Positive Health Online

Over the past few years I have practised as a hypnotherapist in a working class district of Leeds. Most of my clients come with issues relating to eating disorders, anxiety, stress and phobias, or because they wish to stop smoking. Mostly they are ordinary northern folk with very common 'psychological' problems, and almost without exception the first question they ask me over the phone is "how much will it cost?" Then they might give a few details about themselves and their problem, and make an appointment if my (£25 per hour) charge compares favourably with other hypnotherapists in the area.

I used to find this 'bargain hunting' approach slightly irksome at times, but now I often reply to their cost enquiry by reversing their question: "how much would you pay to have your problem immediately vanish and not recur?" They probably spend as much or more on cigarettes every week than the cost of a session with me; just shifting their mental focus from the (unwelcome) cost of therapy and onto the value of outcome or desired result can be a very effective therapeutic intervention in itself!

Trance and Hypnosis

Other common concerns that I (and probably most other hypnotherapists) have to deal with are various misconceptions about the nature of trance and hypnosis. Certain clients feel 'cheated' if they do not experience deep trance and some kind of altered state on their first brush with hypnotherapy. I point out to some clients that, as a brief strategic therapist, I work to achieve a contracted 'outcome' or solution, and that trance is only one of the tools used in helping them.

On more than one occasion a client has spontaneously 'realized' their pattern and how they should change just through talking, and have left before any formal trance induction was needed. The steps that they needed to take had suddenly become obvious to them, or the 'problem' had dissolved completely upon analysis, just by casting light on the issues. Any further time spent in the therapy room is pointless for them! But other folks feel 'cheated' if they aren't 'put under' and have experience of deep trance or some kind of altered state during the session.

I take Milton Erickson as my starting point, and frequently 'model him' by inducing trance in the client via increasing the immobility of my own posture. The client unconsciously also becomes more still, cataleptic, and then starts to follow me into trance. Erickson had the natural advantage of being paralysed from the neck down in real life, whereas I have to fake it. What a brilliant man for finding one of the few professions where his polio-caused disability could actually be used to advantage!

Erickson is my starting point in hypnotherapy, and a constant reference point as well, but I am not he, and have developed induction techniques and psychotherapeutic approaches that hopefully build upon his legacy. An emphasis of my own, unusual amongst hypnotherapists that I know or of whose writings I am aware, is to stress the (hypnopompic) return to consciousness, more than the preceding and deepening (hypnagogic) process.

Continuous Returning Fist (a Chinese Boxing style I learnt) teaches that exercising the back-pull is more important than the forward punch. The quicker your fist withdraws, the more punches you can deliver. We sharpened this technique by such tricks as sucking out a candle-flame with the back-draft.

To relate this to hypnotic trance, I might spend twice as long bringing a person out of a trance as I do inducing and deepening, since the strategic outcome (final or after-state) is what is of prime importance.

I primarily want the person to be more awake, conscious, and empowered after their treatment. The 20 minutes or so spent in trance is of secondary importance in terms of the overall strategy.

Recursion (repeated trance induction) is known to be an effective and powerful technique of hypnosis. My hypnopompic approach has the additional value of being 'indirect' (true to the spirit of Erickson) since the subject will automatically go successively deeper into trance in order that they can come 'further out of trance' at the end. Back-draught. Paradoxically, by becoming more 'alive' during normal consciousness, the person may also find relaxation easier as well in their normal course of events. And likewise with their hypnotic episodes: reaching deep trance in successive therapy sessions becomes easier almost by default.

Hypnosis was once historically called 'artificial sleep' and (similarly to meditation and other relaxation methods) can with certain types of person be overused as an escape from difficulties that should be confronted directly. Depressives in particular seem to engage in a cycle of 'somnambulism' and inability through 'tiredness' to deal with presenting reality… which in sequence leads to yet more retreating from life, and ever-increasing morbidity. I tend to agree with the folk philosopher who coined the phrase: Activity dispels gloom.

The indirect (unconscious or unstated) message that I hope to impart to my clients is that the 'hypnopompic' (dispelling sleep) state is more desirable and important than the 'hypnagogic' (sleep-bringing, ushering in sleep) state: since I spend more time and effort working on that state between hypnosis and waking than I do on production of drowsiness preceding sleep (particularly after the first induction of the recursion).

Coercion, diplomacy, & fully blown knock-down arguments

Some psychotherapy sessions with some clients I find are much harder work than others. Empathy with your client is essential for good therapy (according to the canon of NLP) but some, fortunately very few, clients can be very exasperating.

A recent instance comes to mind of a feisty middle-aged woman (let's call her 'Amanda') who had come to me to stop smoking, but less than five minutes into the session insisted on going out to her car to "have a fag". I asked her why she brought cigarettes with her since in coming to see me she was expressing her intention to give up. It transpired that she had brought a new (unopened) pack of 20 on her drive over, and that she was still very much attached to the notion that she was a smoker. I challenged her that by buying the ciggies on the way here, she was setting up an expectancy that she would continue to need to smoke later on.

Amanda smokes for reasons of boredom and habit. She is pregnant, has one young boy already, and feels guilty for smoking. Her boyfriend had no intention of stopping smoking, nor her mother, and I suspect that Amanda felt hard-done-by because she was under pressure to stop smoking whilst they weren't.

Pointing out contradictions in underlying assumptions can set up a useful current of energy that in many cases can be channelled into a desired, healing, direction. But with Amanda, the sudden realization that after hypnosis she would be expected to face life without her precious fags provoked a furious reaction towards me… since I was threatening to deprive her of her ciggies… and her determination to have a fag outside in the car redoubled. So she went to the car to have it, but only after she promised me that she would either smoke and drive off, or if she came back would bring the new pack of ciggies with her and drop them in the bin. This irritated her hugely, since she saw it in terms of throwing £3 in the bin, and she argued that her boyfriend should have the pack instead. I had to flip her frame of mental reference from the ciggies being valuable to them being 'worthless', or seem even positively loathsome to her.

Anyway, she stormed out, loudly protesting. I waited for a few minutes (half hoping, I am ashamed to say, that she would clear off) until she returned, no more quietly than before, and made a big show of throwing away the cigs. "OK then, hypnotize me into not wanting to smoke" she said, somewhat belligerently. I sat her in the special recliner chair that I use… until this point she had pointedly stood near to the front door, ready to flee. The chair is one of my secret hypnotic weapons. Once a client is comfortably sitting and going into a light trance, I pull the mechanism that reclines the chair, and suggest that as their physical posture becomes even more (involuntarily) relaxed, they will find themselves going automatically deeper into trance. The chair has two reclining positions, so is very effective for trance deepening, and works much quicker than the laborious countdowns that many hypnotherapists employ.

The argument had got both of us highly motivated, and although very wearing, seemed afterwards and on reflection to me that it had been a necessary conflict.

The conflict had exhausted us both, and the rest of the hour went more smoothly. I ran through my normal diatribe about smoking being bad for you in many and various horrible ways. Then we explored more about Amanda's reasons for smoking (she had started when very young, 5 or 6. Had never really liked it, but all her friends did it). In light trance, she said she felt like she was 'trapped in prison', and I suggested that she actually smoked to punish herself. The boredom that she tried to avoid by smoking was the boredom of being an old lag, shut inside of her house. She had created a mental prison from which she needed to break out.

This scenario seemed to make sense to her, and once she had mentally visualized either escaping or being paroled, I suggested that she didn't need cigs because she was no longer an inmate. She had served her time, and so didn't need to feel the (generalized) guilt about whatever imaginary 'crimes' had condemned her to this self-imposed jail. A life-sentence of 30 or so years served the behest of her childhood friends.

We got into deeper trance using recursion. "Which hand did she smoke with?" I asked. (Left rose up). "Try smoking with other hand" I next suggested. (She couldn't lift it. Her right hand collapsed. Her desire to smoke had gone in that instant... Unconsciously she couldn't even contemplate smoking using her right hand instead of the normal left.) The psychotherapy had taken place previously, but the Ericksonian-type observation of the hand movement IMR (ideo-motor response in the jargon) during trance was a useful 'glue' to help make the psychotherapy stick.

A successful outcome in the event, Amanda no longer smokes. But I hope I don't have to shout and get quite so apocalyptic on many future occasions. £25 very hard earned.