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stop smoking aversion

Spiegel’s method for stopping smoking

Herbert Spiegel was an American physician in North Africa with the US Army during the Second World War. He had learnt to use hypnosis clinically before the war. As an army doctor he had to deal with hundreds of soldiers who were physically injured, but also hundreds more who had what is now called PTSD. As always in any wartime situation he was short of morphine and other drugs. So he turned to hypnosis. He discovered that he was able to greatly reduce the amount of morphine by using hypnosis instead. He was also successful in using hypnosis to reduce battlefield induced psychological injuries.

Spiegel's method

When he returned to civilian life he began to apply hypnosis in his normal medical practice. He published extensively and his ideas on hypnotherapy were widely taken up in the medical profession. Spiegel  moved hypnosis out of the area of stage hypnosis and into the area of proper academic study. He applied his hypnosis treatments to weight loss, depression, and in particular smoking.
He was able to claim consistent success with a single session hypnosis technique known as Spiegel's method. Spiegel's method encourages smokers to keep reminding themselves of three basic ideas. A) smoking is poisoning your body. B) if you keep poisoning your body you will die. C) if you don't want to die, then you have to respect and protect your body.

The method consists of teaching smokers self-hypnosis. The self-hypnosis installs a post hypnotic suggestion to encourage the smoker to repeat A, B, C every two hours, and any time they feel the craving to smoke.
The theory behind this method is that motivation is the key factor in stopping smoking. Spiegel believed that concentrating on preserving your own body is the key to changing any destructive behavior.

Testing Spiegel's method

Academics tested and repeated his technique several times, under scientific controlled conditions, and got consistently good results. About 25% of random smokers will be smoke free a year later.
However, a great deal of research and development has happened in the 40 years since Spiegel introduced his method, and modern hypnotists claim a much higher rate of success.
It would be interesting to go back to the motivation method, and see how today's  smokers accept the idea, and whether it works any better now than it did then.

 

Source: Spiegel, H. (1970). A single treatment method to stop smoking using ancillary self-hypnosis. International Journal of Clinical and Experimental Hypnosis, 26, 22-29.

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Surprise Easter egg

A surprise Easter egg

I had a client today who reminded me of the deep and complex psychology that our clients bring to us. When I went looking for the origin of this client's problems, I had no idea what I would find. This one brought me a surprise Easter egg.

This client came to me several months ago, and at that time I treated her for the anxiety she felt during meetings at work. She felt unable to speak up and was afraid of conflict. She said that she felt a tremendous change after the last session and felt it was time to change some more.

I asked what her problem was today, and she said that she has a knot of anxiety in her stomach all the time. Her constant anxiety means she overeats and drinks too much to deal with the stress inside her. She also eats too much when she is "bored".

Visualising the problem

The problem seemed simple enough. I got her to close her eyes and become aware of the feeling inside her body. She identified it quite easily and said that it was located in her abdomen. I asked to describe what it seemed like. To my surprise he said it is like a huge oblong egg. I asked her to describe it and she told me that it had a shell, with a mottled black and dusky gold surface.

When I asked her to describe it in more detail it told me that it was womblike, that there was something like a foetus inside it. This really surprised me. I have never come across anything like this before. It clearly had deep significance to her. It is not often that a client gives you such a powerful and direct metaphor.

Chair therapy

I decided that the best therapeutic technique would be to use the Chair method. I told her to imagine a chair in front of her. Then I told her to imagine taking that egg and placing it in the chair. She said she had done that:that was the most critical part of the therapy done.

I then told her to just regard it. Look at it, be curious about it, to think about what she felt about it. She said there was something inside it. I asked her what she thought it was, and she told me that the thing inside was the true essence of her. She felt that this thing inside the egg shell had been trying to get out for a very long time.

Breaking open the surprise Easter egg

The next job than for me was to help get this thing out of the shell. I told her to imagine leaning forward and putting her hands on the shell. Then I suggested that the contact of her hands would begin to transmit heat into the egg. I asked her what the thing inside the egg wanted. She told me that it wanted to come out.

I then asked what was happening in the egg, and she said that it was now warm inside. Then I told her to move her hands around on the surface of the egg to see if thing inside would begin to follow the movement. After some time she said that it was moving and that it was ready. I told her to move her hands closer together at one point in the egg and to leave a space between them. I suggested that between her hands she would begin to feel bumps and tremors and little cracks begin. Quite quickly she said that yes it's happening. Then with out any more input from me she said "it's out".

Keep the change

At this point there were tears in her eyes, so I decided to consolidate the experience. I told her to take this thing (and at no point did I ask her to describe it) and hold it the way she would hold a new baby. I told her to love this thing and allow it to love her, to open herself up to it, to allow it into her body.

This brought more tears, and I spent some time getting her to take it into her body, to feel it spreading to every part of her.

She needed to have this change impressed into her unconscious mind so I did a kinaesthetic confirmation. This consisted of suggesting to her that she send a message of gratitude to her own mind for having allowed this to happen.  I suggested that she might get a message back. I told her to focus attention on her hands, and that she might feel a need, a compulsion to move a finger or perhaps the hand would move. She got a motor response in her hand. I told her that that was her guarantee that her mind had heard and would be applying the changes.

Visualise the outcome

I finished the session with lots of suggestions of her new ability to stand up for herself in meetings, ( the original thing she came for) and that she would no longer have any problems with eating or drinking.

She came out of the session saying that she felt completely changed. She said "I feel like I can do anything today".

I gently suggested that she would feel like that every day from now on.

 

 

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fear of earthquakes

Fear of earthquakes

I live in an earthquake zone, but up until today I had never actually had a client with a fear of earthquakes. My client was a young mother who had lived in New Zealand all her life.  Earthquakes are a monthly occurrence here. But since the last big earthquake she had been getting more and more fearful. Her anxiety was now becoming a serious problem. To the extent that she was seriously considering moving her family to Australia to avoid earthquakes. Strangely, it was not the earthquake itself she was afraid of, it was not being able cope with the aftermath. 

Not an irrational fear

She was very embarrassed about having such an irrational fear. She asked her husband if anyone else where he works was afraid of the next earthquake, and he said no. It was well is the fear is suffering from acute embarrassment.

I said that it seems to me like a simple phobia. She told me that her mother had also been terrified of earthquakes, and as a child, he had been disturbed by her mother's distress. It seemed to me that this might be a case of phobia by proxy.

I told her that as far as I was concerned, her fear of earthquakes was not irrational, although it was unusual. I told her that it wasn't irrational because it was actually based on a childhood fear that had never been dealt with. Something in the last earthquake  had triggered that childhood fear, possibly about an earthquake, possibly about something else. And now, every time she thought about it, that childhood fear was triggered back into action. The way to treat her fear of earthquakes was to treat the childhood fear.

Treating her fear of earthquakes

She was easily distressed just by talking about it and so I explained about Gestalt metaphor technique. I talked her through feeling the fear and got her to feel it in her body. I developed it as an object. She told me that she felt something oblong in her stomach. It was black and wobbly and soft and cold like jelly. I asked what she wanted to do with it. She told me she wanted a stamp on it. Gradually, I got her to change the object until it became like a teardrop, but she could not change it any further.

I asked her if she had ever done any baking. I talked about rolling, spreading, flattening, twisting, to seed the idea in her mind. This worked and she said that it had now become like a balloon. I got her to expand it and expand it, until it popped. She then put it down the sink disposal unit.

Then I got her to think about the place where it used to be. I encouraged her to fill it with something nice, like a flower, or a candle, or a child's smile, or something else that she liked. He decided to fill it with the view from her new house.

Replacing the fear of earthquakes

I then deepened her into a safe place, where she had everything she needed, and felt safe and comfortable. I suggested that her baby was there with her. Together they were surrounded, protected, and loved. In that place they were not affected by what happened outside.

Then I added some personal resources for her. I suggested that she was the type of woman who shines in an emergency. The type of woman who takes control, the type of woman who is in charge of herself and everything else. I suggested that she was ready, and in control, and a survivor. That she was the type of person that other people rely on.

Then I allowed her to bring herself back to the present.

That she felt very tired, but now thought of earthquakes quite differently.

I guess we shall just have to wait for the Next Big One to find out. 

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black and white thinking dogs

Black and white thinking dogs

Over the last 15 years I have been trying to figure out exactly what is going on in other people's heads. And in my own. I'm beginning to suspect that a great many things that clients come to therapy for have to do with black and white thinking.

As I get more experienced in hypnotherapy, my ideas about what causes common problems has continually changed. When I came out of my hypnosis course many years ago my head was filled with NLP and Ericksonian Hypnosis and other good things. The approach to therapy was simple, obvious, and there was a solution to every problem.
Right from my first client, I discovered that this just was not true. Almost everything I had been taught in my course turned out to be simplistic and/or over-hyped. 

Black and white thinking

I was reminded of this by a post on another forum that I occasionally visit. A woman there posted a story of how she had many years ago moved to a house near the beach. On her first night there she found it delightful to be lulled to sleep by the sound of the waves and a distant foghorn. On the second night she couldn't get to sleep because of the incessant barking of many dogs. She tried to sleep but the barking went on and on and annoyed her so much that she got up out of bed, got into her car and drove towards where she thought the noise was coming from. These noisy neighbors had to be sorted out once and for all. She was just not gonna stand for this.

Then she found the source of the noise. There was a colony of seals on the beach. They were all doing the things seals do, and barking at each other in the dark. It wasn't dogs at all. Sounded just like dogs, but it wasn't dogs. So she went home satisfied that wasn't dogs and went to sleep. The seals barked on many nights, but none of that barking bothered her at all. She just added it to the list of pleasant noises you get when you live by the beach.

Theories about perception

The story illustrated a point about how her feelings changed when her perceptions changed. She was wondering how it is that our perceptions affect our emotions. If we can find a way to change our perceptions, then perhaps that technique could be used in hypnotherapy. There then followed a discussion by many contributors about the nature of perception and how everything is perception. 

I thought about this story. And I came to a different conclusion. I don't think her behavior, her ability to sleep after she knew the barking was seals and not dogs, had anything to do with perception. It is actually to do with black and white thinking. It is not that perception affects emotions, it is that emotions influence perceptions.

Personal Beliefs

The starting point for me, is asking why do barking dogs annoy her in the first place? Some people get annoyed by dogs barking, some people just ignore it. It's got nothing to do with the barking, and everything to do with our beliefs about barking. If you believe that dogs barking is just what dogs do, and it's meaningless, that a barking dog is just an unhappy dog, then it doesn't bother you.

If you have a personal belief that dogs should be controlled, that uncontrolled dogs are an indicator of bad training, and caused by inconsiderate people, then those people should be made to change. It is the compulsion, the call to action, that causes the emotions. The emotion is there to make sure you do something about it.  

I believe that a great many people, who would be horrified to learn it, actually have black and white thinking. When I discuss it people often say "Oh no. I can see things in shades of grey." But what they don't realize is that they have many rigid internal rules about right and wrong. And those rules are tied to emotion. The woman in the story was so annoyed about the dogs that she got up in the middle of the night to go and sort out the people allowing the dogs to bark. This is classic black and white thinking.

Consequences of black and white thinking

The essence is: "This is wrong. I am allowed to get annoyed about this. I have the right to punish people who don't behave the way I expect them to". My theory is, that for this woman, this was one of her personal beliefs. She has a black-and-white rule about dogs barking. It mustn't be allowed, and it fires off anger inside her when someone contravenes that rule. Anger makes her act. It seems irrational, but it is in complete accordance with her internal rule. And every time it happens she reacts the same way.

She has a different rule about waves on the beach, and foghorns, and for all I know, seagulls and rainstorms and many other things. I would speculate that she has a rule that natural things might be annoying, but they are things that must be accepted, welcomed even.

Reframing the perceptions

Therefore when she discovered that the source of the noise was seals barking, she realised that her rule was not being contravened. There were no grounds for getting angry, and she could sleep through it. It wasn't her perception that changed, the noise was just the same as it had been. What had  changed was the realisation that the rule didn't apply in this situation.

Probably, in that town, there were people who also believed that the barking of the seals was barking of dogs. But those people didn't get up in the middle of the night to do something about it. They have a different rule about barking dogs. So it is not about perception, it is beliefs about the rightness or wrongness of other people's behavior.

The woman in the story went on to ask about what she could do to alter her perceptions to stop her getting angry about various things. If she came to see me I would advise her instead to start searching her memory about what it was that created the rule in the first place. Change the rule, and you change the emotional response.

 

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drinking

Drinking addiction?

Addicted to drinking

Yesterday a man came to see me about drinking. I saw him about eight years previously to stop smoking, and he hadn't touched a cigarette since. He said that he was addicted to drinking and wanted me to help him the same way I'd helped him stop smoking.

I asked him why he thought he was addicted to drinking. He told me that almost every night he had a few drinks, and more than a few at the weekend. He had't had a weekend without drinking since he was a teenager.  I asked him why he drank. He said he drank because he was bored. Also he thought that stress played a role.

He runs a small business with seven employees. His business is outdoors, weather dependent. So there's a lot of downtime, a lot of explaining to clients why he can't get the job done on time, and then he feels bad because he wasn't doing what he said he was going to do. He said he hated being late, for anything.

Drinking through boredom

Now this got me thinking. The word "bored" generally means that the client has anxiety. I was also interested to find out whether it was the having to explain to the clients, or the not living up to what he promised, that was causing the stress.

I pursued the idea of drinking, and asked him to detail when he drank. He actually didn't drink every night, and he had no problem with not drinking. I asked him how he knew when to have a drink. A told me he usually drank at night, when the boredom set in. And really that was the key to his problem.

When people say they do something when they are bored, but they really saying is that they do something when they have a lack of stimulation. In this case, when he got home after a hard day, he would start to think about the jobs, what he hadn't got done, and how he might have to deal with it. This caused anxiety and he drank for something to do to take away the feeling. This was exactly what he had done when he was smoking. When he felt anxious previously it just went outside for another cigarette. Now he was having a drink when he feels stressed. Basically he is self-medicating with alcohol.

No drinking addiction

So he doesn't have an addiction to alcohol. He just doesn't have a way of dealing with stress. We explored this for a while, and confirmed that he had suspected for a long time that he might have depression. We discussed his drinking cycle. When he gets anxious, he does not know what to do, so he takes a drink. That drink leads to another drink, and leads to another, until he has too much. Then he wakes up in the morning feeling bad, feeling guilty, and that adds to his anxiety. And of course the worry about the job hasn't gone away. Alcohol is a depressant, so his drinking is actually making his depression worse. And his depression is making his drinking worse. He is on a downward spiral.

The solution

The answer is to change his lifestyle. We talked for the rest of the session about how you can get more exercise into his life. I taught him  self hypnosis  to reduce his anxiety. We then talked about is drinking at weekends. He said that if he was on his own he would not drink. But every weekend there was a big family gathering at somebody's house. Everyone drinks at the BBQ, and everyone is expected to drink. Social pressure means he just couldn't not drink.

So I got him to think about how he could keep onside with his family but not join in the drinking culture. This is something he had never thought about. He is now happy that he does not have an addiction to alcohol. What he does have is a lack of ways of dealing with stress, and a family that pressures him to drink with them.

Those are things he can do something about.

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Hypnosis depth scale

Hypnosis depth scale

The first hypnosis depth scale was developed by Theodore Sabin.  He was a social psychologist who developed a theory called role theory. The basic idea is that we all live out a number of well-defined roles. These roles are socially constructed. That means that we learn them from other people and we behave in certain ways depending upon what other people expect us to do. Each of these roles comprises of a consistent and repeatable cluster of behaviors, ideas, beliefs and attitudes.  Who we want the world to believe we are is the result of the learned roles we choose to play.

Each person has family roles, social roles, business roles, public roles and private roles. For example, I may have a father role, a husband role, a different role when interacting with my dog, another set of behaviors when I’m in the pub, and another role in the cinema. The role may be automatic, or I may be putting it on, pretending to be angry with a late employee. In all of these situations I behave according to a set of unwritten rules.  And so does everyone else. As long as we all play our roles, and we all do what’s expected of us, everything is fine. There are policeman roles, teacher roles, pastor roles, etc., which are actually different from the private values of the people carrying out those roles.

Role-playing and role taking are two different things. Role taking is where you knowingly take on another role and act it out. It is done deliberately in order to influence other people, usually so they will approve of you. Teenagers do it all the time. Go to any concert and you will see people taking on the role of a fan of a particular type of music and trying to behave as they believe real dedicated fan would. The difference is that the real fans are not acting.

The hypnosis depth scale

Most students of hypnosis will recognise something called the hypnotic depth scale, although few will know the origin of it. This was published by Friedlander and Sabin in 1938. It used a standard text that was delivered in a standard way under standard conditions. The idea was that some people would be hypnotised some people would not, and by using a standard text the only difference would be the susceptibility of the people being hypnotised.

People were classified according to whether hearing the suggestions in the text would induce eye catalepsy, muscle paralysis, finger lock, post hypnotic suggestions and so on. The more things that you showed under hypnosis was a measure of the depth to which you were hypnotised. This scale was later further developed into the Stanford scale.

Sabin believed that everyone acted out roles, consciously or unconsciously. His theory of hypnosis was that every person who was being hypnotized was actually choosing a role. You could choose the role of being highly susceptible, or you could choose the role of being unhypnotizable. Neither were true: they were both roles. So a person on stage being hypnotized would react in the way that they imagined someone on stage being hypnotized would act, and they would act accordingly. This became known as the Role Theory of hypnosis.

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Self diagnosis

Self-diagnosis technique

I think I may have discovered a new self-diagnosis technique. My client yesterday was overweight. Overeating in my experience is normally associated with some sort of childhood trauma. However, after much questioning this client said that she could not remember anything about her childhood that was bad. She did say that she had lots of feelings but for the whole of her life she has just pushed them back, refused to deal with them.

I decided that the best approach would be to do Gestalt metaphor therapy. I used a breathing induction with her, and gently lead her into trance. As soon as I was sure that she was in trance, I began fishing for the dominant feeling in her unconscious mind. This involved suggestions such as  "There is a feeling that you get, a feeling you have had many times". "It is a feeling about not being good enough, a feeling of being worthless, no good". "A feeling from long ago, and as you think about that feeling, as you get that feeling, this something will come into your mind about that feeling".

And sure enough, she immediately began to cry as the memory that she had tried to push back began to emerge. Gestalt metaphor technique is a way of dealing with the feeling in terms of a metaphor. It is a safe way of dealing with trauma, because you don't have to access the memory directly.

So I got her to express her feeling as an object. She told me it was like a white ball, then it turned into a jelly bean-shaped thing,  hard and smooth and lodged somewhere in her chest. I then started the process of suggesting to her that it might change. Eventually it shrank and wrinkled and ended up like a deflated balloon. The next step was to ask if she had ever used a chopping board. That prompted her to imagine chopping up the limp balloon. Whatever that feeling or memory was it was now gone, for ever.

A self-diagnosis technique?

After she came out of trance, we discussed the nature of metaphor healing therapies. She is an intelligent woman, and is very interested in the process. So I decided to do an experiment. I told her I was going to teach her self hypnosis, so that when she was in trance in her own time she could explore her own subconscious mind.

I used a progressive muscle relaxation induction, followed by an eye catalepsy test. She, like many overweight people, had a rapid, shallow breathing pattern. So I deepened her until her breathing became regular and slow.

In this induction, I spent some time emphasizing the power of her own mind, and how strong it was. I told her that in trance her mind would open up to a large empty space and in that space perhaps her mind would show her something. Something to do with the feeling that she gets, something to do with that need to eat, something to do with why she is unhappy. This was something I had not done before. I really wasn't sure what to expect. My hope was that her mind would reveal to her something that she had spent a lifetime trying to hide, but who knows?

 

She came out of trance, telling me she felt a very profound feeling, unlike anything she had ever experienced before. We wound up the session and she still didn't say anything about seeing something or not. So I asked her if she had seen something. She said "Yes I did, but I'm not telling you what it was", and laughed.

It seems it did work. And I will be exploring this technique in future.

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Smoking alters your DNA

Smoking alters your DNA

Smokers have just had a new worry added to their fears. Smoking alters your DNA. A recently published study demonstrates that cigarette smoking not only damages your health while you are smoking, it also causes mutations in the tissues which last forever.

Smoking alters your DNA

Smokers create permanent changes to the DNA of cells in their lungs, throat, mouth and liver. Although the smoker's health improves when they stop smoking, the damage to the cells is permanent. There is a direct link between the number of cigarettes smoked and the number of mutations found.

This means that even long after you stop smoking the potential for cancer is still lurking deep inside the cells of your body. It really is true that every time you light up it's like pushing the button on a slot machine. Every turn of the wheels makes it more likely that you'll hit a jackpot you don't want.

The problem of course is that the more mutations there are, the more likely it is that one of them will turn into cancer. The more you smoke the more mutations you have, so the more chance you have of developing a life-threatening cancer.

Smoking affects distant organs too

Smoking doesn't just affect the tissues that come into contact directly with the smoke inhaled. Traces of smoking linked mutations are found in organs such as the bladder. Exactly how this link is established is not known but there is a clear link.

Smokers are well aware that they are damaging their health. Perhaps now that they know they're not merely damaging their health right now, they are actually altering the DNA inside the cells of their body, they will be more motivated to stop smoking.

It is quite horrifying that scientists are now able to examine your DNA, and like an archaeologist, trace your bad behavior from long ago.

 

 

Source: Science 04 Nov 2016:
Vol. 354, Issue 6312, pp. 618-622
DOI: 10.1126/science.aag0299

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Representational systems

Do representational systems matter in hypnosis?

Do you need to pay attention to the representational systems that clients use? I was asked this by a newbie the other evening. He had recently finished a hypnosis training course, and was full of enthusiasm about NLP, wordplay, and the scientific approach to hypnosis.

Representational systems theory

What he was talking about was the old NLP belief that people tend to represent the world using one dominant representational system. These are generally known as VAK, standing for visual, auditory and kinaesthetic (feeling).
I was rather surprised that this is still being taught, or rather that it was being given so much importance. Even the founders of NLP have said publicly that is perhaps a little overdone.

Representational systems reality

When I started my hypnosis practice I was fully convinced that VAK was important to success. I used to start every session by asking the client to close their eyes and imagine a horse. Then I would ask them to describe their horse and note the type of words they use to describe it. I did this hundreds of times. Eventually I concluded that it was a waste of time. I could find no evidence for consistent VAK.  Dominant primary representational systems do not exist.

I did get some very interesting answers. One woman told me that her representation was in fact auditory. What she was getting was something like a race caller's patter "and now the leader is rounding the bend, and the second favourite is coming up the outside…". Another woman told me that she could feel the horse. I said so you can feel what? Its back, its legs? "No, I can feel this much". And she demonstrated with her hands that she could feel about two palms width on any part of the horse she chose to. Another told me that what she got was patches of random colour in her mind.

Now these were all very interesting, in fact fascinating, but not really useful in therapy.
What I found much more useful was listening carefully for the metaphors that the client uses. In my opinion, these give a much more accurate representation of how the client is feeling and where their problems lie. And unlike VAK, they also give you a very good idea of where to direct your therapy.

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organ language

Organ Language

Organ Language in the treatment of pain

I was asked recently about the use of organ language for the treatment of pain. This is something I had heard of but never used. The person asking had no idea what it was.

Theory of organ language

Organ language is a concept introduced by Leslie LeCron in his writings in the 1920s. The basic idea is that the language that you use, the words that you say, can affect the organs you talk about. NLP uses similar ideas about the power of words to influence feeling.
According to LeCron, if you repeatedly use a phrase such as "this guy is a pain in the neck" then saying the phrase over and over will actually give you a pain in the neck.

The theory is that constantly mentioning the organ in everyday phrases focuses attention on that organ. That causes it to malfunction. If your illness is being caused by the overuse of a metaphor such as "I'm sick of seeing my team lose every Saturday" then the answer is to stop saying it. If you change your language to something different such as "I'm really looking forward to our next win" then that will keep you healthy.

Overused Metaphors

Personally, I just don't believe this simplistic logic. Most of us use metaphors all the time, and we don't know the origins of them. These are known as lost metaphors and are basically a lazy way of speaking. These metaphors used to be bright and fresh and colourful but overuse has dulled them to the point where they lose all their force. Telling someone "I was taken aback" nowadays simply means that the speaker was surprised.

The phrase "taken aback" originally referred to a sailing ship. Sailing ships are designed to take the wind from behind. If the wind suddenly 'backs' to come over the bow then the masts get pressed backwards instead of forwards. Masts are not designed for that. They can snap. Being "taken aback" is very dangerous. The image is of immediate panic and the crew running around to save the ship. But that original colourful meaning of the phrase has been lost through time.  

 I suspect that someone saying "it's a pain in the neck" really is not thinking about the neck or anything else. All they're doing is substituting an overused phrase in place of original thinking. To suggest that someone using the phrase "I was taken aback" has in mind an image of a sailing ship suddenly plunged into danger is just not believable. Our minds are not as literal LeCron suggests.

Treatment

I think the truth is more straightforward. When someone says "I feel stabbed in the back", then they probably do feel that. It's not the metaphor that is causing the pain, is the pain that is causing the metaphor. And therefore the correct course is to use the metaphor to alert you to their pain.

Simply telling the person not to use the phrase again is not going to work.

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