moment and reframe it in some way so that the patient
leaves therapy with new beliefs.
Usually traumatic memories have a cast of characters. In the case of
abuse it may be one person. In the case of humiliation, for example a
child at school being laughed at, it may be a number of characters. The
patient will usually have intense feelings towards the characters in the
trauma. These feelings may be anger, resentment, and possibly even
revenge. The feelings that the patient has are usually negative and
aggressive in some way. Patients are quite justified in feeling like this as
they have probably carried around the symptoms of this event for most of
their life. Sometimes it is positive to allow the patient to keep these
feelings. Usually it is more therapeutic to reframe these feelings in some
way.
For example a child abused by a parent will feel very angry and resentful
yet at the same time want to be loved. The needing to be loved is an
important element in Reframing the patient's beliefs about and attitudes
towards the parent. The parent may be alive or dead but the patient's
feelings of anger may still be the same. One approach might be for the
therapist to suggest that the parent had a reason for abusing. Usually the
patient has information about the parent received non-consciously in
childhood. The patient may even be able to give valid reasons why the
parent abused. Bearing in mind that the patient wishes to be loved he may
be willing to look at ways of understanding why the parent abused.
Possibly the patient has an awareness that the parent was abused as a
child which might help explain his behaviour. Leading on from this the
therapist can suggest that the patient consider forgiving the parent. If the
patient wants to be loved and would like to change the negative feelings
they have towards the parent then it may be possible to convert the hatred
into forgiveness. The patient would then leave the therapy session having
had the emotions evoked by the abreaction, and dealt with positively by
the therapist.
Summary –Abreactions
- An abreaction is the reliving of traumatic early life experience.
- These traumas have often been repressed and amnesia for the
traumas may exist prior to the abreaction.
- An abreaction should be carried through to the end.
- An abreaction can be dramatic and the therapist should stay calm
throughout.
- An abreaction can sometimes lead to realisation but rarely
resolution.
- Patients often feel vulnerable after an abreaction - this is when
therapy should occur.
- Where the abuser is no longer alive, the guilty parties / negative
experiences / events can be reframed to "heal the memory".
Chapter 10 - Multiple mirrors
Multiple dissociation
Hypnotic hallucination is one of the classic hypnotic phenomena. Patients
can be persuaded to see things that are not there (positive hypnotic
hallucination) or fail to see things that are there (negative hypnotic
hallucination). Hallucinations occur through a fairly deep trance state
involving suggestions that the patient sees something or fails to see
something on a given signal.
When therapists ask patients to dissociate by stepping out of their bodies
and seeing themselves sitting in the therapy chair a hallucination has been
created. Most patients can visualise their own bodies but this is not a true
hypnotic hallucination. The patient must believe that he is really seeing
himself for the dissociation to be a true hypnotic hallucination.
Dissociation is a useful therapeutic tool. A patient may experience new
insights through the experience of observing themselves from a
dissociated position. Additional insights can be achieved through a
further dissociation to a second position in which they see themselves
watching themselves. Thus the patient experiences an objective
perspective. If the patient is dissociated once more to the third position
(in which he has stepped out of his body three times) additional objective
insights can be obtained. This process of stepping out of the body up to
three times causes a dissociation from their feelings. This allows the
patient to experience stressful situations without experiencing any of the
unpleasant emotions; this is particularly useful when treating phobias or
traumatic memories. The advanced therapeutic hypnotic induction
regression method known as "The Multiple Mirror Technique" is such a
dissociation technique.
For a hallucination to qualify as one of the classic hypnotic phenomena it
has to be experienced by the patient with eyes open. Often this kind of
phenomenon will be achieved with a post - hypnotic suggestion. The
therapist may suggest that the patient will notice an alteration in his visual
field when he comes out of trance. Hypnotic hallucination can be useful
for ratifying or deepening trance, and for therapy. It can also be employed
as a form of Gestalt Technique in which the patient is asked to see a
relative or friend when that person is not present. In Gestalt the patient
imagines the other person whereas in hypnosis the patient really believes
that the other person is in the room.
The therapist might want to induce a negative hallucination to teach the
patient to be unaware of stimuli. This would be particularly useful in pain
control cases.
This technique can also be used to allow the patient to enter into potential
phobic situations and test their response without having to enter the real
life situation, for example, with a fear of dogs. Having created a positive
hallucination of a dog, the therapist can then make changes to this image
which help the patient to lose the phobia.
Crystal gazing
This technique is excellent for patients who are confused or lack direction
in life. A trance is induced and the patient then hallucinates either a group
of crystal balls or a number of movie screens on which they see various
important life events. The therapist asks the patient to allow their nonconscious
mind to choose the events that are most relevant to their
problem. While in this dissociated state the patient cannot feel the
unpleasant emotions connected with these memories. This allows a safe
review of early life experiences without much stress.
The result of this technique is often that the patient is able to move
forward in life having reorganised their previous life experiences, “sorted
through old files” and re- appraised some life experiences. By viewing
several events simultaneously patients may recognise new behaviour
patterns and this allows them to reinforce useful ones or alter others
which are of no value.
A review of positive life experiences can be as therapeutic as an appraisal
of negative ones. Some patients will have had few negative experiences
and may only be in therapy because they lack direction - in this case it
can be rewarding to sort through the files. However most patients see
negative and positive experiences simultaneously in different balls - an
experience which can be very therapeutic.
The patient's ability to hallucinate crystal balls and multiple screens
usually depends on their hypnotic personality and depth of trance. A
relatively deep state of trance is needed if patients are to hallucinate with
their eyes open. If you think your patients are unable to experience this
kind of phenomenon then you can suggest that they imagine the crystal
balls while their eyes are closed. It is my experience that those patients
who are able to hallucinate with their eyes open usually find the
experience more rewarding and more effective
Exercise - The Multiple Mirror Technique
In this particular technique your patient is encouraged to see
himself/herself in a mirror whilst stepping out of their body to either the
left or the right. Further dissociation can be achieved by either asking the
patient to step out of the self that has previously stepped out of the body
(like a set of Russian dolls) or by having many different sub-selves
stepping out of the patient in turn. This particular technique is fairly
useful for inducing age regression whilst inducing trance.
The technique creates a dissociation, simultaneous age regression and
trance induction. Because this technique combines dissociation and
regression within an induction it is very useful for treatment requiring
these three components. As each self dissociates and steps out of the
other the patient can see and hear each self at a different age. If the
therapist suggests that each self will step out at an age related to the
formation of the Patient's problem the patient then has access to the self at
these different stages.
The selves can be encouraged to form a committee of selves to work on
the patient’s problem. The patient can be encouraged to converse with the
different selves or give support to each self as part of the healing process.
This process of therapeutic negotiation can be very powerful for the
patient. It uses non-conscious processes that give the patient the feeling
that their non-conscious mind is an important part of the healing process.
The selves should always be re-integrated before trance or therapy is
terminated. You should not leave your patient in a dissociated or
regressed state. You should always ask that they put themselves back
together. The taking apart and re-integrating is an important part of the
healing process. It helps the patient develop insight into the structure of
their problem and gives them the opportunity to give resources to the self
at different ages. Therapy can also be given to the self at these different
stages of development. The technique should not be used with psychotic
patients or patients with multiple personality disorders.
Summary – Hallucination
- Patients can hallucinate in hypnosis
- Hallucinations can be positive or negative.
- Hypnotic dissociation is a from of hallucination
- Dissociation protects the patient from feelings.
- Dissociating the patient to the second or third person position can
lead to insight or new understanding.
- Patients can be asked to see important life experiences in
hallucinated crystal balls or on multiple movie screens.
- Patients are dissociated whilst viewing.
- Patients re-organise or take stock of their life experiences whilst
and or after viewing.
- Life experiences can he positive and/or negative.
- Viewing can he done with eyes open or closed.
Distorting time
Time distortion was one of the first hypnotic phenomenon to be explored
by Milton Erickson. Erickson applied time distortion to identify how
much time was required by patients to accomplish tasks which normally
would involve many hours of work. Perhaps he was looking into the
possibility of accelerated learning though he did not acknowledge this
openly. Hypnotised patients can be given a task and be told that they have
been working on it for a number of hours. The therapist then gives the
patient only a few minutes of real time. The subsequent distortion of time
under hypnosis allows the patient to gain the experience normally
associated with training of a longer duration.
Obviously no person can store information that takes time to
comprehend. You cannot ask a patient to read a book and expect that new
information which normally takes hours to acquire will somehow
magically be remembered. However for the revision of previously learned
material it is possible to convince a patient under hypnosis that they have
revised a certain topic (which would normally take hours to do). This is
possible because information is stored at an non-conscious level and the
revision process is just a way of bringing this material to the surface.
This retrieval of non-conscious information is often difficult in normal
consciousness because so much effort is needed. However if the patient is
asked to allow the process to occur non-consciously in trance then the
information is readily available. If this is suggested within the context of
a time distortion exercise then the patient believes consciously and nonconsciously
that the outcome of accelerated learning has occurred.
When people go into trance their perception of time changes. If you ask
patients how long they thought they had been under then most would say
“just a few minutes”. In fact the true trance time is usually much longer.
Patients are usually pleased when they realise that they have been in
trance for much longer than they thought. This form of time distortion is
useful in ratifying the trance experience at the end of the therapy session.
The patient often becomes so absorbed in the trance experience that they
have amnesia for some areas of the experience. When they think about
what has just happened they remember only those portions of the trance
that they can recall. These may comprise just a few minutes and the other
sections of the trance are forgotten.
We have already talked about using time distortion for accelerated
learning. It is also possible to use the technique for desensitisation. The
therapist asks the patient to re-experience a traumatic event or fear in
slow motion. By giving the patient control over the speed of remembering
or replaying an event, the therapist gives the patient more control of and
responsibility for their own treatment. Patients can freeze-frame an event
or speed it up. In pain control work you can suggest that the duration of
the pain lessen using a “fast forward” technique. The patient can also be
taught to lengthen the pain - free intervals in cases where the discomfort
is intermittent
Summary – Time Distortion
- In hypnosis time can be contracted and expanded.
- Contracted time distortion is a common spontaneous hypnotic
phenomenon.
- Time distortion is useful for accelerated learning, desensitisation
and pain control.
Chapter 11 - Snowballing effects
Future planning
Most therapy happens between sessions because of the “snowballing”
effect that occurs when a therapist intervenes in a patient's life. A healing
hypnotherapist will intervene so as to cause a chain reaction, which of
course is therapeutic as it allows some changes to occur in the patient's
life between sessions and after therapy is finished. The therapist is not
just a problem solver but should also a teacher. The patient must learn
how to solve problems in the present moment and also understand how to
avoid future problems and accomplish long- term goals.
One day all patients have to terminate therapy. The duration of therapy
can vary and some Patients may be in therapy for just three or four
sessions. Even if therapy is of a short duration there may be a
“snowballing” effect after therapy has finished. It is not unusual to find
dramatic changes happening much later in a patient's life as a result of
therapy during the problem phase of the patient's life. These changes can
sometimes be the result of the therapist's intervention though often there
may be no direct cause - and - effect relationship. However when the
therapist or patient reviews the past it is often clear that certain events or
situations only occurred because of the therapist's intervention.
As healing hypnotherapists we do not want our patients to become
dependent on us. Patients should feel responsible for their own changes
whilst acknowledging the participation of the therapist. When the
therapist considers that treatment is nearly over he should start weaning
the patient off therapy. This is done in two ways -
a) Re-framing therapist/patient relationship.
b) Clearly defining long term goals for the patient.
Normally the patient considers that the therapist is at least partially
responsible for any therapeutic changes that occur. Usually a friendship
develops and while this is useful for building rapport it should not
become so strong that the patient feels reluctant to finish the therapy. It
would be wrong for a patient to remain in therapy simply because he or
she is afraid of losing a friend, so the therapist has to re-frame the
relationship. The patient needs to know the therapist is always going to be
there even if the patient no longer attends. The patient should feel
responsible for their own recovery, yet also acknowledge the help of the
therapist. Just knowing that the therapist is available if required, should
encourage the patient to feel more independent and able to leave the
therapeutic partnership.
As part of this weaning process it is important for the therapist to make
sure that the patient knows where they are heading. Clearly defined longterm
outcomes are essential, not only so that the patient moves forward in
a positive direction, but also so the patient can have a "map of their
future". Reading this map will give the patient the confidence to finish
therapy. The decision about when to finish therapy depends upon the
therapist's skill in knowing when the patient is independent enough to
progress on his own. Usually this decision will be made after significant
changes have occurred. These changes will sometimes be directly related
to the problem that was first presented when treatment began and often
related to subsequent changes that have occurred as a result of therapy.
The therapist should have identified the patient’s needs beliefs, values
and criteria and interwoven these with the long-term goals of the patient.
As stated earlier the therapist helps patients to feel more independent and
positive about the future by achieving desired goals.
Future planning criteria:
- The therapist should pay attention to the snowballing effect of his
interventions.
- The therapist should develop ways of helping the patient to
decrease dependency on the therapist.
- The therapist should learn how to re-frame the therapeutic
relationship.
- The therapist should help the patient plan realistic long - term goals
that match the patient's revised positive beliefs and values and their
criteria about what is important for them in the future.
Future Pacing
When patients leave your consulting room they often have no idea
whether therapy has worked. The patient and therapist can be hopeful but
can never really be sure until the therapy has been tested in real life. At
the end of the session you should ask the patient to come out of trance
and then test the therapy. You should ask him to imagine entering a
context, which previously would have triggered the old problem
behaviour. If therapy has been successful there should be no signs of
stress or symptoms related to the problem.
Future pacing also allows the patient to discover whether the change
brought about by therapy is really appropriate patients sometimes choose
a specific outcome and then discover - through future pacing - that it is
not suitable for them. If this happens then the therapist should do further
hypnotic work, altering some of the changes to make certain that the
therapeutic outcome is congruent with the patients future contexts, needs
and beliefs. When the patient sees and experiences themselves behaving
better in a previously difficult context this experience compounds the
success of the treatment and becomes a mental rehearsal of the
therapeutic outcome.
Pseudo-orientation of time
How often have you said "If only I had known then what I know now, I
would do this.”' When people are involved in a problem it is difficult to
be objective. All they want to do is change the situation at that moment.
They spend very little time looking into the future at the possibilities
available to them. Conscious fantasies represent accomplishments
divorced from reality - they are complete in themselves yet are no more
than wishful thinking. Non-conscious fantasies are incomplete and are not
divorced from reality. They are partly completed strategies which the
non-conscious wishes to make part of reality. They do not merely signify
wishful thinking but rather the actual intention to act at the opportune
time. So non-conscious fantasies are not people's imaginations running
away with them, but a serious non-conscious appraisal, in fantasy form,
of possible realities which are in keeping with the subjects own
understanding of themselves.
In Neuro - Linguistic Programming (NLP) this is often called future
pacing, although this is not quite the same thing as pseudo - orientation in
time. The difference between pseudo – orientation in time and future
pacing is that pseudo - orientation in time is carried during a therapy
session whereas future pacing is carried out at the end of therapy.
If the therapist is stuck and unable to decide how therapy should progress
he can ask the patient (in hypnosis) to go into the future, and imagine
receiving successful therapy. The therapist can then ask the patient what
was done to help during treatment. The patient then tells the therapist
what happened and the therapist can then carry out the treatment created
by the patient’s non-conscious.
The therapist then asks the patient to go into the future to find out
whether these therapeutic interventions will work. The therapist is
actually asking the patient to rehearse the successful result of the
treatment. The patient imagines a situation that previously would have
caused difficulty. Ideally the patient experiences new behaviours in the
future. This rehearsing of a new behaviour is a way of compounding the
success achieved.
In this way the therapist can check to see if the new behaviours are
appropriate for the person's way of life. Sometimes a patient may
experience therapy - induced changes which can clash with their belief
systems or life-styles The therapist can check whether a therapeutic
intervention is appropriate for the patient by taking them into the future.
As in the case of new behaviours, this ratifies and compounds the
therapy.
Exercise - Steps for Pseudo-orientation in time.
- Be conversational and give analogies about dreaming and how it is
possible to dream of something that occurs a few days, weeks, or
even months later, almost as if the future is non-consciously
planned.
- Tell stories about personal experience and future orientation
experiences of patients or friends.
- Give metaphors about amnesia, forgetting those dreams, and
experiences of knowing what you have to do - and then discovering
that you have already done it.
- Introduce a good reliable trance possibility by asking the subject to
consider plans that he had in the past and has for the future, pacing
and leading the subject into a state of absorption.
- When future pacing and leading remember to utilise your
experience in pacing the subject's primary representational system
(identified by predicates) and then leading them into a different
system.
- Deepen trance by counting, arm levitation, multiple tasks and
stacking realities etc.
- Orientate the subject into the future (not specifying the exact time
at the present) by offering confusing yet explicit suggestions for
age regression.
- Introduce the implication that the subject can discover himself in
the near future at some time when he has overcome his presenting
problem.
- Continue the progression/confusion techniques introducing
visual/kinaesthetic experiences of walking into the future or seeing
the pages of a calendar flip over into the future.
- If possible establish verbal contact with the subject and confirm the
date of the future orientation.
- Utilise the subject's previous experience with dissociation during
hypnosis to review all of the positive changes that have contributed
towards resolving the problem.
OR
- When the subject is orientated in the future offer him a challenge to
build motivation and then utilise 'shock' to bring about a sudden
realisation at the non-conscious level that he has overcome his
problem in some way. This should be followed by discussion of the
changes that may have contributed towards resolving the problem
(these will consist of the various therapeutic interventions that the
therapist was considering introducing).
OR
- Give extensive post-hypnotic suggestions for a chain of new
behaviours that will accomplish resolution of the conflict, then
project the subject further into the future and have them tell you
about the completion of the new behaviours and successful results
of therapy. Re-orientate the subject to the present and give
extensive suggestions for amnesia.
Summary – Future Pacing and Pseudo-orientation.
- Future Pacing gives the patient the opportunity to check out the
resolution to the problem at the end of therapy.
- Future pacing is also a class of post - hypnotic suggestion.
- Differentiate between conscious and non-conscious fantasies.
- Pseudo-orientation is a rehearsal of new behaviours.
- Pseudo-orientation is an ecology check.
- Pseudo-orientation ratifies therapy.
- Pseudo-orientation identifies new therapeutic approaches.
Lingering suggestions
Post - hypnotic suggestions are given in trance and suggest that a
particular outcome or behaviour should occur after trance is over. This is
done so that the patient receives benefit after and between therapy
sessions. While some changes occur during therapy sessions most
therapeutic changes occur after or between sessions.
Post - hypnotic suggestions usually require a trigger which is often
something that is part of the patient’s everyday life. The trigger can be
part of the patient’s habitual behaviour like smoking a cigarette. It can
also be something that happens to the patient and is outside of his normal
control, like the time of day. You should choose a trigger that is likely to
happen and is not too unusual, for two reasons . Firstly, the trigger has to
be a part of the patient’s life and secondly, if it were unusual the patient
might twig what was happening and sabotage the therapy.
Patients re-enter the hypnotic state when the trigger initiates the post -
hypnotic behaviour.
A brief trance of approximately the same depth and quality develops
when the patient carries out the post - hypnotic suggestion. Even though
they may have their eyes open in order to carry out the behaviour they
will still have entered a hypnotic state similar to the one they experienced
when the post - hypnotic suggestion was first given.
Post - hypnotic suggestions can remain active for years. As long as the
context and conditions are right, the patient will respond to the post -
hypnotic suggestion in the distant future even without any conscious
memory of it being given. However, if the context is not right, the
suggestion will be ineffective. For example, if the therapist asks the
patient, in hypnosis, to automatically re-enter trance on each subsequent
meeting, the patient will probably respond positively and re-enter the
hypnotic state as soon as they enter the consulting room. This could
happen even if the return visit were to take place several years in the
future. If, however, the therapist and patient met by accident in a social
setting then the patient would be unlikely to re - enter hypnosis because
the context would be different and inappropriate.
Trance recall
Trance can be induced by recalling appropriate trance contexts and
associations. Therapists can bring about a trance state by talking to the
patient about previous experiences of hypnosis. The therapist asks the
patient to remember what happened when they were hypnotised. This
brings back memories of trance which lead to the return of feelings
associated with the hypnotic state. This in turns leads to the patient reentering
trance. It is possibly the quickest form of hypnotic induction
available. Simply by requesting that the patient recall a previous trance
the trance is re-induced.
Always use a positive and successful example of a previous trance. When
you first meet your patient ask them if they have previously been
hypnotised successfully . Ask them what it was like and whether it was
beneficial. If the previous experience was positive then you can use that
trance as a re-induction procedure. All you need to do is ask the patient to
recall the induction as you slowly feed back their words, re-capping the
stages of the previous trance and compounding their experience by
emphasising their minimal cues.
Chapter 12 - Perceptive guidance
Teaching your Patient Self Hypnosis
Self - hypnosis can be taught to patients receiving progressive future -
orientated therapy. When a therapist is confident that the patient requires
help in achieving positive future outcomes, which do not involve digging up
past experiences, self – hypnosis can be taught. The therapist must be sure
that the patient does not have difficult, repressed, negative early learning
experiences. Self-hypnosis normally does not cause the resurgence of early
traumatic experiences unless directed towards that goal. It should not be
taught to abreactive patients or patients receiving regressive therapy. If
patients use hypnosis when there is a danger of abreaction then the therapist
is acting dangerously and unethically. Patients should not even use self -
hypnosis if they are undergoing any form of age regression. Many patients
are keen to help themselves but the last thing any therapist wants is for the
patient to go home and regress themselves to early traumatic experiences.
Sometimes patients need additional encouragement, reinforcement and help
between sessions. This is especially true when patients are being
reprogrammed to change habits. It is also true when patients need to relax
themselves and self-hypnosis is ideal for this purpose. Often all that is
needed is a number of simple open-ended suggestions implying that any
previous therapy can continue between hypnotic sessions. The patient can
thus reinforce everything that the therapist has been doing.
Self-hypnosis tapes are useful when a lot of information has to be given to
the patient between sessions. The tape should be designed specifically for the
patient, based on the structure of the patient's problem and should be future -
orientated with only positive suggestions.
Tapes are also useful for patients who have problems hypnotising
themselves. Some people need to maintain a degree of conscious awareness
in order to give themselves therapeutic suggestions - by listening to a tape
they can just let go. Mass produced, manufactured self - hypnosis tapes are
not as effective as personally designed tapes for obvious reasons. Mass
produced tapes have to be so general that they match everyone's needs as a
patient. Because these tapes are so general their healing potential is limited.
Many patients have difficulty motivating themselves to play their tapes or
practice their self - hypnosis. To increase the possibility that they will
practice, it is a good idea to suggest that the patients feel more and more
compelled to practice their self - hypnosis between the sessions. The
therapist can give these suggestions during the therapy session or put them
onto the tape as part of the exercise. In addition to this written suggestions
can also be given to the patient to give to himself during the self - induced
trance. It is rarely necessary to explain to the patient why they should give
themselves these suggestions.
Summary – Self Hypnosis
- Self hypnosis can be taught to patients receiving progressive future
orientated therapy.
- Self hypnosis as homework can reinforce therapeutic progress.
- Self hypnosis tapes can be given if designed specifically for the
patient.
- Self hypnosis should not be taught to abreactive patients or patients
receiving regressive therapy
- Patients often forget to practice so suggestions to practice should be
included during the session, on the tape or as part of the self-hypnosis
exercise.
Hypnotic Amnesia
How often have you been absorbed in a conversation and then someone has
interrupted your flow by distracting you? After the distraction it is often
difficult to remember the gist of the original conversation. If you deliberately
distract your patient during or after trance they will often develop a
spontaneous amnesia for the therapy that happened before the distraction.
You can take your patient on an inner journey through various trance
scenarios. When you are at the deepest level of trance you can then offer
therapy in that particular scenario. By returning back through the other
scenarios you can create an amnesia for the therapy. This is similar to the
distraction principle, except that here you distract the patient several times as
they come out of trance. Each time that they recall a different trance scenario
they get further away from the memory of the deepest scenario used for the
therapy.
For example if you first induce trance with a visualisation of walking along a
beach you can then get them to shift from this scenario to a second scenario
of walking through the countryside. You can follow this with a scenario of
sitting by a log fire and then one of them relaxing by a swimming pool. After
this they could experience being absorbed in a music concert at the theatre
followed by enjoying paddling in a boat.
If the therapy occurs in the final scenario and the therapist then retraces the
steps back out of trance through the various different scenarios the patient
may experience amnesia for the boat scenario and all of the therapy that took
place there at that time.
Amnesia usually occurs in a particular sense system when that particular
system falls below the line we call "normal waking reality". This line
represents what we may loosely describe as everyday awareness without any
bias towards either internal or external reality. When the sensory experience
is above this line we are able to perceive reality externally, focus our
attention on external objects and generally have an awareness of our external
world.
When our senses fall below the line however our focus of attention shifts to
internal or imagined experiences inside our head. Even if we still have our
eyes open our mind switches off the input from outside and watches the
internal imagery instead. I am sure that you have had the experience of
daydreaming with your eyes open and seeing images related to your
daydream more clearly than what is actually in front of your eyes at the time.
Daydreaming occurs in each of the senses also. This is because daydreaming
and hypnotic trance are essentially the same thing.
Even experienced hypnotherapists are surprised to hear that amnesia can be
experienced selectively in each sense. Amnesia is usually thought of as
happening in all the senses simultaneously which often happens. However,
each sense also works independently.
Patients can often have amnesia for the therapy or hypnotic phenomena
experience in trance. For example with automatic writing a fairly deep trance
level is induced and there is often a corresponding amnesia for the process.
The amnesia is caused not only by the depth of trance but often because the
material communicated by the automatic writing is traumatic. The patient’s
non-conscious mechanism has spent time in the past repressing traumatic
experiences and wishes to continue this until the patient is ready to accept
the information that was previously repressed.
Hypnotic Anaesthesia
Pain is usually experienced for a purpose. It is usually a signal or a message
saying, “please look after me". When someone hurts themselves they have
pain and this pain is a way of reminding them to take care of that particular
part of the body. Even psychosomatic pain is a message – this will be
discussed later. As therapists we should not attempt to take away pain as it
has a function. Patients should be taught to re-interpret their pain and to
develop an attitude of indifference to the discomfort rather than developing
total anaesthesia for what is an important signalling system. The only time
when pain should be removed altogether is when the patient has a terminal
illness or when hypnotically - induced anaesthesia is being used for surgery.
Patients experience pain physically and mentally. Their concept of pain can
be changed via hypnosis. Hypnosis can be used to change the patient’s
attitude to pain and also bring about physiological changes. Patients perceive
their pain according to how it is classified. The patient's perception of acute
pain is different from that of chronic pain. Psychologically the patient has
different expectations regarding recovery. They also have the perception of
pain as being something of an ongoing experience consisting of past
remembered pain and future anticipated pain.
Acute pain is the term used when a patient experiences pain through injury.
Acute pain has a beginning, middle and end. The patient can see an end to
the pain after the healing process has occurred. Acute pain also occurs after
surgery - again there is an expectation that the suffering will cease in the near
future. Chronic pain is the term used for pain experienced in terminal illness.
Chronic pain is an ongoing experience. Patients experience the pain of
yesterday, the pain of today and the pain of tomorrow. Chronic pain is also
the term used to describe the pain in disorders of an organic nature. Again
the therapist should decide whether the patient experiences chronic or acute
pain before opting for a particular treatment .
Sometimes patients experience a pain in one part of the body from a cause
elsewhere. It is important for therapists to identify the source of the pain.
Some pain is psychosomatic in origin. In this case there is no physiological
cause for the problem although the pain is felt in a very real way by the
patient. Often patients who come to psychotherapy for help with
psychosomatic pain have already been through the hospital system and been
told that it is 'all in their mind". When you meet such patients you should not
reinforce this brush-off approach. You should attempt to be sympathetic
because your patient does experience real hurt even though the pain is
psychosomatic in origin. The psychosomatic pain is a message or a cry for
help. It can be viewed as a hysterical response to some life issue or problem
in the patient's past.
Abreactions are sometimes helpful in eliciting the cause of psychosomatic
pain. Sometimes the pain occurs in a certain organ or limb and the therapist
may be able to interpret the symptom as a form of metaphor. However, often
the symptoms that do occur are chosen purely because of their ease of
access. For example, a child who developed aching feet at school (as a way
of avoiding sports) might suffer walking-related symptoms as an adult
should he ever have the non-conscious need to have a psychosomatic
problem as a cry for help.
Summary – The Structure of Pain
- Pain is a signal.
- Pain is a psycho-physiological experience.
- Acute pain is different from chronic pain.
- Pain can he referred or psychosomatic
- Pain can be treated with hypnotic phenomena.
Pain Control
There are many hypnotic techniques for pain control and here I have
presented the most useful.
Hypnotic suggestion.
The therapist can suggest, either directly or indirectly, that the patient
experiences anaesthesia of the hand. This is known as a glove anaesthesia
and is a technique often used by dentists. The patient can then place the
numb anaesthetised hand onto whatever part of the body is in pain. If the
therapist is using indirect suggestion it is useful to prime the patient by
suggesting many kinds of naturally - occurring anaesthesia that occur in the
patient's everyday life. This is a similar approach to using metaphors and
analogies. I will cover this area a little later in this unit.
Time Distortion.
As stated earlier in this chapter, time distortion can be used for pain control
by expanding the duration of each pain – free interval and contracting the
moments of discomfort.
Glove Anaesthesia.
Glove anaesthesia can be induced directly or it can be induced via imagery.
Images of the patient plunging his hand into snow help create numbness of
the hand for use in glove anaesthesia.
Dissociation.
The patient can be asked to imagine seeing himself as if he was another
person. As the patient looks at himself as another person with the pain, he
has the experience of being free of the pain. If this is carried over posthypnotically
into the everyday life of the person they have a profound sense
of being separate from their own reality. Whilst this is a technique that can
be applied to hospitalised patients or those with terminal illness it is a
technique not appropriate for patients needing to function normally in
everyday life.
Metaphors and analogies.
Therapists can tell stories about times when the patient would naturally have
had an anaesthetised hand - for example the experience of waking in the
night and discovering that the arm is numb from having been slept on or the
experience of playing in snow.
Another approach might be to describe the process of becoming hardened or
insensitive to pain. The therapist can tell stories about his own experience of
developing blisters on his feet whilst running and how these blisters
hardened so that he no longer felt any discomfort or pain. The therapist is
actually suggesting to the patient that he develop a resistance to the pain by
being exposed to it.
This re-framing is actually including the pain as an educational tool for the
purpose of pain relief. Likewise the therapist can tell stories about other
patients who have been successful with pain control. A patient who wishes to
learn self - hypnosis for pain-free child birth can be told the ease with which
an earlier patient achieved the same results. If the actual induction and
hypnotic phenomena are described in detail then the patient may well
develop the same phenomena spontaneously as they respond to this indirect
form of suggestion.
Visualisation.
Here the patient can be asked to visualise both the pain and some way of
fighting it. For example they may say that the pain is a stabbing pain. They
can be asked to see themselves cushioning the stabs with pillows. By
numbing the pain and deadening it with their visualised pillows they can
bring about a change in their perception of the pain.
Distraction.
The patient can be encouraged to avoid the pain by finding things to do as an
alternative. By distracting the patient from the discomfort, it is difficult for
them to pay attention to the painful experiences. Analogies can be given of
how much easier it is to remove a headache when one has something to
absorb oneself rather than sitting concentrating on the pain and feeling sorry
for oneself.
Re-framing.
Another approach would be to use the reframing of parts technique taught
earlier in this book. Since pain is a signal or a message the therapist can ask
the patient to develop creative abilities to generate alternatives to pain as a
way of meeting the needs of the signal. I suggest you refer to the re-framing
parts model taught earlier.
Self suggestions and dissociation
A person is more likely to carry out a behaviour if they are self motivated.
Some people say that all hypnosis is self–hypnosis. This may be true in a
sense, in that "the self" has to allow the therapist to apply hypnosis. The
selfsuggestion
induction requires the patient to repeat everything that the
therapist says. So for example; if the therapist says "you can experience
trance", then the patient says to himself "I can experience trance". The
patient is involved in converting all the therapist’s suggestions from the
second person to the first person – something which is itself hypnotic and
requires a certain amount of concentration.
However once the simple conversion process is underway it becomes
automatic and the patient just finds themselves listening to the suggestions
like an observer. As the suggestions are given and then repeated by the
patient they become more and more absorbed in the sounds of both the
therapist's and their own voice. This in itself is trance- inducing. Because the
suggestions are self-directed they are highly self - motivating. However the
patient does not have to think how to construct therapeutic suggestions. The
therapist does this while the patient repeats the suggestions, having trusted
that the therapist can create appropriate therapeutic suggestions.
When patients practice self-hypnosis they often experience difficulty because
they have the conscious task of creating therapeutic suggestions whilst
simultaneously remaining at a depth of trance suitable for absorbing the
suggestions. With this self-suggestion induction technique the patient can
relax into trance and allow their own voice to give the suggestions repeatedly
without conscious effort.
Another important aspect of the self-suggestion induction is that the therapist
asks the patient to imagine seeing themselves sitting in the therapy chair
while they simultaneously feel as if they are sitting elsewhere. The best way
of setting up this process is to suggest that the patient notices a second chair
in the therapy room before the induction begins.
Next the therapist asks the patient to close their eyes and to imagine what it
would feel like to sit in this second chair. Then the therapist asks the patient
to imagine, as they feel as if they are sitting in the second chair, to look at
themselves sitting in the therapy chair. We are in effect asking the patient to
dissociate. The therapist then asks the patient to repeat the suggestions the
patient hears. Because the patient repeats the suggestions in the first person
he experiences a simultaneous association and dissociation. The patient
experiences sitting in a second chair and so is kinaesthetically dissociated.
The patient also experiences seeing their self from this second position and is
now visually dissociated. In addition to this, as the patient repeats the words
they remain in auditory association. As difficult as it may seem patients are
able to accomplish this complex task, however the process is somewhat
confusing to the patient.
If the patient is unable to dissociate and see and feel their body elsewhere in
the therapy room then the therapist can suggest that the patient imagine
transporting their self to other contexts. For example, lying on a beach whilst
simultaneously seeing their self lying in bed. Any number of combinations
are possible and the therapist should adapt the technique according to the
patient's needs.
The task of trying to accomplish this simultaneous association and
dissociation in all three major representational systems creates confusion.
Confusion is itself trance inducing. As the patient attempts to tackle these
tasks simultaneously they find that they have no room left consciously to
attend to other information or stimuli. Their total attention is taken up with
the task of simultaneously experiencing different experiences in their sense
systems whilst feeling associated and dissociated at the same time.
They also have the auditory task of remembering to say certain suggestions.
Because the therapist ties up the visual and kinaesthetic sense with other
experiences or challenges, the patient starts to repeat the suggestions of the
therapist automatically. The process is similar to learning to drive a car
where the easiest task, for example the amount of acceleration, is handed
over slowly to the non-conscious part of the person. With this particular
induction the easiest task is just to repeat the words heard previously which
decreases any resistance to suggestion.
When a patient becomes confused they want to understand and so find a way
out of the confusion. If there seems to be no way out then they give up. They
stop trying to understand and allow the confusion to wash over them. It
would be a similar experience to attending a lecture and finding that the
content was too advanced for the student. The student pays great attention
and then becomes confused.
The next stage is that the student attempts to make sense of the confused
material, and then just gives up and resigns himself to sitting through the rest
of the lecture absorbing the information without conscious effort. The
process by which confusion is resolved usually involves searching for new
information externally in the world outside of the person’ s sensory
awareness and internally inside the person’s sensory awareness.
When the patient's confusion is caused by the difficulty of attempting
simultaneous tasks then the search for further information is internally
orientated because the patient knows there is not enough information
externally. By trying to make sense of the tasks i.e. to recall times when they
were able to feel as if they were sitting in a second chair or times when they
were able to see themselves, the patient goes internally into memory and
previous experience deepening the trance state.
Summary – Self Suggestions
- Self suggestions are self - motivating.
- Self suggestions involve all the sense Systems.
- Self suggestions create "trance inducing confusion".
- Patients usually enter trance when confused because they give up
trying to understand or they seek clarification internally.
So to clarify here is a summary of the technique:
- The therapist asks the patient to close his eyes and see himself sitting
in the chair.
- Then the patient is asked to feel as if he is sitting in another chair.
- Then the patient is asked to repeat out loud everything the therapist
says, translating it from the second person to the first person.
PART TWO
Introduction
Despite the advances that have been made in the field of clinical hypnosis
over recent years many people are still unaware of the vast array of
therapeutic skills that lie behind the process of indirect hypnotic induction.
This transcript makes specific the innovative, and often complex, techniques
of its author Steve Brooks. The transcript of the hypnosis session is
interspersed with a commentary by the author.
The commentary throws light on many of the complex hypnotic language
patterns used and expands on the techniques and principles introduced in this
book. To avoid repetition, the author has deliberately avoided commenting
on what has already been written in the main text of this book, preferring to
comment of the more subtle dynamics of the session and what at first seems
to be a magical form of therapy but when explained, is seen as the result of
many years of perfecting the art of Indirect Hypnosis.
Not only does the author demonstrate the induction of Indirect Hypnosis he
also evokes many of the classical hypnotic phenomena in an indirect and
informal manner. Phenomena include arm elevation, arm catalepsy,
anaesthesia, age regression, dissociation, hallucination, eye catalepsy and
post hypnotic suggestion. For a full list see below.
The indirect hypnotic suggestion is so informal in nature that the reader may,
at first, not realise everything that is happening. However subsequent reviewing
of the transcript and its commentary will reveal many new ideas and
indirect hypnotic interventions.
For any student of Indirect Hypnosis this transcript represents a unique
record of a spontaneous hypnotic therapy session. The author works
intuitively calling upon his many resources gained through experience of
Indirect Hypnosis. The approach is conversational in nature as is the
commentary. Wherever possible the author has attempted to avoid the use of
jargon preferring to describe the techniques and language skills in everyday
terms. It is hoped that this transcript will be the source of inspiration for
many people wishing to develop their skills in the field of Indirect Hypnosis
and covert influence.
In the past, traditional hypnosis has been authoritarian in nature with the
hypnotist giving commands or orders to the person. This approach limited its
application in many contexts and often created resistance to trance and
limited success with people. Indirect Hypnosis is entirely different and this
new form of hypnosis whereby the hypnotist applies indirect suggestion
covertly and in a very conversation manner allows the hypnotist to by-pass
the normal conscious resistance to hypnotic commands often experienced by
the person.
Steve Brooks credits Milton H Erickson as his early mentor and inspiration
for his Indirect Hypnosis approach and although Brooks still includes much
of Erickson’s style in his work readers will see in this book how Brooks has
developed this into his own innovative style. As this approach is so indirect,
hypnosis can be employed in areas and contexts where hypnosis would
previously been inappropriate. Through the hundreds of teaching courses
presented by Brooks during the 1980’s and 90’s, Indirect Hypnosis became
widely used throughout the United Kingdom, France, Belgium, Ireland and
Spain in many non-traditional contexts such as business, politics, sales,
advertising, education, social skills and social dynamics training. His work
was and continues to have a major influence on how hypnosis is practiced
within the health and caring professions in Europe such as social services,
nursing, counselling, psychology as well as the more traditional contexts of
medicine and dentistry.
The subject of this hypnosis demonstration is Avril. She has no experience or
knowledge of hypnosis and has volunteered out of curiosity. The session was
held in the TV studios of the University of Sussex in England in 1990 and
the transcript made from the original video recordings. As the session
progresses Brooks teaches Avril to experience hypnotic trance and hypnotic
phenomena. At the same time he also instructs the reader in the art of
Indirect Hypnosis. His running commentary on what he is doing follows his
personal teaching style whereby he comments to his audience while
demonstrating covert hypnotic skills with volunteers – possibly one of the
most powerful and enriching ways of learning Indirect Hypnosis.
Hypnotic Phenomena evoked indirectly during this session
One of the author’s main aims during this session was to demonstrate how
Indirect Hypnosis can be used to evoke all of the classic hypnotic
phenomena in an indirect and conversational manner. The advantages of
such an indirect approach being that the subject does not realise how and
when they are being hypnotised and so do not consciously resist or overtly
monitor what they are experiencing or what the hypnotist is doing. In other
words, as long as there is rapport, they just go along with what the hypnotist
is saying and doing and to their astonishment, are able to experience all kinds
of hypnotic phenomena without knowing how they are doing it.
The following is a list of some of the classic hypnotic phenomena evoked
indirectly by implication during this session:
1. Accessing Emotions.
2. Accessing Relaxed State.
3. Age Progression.
4. Age Regression.
5. Inducing Confusion with Ambiguity.
6. Creating Amnesia.
7. Anchoring States.
8. Arm Anaesthesia.
9. Arm Catalepsy.
10. Arm Levitation.
11. Associating Psychological Change with Trance.
12. Auditory Hallucinations.
13. Conscious – Unconscious Dissociation.
14. Conscious - Unconscious Left Arm Levitation.
15. Deepening Processes.
16. Time Distortion.
17. Hypnotic Metaphors.
18. Dissociated Visual Experiences.
19. Visual Hallucinations.
20. Double Dissociated Visual Hallucinations.
21. Early Learning Set with Age Progression.
22. Everyday Association.
23. Eye Catalepsy.
24. Finger Catalepsy.
25. Frustrating Trance Techniques.
26. Inability to Lift an Arm.
27. Kinaesthetic Hallucinations.
28. Evoking Minimal Cues.
29. Setting up Post Hypnotic Cues.
30. Double Dissociation / Conscious & Unconscious Double Binds.
31. Post-Hypnotic Suggestions.
32. Prescribing a Relapse.
33. Pseudo Orientation in Time.
34. Re-entry into Trance with Post Hypnotic Cues.
35. Rehearsing Visual Hallucinations.
36. Teaching the person Self Hypnosis.
37. Time Distortion.
38. Pain Transfer.
39. Pain Reduction.
40. Utilization of Tension.
41. Visual Illusion of Dissociated Hand.
Students of human interaction of any kind and within any context will gain
considerable benefits from repeated study of this eBook and are encouraged
to return time and time again to discover new insights, ideas and previously
hidden gems of wisdom surfacing through the work as experience develops.
This text continues to be a major teaching resource for students of hypnosis
with an almost legendary status as a classic in the field.
To purchase the double DVD training set based on this therapy session, with
a running commentary plus interviews, please go to the BHR online shop:
British Hypnosis Research.
Training In Indirect Hypnosis
BROOKS: Hi there AvriI.
SUBJECT: Hello.
BROOKS: Well now, we met briefly the other evening and one thing I do
know about you is that you are very curious about hypnosis.
I always start using indirect suggestion as soon as possible when
working with people. Hypnotic time is valuable and there is no point in
idle chatter unless it's hypnotic. By saying that there is only 'one thing'
that I know about her I am suggesting that she should tell me more. I
am also reinforcing her curiosity about hypnosis by pointing it out. The
subject has no previous experience of hypnosis but is curious about it.
But she does not know that my intention is to hypnotise here indirectly,
but she will soon discover that her reality starts to change inexplicably.
BROOKS: ...about the experience of hypnosis and about how people go
into a nice comfortable hypnotic state and how this often just
happens all by itself.
In addition to suggesting that hypnosis is comfortable and 'just happens
all by itself' I am emphasising these suggestions by altering the pitch and
tonality of my voice so that they stand out from the rest of the
communication. I also use my eyes and expressions to place additional
emphasis on these secondary messages.
BROOKS: First of all, before you start to, really learn something new for
yourself. I wonder can you just tell me how you feel at this
moment.
Here I am suggesting that she can learn something new when she has
finished talking about how she feels - the act of talking about her
feelings brings her closer to the new learnings. By asking her to describe
her feelings at 'this moment' I am also suggesting that the feelings will
change. A moment only lasts for moment. I did this because I could see
that she was nervous.
SUBJECT: Slightly nervous.
BROOKS: Slightly, only slightly nervous?
SUBJECT: Yes actually.
BROOKS: You don't feel incredibly nervous?
SUBJECT: No, no.
BROOKS: Only slightly nervous.
Now this is quite complex. When she says that she is only slightly
nervous it gives me the chance to introduce humour. The humour helps
her relax. By suggesting that I expected her to feel more nervous I am
indirectly praising her on her ability to relax and implying that I am
possibly more nervous than her. This is my way of matching her feelings
about the experience. It brings us closer together because we share the
same feelings. After all, we are both in a TV Studio, live on camera in
front of film crew.
I also want her to feel positively motivated about the session so I want
her to agree with everything I say. So every question has a positive
answer. Even when she answers 'no, no' she is still agreeing with me.
SUBJECT: I'm a fairly relaxed person.
BROOKS: Oh well that's good. But I can tell you now it's important to have
a little bit of nervousness somewhere. Because you can only do
good work if you have some good materials to work with so a
little bit of nervousness is rather a nice asset.
Here I am focusing her attention on the 'little bit of nervousness
somewhere'. By doing this I am limiting her nervousness even more. I
am also praising her for having a little bit of nervousness in the same
way that I praised her for being relaxed. She feels both nervous and
relaxed. I want to match both of her experiences so that she feels that I
understand her and that it's ok to feel this way.
SUBJECT: There is a bit there, don't worry
BROOKS: Where about is it?
I want to limit her nervousness even more so I ask her to tell me where it
is. By identifying exactly where it is she will know when it has
disappeared. I am also directing her attention inwards as she tries to
identify the feeling. This is one of the first stages of hypnotic trance.
SUBJECT: I don't know, around here sort of...
BROOKS: In the chest here?
SUBJECT: Mmm.
We both know where her nervousness is and I check to see if there is any
anywhere else.
BROOKS: Yeah, anywhere else?
SUBJECT: The hands I suppose are a bit tense but... no it's alright.
BROOKS: Ok.
(Subject takes a deep breath)
I had noticed her holding onto the chair but before I could say anything
she took a deep breath. I time my breathing to match her exhalation so
that she starts to feel that I am more and more a part of her experience,
simply because I am breathing in the same way. It also makes her aware
of how much attention I am giving her.
BROOKS: Feel a bit better?
SUBJECT: Yes.
Here I am praising her again for being able to relax.
BROOKS: Isn't it interesting… when you take a breath like that, you didn't
have to think about it?
SUBJECT: No
Here again, I am giving her the chance to say no but still agree with me.
This is
important, because people want to feel that they have some
independence and if
they find themselves saying yes all of the time they start to feel
manipulated.
BROOKS: Somehow your body knew that it had to take a breath in order
for you to relax and… how are those hands, feel now?
SUBJECT: Mmm not too bad.
I am now placing more emphasis on the ability of her unconscious mind
to help her achieve trance. I normally use the term unconscious mind
when teaching hypnosis but will call it the subconscious mind if I think
that the person feels more comfortable with this term. I am also
implying that because she has taken the breath her hands will feel
different.
There is no actual cause and effect relationship here at present but I am
suggesting that her breathing and the feelings in her hands are somehow
related. I am doing this because I want her to start noticing how one
physiological change can initiate another.
By doing this we can make the trance self-generating. For example later
I tell her that as she breathes out she can go deeper into trance. This
makes her on-going breathing a trance deepening process. All I have to
do is watch and comment on the process.
I also deliberately offer her a grammatically ill-formed question; 'how
are those hands, feel now?' This is another way of emphasising certain
suggestions, deliberately miss-pronouncing words is another, as is
deliberately missing words out. Each time I deliberately make a mistake
she corrects it inside her head. She completes the statement, puts in the
missing words or re-pronounces them correctly and so emphasises them
to herself.
BROOKS: Which hand do you think feels the most tense at this moment?
SUBJECT: That one I think. (Indicating her right hand)
It is impossible for both hands to feel the same. Some people may not be
able to tell the difference at this stage however usually they can be
persuaded that one hand feels different from the other. By asking ‘which
hand’ I am suggesting that one hand feels less tense. I am slowly
relaxing her more and more by a process of elimination.
BROOKS: You're right.... (pause) hand feels more tense than your left, so
your left hand is left there feeling more relaxed than your right
which is tense here. Is that right?
SUBJECT: Mmm.
BROOKS: Ok. So you'd be surprised if this right hand was left feeling
more relaxed than your left.
SUBJECT: Mmm (laughs)
Here I use confusion to disorientate her from her present reality and to
get her to start doubting her organised conscious understanding of the
situation. When a person is confused they want to get out of the
confusion. If they can't resolve the confusion with the information at a
conscious level they search for it at an unconscious level.
There are two kinds of confusion techniques here. The first utilises a
pause to imply one meaning and then offers a secondary meaning when
the statement is completed. The second uses ambiguity by mixing up the
meaning of left and right. This also primes her for the multiple
communications that follows.
BROOKS: Mmm... nice to just smile when it's unexpected, have a little
laugh or a smile. Do you enjoy humour?
SUBJECT: Yes.
Once again I introduce the idea that her unconscious mind can give her
something positive without her consciously deciding to make it happen.
By drawing her attention to the spontaneous smile I am also suggesting
that other things can happen spontaneously. By asking her if she enjoys
humour, I am getting her to agree with me and acknowledge that she
enjoys her present situation. I know she enjoys humour, because she has
just smiled, so I use this as a way of ratifying the positive aspect of her
experience at this time. Notice that I am not taking any risks, I am just
utilising what she gives me and feeding it back covertly to persuade her
to take the next step.
BROOKS: Mmm so do I, now I think humour is very important in therapy
and in hypnosis. A lot of people think hypnosis is something
quite serious, I find that that it's something you can utilize
humour with, I like the idea of utilising the natural resources to
laugh and, enjoy this experience. I find that very important.
I am telling her that laughing is a natural part of the hypnotic induction
and therefore she must be going into a trance. I also give her an
ambiguous suggestion which is at the same time an observation and a
command: ‘I like the idea of utilising the natural resources to laugh and,
enjoy this experience”.
BROOKS: Now people often ask me what happens when you, go into a
trance, and I say to them well when you, go into a nice
comfortable hypnotic state, all kinds of changes happen to your
body... to the muscles in your body, in your face, breathing
changes, blink reflex changes.... and a little smile comes all by
itself.
SUBJECT: (laughs)
BROOKS: It's almost like there is a part of you that knows what I’m
talking about.
Here is another grammatically ill formed statement, which is also
emphasised with a voice tonality change. I also point out all the
physiological changes that I can see developing in her at this time. It is
rather charming how her unconscious mind picks up my two-level
communication and gives her a smile, which I immediately include on
my list of physiological changes that accompany trance.
When I mention the part that knows what I'm talking about I am
referring to the unconscious. This is my informal way of introducing her
to the concept of the unconscious.
BROOKS: Now, you know people communicate on many, many levels.
People communicate with language and also with non-verbal
communication. I'd like to include as part of the non-verbal
communication changes in tonality, changes in the tempo of a
voice, pitch of a voice. You know you can say things in so
many different ways. I can say to you; "I wonder what it feels
like to, go into a trance?" and you can take that in many
different ways.
SUBJECT: Mmm.
A number of things are happening here. Firstly I am giving her a
truism, and this helps develop an acceptance for what follows. Secondly
I am actually telling her about the very technique I'm using. I thought
this would be a fun thing to do because I love playing with words. As I
explain the principle behind the two-level communication I am actually
communicating on two levels. She doesn't know whether I am giving an
example of the technique or whether I'm actually using it on her.
Thirdly, if she chooses to pay attention to my explanation she will
possibly spend the rest of the session listening for the two-level
communications thereby emphasising them for herself. If she remains
unaware of them they will influence her behaviour anyway at an
unconscious level without her conscious awareness. She is in a nonverbal
double bind – which means that she has no choice to be affected
by what I am doing, but does not know that she has no choice and does
not know that the affects are the result of her not having a choice.
BROOKS: You can think of it as a question. You can think of it as
something else that you can respond to...
It appears as if I'm giving her a choice here but whichever way she
thinks about it I am really only suggesting one thing - that she responds.
.... but you don't have to think that you're thinking about it
because that change in tonality that occurs as I say that
statement can in fact register at a different level.
Are you aware that you pick things up consciously and also subconsciously
as you go through life?
SUBJECT: Yes I think so.
Here I am telling her not to think about thinking because she can pick
up my communication at an unconscious level. I am reinforcing the
double bind by telling her not to do something I have just told her to do.
If she takes me literally and doesn't bother thinking about what I have
said, then it will influence her unconsciously, if she makes an effort to
try not to think about it, the more she tries not to think about it, the
more she will have to think about it in order to not think about it.
BROOKS: Mmm... it's a bit like you can walk down the street, you see a
smile on a face of a stranger and you register that smile but you
don't think about it consciously, it just happens to pass you by, it
may be another time, another day, in another place you
remember that smile on that face. Maybe you see somebody that
looks like that person and you're reminded of that person that
smiled to you, because you picked that information up without
even considering that you were picking it up consciously.
Here I decided to give her some serial suggestions embedded within an
analogy overlapping descriptions of a universal experience. It is a truism
that describes a naturally occurring unconscious learning process
common to everyone; the shifting between external stimuli (smile on a
face) and storage of information at an unconscious level and how a
similar external trigger or anchor can evoke previous associations.
I want to encourage this shifting between external and internal
awareness. It is this transition from outside sensory experience to inside
sensory experience that is the essence of hypnotic trance. I am
simultaneously describing this shifting experience and evoking it. In
order to make sense of the analogy she has to shift her awareness from
my words (external auditory stimulus) to her memory of the same or
similar learning recognition situations (internal experience) thinking in
pictures, sounds and feelings. I am also telling her that she doesn't have
to pay attention to me consciously - she will receive my communication
regardless.
BROOKS: Now with hypnosis what I do is talk to both parts of you, that is,
your conscious mind and your sub-conscious mind. And you
know that the interesting thing is that you don't even have to
listen.
SUBJECT: Mmm.
I am now overtly commenting on the process I am using. I can do this
now because I have primed her. Again she can choose to pay attention to
the process or just let it happen. I also reinforce the suggestion that she
need not pay attention. In fact I suggest that she become absorbed in
thinking about how 'interesting' it is, not having to listen. You should
never tell a person to 'not listen'. That's a command, and they will either
resist and listen to you or they will try to obey and by trying to not listen
find it impossible simply because they first have to listen so that they
know what not to listen to.
It is better to give them something else to listen to, think or do. This then
takes away the effort of trying. This is why I suggest she get 'interested'
in thinking about the process of not having to listen. If she gets
interested in the concept she will be having internal experiences of
thinking and not listening to me (external).
BROOKS: You know at school you're taught to concentrate and you
mustn't daydream. You're told that you should have your
attention focused all the time on the teacher. Well here I'd like
to encourage you to let your mind wander.
SUBJECT: All right.
I gave her another analogy (external) to evoke possible memories
(internal) and I give her permission to daydream. I say permission
because the analogy is framed within the context of school. I am
suggesting that she can break the rules of learning. It's also a new
concept that can disassociate her from her normal frame of reference
related to learning.
BROOKS: Mmm.... do you ever let your mind wander sometimes?
SUBJECT: Yes.
BROOKS: Yes. What do you wonder about when you wander?
Here I want to associate the experience of wondering with the process of
mind wandering. I want to make wondering contingent upon wandering.
The nominalization 'wonder' has no boundaries. It implies discovery,
awe, magic, exploration and a whole chain of open-ended associations.
These kind of nominalizations break through conscious barriers and
rigid learning sets. The more she wonders the better. Wondering can
only be done internally.
SUBJECT: Well I lead quite a hectic life so I don't have too long to sort of
think. When I do relax.... I don't know. I like to read books or I
think of things I suppose.... and books…
BROOKS: Mmm.
SUBJECT: …as I watch television in the afternoons, that's when we're
closed.
BROOKS: Mmm.
SUBJECT: And... I don't know... far away places. I would like to travel.
BROOKS: Do you ever travel in your mind?
Here she gives a brief list of trigger-response cues that trigger
wondering; books, television, travel. All are trance inducing and involve
a shifting from external to internal reality and I latch onto one and
expand upon it - focusing on her internal experience with the question
'do you ever travel in your mind?' Of course, at this point in time I
know that she must travel in her mind because she has just made a
future orientated statement based on her wish to travel, and as I
discover this as based on a past memory of travel. This is why I latched
on to this particular trance inducing leisure activity.
SUBJECT: Mmm sometimes.
BROOKS: Where do you like to go?
SUBJECT: Well I think back to holidays we've had...
“We” being her and her husband.
BROOKS: Mmm.
SUBJECT: Do you mean a specific place?
BROOKS: Do you have somewhere in mind?
I keep her internal by asking ‘somewhere in mind?’
SUBJECT: Um, I think Turkey was my favourite place.
BROOKS: Mmm.
A simple mmm will suffice here to reinforce her internal absorption. I
don't want to distract her with words. The tonality of the mmm is meant
to evoke wondering. I use mmm a lot as it implies understanding,
curiosity, agreement, interest, a question – depending on the tonality you
use when saying it.
SUBJECT: I think about that because we're thinking of going back there
this year so...
BROOKS: Yes, what stands out in your mind about Turkey... what’s the
memory that comes to mind most easily.
I keep emphasising the "mind” aspect of her on-going experience and
suggest “most easily” implying that all memories will be easy to recall
but that one will be easier than others. This is much better than saying
“Try remembering something” or “Can you remember”, as these imply
doubt.
SUBJECT: Umm, lying by the swimming pool. (Laughs)
BROOKS: Yeah!
She laughs as she remembers something and I match her with the
tonality of my "yeah" It's important to pace your subject as closely as
possible during the induction. Stay with her at all times until she
develops her own totally subjective experiences. Even then pace her as
closely as possible. If she comes out of trance for a second you come out
too - just long enough to guide her back in again. When I am using
hypnosis I go into an altered state too. But my state is one of heightened
concentration.
SUBJECT: What everybody does on holiday I suppose.
BROOKS: And what is it you like about lying by the swimming pool?
I want her to get into the experience.
SUBJECT: That there was nobody else around, except the person I was
with obviously.
BROOKS: Umm.
SUBJECT: It was absolutely deserted.
BROOKS: And so you felt.... (pause) ?
I still want to get her more into the experience.
SUBJECT: It was lovely.
BROOKS: Yeah. It's nice to have that feeling, yet there was one person
there you could communicate to whenever you wanted to and
they could communicate to you but you could just be in your
own little world.
SUBJECT: Well yes. We go on holiday really not to have to talk to anyone
because we do it all year round.
Here I attempt to parallel the current hypnotic situation with her
scenario. Her and her partner on holiday and her and I in the hypnotic
situation, equals, no one else around, deserted, lovely (her
communication) two people communicating, ‘be in your own little
world’ (my suggestion). I want to blur the distinction between her
memory and her current experience. This way she can more easily
associate with the holiday experience and it's associated feelings. She
doesn't recognise I'm doing this. In fact she takes me literally and
answers on a conscious level. Hypnosis is matter of negotiation between
the hypnotist and the conscious and unconscious mind of the subject.
BROOKS: Yes. How nice to have that peace and comfort and relaxation.
SUBJECT: We really like to be on our own but it is rare in a holiday resort
so it was lovely to find this part where there was nobody there
BROOKS: And how do you feel, what does your body feel like when
you're in a place like that?
SUBJECT: Totally relaxed.
Good we’re getting there now. Next I want to draw her attention to how
her body is responding to the holiday memories.
BROOKS: Have you noticed how your breathing has changed as you have
been talking about this?
SUBJECT: Has it?
BROOKS: Mmm, how has your breathing changed, slowed down?
She hasn't noticed how her breathing has slowed down so I give here
some hints by asking her “how has your breathing slowed down” – the
important word here is “how” as she will now have to think about the
“how” rather than the “has”. It would have been more compounding
had she noticed on her own without my hints. She does notice the
nervousness though. This is her anticipation of going into a deeper
trance. I say deeper because she has already been in and out of a light
trance several times as we have been talking and without being aware of
it.
It's good to have some nervousness in a subject. It makes them believe
something will happen. The worse kind of subject is the totally relaxed
'now do your stuff on me' kind of subject. They are relaxed because they
believe nothing will happen. It doesn't mean they can't be hypnotised it
means you have to be more indirect or call it something other than
hypnosis. This is quite ethical if your outcome is to help the person. A
chiropractor manipulates bones so why not manipulate concepts, it
doesn't hurt so much either. So if possible, discover any anticipation and
utilize the tension.
BROOKS: Notice you keep a little bit of nervousness there still a little bit?
And you're probably quite.... yes?
SUBJECT: My hands are still gripping I think.
BROOKS: Yeah. Well, keep a real firm hold of that chair.
SUBJECT: (Laughs)
Here I utilise the tension. Never tell a subject to try and relax. The effort
of trying to relax causes anxiety. Tell them to try to become even more
tense they will then either tire themselves out or make the process so
conscious that they shift the tension from unconsciously initiated tension
to consciously chosen tension. They might then be in a position to also
decide to let go of the tension. The humour also helps her relax by
making her laugh. I like people to laugh themselves into hypnosis. It’s
also more fun for me.
BROOKS: And whatever you do don't let go until your sub-conscious mind
knows that you can, go all the way into a nice deep comfortable
hypnotic state. Don't let go....
SUBJECT: (laughs)
BROOKS: …until, you find that happening all by itself.
This is a dependent suggestion where letting go is contingent upon the
conscious mind 'knowing' that she can enter a deep comfortable state.
This places more emphasis on her unconscious processes. It also gives
her a way of knowing when to expect to go deeper. Here, letting go of
tension equals a deeper state. If she is making an effort to hold onto the
tension sooner or later she will have to let go. She is in a double bind
again and doesn’t know it.
Somebody asked me the other day. "Ok so these changes occur
to you when you go into trance; changes in muscle tension in
your face, alteration in your respiration, blinking....
SUBJECT: Mmm.
BROOKS: “What actually happens”?
I said, "you know I don't really know quite what happens when,
you go into a trance, but something I've noticed is that, your
awareness or your attention seems to shift from external things
to internal things".
I want to point out the physiological changes characteristic of going into
trance. One of the best ways of doing this is Erickson's 'My Friend John
Technique' where the hypnotist describes an imaginary friend and what
happened to them as they went into trance. Here I am recounting a
question session with one of my students. It allows me to place emphasis
on certain suggestions and give suggestions to shift her attention from
external to internal reality while telling her a story. She thinks I am just
telling her a story, but really I am hypnotising her.
You can see me sitting here talking to you but you could
probably also imagine me sitting in front of the front door of
your house. You could superimpose your front door of where
you live behind me and see two images simultaneously. One's
outside and one's inside and hypnosis seems to involve a
shifting from external reality to an internal reality.
Now I'm very curious about those feelings you are having in
your eyes right at this moment.
The shifting from external to internal reality and overloading of indirect
suggestions has triggered acceleration in the blink response. By pointing
this out I indirectly suggest an association between blinking and going
into a trance. This can result in one of two responses in the subject.
Either the blinking will increase or it will stop altogether. Increased
blink reflex is unconsciously generated or indirectly consciously
generated through consciously trying to stop it. The increase compounds
the ensuing trance. Consciously controlled termination of the blinking
usually demonstrates a temporary unwillingness to enter trance at this
stage if this is the case the hypnotist has two choices here, either he can
retrace his steps and hold off until the subject feels ready or he can
utilize the lack of blink reflex suggesting that the subject blink less and
less. The subject can resist and yield simultaneously. Either way the
blink response compounds the ensuing trance as long as the hypnotist
implies an association between the two.
SUBJECT: Yes. (Blinking)
BROOKS: You notice how you're blinking?
SUBJECT: Yes. (Laughs)
BROOKS: And that's not something you do everyday, blinking in that
special way.
I reinforce the association between blinking and the ensuing trance.
But don't close your eyes and go into a deep trance until your
subconscious mind knows that it can happen all by itself. You
understand that?
SUBJECT: Mmm.
BROOKS: Mmm. OK you just wait and hold on. Ok. You don't want too
much of a good thing all at once.
SUBJECT: No.
When you see a desirable response in a subject, frustrate it, it then
makes it more compelling. The harder she tries to delay an on-going
unconscious response the more difficult it will be to prevent it from
occurring. She can choose to take my suggestion to resist going into
trance thereby making it more compelling or she can choose to resist my
suggestion to resist and so go into trance.
Because of her apprehension I decided to use an authoritarian
approach. I am overtly provoking her and hoping to evoke resistance to
my suggestion to resist, yet I am doing it in a humorous way to blur the
congruity between my verbal and non-verbal communication. It can
create 'therapeutic confusion' as she's relying on me for her frames of
reference. In order to maintain the frames of reference she has to
narrow her attention even further - she's relying on me totally for
direction as I juggle with her sense of logic.
BROOKS: You know the best kind of presents, I think, you can give to
someone are the one's with a lot of wrapping paper. Because
you have to unwrap them nice and slowly, and as you unwrap
them so the excitement builds, you become more and more
interested and curious about what's inside that present.
I think of myself as someone who gives presents to people an
awful lot, often they don't know they're getting it.... Mmm,
every now and then have a little glimpse or some idea of what
the present might be.
Here I am giving a metaphor that parallels her on-going experience. It
paces her present reality (sic) and suggests what is to follow. Present
reality = something new being discovered a bit at a time. What follows =
excitement and curiosity about ensuing trance experience. The word
present implies a pleasant surprise. It can also mean 'present moment.'
SUBJECT: I can close my eyes if I want to?
BROOKS: But not until it happens by itself.
You notice however how the harder you try to keep them open
the more difficult it becomes. They almost want to close.
I continue to frustrate her response despite her wanting permission to
close her eyes.
Now when you hear a word, you don't pay attention to the
individual letters, when you hear a statement you don't pay
attention to the individual words.
You can take the word like now, and there is an N, there is an 0,
and there is a W and of course there is a W in the word NOW.
The word backwards means WON. Now won, won now.
There is a W in the word now. There can be a won in the word
now and a W in the word now.
Now this is really complex because not only am I inducing confusion to
get her into a trance. I am also setting up a number of things for later. I
am also again reinforcing her ability to listen to me on different levels
(unconsciously) with a truism. I chose the word 'now' because I intend
using this as a trigger word to evoke trance in the future. I break it
down into individual letters because I want to suggest a 'W' (double
you), as I want her to hallucinate seeing her self later. So I am suggesting
that there can be two of her - a double you, yet at the same time only one
of her.
This is why I emphasise that associated with the word ~now' can be the
word 'won' (one of her) and a 'W' (two of her). When setting up
hypnotic phenomena like hallucinations it's best to spend time in
priming and indirectly suggesting that it will happen.
How do you make sense of something like that?
SUBJECT: I've really never thought about it.
BROOKS: You've really never thought about that in the same way that
you've never paid attention to the individual words in a sentence
yet the subconscious mind listens for every word, every
syllable, every letter but you don't have to pay any attention to
those details, you can just enjoy being in Turkey.
SUBJECT: Mmm.
She's never thought about it, of course she hasn't - she has to go on an
internal search to answer the question I then use her response to
compound the suggestion with repetition. You should always use every
opportunity to use repetition - in enforces the suggestion, however don't
do it directly.
BROOKS: Yes, you noticed how you keep going there every moment; you
just close your eyes you go back to Turkey. That's it. A nice
feeling. That's it. Now that's right.
Now.... Now those alterations in your body can develop in their
own way in their own time. I'd like you to carry on holding on
to the chair with those hands. Just holding on to the chair with
those hands, keeping that grip on that chair.
I pick up on her blink reflex and I encourage it by suggesting going back
to Turkey. Having frustrated the response to close the eyes and
dissociate her with confusion she can't resist eye closure any longer. As
she's still holding on to the chair I decide to capitalise on the previous
association between holding on and not going into trance until her
unconscious decides. I am frustrating the response still further.
Now I can tell you that the muscles in your face have smoothed
out really very well. The respiration has changed, breathing,
pulse is slowing down, I can see the alteration in your pulse in
your neck and this alteration in your physiology parallels the
experience of going into a nice hypnotic state but you don't have
to try to do anything. You really don't have to try to do anything
Avril because your subconscious mind can let that happen.
Here I point out the physiological changes that I can see and make
trance contingent upon the continuation of these changes.
Now how do you feel at this moment? I’d like you to share that
with me. How do you feel right now?
SUBJECT: Warm.
BROOKS: Warm. Mmm, do you feel warm more on one side of your body
than the other or maybe the top half compared to the bottom
half, or all over.
SUBJECT: All over.
BROOKS: All over and is that how you feel if you re in Turkey? Nice and
warm?
SUBJECT: Yes.
BROOKS: Mmm... yes. Nice place to be. That smile tells me an awful lot
about your experience. You find this a little bit humorous as
well?
SUBJECT: Mmm…
BROOKS: Mmm… what do you find humorous about it? Please tell me.
SUBJECT: Just comfortable.
BROOKS: Just comfortable.
SUBJECT: Very comfortable.
BROOKS: Very comfortable. Now I wonder where you can be even more
comfortable.
Trainees often ask me; "Why do you ask a subject to share her
experience just as she is going into trance - surely this brings her out?"
Well firstly I don't mind if she comes out because I like to frustrate the
response and secondly she will give me information about her subjective
experience. So far I have been utilizing only what I have been able to see.
Now I'm getting inside information. Also to share her experience she has
to go on an internal search once again, especially when I ask her to
identify where she feels warm.
I can talk to you. As I talk to you I can also talk to "you," only
when I talk to "you" is there any need for you to listen.
Because when I'm talking to you, you don't need to pay any
attention. Just let your mind wander, become absorbed in your
own thoughts.
Here I am separating my communication to the conscious and the
unconscious more directly with a change of voice loci. When I lean to my
left I am talking to her unconscious and when I am leaning to my right I
am talking to her conscious mind. As long as I am consistent she will be
able to unconsciously respond to the separate communications. I'm
actually telling her to not listen consciously. I want her conscious mind
to be in Turkey while I have a private chat with her unconscious. I don't
want 'her' (conscious mind) interfering with her autonomous processes
You're breathing out, each time you breathe out so you can go
nice and comfortably deeper into this hypnotic state without any
effort on your part.
This makes trance depth contingent upon her breathing. Dependent
suggestions should always utilize an on-going behaviour that is
important for the subject. Breathing is pretty important so we use it.
Also breathing out is more conducive to going deeper than breathing in.
Now, those hands can experience something very special for
themselves. Now you are nice and upright in this chair. Upright
in this chair. A nice comfortable position.
You know in this country we call a lift a lift. In the states they
call a lift an elevator. But in the states they call an elevator an
elevator and they think that we call an elevator a lift. It doesn't
matter what you call it, the same thing applies. That movement.
It's nice to have a little bit of movement in your life.
Do you like to have movement in your life?
SUBJECT: Yes.
Here I am priming her for the experience of an arm levitation and
catalepsy with a metaphor. The metaphor isn't relevant at the present
moment, she will have to wait in unconscious anticipation to discover its
relevance.
BROOKS: Yes and isn’t it interesting in just attempting, and trying to
respond to a question like "do you have a little movement in
your life"? It's difficult to actually answer. Difficult to put a
little movement in your life at this moment. That stillness, do
you notice that?
Yes but you can nod your head can you not? That's right. You
can nod your head.
I capitalize on the difficulty in responding to my question whilst limiting
her movement to head nods. By saying 'but you can nod your head can
you not? (Nod) I am implying that she can't move anything else. I am
also using repetition (not/nod) and giving her a difficult to resist
negative tag suggestion (can you 'not') By putting in the 'not' for her it
reduces any temptation she had to say no. However she's in a double
bind because even if she shakes her head she's agreeing that her
movements are limited to head movements.
Tell me, as you breathe, notice how your hands feel different
from each other. Which hand feels maybe the heaviest, the
lightest, warmest, maybe one hand feels it's holding on and the
other hand feel more relaxed. Tell me at this moment. How
does your left hand feel compared to your right hand?
SUBJECT: It's lighter.
I'm making her response to the double bind presupposition about her
hands contingent upon her breathing. I give her very open-ended
suggestions which imply there must be a difference between her hands.
It also gives her the chance to explore her unconscious potential. If a
hand wants to feel light, it can. If it wants to be heavy it will be.
BROOKS: Your left hand feels lighter than your right. Mmm... so you are
left there with a light feeling. Mmm.. and isn't that interesting.
Notice those feelings in that hand and this moment now. In that
left hand. Notice what's happening to that left hand. It happens
all by itself and you're not even thinking about the heaviness in
your right hand as that movement in your left hand occurs all by
itself. Now I wonder whether that left hand will lift at the wrist
or the elbow. You can wonder how that will happen.
Will it be the fingers that lift up before the wrist or will it be the
wrist that lifts before the elbow or will it be at the shoulders
that, that arm lifts up into the air.
Mmm... do you feel that? That's it just let it relax. Now you're
going to have difficulty keeping it down. Almost as if there is a
nice relaxing blast of air pushing it up just letting it hover nicely
and as that starts to happen more and more now AvriI, just
allow yourself to go deeper and deeper into hypnosis but you
don't have to do anything with that arm, that can just happen all
by Itself.
Mmm... that's right, now normally you can open your eyes
whenever you wish.
As soon as she says that her left hand is lighter I decide to go for an arm
elevation. This wasn't a good idea because earlier I had suggested a lack
of movement apart from the head. However as her light left arm had
presented itself spontaneously I decided to encourage it with open-ended
suggestions. As soon as I saw that she seemed to be trying to respond
consciously. I changed course and distracted her away from any possible
failure at arm levitation and quickly suggested eye catalepsy.
Maybe you'd like to learn something now as you try to open
your eyes, you can try to open your eyes. That's it that's
interesting, the harder you try, the tighter shut they become and
the tighter shut they become the deeper and deeper and deeper
you can go into nice hypnotic state. That's right just deeper and
deeper that's it. Mmm... that's it, that's it, that's it.
I tell her to learn something interesting as she tries to open her eyes.
Normally she can open her eyes so what can she possibly learn this time?
I then compound the suggestion with a group of stacked dependent
suggestions trying = learning = trying harder = tighter shut = deeper
trance.
Now you can enjoy being in Turkey and your subconscious
mind can understand everything I say without you having to
listen.
Your subconscious mind has already demonstrated how that left
hand can lift and get light by itself. How your right hand can
feel that heaviness and how those eyes have difficulty in
opening. Your subconscious mind knows more about you than
you do.
Here I re-cap by saying her multiple experience of hypnotic phenomena
proves her unconscious is more able to control her subconscious
functions than she is.
Mmm.... and as I talk to you so, you can just allow yourself to
go deeper and deeper and you can be in this special place. You
can be by the swimming pool, how does If feel to be by the
swimming pool? Letting your mind wander, you can have a
dream, you can have a dream and in your dreams you can go
anywhere you choose and my voice can become part of that
dream. The sound of my voice be part of that experience of
dreaming. Become part of the sound, the wind, part of the sound
of your own breathing sound. This becomes part of your
experience as you go deeper and deeper comfortably into a nice
hypnotic state. You don't have to do anything, you don’t even
have to think about it, you don't have to pay any attention to
how you're going deeper. That's right, that's right.
Notice how I hitchhike her going deeper onto my continuing to talk to
her. I am going to do a lot of talking and she's going to go deeper. I find
it useful to use a lot of presupposition when inducing trance. The subject
gets her confidence from the hypnotist. If the hypnotist presupposes
trance will occur he is demonstrating confidence in his ability as a
hypnotist and hers as a subject.
Even the phrase "just allow yourself to go deeper and deeper" is a
presupposition that she can go deeper subject to her giving herself
permission. I re-evoke the swimming pool because she has already
suggested that this is her favourite place. I want to associate deeper
trance with her favourite place.
I give her a dream analogy about mind wandering and the analogy
parallels her current experiences. The analogy and reality don't have to
match exactly, in fact the analogy is there to parallel the basic elements
of the current experience yet lead her towards including more and more
of the trance elements inherent within the analogy as part of her present
reality.
I want her to include external elements of dreaming in her present
reality. Inherent with the dreaming experience is amnesia, distorted
perception, time distortion and all of the various classic hypnotic
phenomena. What better way of training her in these experiences than
reminding her that she does it in her sleep every night.
I anchor the sound of my voice into her present on-going dreaming
experience so that I become part of it. I don't want to lose her
somewhere in never-never land so I include my voice. By making it part
of her breathing she will keep me with her wherever she goes in her
experience.
Firstly I tell her not to think about how she's going deeper. I don't say
"if" she's going deeper I say "how" again a presupposition. It also
conserves psychological energy for the work to come and stops her
trying consciously to do something she's better experienced at doing
unconsciously.
Mmmmm.... Mmm, and you know you can experience a change,
an alteration in time. You could be enjoying yourself watching a
good film and time seems to pass so quickly. You are not even
aware that the time has flown by.
It seems like just a few moments have passed and you feel so
comfortable watching the film yet also you could be doing
something you don't like and time seems to really drag. You
know those kinds of experiences? Mmm... How do you do that?
How do you alter time? How do you make a long time happen
in just a few seconds? You know you can dream, you can dream
of a whole series of events that spans over hours and you put all
of those moments into just a fraction of a second of dream time.
In real world time I could give you just ten, twenty seconds, yet
in hypnotic time you can experience a whole lifetimes
experience of doing things, achieving things for yourself and
that just happens automatically.
Here I give her another analogy to induce time distortion. Time
distortion is a natural everyday occurrence.
By asking her how she does it I am evoking the psychological processes
involved. She can't answer consciously so she has to search and thereby
evoke the processes.
The question "how do you make a long time happen in just a few
seconds" is a double entendre. The words "in just a few seconds" can
have a different meaning depending on context. When the contextual
framework is loose the meaning can become blurred. At the conscious
level the subject interprets the words within the framework of the time
distortion analogy. At an unconscious level the unconscious will not
interpret but save the information for future reference. If the context
were to change or expand to include other contexts then the unconscious
would apply these stored learnings appropriately. For example within
the current framework the question will probably be taken literally i.e.
"How do you contract a long duration of time into a short period of
time."
However, because the framework is loose, and loosening up with every
minute, (sic) the contextual boundaries are becoming blurred.
Unconsciously the question can also be taken as meaning "you can
experience a long duration of time in just a few seconds time" (very
soon). Double entendres are an important part of my psychotherapy
with persons and whenever possible I will use contexts that are parts of
the persons life experience and preferably ones that are compelling for
the person: interests, symptoms etc.
By embedding this analogy in to the dream analogy I can expand the
possibilities, and because the dream analogy refers to her current
experience I am implying that almost anything is possible.
Also in a hypnotic state you can bring about alterations and
sensations in different parts of your body. In your hands, your
arms, your legs, your face, you know a hand can easily lose
sensations and you don't have to even know how it's happening.
I am now extending the possibilities to include alterations in her
kinaesthetic and tactile experience. I remind her of the other experiences
with her hands to compound the suggestion.
You may have had the experience of lying in bed and realising
that you have been sleeping on an arm and that arm is numb and
heavy sort of a wooden-like feeling almost as if it doesn't
belong to you. You know what I'm talking about do you not?
You notice a little of this at this moment?
SUBJECT: Yes.
I'm attempting to induce three kinds of phenomena here; anaesthesia,
disassociation and an illusion of heaviness. They can exist
simultaneously or independently. By attempting all three I increase my
chance of achieving at least one. Notice that I say, "attempting", you
can't guarantee hypnotic phenomena you can only hope to evoke it. By
using a combination of suggestions you can get close to guaranteeing it
but it's never predictable. When I ask her whether she experiences some
of the anaesthesia "at this moment" I am not making a random guess. I
check it out first. Earlier she had stated that her left arm felt lighter
than her right. This of course also means that her right arm feels heavier
than her left. So I know she has some heaviness in the right arm.
Secondly she has had the experience of an induced heaviness and
catalepsy in the eyelids. So these sensations are familiar to her. She has
also responded well to all of my suggestions so far so we both have
expectations of success. I also check it out with the question "you know
what I'm talking about do you not?' To answer the question she has to
have had the experience, so again it is familiar.
By tagging the "do you not" on the end of the question she feels more
compelled to answer positively. Finally I limit the "little bit of
numbness" to the moment. A moment only lasts for a moment. It leaves
the future open for possibilities. If I choose to suggest that the arm will
return to normal then it will or if I emphasise the numbness then she
will follow with the appropriate response. What I do not know is
whether the sensations (or lack of them) existed before I made the
suggestion or whether they were evoked by the suggestion.
BROOKS: Yes and which arm is that in? That arm, yes. Mmmm... almost
a temptation to move it to get rid of that numbness yet the
harder you try to get rid of that numbness the more numb it
becomes. I don't know whether that numb sensation can spread
down from the shoulder all the way down to the tips of the
fingers or from the fingers upwards. You can be curious about
how that numbness develops in its own way, maybe a tingling,
maybe a pins and needles type feeling or just total lack of
sensation in that arm as if it doesn't belong to you.
SUBJECT: My neck is aching.
BROOKS: Your neck is aching. Mmmm... now which side of your neck
aches? The left side of your neck aches and the right side of
your neck feels comfortable.
SUBJECT: Mmm...
BROOKS: I'd like your subconscious mind to make the right side of your
neck ache. Will it ache more towards the front or to the back I
wonder? Just wait and discover how your subconscious mind
makes the right side of your neck ache. Let me know when you
notice that ache in the right side of your neck. Meanwhile that
arm can get heavy in its own way. Now normally you could lift
that arm could you not?
SUBJECT: Mmm..
Some people think that I am blessed with good subjects. Maybe it's
because I recognise problems as a blessing in disguise. Her neck hurts. I
remember a time when I would have though to myself "oh no another
difficult subject'. There really is no such thing as a difficult subject,
there are only opportunities for learning. As soon as she announces that
her neck aches I immediately limit the ache to one side of her neck with
a presupposition. This reduces the potential problem by 50%. I start
reframing the problem by telling her that if one side of her neck aches
then the other must be comfortable. She has to agree and this helps
build acceptance for my other suggestions. I then shock her with a direct
suggestion for the right side of her neck to ache. This shocks her because
it's the last thing she expects to hear. On the conscious level I am
actually asking her problem to get worse. I am also not addressing her at
all, I am talking directly to her unconscious. By cutting across her in this
way I am telling her that she has no choice in the matter - her neck is
going to ache on the right hand side. Her only participation in this is to
let me know when she feels it aching. I then immediately change back to
the numb arm. I do this for two reasons. Firstly, because I want her to
have amnesia at the conscious level for the preceding suggestions
regarding her neck so that she doesn't sabotage the process by trying
consciously, and secondly, because I believe that people perform
hypnotic tasks better if they have a number to do simultaneously.
The unconscious mind can control your balance whilst letting you read a
newspaper whilst chewing gum whilst having a conversation whilst
walking down the street. You can only do these things well
simultaneously because you don't do them consciously. Because hypnotic
tasks can only be done unconsciously give your subjects several to do
simultaneously. The conscious mind has to hand over responsibility to
the unconscious.
I finish with the question" now normally you could lift that arm could
you not?' Of course this implies that now she can't.
BROOKS: Notice that heaviness now maybe almost as if it's tied down to
the arm of the chair as if it's stuck down to the arm of the chair.
The harder you try to lift it the heavier it becomes. You can
really try and move the muscles in your shoulders, try hard to
lift that arm. That's it. You were not trying hard enough. Really
try hard. That's it. It's so difficult and isn't that a strange
sensation to have? And you can wonder what else you can
achieve in this special hypnotic state. You are doing very, very
well Avril, learning on many levels.
Hypnotic induction is a matter of negotiation however there comes a
time when you can become more direct. I will use a combination of
indirect and direct suggestion with subjects. I tend to use direct
suggestions only if I have a good trance and a responsive subject. Here
I'm actually challenging her in what appears to be a very direct way.
The indirect aspect is my 100% confidence in her not being able to lift
her arm and the utilization of the law of reversed effort (the harder you
try the more difficult it is). I use her success here to compound future
hypnotic experiences and congratulate her. Everyone likes
acknowledgment for their efforts so congratulate your subjects both in
and out of trance. I'm congratulating her on her ability to trust her
unconscious and her willingness to learn that she can’t do things that
she would normally be able to do.
And what's happened to your neck now?
SUBJECT: I don't know.
BROOKS: You don't know? Have you got an ache on the right side yet?
SUBJECT: A bit.
BROOKS: It's starting to happen. And what's happening to the left side?
SUBJECT: Feels a bit better.
BROOKS: Feels a bit better. How interesting that as we shift the ache from
the left to the right so the left feels a little bit better, you are left
with that comfortable feeling and right here I have control over
that ache. You know I can make that ache, ache on the right side
or I can take it away because I made it happen. And so I can
help you feel even more comfortable but not until all of the ache
has shifted from the left to the right.
That can just happen in it's own time.
If you want to take away pain don't try and remove it. Firstly it's there
for a reason and secondly it will respond better to negotiation. By asking
her ache to appear in the right side of her neck I am actually asking it to
move from the left to the right. As soon as the subject realizes that the
pain can move she also realizes that it can disappear. She has the
experience of comfort developing in the left side of her neck where the
ache used to be. She also believes that I created the ache on the right so
she can believe that it will go if I tell it to. Because I haven't the right to
remove the pain I leave it up to her unconscious. If her unconscious
wants me to remove it, it will shift it all to the right. If it wants her to
keep the pain then she will and if it wants to remove it itself then it will
do it without telling anyone. I prefer the unconscious to do the work
because I'm lazy.
I also include a little confusion regarding left and right just to reduce
any conscious involvement.
Now how does your right arm feel now?
SUBJECT: All right.
BROOKS: All right?
SUBJECT: Mmm...
BROOKS: What do you think you can or cannot do with it?
SUBJECT: I can't lift it.
Now we're back to the arm. Remember to keep bouncing your subjects
around; it loosens up their frames of reference.
I ask her what she can or cannot do with her arm because I'm not sure
whether the heaviness is still there. If I had asked her "what can you
do?" She would look for all the positives. If I had asked her "what can't
you do?" She would look for the negatives. Sol ask her what she can and
cannot do, this way she has to consider both. As I said earlier, hypnotic
phenomena can be unpredictable unless conditioned through repetition.
But then it wouldn't be spontaneous and so much fun to evoke.
BROOKS: You can't lift it. You not only cannot lift it, you can't release that
grip you have on the chair. Notice how those fingers are just
stuck in that position, that rigidity in those fingers on the right
hand.
I quickly utilize the success with the arm to evoke catalepsy in the
fingers. I did this because I recognised the rigidity earlier related to my
suggestions to grip onto the chair. I don't like to take too many risks so I
prefer to hitchhike suggestions and then imply that I created them.
Now in a few moments I'm going to ask you to open your eyes
and look at that right hand, so just move your head so that you
are in a position to look at that right hand. That's it,
To further compound her success I want her to have a visual
representation of anaesthesia. What better way than to see the hand as if
it were someone else's. By asking her to prepare herself by repositioning
her head, I am implying that she is about to do something special. To be
able to reposition her head to so that it is in the correct position she has
to hallucinate seeing her right hand with her eyes closed in order to
gauge the best position for her head. She is mentally rehearsing the task
before I give it to her. This will increase its success.
Now you can try to open your eyes and look at that right hand.
I asked her to "try" and look at her hand because I thought that there
was a chance that she might not be able to open her eyes. If she had been
unable to open her eyes then I would have pretended that this was the
response I wanted to evoke.
That's it.
Now look at that right hand and you can be most curious about
whose hand that is. You can look at that hand and wonder if it's
yours but have a different feeling or you can think it's someone
else's but know that it's yours without knowing that it is. How
does it feel to look at that hand?
SUBJECT: It looks strange.
By asking her to be curious I'm not telling her that it's not her hand but
I'm implying that she will not know. I want her to have doubts - so I give
her a complicated suggestion requesting disassociation. This could be
classed as a form of Double Disassociation Double Bind
(Rossi/Erickson).
BROOKS: It looks strange. You know it can look even stranger and in a
moment I'm going to lift that arm in a certain way and whatever
you do, don't take your eyes off that hand.
You're going to find it difficult and as I lift that arm, I'd like you
to notice something happening now.
You may remember that earlier I was priming her for a right arm
catalepsy by telling her about being upright in the chair. Well here I
evoke the catalepsy and one response after another which rapidly moves
from phenomena to phenomena. By telling her not to take her eyes off
her hand I am compounding her belief that something important is
going to happen. I tell her that she will find it difficult but because I
don't specify what will be difficult she has to wait with anticipation thus
increasing her responsiveness. I make noticing something happening to
her contingent upon me lifting her hand in a certain way. I am actually
lifting her arm in a rigid way and slowly giving responsibility for
maintaining the rigidity to the subject. By alternately releasing and then
holding her arm I can feel her catalepsy developing. Once it has
developed enough to support the arm by itself I give the wrist a number
of conflicting pushes in opposing directions This seems to confuse the
conscious mind and 'fix' the arm in a cataleptic position. Because I am
giving the arm conflicting messages it gives up trying to respond and
becomes immobile
Notice that rigidity in that arm now. Now that hand feels almost
as if there is a sort of iron bar inserted down the middle of that
arm. Just that staying there in that position. But that hand can
be limp or be just stuck there in that position. That's it, that's it.
Now how interesting to have that rigidity in your arm yet that
limp feeling in your hand now you can move your hand.
SUBJECT: Mmm.
BROOKS: But then as you move your hand, notice a certain rigidity
developing in your fingers.
SUBJECT: Mmm.
BROOKS: And how does that happen all by itself?
Now there isn't anything particularly subtle about this. It's very direct
but effective in this case. It may not be as effective with another subject
or at another time. I decided to use the iron bar as visual conceptual
reinforcement but as I was giving the suggestion I noticed that she was
moving her hand so I immediately used it to reinforce the rigidity in the
arm. As her attention shifted from the hand to the arm I used the
opportunity to encourage the catalepsy I saw developing in the fingers.
You can be curious about what it feels to bend those fingers but
not able to demonstrate it to yourself and then notice what
happens to your eyelids now. That's right, and you really can't
put that arm down.
This is such an exciting part of the session because so many phenomena
are happening at once. As she tries to bend her fingers I noticed a
drooping of the eyelids so I utilized the opportunity to trigger an eye
closure with the word 'now'. I then went straight back to reinforcing the
catalepsy in the arms.
You can't move the left arm, you can't move the right arm. You
can really try hard to lower that right arm. The harder you try
the more difficult it becomes, almost as if there are strings just
holding it up here, holding it up, lifting it up, that's it, lifting.
Once again I give her a couple of examples of what her unconscious has
achieved - just to compound future phenomena and maintain positive
expectation. I also use the law of reversed effort. I decided to give her
some hallucinated strings to hold up the arm because I thought that the
iron bar might have been a little heavy. It also meant that the strings
could pull the arm up into that 'upright' position.
And as you are upright get that feeling, that's it and that hand
can slowly move towards your face very slowly but don't go all
the way back Into the past until that hand touches your face.
I am now using the arm elevation as an age regression but I frustrate
her expectation of regressing 'all the way back' until her hand touches
her face.
This achieves three things. Firstly it gives her the choice of how far back
and at what speed to regress and secondly it makes regression
contingent upon an on-going behaviour (movement of the hand towards
her face). Lastly it frustrates an exciting possibility (regression) and so
makes it more compelling. The frustration compels the arm to continue
to levitate and the levitation makes the regression more inevitable.
That's it. That's it all the way back through time. A calendar's
pages changing, turning back, going back through time very
quickly all the way back to some early memory when you were
a little child and a little child first learns to touch her face and
explore her face. Explore the feelings in that face now. Just
learn what it feels like to have a face. Mmm.. really learn
something from exploring that face and you can feel that hand
touching your face, you may even not be aware that it's your
hand.
I included the calendar’s pages turning back as a visual component (her
kinaesthetic was tied up with the hand moving and her auditory with the
sound of my voice). By telling her that she may not be aware that it's her
hand touching her face I am merely capitalising on the earlier hand
disassociation (associated with anaesthesia) and reminding her of a
universal learning experience that young children have, that of
discovering their face and hands.
She regresses and I utilise the hand touching the face as part of the
regressed experience. You should never hesitate to use whatever is
happening.
Interesting sensation to have. How does it feel as a little girl to
have that hand just gently touching your face? Is it a nice
feeling? Do you know whose hand it is? You don’t know, you
can think you know but you really don’t know. That’s right,
well, it’s nice to feel that safe, comfortable, secure feeling as a
child just exploring and learning something about yourself.
I told her that she was safe and secure in case that she found that a
dissociated hand touching her face was disconcerting.
Tell me where do you think that you are as a child now?
SUBJECT: In the cot.
I ask her where do think that you are 'as a child' now because I didn't
want her to respond as an adult. When subjects are in trance they often
respond literally to questions. By framing the question in the tense of the
child (past yet present) I reduce the risk of her answering as an adult
and possibly slipping out of the regressed state. When she answered that
she was in the cot I though that she might feel trapped so I suggested the
possibility of being out of the cot. However she preferred being in the
cot. The sense of freedom being out of the cot was something I felt, yet
was not part of her reality. I shouldn't have projected my own
assumption into the situation.
BROOKS: In the cot. And you can look out of the cot and wonder what it's
like to have the freedom to be outside this cot. Mmm... you like
to get out and play or do you want to stay in the cot?
SUBJECT: Stay here.
BROOKS: Stay in the cot. What are you wearing?
SUBJECT: Blue.
BROOKS: You are wearing blue.
SUBJECT: Mmm.
BROOKS: Mmm, seemed to surprise you. Mmm.
SUBJECT: Mmm.
BROOKS: And you really didn't know you'd be wearing blue.
SUBJECT: Mmm.
It's nice that she sees herself wearing blue. It ratifies the experience
because in reality she is wearing grey, and as she is a female she may
have expected to see herself wearing pink.
BROOKS: Now let's move ahead in time a little way maybe a few years
being a slightly older child. Tell me as your hand lowers down,
slowly as it lowers become that child at a slightly older age.
What's happening now? Mmm.. what is this experience about?
Do you know how old you are at this moment?
SUBJECT: No.
BROOKS: You really don't know. What's happening? You don't know.
Ok, let your subconscious mind give you some images, shapes,
colours, experiences. Mmm, there's some feelings there as well.
You notice those feelings? That's it just hold on to those
feelings. Where do you feel those feelings Avril, where do you
feel them?
SUBJECT: Music - my ears.
BROOKS: Your ears, you can hear with your ears?
SUBJECT: Mmm.
BROOKS: And you can hear with your ears here. And what's the music
that you hear?
SUBJECT: It's a radio.
BROOKS: A radio?
SUBJECT: Mmm.
BROOKS: Well just listen to this radio and tell me what happens next.
Here I use the hand lowering as an age regression technique. Whenever
possible use an ongoing behaviour and hitchhike the behaviour you wish
to occur onto the on-going behaviour. She had an experience that I
misinterpreted
as being a possibly bad experience; I was wrong. However I
checked it out because it is important to utilize an abreaction if it occurs.
An abreaction is a reliving of past trauma often triggered by an
association of memories. If you are doing therapy and you get an
abreaction you should let your person go all the way through it even
though it may be quite dramatic. To stop it halfway through may
repress it further and make it harder to access later. In this case I didn't
want an abreaction as I was demonstrating hypnosis not therapy, but I
was prepared to utilize it if it had occurred.
Because she seems to be having difficulty holding onto the memory I
suggest shapes, colours, experiences and feelings. I am suggesting some
of the sub modalities of her sensory experience for her to pay attention
to. Sometimes subjects need a little prompting. When she seemed to
respond to feelings I told her to hold onto them - to locate them. Feelings
are usually tied to sets of images and sounds. I really doesn't matter
which comes first - feelings, sounds or images. Grab the first one,
encourage it and usually the other senses will follow. In this case the
feeling led to auditory and then visual.
I play around with the words hear, here and ear simply to repeat the
word hear. Indirect repetition will usually increase the response. I say,
"let's listen" so as to include myself as part of the experience. If I am a
disassociated voice outside of the experience she will not be so involved
or associated with the memory.
SUBJECT: I don't know.
BROOKS: You don't know. Mmm.. And where are you listening to the
radio?
SUBJECT: Front room at home.
BROOKS: In the front room at home.
SUBJECT: Mmm.
BROOKS: Anybody with you?
SUBJECT: My father.
BROOKS: Your father.
SUBJECT: Mmm.
BROOKS: And what are you doing in addition to listening to the radio, are
you are playing?
SUBJECT: Sitting on the settee.
BROOKS: Sitting on the settee. Are you feeling happy or sad? Are you
happy? Is it a nice feeling you have?
SUBJECT: Mmm.
I am still having to prompt her a little and I'm still checking out possible
abreactions.
BROOKS: And what's your father doing?
SUBJECT: Reading a newspaper.
BROOKS: Reading a newspaper that's a nice thought to have. OK. Hmmm.
Mmm.. Now throughout your life you've done a number of
different things, you've had a number of different interests;
activities you've enjoyed and you know those activities that
you've enjoyed. It's sometimes as easy to forget things. You
know you can be in conversation, and half way through the
conversation you forget what you were talking about. You've
had that experience have you not? Or you go off at a tangent
and you loose thread of the conversation and you really can't
remember what you were talking about.
Now this may seem unrelated however I am suggesting voluntary
amnesia. Not that I want her to forget her pleasant memories or
experiences but I want her to have the choice. If these memories have
been amnesic yet pleasant there may be a reason why they have
remained amnesic. So I give her the choice. Now she has remembered
them I am letting her know that she also knows how to forget.
Now, you know from your own experience that there are some
times when you can't open your eyes and there are some times
when you can and you can wonder what the difference is. How
do your eyes feel at this moment?
SUBJECT: They're not too tight.
I am checking out her eyes because in a moment I want to her to
hallucinate herself at a younger age and with her eyes open.
BROOKS: They're not too tight? Well that's wonderful. Now you can know
what you look like. You know what you look like do you not?
SUBJECT: Mmm.
BROOKS: And you know what a chair looks like. I'd like you to look at
yourself on that settee listening to that radio. Can you describe
what you look like now?
SUBJECT: I had a jumper and skirt on.
BROOKS: Mmm.
SUBJECT: Straight hair.
BROOKS: Mmm.
SUBJECT: Brown.
First of all I have her rehearse the hallucination. This compounds it in
her mind. Because she has the experience of seeing it with her eyes
closed (which is often easier) She will expect to see it with her eyes open.
Notice also how she is disassociated from the image because she
describes it in the past tense. Earlier I talked of the "double you" in the
word “now”. I am now attempting to induce the "double you"
experience. The experience of being two people simultaneously.
BROOKS: Brown. OK in a moment, I'd like you to learn something of
importance to yourself. At the moment, just as soon as your
subconscious mind is ready, I'd like you to discover that your
eyes open all by themselves and when that happens, you look in
front of you and you see yourself sitting there. I don't know
whether you will see yourself as a child, as a teenager, as an
adult.
I don't know what you will be wearing when you see yourself
just as soon as you open your eyes whether it will be a certain
age when you were a young child, or at an age when you were a
teenager or as an adult that you can see yourself and when you
see yourself, learn something new about yourself that you never
knew before but I don't want you to do that until your
subconscious mind is ready to give you that image, to give that
experience so real in such detail that you really see yourself and
believe in every way that you are there almost like a twin sister
sitting there in front of you. See yourself in every detail there in
front of you. That's right. Just look at yourself now. Look at
yourself up and down and learn something.
I use repetition here and am quite emphatic about exactly what I want
her to see and believe. I can do this directly because I have built up
rapport based on truisms. Everything I have suggested has happened so
she has a high expectancy.
How does it feel?
SUBJECT: I was a lot thinner.
BROOKS: How old is she there? How old are you?
SUBJECT: Fourteen.
Now she has partly associated with the younger self. What is interesting
is that she has not associated fully because her statement implies an
awareness of the adult self which an associated 14 year old would not
have. She is experiencing being two people simultaneously, which is
exactly what I want.
BROOKS: You are fourteen here, and there. Now I wonder what it's like
for a fourteen year old to look at a woman like yourself. You
can be the you here looking at the you there. Look from over
here at the you there. What do you think that you think of her?
Now that I have both of her here I am suggesting that she step into her
younger self and look into the future at her older self through the eyes of
the younger self. This can be quite a dramatic learning experience for
her because it requires a shift in her perspective. She may well learn
things about herself that she has either never acknowledged or realised.
Of course she may not learn anything.
BROOKS: You know this here is how you are going to become. Is there
anything that you want to change about the you here in this
chair?
I am giving her the opportunity to do something therapeutic for herself.
I am very careful about specifying which "her" I am talking to or about.
Lack of precision on the part of the hypnotist as this point could result
in a very confused subject, which although appropriate in some contexts
would not be appropriate here.
SUBJECT: I'd like to be thinner stay the same weight I think.
She makes two interesting statements here, as she looks at her older self.
Her first statement about her being thinner seems to have a future
orientation and requires an awareness of the belief systems of both older
and younger self. Her second statement seems to be oriented to the ongoing
present experience of maintaining the weight of the younger self
and does not necessarily require awareness of the beliefs and criteria of
the older self. The first statement is about loss of weight whilst the
second is about the maintenance of lack of weight. Therapeutically the
second approach may be more compelling for her than the first.
However we should use both. She has given me both perspectives so I
will feed them back to her therapeutically. I will have her discover how
she can lose weight by going into the future. I will then have her look
back at how she managed to maintain her success. Persons often
establish their beliefs about themselves at different points in time and
access to these beliefs, for the purpose of change can be hindered or
helped by the degree of awareness (or disassociation) between the selves
at different times.
BROOKS: Like to be thinner?
SUBJECT: (Nods)
BROOKS: Deeper. Mmm fine. Now your eyes can close, that's it as you go
deeper and…
As her eyes close so she re-orientates with her older self. You may
remember that the disassociation between the younger and older self
was made contingent upon her opening her eyes. Now she has closed her
eyes she is ready for the first part of my therapeutic intervention with
the older self. For this I ask her to go deeper into trance so that she has
access to the resources required for the process. I do this by making
going deeper contingent upon the ongoing experience of eye closure.
BROOKS: And how can you find yourself feeling thinner? How is that
going to happen? It's not going to happen in a matter of seconds.
But let's do some travelling in time.
I often ask persons impossible questions. However they only seem
impossible to the conscious mind. By asking her how she can find herself
thinner I am initiating an inner search of her unconscious resources. I
then give her a truism; "it's not going to happen in a matter of seconds"
which I will later contradict. I give her this pacing truism to put the
therapy into perspective. I don't want her to come out of trance later
believing that she has lost weight when really she hasn't. However I will
want her to discover how "in a matter of seconds" she can discover she
can lose weight.
BROOKS: In a few moments I'm going to give you a task but I am not
going to tell you what it is until I give it to you.
This is a semantically confusing suggestion to make, however it is given
in all seriousness. Obviously she will not know what the task is until I
tell her. What I am suggesting here is that she frustrates what she may
anticipate as the task until I give her a signal to carry it out.
But you know how you can change time you can experience 3,
4, 5, 6 months of time happening in just a few seconds of real
world time.
And you're going to learn from this and I'm not going to tell you
the task until it's time to do it.
You may remember that earlier I was priming her for this with
suggestions about time distortion. Any hypnotic phenomena is more
likely to occur if you prime it well in advance. I like to leave about
twenty minutes between any priming and the more direct evocation of
the phenomena, almost as if the priming suggestions were post hypnotic
suggestions.
You may notice that I have already given her part of the task yet have
just told her that I haven't given it to her. This is because I didn't want
her to confuse the process of the task with the content of the task.
I'm going to give you twenty seconds of real world time, and
I'm going to time that, twenty seconds of real world time and in
that twenty seconds I want you to experience 6 months of future
time.
Are you ready?
SUBJECT: Mmm.
I now give the second part of the process, which frustrates her even
more.
BROOKS: OK now I want you to experience the next six months of your
life and discover everything you needed to do, everything that
you had to do and did successfully to lose weight - now. (Pause
- 20 seconds)
I now give her the content of the task and I give it to her in a very direct
emphatic way. By almost spelling out every word I am stressing the
importance of the task. Because I have frustrated the task a number of
times she should feel more compelled to carry it out.
BROOKS: OK are you finished? OK now just look back over the last six
months and look back at all of the steps you needed to take in
order to lose that weight, that you wanted to lose the first time
you saw me.
Notice how you broke those things down into easy to handle
steps.
Here is the second part of the therapy. She's looking hack now instead of
forward. She's developing a second perspective on how to lose weight.
This perspective is based on the first yet presupposes that she has lost
weight. To do this she has to disassociate from the present self and
become the future self. I am helping her install a future belief about
herself six months in the future. Because this belief is associated with a
future date it will hopefully act as a motivator. It's her unconscious
carrot on a string, compelling her towards success.
And how much weight have you lost over this six months since
the time that we first met, how many pounds do you think
you've lost?
SUBJECT: About a stone.
BROOKS: About a stone? And that’s some achievement.
SUBJECT: Mmm.
BROOKS: And look back and notice how you did it in those easy to
manage steps.
Notice how I put myself into the future with her. I am asking her to look
back six months to the time when we first met when in reality we have
only known each other for a few hours.
And just take a look at yourself now in the mirror and notice
how you look. Do you want to put a little bit more weight back
on?
SUBJECT: (Shakes head)
BROOKS: You're happy with this amount of weight loss.
SUBJECT: It's a start.
BROOKS: It's a start? One stone is a start? I'm going to suggest that with
your success that you ought to have a little relapse. You know I
don't know whether it'll be in a few weeks or a month that you
could relapse and put on maybe half a pound or so before you
get back on course again. And then maybe you have another
little relapse a month or so after that before you get back on
course again, and for your subconscious mind to give you as
many relapses as are healthy for you. For you to lose weight
successfully but to maintain your optimum health for your own
well being.
Sometimes persons expect too much from themselves. In this case I felt
that she might benefit from relapsing a few times because too much
weight loss might be unhealthy for her.
Persons often relapse anyway so why not suggest that it can happen,
then if they do relapse they see it as part of the success of therapy rather
than as failure.
For you to lose weight successfully but to maintain your
optimum health for your own well being.
OK now let's travel back through time to the present moment
with me, back to the present moment with me. Mmm, have you
got the feelings back in that arm yet?
It's always important to re-orientate your persons to the present time
frame. The last thing any hypnotist wants is a disorientated person
walking around the streets. I use repetition to reinforce this suggestion.
There's a presupposition in my question about the feelings in the arm.
You must always be very confident whenever you give any form of
hypnotic suggestion. There should be no doubt in the person’s mind that
you believe, fully, that the feelings will return to the arm.
SUBJECT: Mmm.
BROOKS: Wonderful and what about the right hand?
SUBJECT: Mmm.
BROOKS: Does that feel fine? Yes
SUBJECT: It still aches that one.
BROOKS: That still aches? Maybe you could keep a little of that ache for a
while after you come out of hypnosis as part of your education.
Some persons may show concern if the physiological changes that occur
during trance continue after trance has been terminated. I always
reassure my persons by either giving a post hypnotic suggestion for the
continuation of a physiological change after trance has been terminated
or by reframing the condition after the person has come out of trance.
Of course, maintaining a physiological change that was initiated during
trance is another way of ratifying the trance experience.
Now I can ask you to come out of hypnosis in any number of
ways I can use all kinds of sound, I don't have to use my voice
and you can find yourself going back into a trance very quickly
in a way that is very surprising and humorous for you.
Here I am priming her. I am preparing her for the trigger that
indicates the termination of trance. I eliminate the sound of my
voice and I include in an open ended way other alternatives. I
link this to a post hypnotic suggestion that she can find herself
going back into trance very quickly. I add that the experience of
re-entering trance can be surprising and humorous. This in itself
is a second post hypnotic suggestion that I've hitch hiked on the
first one. So here we see a pattern. Firstly she awaits the trigger
or the signal that indicates that she can come out of trance, this
signal not only triggers the termination of trance but then
triggers a post hypnotic suggestion that she can re-enter trance.
Re-entering trance is in itself a trigger for the experience of
humour and surprise.
So prepare yourself for coming out of trance in a moment. One,
two, three (clicks fingers)
Hi there. Well how are you?
SUBJECT: Fine.
BROOKS: Feeling fine. What does it feel like to go into a trance now?
Here I carry out the post-hypnotic suggestions as promised. The trigger
word to re-enter trance is the word "now". Very early in the session I
had used the word now a number of times to induce hypnosis. It now
acts as a post hypnotic cue.
You can try and open your eyes and this time the harder you try
the more difficult it becomes. Just try to open those eyes now
the more tightly shut they become. The harder you try, the more
tighter shut they become. Really try, you're not trying hard
enough…
It's always important to ratify the trance in the persons mind. They need
to have the experience of knowing that they were in hypnosis. They also
need to have the experience of some form of hypnotic phenomena; this
could be hand levitation, catalepsy, amnesia or just responding to a post
hypnotic cue. Here I give her the experience of catalepsy of the eyelids.
Here she discovers that she has re-entered trance and is experiencing the
hypnotic phenomena. When a person responds to a post hypnotic
suggestion they actually re-enter the same depth of trance that they had
experienced earlier when the suggestion was originally given. When the
person responds in this way it is quite easy to evoke further hypnotic
phenomena utilizing this second trance experience initiated by the post
hypnotic suggestion or the carrying out of a post hypnotic act. In this
case I wanted to demonstrate to her that her unconscious mind had
control.
…that's it a real effort. Really put all of your effort into it and
then when you don't expect it (clicks fingers)
SUBJECT: (Laughs)
I want to put her into and take her out of trance a number of times, this
not only reinforces the post hypnotic cue to re-enter trance it also
ratifies the whole experience and is educational for the person.
BROOKS: Hi there. Mmm, what do you like to do with yourself in your
spare time Avril?
SUBJECT: Well we usually sleep.
BROOKS: You sleep in your spare time.
SUBJECT: Yes because the rest of the time we're working very hard so...
BROOKS: So sometimes you need a...
SUBJECT: I'm not at all energetic which I should be.
BROOKS: You need time to relax and just let go sometimes. It's nice just
to let yourself go… now…
Here I immediately change the subject and ask her an irrelevant
question about her spare time. Often students ask me why I do this. I
find that by changing the topic of conversation after trance has been
terminated it helps ensure some form of amnesia for at least part and
sometimes all of the trance experience. In this case I wanted to use this
strategy and also create a context in which the post hypnotic cue to reenter
trance would come as a surprise once again.
That's right, that's right. Just deeper and deeper relaxed and you
have the wonderful way of relaxing and altering your breathing
and did you know that you can go into a trance, you can go into
a nice comfortable relaxed state any time you wish. You know
how to do that? All you have to do is to think of that word now,
As she's once again in a trance I can give her more post hypnotic
suggestions. Here I give her a post-hypnotic suggestion to re-enter
trance whenever she wishes. I am in fact teaching her self-hypnosis.
and that happens for just one person, that happens for you. It
also happens for the double you, both of you, the double you
can go back into a hypnotic state just by hearing the sound of
my voice say that word... now.
To guarantee that she will be fully associated when she re-enters trance
on her own at any time in the future I include the "double you"
statement. The last thing I want is for her to practice self-hypnosis and
discover that she disorientates and dissociates into two different people.
It is very important to remember to undo any suggestions that you
suggest during trance if they could perhaps be detrimental in the future.
As I am teaching her self-hypnosis here it is important that when she reenters
the trance on her own she doesn't experience a reoccurrence of
hypnotic phenomena that could be disorientating or harmful in any way.
So any time whenever you want just a few moments to yourself
just to relax yourself at work, just to take a little time to yourself
all you have to do is hear my voice saying... now, and just by
hearing my voice saying now so your eyes can just close and
both of you can just go into a nice comfortable hypnotic state.
Here I use repetition to compound her ability to practice self-hypnosis.
The two you's that happen when you hear the word now. And to
get yourself out of this nice comfortable hypnotic state all you
have to do is to hear this (clicks fingers)
Hi there.
SUBJECT: (Laughs)
Here I'm asking her to hallucinate the sound of my fingers clicking. In
future hypnotic contexts if she practices self-hypnosis on her own I
won't actually be there to click my fingers. It's now important for her to
learn to hallucinate the sound of my fingers clicking and in addition to
this to hallucinate the sound of my voice saying the word "now".
BROOKS: What keeps happening to you?
SUBJECT: I don't know.
BROOKS: How does it feel when that happens?
SUBJECT: It feels nice.
BROOKS: It feels nice. I'm glad it feels nice.
SUBJECT: Mmm.
BROOKS: Interesting how it seems to happen all by itself, it's not
something that you make happen, it seems to just happen to you.
SUBJECT: Mmm.
Here I reinforce the fact that the response she is experiencing is
occurring at an unconscious level. For her to practice self-hypnosis in
the future it is important for her to trust her unconscious mind more
and more.
BROOKS: You know the feeling? Yes. I'd like you just to hear me saying
the word.... now. That's right. Almost don't believe that it
works. How nice to have that skill at your disposal any time that
you want it. You know that's going to help you lose weight as
well, but you don't even need to know how because your sub
conscious mind knows for you. Just taking that little time for
yourself is going to alter the way you eat so that you lose weight
effectively.
Once again I induce trance with the word "now". I add that by going
into trance she will be helping herself lose weight. It's important to
realise that the experience of going into trance is not in itself a way to
lose weight. However in this context, because losing weight is bound
within the therapeutic framework of this session, the re-entry into
trance at a later date should re-instate all of the therapeutic hypnotic
suggestions and therapeutic processes that occurred.
I'm very keen to hear from you in the future about how
successful you are at losing weight and then to bring yourself
out of this trance all you have to do is hear (clicks fingers).
Mmm how about that? I'd like you just to listen and hear that
word. This time hear it to yourself. That's it. That's it. Shifting,
shifting the experience from outside now so that it's...now inside
of you, now inside of you.
That's it you're doing very, very well. Now inside of you. Now I
wonder if you can hear the sound of my fingers clicking inside
your head and bring yourself out of this hypnotic state in that
way.
I want to be one hundred percent certain that she's able to practice this
technique so I get her to go in and out of trance a number of times. I am
also shifting the trigger to enter and the trigger to come out of trance
from her external reality to her internal reality. I want her to be able to
hear those words and hear the sound of my fingers clicking inside her
head without me being there.
Yes, yeah you did very well. Very very, well. What do you
keep shaking your head for?
SUBJECT: I don't understand it.
BROOKS: You don’t understand it?
SUBJECT: No.
BROOKS: You know there are a lot of things in life that you won't need to
understand because they're going to happen all by themselves.
How nice to lose weight…
SUBJECT: (Laughs)
…to give yourself those few moments in time without knowing
how you have to do it, it just happens all by itself. That's a nice
thing to have.
Once again I reinforce her unconscious minds ability to control the
situation.
Do you know what I mean by giving people presents now? I
like to give people presents like that.
SUBJECT: Thank you.
BROOKS: That's a present you're never going to lose, it's always going to
be part of you.
SUBJECT: Mmm.
BROOKS: Like tying a shoelace.
SUBJECT: Mmm.
BROOKS: All those things you take for granted, it's just going to become
part of your everyday life. Once more OK. Now hear the
word....
She hallucinates the word “now”.
… ah you're doing it already.
SUBJECT: (Laughs)
BROOKS: Hear the word.
SUBJECT: I don't understand.
BROOKS: I'd like you just to discover that you can try and open your eyes
and find it difficult until you hear the sound of that click. Just
try first. Notice that?
By having her experience the inability to open her eyes until she
hallucinates the sound of my fingers clicking I am really ratifying the
whole experience and her ability to utilise these learning for herself.
SUBJECT: Mmm.
BROOKS: And you know how to bring yourself out? (Pause) That's it.
Well you've done very well.
You know what I do for a living? I push snowballs down hills.
What I do I get a handful of snow and I…
Here I finish with a metaphor. Taking a small handful of snow, rolling it
down a hill, watching it get bigger, watching it grow. I aim to help every
person that I see grow and develop in this way. This was one of Milton
Erickson’s metaphors, and as a mark of respect to him I decided to
finish the session with one of his metaphors. That brief moment in time
when the person and hypnotist are together is such an important
moment that the hypnotist should put their whole being into helping
that person. The results of therapy are not just the immediate responses
that occur. The results of therapy will be noticed throughout the
person’s life and long, long after the person and hypnotist have parted
company.
To purchase the double DVD training set based on this therapy session, with
a running commentary plus interviews, please go to the BHR online shop:
British Hypnosis Research.
THE END