Last week I had one of those nightmare clients: no matter what you do, they will not go into trance. I had no reason to think that there would be any problem with this client. She seemed ready to go into trance and really wanted to give up smoking because I had treated her husband the day before and she wanted to help him give up as well as herself. However, when I started with my usual induction it was clear that she was not responding they way I expected. She kept opening her eyes and when I asked her what she was experiencing she said "I can't visualize going down a corridor as you are asking me to". She also was not able to relax either. I kept on with a different progressive muscle relaxation induction, and she seemed to be relaxing a bit. I then tried an Elman induction but she couldn't make the numbers disappear. I tried induction after induction and every time I tried for eye catalepsy her eyes opened. She was not responding to the inductions at all. In fact she could not do anything that would lead to trance. I tested her for visualization ability and found that she could not visualize at all. She did have a little kinesthetic orientation, but nothing else that I could find. The Going down the Stairs induction is supposed to be ideal for kinesthetic people, but it didn't work either. I had to admit defeat and I asked her to let me think about it, and for her come back the following day. I spend the night thinking about what to do, and really worrying about what if I just couldn't get her into trance. I like to think that I know what I am doing, but this was a real challenge. The following day I had decided on a strategy. She came in I set up an instant induction and fired it. Nothing. She didn't even flinch. Then I did an induction where the person is invited to think of feelings associated with a color. This is supposed to be a fullproof induction for kinesthetics. By the third color she told me she didn't feel any associations with colors. I tried her on an induction where the client imagines a cloud around them, and by increasing their depth of relaxation they can make the cloud dissipate. Several rounds of this did produce a noticeable level of relaxation. I then threw in a long confusion induction, about the unconscious being conscious of the subconsciouis while the conscious was unconscious of the unconscious, and she finally showed clear signs of trance. I then flowed straight into an elevator deeper where she pushed buttons to go down and down... and finally I got eye catalepsy. So the lesson I take from this is that yes, everyone can be hypnotised, but sometimes it a real battle of wills. She went on to enjoy the feeling of being hypnotized and to give up smoking.

I am always amazed at how sometimes the simplest thing is the best thing to do. I had a smoking client today. I went through my standard questions with her and when I asked her if there was anything worrying her about stopping smoking she said 'Yes, about falling off after the hypnosis and starting back smoking again like I did before'.

My training in Changing Metaphors alerted me to the metaphor in 'falling off'. It is a very common form of speech and might have had no special meaning to her, but I decided to explore it anyway.

I asked her to close her eyes and tell me what it was that she might fall off. I prompted her 'What is it like? Is it like a cliff, or a cart? or something else?'. She said 'No, it is like I am standing on a box, and I might fall off and if I do I have to start smoking again'.

I got her to explore the box, its size; its color; what it was made from, and so on. She described it as a plain brown box made of wood, and small enough so that if she moved in any direction she would fall off. That was what she was worried about. Thinking about falling off was making her anxious and the anxiety was making her more likely to smoke. Every time she stopped on her own the anxiety came back.

I asked what would happen if the box wasn't there. She said that she wouldn't be anxious about falling off, and could give up smoking. So the Metaphor Change objective was to get rid of the box.

I asked if she could imagine it a little larger, and then took her step by step through imagining it bigger and smaller. I pointed out that this meant that she was controlling the box, the box was not controlling her. I told her that she could make the box so big that she could never find the edge, and she could never fall off.  I then asked what would happen if the box became very small. She first joked that she would fall off it, but then said that she could just step off it. I asked her what she would prefer. She said making it smaller, so we worked on making so small that it just didn't seem important any more. I then suggested that she should think about all the problems that box had given her, to put into that box all her frustration about not being able to stop smoking, and all her feelings towards smoking.

I told her that she could smash the box, now that it was tiny, and she described how she was stamping on it and crushing it into little pieces. We then got the pieces put in a bin, and taken away to be incinerated. Problem solved.

I than asked how she felt about stopping smoking now, and she said 'it doesn't bother me'.

The whole process took less than five minutes to clear a block she had suffered from for years.

That wasn't the end of the therapy, but it removed a major issue for her.

 

Sometimes all you have to is to listen.

 

 

 

 

 

Today I had one of these clients who starts to smile and laugh during the induction. Very often they will not go into trance easily because of the laughing. After seeing it many times I have come to the conclusion that it is about the client feeling embarrassed because they are the focus of attention and don't feel confident about what they can feel is happening to them. I find this reaction annoying. I know I am not supposed to let my personal feelings intrude but it just seems childish to me when a thirty year old client is still behaving like a giggly teenager.

I think fundamentally this is because they have control issues and feel their control slipping away and are embarrassed at losing control and worried about what an outsider will think of them. You can tell because their fingers start twitching at various points during the induction. This is body language for 'I want to be out of here'. The unconscious wanting to get away is a reaction to internal feelings generated by what is being suggested.

Fortunately the answer is fairly simple: switch to a physical relaxation induction until they relax their body, then do a confusion induction so that they are no longer focussing on themselves which sidesteps the self consconcious embarrassment, and then just lead them down the steps and they will go into trance like little lambs.

I was revisiting one of my favourite books from years ago: Awake This Dreamer! by Walter de la Mare. It is a collection of poetry on the subject of sleep and dreaming. I have always been interested in dreams because I believe that they have a lot to tell us about what is being processed by the unconscious mind, and particularly they let us know when the unconscious mind is moving on from some blockage that previously was preventing the person from fully living their life. A dream is a metaphor, and very often you can recognise in the metaphorical parts of the dream, elements that show the person is discarding previous beliefs and attitudes, and replacing them with different, more flexible beliefs.

One poem particularly caught my attention. It was written four hundred years ago by an author reflecting on his experience of dreams. He observed that no matter how sweet a flower might be, you never dream about its fragrance. And it struck me that he was right: you don't dream of smells. I have not heard of anyone reporting an actual smell in a dream, or a taste for that matter.

I wonder if that is because the sense of smell is located in a primitive part of the brain, and only the more recent developments of the brain that deal with shape and color appear in dreams because they are located in the outer cortex. The outer cortex is accessible to consciousness, while the sense of smell is not, therefore smell does not appear in dreams.

Some time back I ordered the whole collection of Key Hypnosis scripts and find myself coming back to them over and over again because they are just so excellent.

Clients have commented very favourably which is so rewarding for me.

I wondered if I can ask you for your suggestions regarding a new client who I will see next week. He talks of having a 'low mood' most of his life. Has seen many counsellors over the years and said 'counsellling didn't work at all' (said he hated CBT and filling in forms). Is adamant he wants hypnotherapy this time which he hasn't tried before. In our brief phone conversation he mentioned the following things: general low mood as the most pressing problem, mentioned 'depression' but not diagnosed, no sleep issues, is able to function well enough in the workplace, is anxious at times as well, part of him is always thinking and analysing everything, often has a sense of hopelessness. Felt quite depressed about a year ago when a relationship ended however he is now in the new relationship which is going well and he wants to rid himself of the low mood once and for all. Does not want to consider taking medication and has always been very physically active because he knows that exercise helps him.

Perhaps this is a dysthymic disorder!

Anyway I really wanted to do the best I could for this chap and am asking for advice about which of the scripts in your opinion would be most likely to benefit him to get us started.

This guy definitely has depression. All the classic symptoms are there.

What he needs is a lifestyle change, more exercise, better diet and training in how to deal with his rumination.
However, either does these already or has ruled them out so the options are limited.

The leaves the only thing you can do for him is to teach him self hypnosis. During that teaching you can plant suggestions as to how he should deal with his negative thinking patterns.

Talk about the benefits of self hypnosis - quieting the inner voice, instilling calm into his mind, resetting his feelings etc.
Then show him how to put himself into trance. Make it an easy to follow set routine, eg relaxation, breathing, stairs etc. As part of the trance experience you need to make the placebo effect as strong as possible. Take him through the exercises of eye catalepsy, finger lifts, dissociation and so on. Then let him open his eyes while in trance and all the rest of his body is frozen. This will convince him of the power of the mind and he will follow whatever you say.
Put in some suggestions about challenging his thinking, getting out and about, recognising his triggers, etc.

Then bring him out of trance and get him to go back into the state all by himself. Coach him some more if necessary.
Then leave it up to him. Tell him you have provided the tools and now he needs to apply them and he can come back to see you anytime he feels he should.

That should improve the client's outlook, and do some good therapeutically.

The health benefits of exercise are being demonstrated in more and more new research studies. However it often difficult to get clients to be motivated to exercise, so some researchers are offering advice on that as well:

1. Get the client to compare their current level of exercise with what they used to do, to emphasize how it has changed.

2. Talk about the evidence that exercise can help with their problem, and show that exercise should be regarded as one part of their overall treatment.

3. Talk about how exercise shaped the health of their ancestors, that human beings were designed to work hard and be in constant motion, and that our current lifestyle is one of the things affecting their health.

4. Make it very clear that you expect them to start exercising more, and get them to commit to doing some specific exercise.

5. Let the client identify what type of exercise will fit into their life style, rather than recommending a specific method. Point out that they can do simple things like walking and gardening to help get fitter.

6. Show them how to use motivational tools such as exercise diaries, goal setting.

7. Explain what resources are available from their local community, how to join groups such as cycle clubs and weight watchers.

8. Give clear instructions as to how much exercise they need. The usual recommendation is between half and hour and an hour a day, at least three times a week. However, not to take on too much too soon.

9. Discuss the benefits of aerobic and strength training.

10. Help the client to realise that exercise is not an all or nothing thing. Getting fit is a process, not an end, and they should expect some setbacks, and teach them how to deal with them.

I think that all therapists need to start treating the whole person, and to recognise that a healthy body helps to ensure a healthy mind.

If the client tells you they stopped smoking for a long time and then started again because of stress of some sort then that has be a reason for investigating the presence of Black and White thinking.

Black and white thinking is present in people whose basic attitude is that things have to be right, or they are wrong. There is no in-between, no grey area. It is often seen in women who binge eat. They go on a diet, it all goes well for a while, and then something happens to upset them. Their reaction typically is that 'I have done so well, been so good, and yet this happened to me. Nothing ever goes right for me. There is no point in even trying to stick to my diet, so I might as well eat the tub of ice cream'.

Black and white thinking is found in bad parenting. The parent with Black and White thinking expects their child to be whatever the parent thinks they should be, and when the child fails to reach that standard, the parent either rejects the child, or humiliates him, or uses physical violence. In the parent's mind this is OK, because the child has failed to perform to standard and therefore is useless, and must learn that that is how they are.

The same sort of thinking is applied to the person themselves. They put up impossible standards for themselves, and then when they fail to achieve these standards, they swing to the opposite position and indulge in self punishing behaviour.

This can be spending money, or over eating, or starting smoking again.

Black and White thinking is very difficult to eliminate, but the person can be made aware that they are doing this, and shown how to recognise when they are behaving inappropriately, so that they can then get back in control.