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reasons for smoking

Reasons for smoking

Reasons for Smoking

My client yesterday was a middle aged woman who just could not give up smoking. She could not give any reasons for smoking.

I asked if she had ever stopped smoking. She said "I stopped when I got pregnant". I then asked her why she started again. "About a year ago. A friend offered me a cigarette, and said it might help, so I took it. And then it was a case of another one, and then two, and then very quickly I was back smoking again."

I asked what else was going on in her life at that time. She said "I discovered that my husband was having an affair with my best friend."

The real reasons for smoking

It seems strange to me that someone would blame starting smoking again on a friend suggesting that it might help them, and totally ignoring the fact that their life had fallen apart around them. It is a peculiar kind of blindness that seems to affect people who start smoking again. They will blame the smallest thing, and completely ignore overwhelming emotional changes.

It is also strange that even after years of not smoking, people can believe that smoking will help them. I have had many clients who told me "I took the first cigarette. It tasted horrible. I felt sick and dizzy. But I kept on with it, until I had started again."

I asked "how did you feel when you stop smoking when you were pregnant?" She said, "I felt that I had to quit, and I resented it. Even though I stopped for 11 years I still resented being made to stop. Especially at the beginning of the pregnancy when my husband did not stop smoking but I had to. I hate it when I cannot do what I want and other people make me do things."

And there was the real reason for smoking. It was also the best indicator of how to go about helping her stop smoking again.

 

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past life regression hypnotherapy

Past Life Regression Hypnotherapy

Past Life Regression Hypnotherapy

A client booked in with me writing "I would like to have a past life regression hypnosis. I feel a bit unhappy, like I am not fulfilling my purpose. I feel a bit lost." Past life regression hypnotherapy requests are fairly common but I always wonder what prompts the client to ask for one.

The client was a young primary teacher. She told me "I feel totally confused about my feelings, and my own life. I was going to resign my job because I couldn't really understand how I was feeling. My friends tell me it must be something I did in a past life."

Different assumptions

It became obvious fairly quickly that she really was not in touch with their own feelings. I gave her the dysthymia questionnaire. She identified with most of the areas, particularly with circular thinking. We discussed how rumination was affecting her. On looking at the the other aspects of dysthymia,  it became clear that she also has black and white thinking. This is defined by high expectations and distress at not achieving them. The rumination and failed expectations were driving her  lack of feeling, of disconnection.

It had never occurred to her that she had depression, despite the fact that her sister has depression, and her mother shows every sign of it as well.

I outlined what she has to do to fix her own depression, emphasizing exercise, but not going into detail or suggesting that she should come back.

We agreed that all of her symptoms were consistent with depression, and there was no point in doing past life regression.

There was not a lot of time left, so I had to do something fairly quick to end the session.

Metaphor therapy

She came to my office convinced there was something hidden inside that was making her act and  feel this way. So I decided to use metaphor therapy to clear that thing. I did a short induction. I suggested there was something lodged in her unconscious mind. Her own mind searched for it, found it, and ripped it out. Then it turned to liquid and drained out through her feet.

She was one of those clients who do a lot of moving in trance. I was concerned that she was not deep enough, so I deepened her by going down some steps into a garden. I didn't know what to do next. So I just let my unconscious mind take over. I noticed a potted plant on my windowsill. So I took her to a large glass house. The glasshouse was hot and steamy and everything was growing. I led her to a bench where there was a flower pot with rich earth in it.

Grow your answer Therapy 

There was a packet with her name on it. She felt it, and it appeared to have a seed inside. There was a sign that said 'open me'. I got her to plant the seed. Then someone appeared and said "I have been waiting for you to plant that seed. Now I will look after it for you. The seed will grow into a plant with many beneficial properties. It will continue to grow throughout your life. Who who knows what it will produce?".

I then got her to go outside and had her sit on a bench. She fell asleep on the bench and began to dream of a woman sitting on a bench. She dreamed of a woman sitting on a bench dreaming about a woman sitting on a bench and hearing these words. I continued with the multiple levels of dissociation until even I got lost in it.  This could be a good way of doing multiple embedded metaphors?

Feedback on this Past Life Regression Hypnotherapy

I was a little concerned that she had not really been in trance, due to the amount of wriggling around that she did. So I asked her what she remembered about the hidden object. She said it was that one of those things that suck blood, a leech. So, I was happy that she actually had been utilizing her own unconscious mind.

At then, at the end, saying goodbye, she said "and I really liked the whole plant thing, and this thing growing".

What I learned from this is that it is quite amazing how people can misinterpret their own symptoms. This woman was being encouraged to go down the path of New Age spirituality, and who knows where it might have led her. She just did not recognize the source of her own problems.

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Lost Connections

Lost Connections and Depression

LOST CONNECTIONS AND DEPRESSION

Lost connections is a new book about uncovering the real causes of depression, and the unexpected solutions.

This book takes a fresh look at what really causes depression. The author, Johann Hari, tells his own story. He suffered from depression from childhood. He was on medication for decades. And it was only after decades of not getting any better that he began to question whether pharmaceuticals were the right answer to depression.

This book is the outcome of 30 years of thinking about depression. He proves that almost everything we know about depression and anxiety is wrong.

Chemical Theory of Depression

The accepted explanation of depression is that it is the result of a chemical imbalance in the brain. All mainstream efforts are aimed at correcting that chemical imbalance.

Depression is a brain disease, and Seroxat is its cure. That has been the accepted wisdom for more than 40 years. According to the Prozac theory, depression is caused by lack of serotonin in the brain. Seroxat, Paxil, and all the other selective serotonin reuptake inhibitors restore your serotonin balance and banish depression. Although they don't.

Johann Hardy realised that the pills made you feel good for about six weeks, and then they didn't. The doctors' answer is to increase the dose. That makes you feel better for about six weeks, and then it stops. So the answer is to increase the dose again. And so on. Until you are walking around like a zombie. You don't have depression, but you don't have any real life either.

No support for serotonin theory

The core of this book is about how he started to question the reality of chemical treatment of depression. He realised that even after 20 years of taking the medication, he was still depressed.

So he started thinking about what other things might be associated with depression. He went to  see his doctor early on. The doctor asked about his symptoms, and prescribed him medication. And every time he saw doctor after that, they asked about his symptoms. He eventually realised that they did not ask anything else about his life.

No doctor asked what was going on in his life that moment. Nobody asked if he had had any emotional shocks. Nobody asked about money worries. As long as you believe that it is a chemical imbalance, there is no need to look for any other explanation.

The doctors assumed that all his troubles are the result of the common chemical imbalance. In fact it was the other way round. It is the emotional shocks, and economic circumstances, that give you depression.

Depression is in your environment

The rest of the book examines two things. One, the results of the chemical imbalance theory. And two, the factors that really cause depression.

The first few chapters are a detailed analysis of the astonishing rise in antidepressant prescription. At the time of writing one person five in the US is on some sort of drug for a psychiatric problem. This is an incredible level of drug consumption.

Debunking serotonin

The analysis looks at what is driving this level of consumption. He details the vast profits made by pharmaceutical companies, and the incentives for doctors and hospitals to keep prescribing these things. That story is well known.

What is not well known is the hidden truth. there is not one shred of evidence to actually show serotonin has any connection whatsoever to depression. The entire industry is built on a lie. Every scientific study that has tried to find a connection has failed.

His first breakthrough was to realize that depression and anxiety are simply different aspects of the same thing. They are always found together. When one goes up the other goes up. When one goes down the other goes down. They are not separate illnesses.

The second was to realize that unhappiness and depression are strongly related. There is a continuum between unhappiness and depression and anxiety.

The nine causes of depression and anxiety

It is not all in your head. The cause of depression is in your environment. His researches showed that there are nine interconnected environmental issues which are leading to an increase in depression and anxiety for everyone.

The first cause is disconnection from meaningful work.

People who hate their jobs, people who can't see any point what the doing, have stepped on to the conveyor belt towards depression.

The second cause is disconnection from other people.

Human beings evolved from groups of apes. Humans are happiest when they're in a group. But most of us lead fairly solitary lives. The nuclear family is quite different from the way humans used to live. Most of us have lost the warm interconnections of an extended family and even a village. Social isolation is a driver of depression.

The loss of meaningful values is the third cause of depression.

Society has changed so much that the principal leisure activity is now buying stuff. Our principal social actions are about meaningless fluff on social media. People are driven by extrinsic values, that is, we do things for rewards, physical rewards mostly. Intrinsic values are things that we do because we love it. The Western world has become obsessed with extrinsic values. And depression is the price.

The fourth cause childhood trauma.

This is widely understood. An unhappy childhood leads to an unhappy adult. Childhood trauma is one of the most obvious indicators of depression and anxiety. Children who have been sexually abused, emotionally abused, or neglected are at very high risk of depression. Nothing to do with genetics or brain function. The scientific results are quite simple. The more types of childhood abuse you had, the more likely you are to have depression.

Disconnection from respect

Studies with baboon society showed that the lowest member of the hierarchy was constantly stressed. The highest member of the anxiety was also highly stressed if his position was threatened. Other research showed that the more social distance there is between the haves and the have-nots, the greater the prevalence of mental illness. There is much more mental illness in the USA then there is in an egalitarian society like Norway.

Cause six is disconnection from the natural world.

Spending a couple of hours in the natural woodland has a remarkable effect on people's feelings. This can be measured by the stress hormones in the blood. Living in modern cities is the exact opposite of that.

Cause seven is disconnection from a hopeful or secure future.

The more insecure your future income or personal security is, the more likely you are to have depression.

The length of time you have been under stress is the eighth cause.

Your brain is constantly changing to meet your needs. Your brain changes as you suffer life changing challenges. If this goes on for long enough, your brain changes to deal with it. Part of the brain become more sensitive to bad things and parts that are sensitive to good things get smaller. This leads to the common feeling of being stuck in anxiety and depression. The good news is that once the external factors begin changing your brain can repair itself.

The ninth cause is genetics.

There is a clear and proven correlation between certain genes and the tendency to become depressed. However having the gene only gives you a tendency. If the other eight factors don't happen, then you are no more likely to get depression and anyone else.

 

"Depression isn't a disease. Depression is a normal response to abnormal life experiences."

 

Hari, Johann. (2018) Lost Connections. London: Bloomsbury Publishing. ISBN 978-4-1-4088-7868-2

 

 

 

 

 

 

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disphonia

Disphonia

My client today was well aware that she has depression. She is on prescription drugs for it. We had a long talk about how it is affecting her life and what she is able to do about it.

We talked about how she has All or Nothing thinking and how this affects her moods and her behaviours. She is aware that she sets unrealistic standards and get annoyed with herself when she does not reach them. She also told me that she also gets annoyed when other people at work do things that she doesn't like.

Disphonia

She described how it affects her when people do things that are not the way she thinks they should be done. So people eating in the workplace annoy her. People whistling or humming as they work annoy her. They annoy her intensely. She in fact has disphonia, an excessive almost rage-like reaction to ordinary harmless noises.

I had heard of this but never come across it before. I had thought about it, but could not imagine any mechanism that would explain it.

Disphonia is a symptom of depression

However this client may offer the key to the mystery. It seems in her case that it is an extreme case of Black and White thinking. People are doing things not the way they should be and that is what gets her annoyed. Eating, humming, whistling annoy her. It seems to me that disphonia is in fact a rather odd but understandable outcome of having internalized standards that you expect other people to live up to, and you get justifiably angry when they don't.

I imagine that at some point my client was told not to make a noise when she ate, and that became an internal rule for her. In her world, rules have to be obeyed. If they are not then anger arises. I can also see how she might have been told not to hum or whistle etc., and they too became must-obey rules.

Do you know someone with disphonia? Leave your comment below.

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PTSD and Depression

Explanation for PTSD and depression

I am reading a book that I think might contribute the theory of how hypnosis works in therapy. The book is In an Unspoken Voice: how the body releases trauma and restores goodness by Peter Levine. It might be an explanation for PTSD and depression.

Everyone will have seen an instant induction, where the hypnotist startles the client by shouting or pulling them off balance. It has long been known that this is the result of the parasympathetic nervous system putting the client into tonic immobility. The person goes limp, their eyes roll up into their head, their breathing changes, they are impervious to pain.

Origin of PTSD and Depression

The Levine book explains this as being one of the five bodily reponds to danger. When danger appears our body first goes tense and alert, then tries to run away, or if it can't run away gets ready to fight, if that isn't possible then the body freezes motionless, and when danger is imminent the final stage is tonic immobility, the body flops and becomes helpless.

So instead the Flight or Fight responses, we should be talking about Flight, Fight or Flop. The book's argument is that when a person is frightened they go through the five stages. What is interesting is that the book claims that when the body is so frightened that we freeze, unless we are able to find a way to unfreeze the fear, the result is PTSD. According to his theory PTSD is result of not coming out of the freeze state. The therapy is therefore to help the client release the old fear.

How therapies work

This makes sense to me, and explains why relaxation, reiki, grounding, and yoga work to relieve mental stress by relaxing the body. It also offers a basis for understanding how metaphor therapy works.

Perhaps the five stage theory also gives a basis for understanding the cause of depression. Depression is triggered by learned helplessness. If the response to relentless pressure and fear is tonic immobility, then this explains where the depression comes from. I am only part way through the book and this link has not been mentioned yet, so I am reading on with anticipation.

What do you think?

How do you deal with PTSD? What do you think causes these things?

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gastric band fallacy

Gastric band fallacy

I saw a client today who wanted me to do gastric band hypnosis on her. She slumped in the chair and told me that she had to lose weight. She acted as though the weight was something being put on her and she was a victim. Her whole attitude was that there was nothing she could do about it. Everything about her just seemed like apathy.

As I asked her about her behavior and attitudes to eating.  She just sat there and expected me to believe she wasn't overeating, didn't have any problems, life was just fine. All she wanted was for me to do the gastric band thing to her. She was going to just lie there while I dissolved her fat. Basically just  sprinkle the fairy dust over her and send her on her way.

The gastric bypass hypnosis fallacy

Her whole attitude was that the weight gain had nothing to do with her. I could not get any sense that she was willing to make any changes at all, didn't need to.  Just fix me and I'll be gone. I have had several clients like this. I think the whole gastric band hypnosis idea appeals to people who want someone else to do something about their behavior. They are basically looking for an effort-free magic solution. 

She said she had been piling on the weight since she got married six months ago. It didn't seem to have anything to do with the actual wedding since they had been living together for seven years before that. She told me that she was on depression pills. She was a twin, and her nonidentical twin was grossly overweight. I asked about her upbringing. She told me her father was a drug addict, was narcissistic, and had mental health issues. He physically and verbally abused her mother. My client said that she was not abused, although she was frightened by all the arguing when she was growing up. She did not say very much about her mother, except that her mother spend her time trying to placate her father.

Exploring motivation to exercise and diet

I really wasn't getting anywhere with her. I felt that she had been holding back on me, not deliberately, but that she really was not in touch with herself. I discussed depression and how this affected her. She gave me conflicting views about exercise. She had been to outdoor hockey as a player this week, she had been to the gym, but still managed to be overweight. I asked her why she didn't stop eating she said "I enjoy eating". That really was about the depth of her introspection on this. I could not get her to even start to think about her own motivation to over eat.

It seemed to me there were three possibilities. She was suffering from some genetic based issue inherited from her father and mother. Or, she was holding in a lot of bad stuff from childhood and her upbringing in an unpredictable household, and not looking at that. Maybe she was actually being influenced by the side effects of the depression medication she was taking.

After a lot of discussion I told her that I thought it might be a side effect the medication. I was careful to stress that in no way was I qualified and she should not change her medication, but she should discuss it with her doctor. I was hoping that seeing another person might jolt her out of her current state. I just could not get past her defenses. In fact, I could feel myself getting annoyed inside at her total stonewalling responses. Not a good response from me.

So I told her I couldn't do anything further for her at that point. She said that it had been a useful discussion because it has raised several points she had not thought of. I offered the session at no cost because I had not fixed the problem. She insisted on paying something. So it wasn't a total loss for either of us. 

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Depressed for Success

Depressed for success

Depression isn't all bad

They say you should dress for success, but how about depressed for success?

Depression is usually seen as a negative disease. However, not everything about depression needs to be bad. Not that it is something you would wish on anyone: I have it myself, and I would much rather not have it.

However, a client this week reminded me that there are positive aspects to depression, although it might not seem so to some people.

This woman was successful at business, and had a good marriage. But she was so wound up all the time that she couldn't enjoy them. From being be carefree and relaxed, she now was stressed about everything. She had high expectations of herself, was driven all the time, was always looking for things that could go wrong.
She said she had been brought up in a family where she had to be a provider early on. Her step father was a drunk. As a teenager, she felt that it was always up to her to save the day. There was relentless pressure to do something.

Depressed for Success

It is no surprise that a woman with such a background would be depressed. But in this case, the depression was the driving force to her success. Depression makes you anxious about things going wrong, you worry and catastrophize about everything. In this woman's case, the worry actually drove her to take action. She did everything she could to meet trouble before it started, to always be ready. She had high standards, almost perfectionism from her black and white thinking. That combination led to success in her profession and to recognition of her abilities. From this she started her own hairdressing business. It is ironic to think that it is in fact the depression and dread of failure that has driven her to the top.

I wonder how many other people are successful as a by-product of depression?

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difficult client

Hypnotizing a difficult client

It is said that there are no difficult clients, only unprepared therapists. Well I had a difficult client today.

She presented with social anxiety. She had the usual feelings of getting panic attacks when talking in company, embarrassment when she thinks people are looking at her. In addition she complained of getting a pain in the neck when she thinks people might see her. Clear evidence of psychosomatic reaction.
She blames it on bullying at school. Everything was good in primary school but when she went secondary school she felt not as good as the other girls and shy and got bullied.

Try the standard approach

The obvious way forward was regression to deal with the old bullying. Started to get her into trance. No way. I decided to be subtle and tried to teach her self hypnosis.
We had to stop because she said the light was too bright.
So I tried hypnosis. Said she didn't feel anything with a countdown.
She said she couldn't visualize anything at all.
Then I did a kinesthetic induction, since she couldn't visualize.
I succeeded in getting eye closure.
I took her into regression but she said she couldn't get any feeling and couldn't remember anything.

She couldn't visualize anything. Nothing at all.
I tried talking to her unconscious mind. From her answers it was clean that she was not in trance.

Clients don't come more difficult than this. She gave absolutely no cooperation, no visualization, no feelings, no memories. I was baffled.

So try something else

I wasn't going to give up. I tried eyes open non-trance Metaphor Therapy. Still said she said she couldn't feel anything. Nothing came to mind no matter how much I tried to prompt her. Then got her to talk about what was worrying her. Finally we got it down to the cause. She is over critical of herself and thinks that everyone else will be critical too. Tried to work with that. Then started going round in circles.

Finally, the truth

Then she said she had very high standards.
And procrastination.
After two hours I finally realized: she has depression.
I tested for the classic symptoms of depression and confirmed that she has it.

That is why nothing worked. She has all the symptoms, but doesn't have an emotional problem. She is one of the millions of people with undiagnosed depression who have no idea of the real root of their problems.

I wonder how many other 'difficult clients' are actually just not aware of their real problem?

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Screened for depression

Should everyone be screened for depression?

Smoking, weight loss and anxiety are the most common problems seen by hypnotherapists. But many of the problems that clients seek help with are actually symptoms of depression. Depression is the leading cause of disability worldwide (WHO, 2017), If it is so common, should everyone be screened for depression?

Why not screen everyone?

On the face of it, this would seem like a very sensible option. At the very least we could screen pregnant women and teenagers. Early intervention would seem to be very desirable. And it has been proposed many times by many organisations. So why is it not being done?

The main reason is the fear that it would lead to overtreatment. This concern is so prevalent that medical associations in Canada and the UK have a policy of opposing routine mental health screening for everyone.

It is argued that routine screening has not proved to be effective. In fact, it can prove to be counter-productive. Someone going through a temporary session of "the blues" might acquire a lifelong label. They may actually get depressed through worry, and may spend time and money seeking treatment they don't actually need. Giving people SSRIs that they don't need opens up to unnecessary side-effects of the drug. Too many false positives might make the problem worse.

This is not to suggest that doctors should not screen patients they suspect have depression. However they should not routinely apply it to everyone who presents to them.

Publication bias

The research that has been done on the benefits of screening have not shown good results. Screening has proved effective at identifying problem cases, but the outcomes have been very modest. Medical associations worry that the results show "publication bias". This is the tendency to only report positive or significant research. Editors of medical journals prefer to fill their journals with reports of success. For every successful trial, there may be three or four unsuccessful trials. The trials where the results were just not very clear don't get published. So when looking through published results it appears that the situation is much better and much clearer than it actually is.

Another reason for not doing routine screening is that it would be captured by the pharmaceutical companies. They would see this as a bonanza for their products. In fact, at least one of the most used questionnaires for depression was developed with funding from a pharmaceutical company.

I am not a supporter of the conspiracy theories against "Big Pharma". Pharmaceutical companies produce wonderful products that keep the population healthy and well. They are entitled to make a profit and to market their products. However, routine screening of 100% of the population would lead to a blowout of virtually every health authority's budget.

Without a guarantee of a clear and measurable benefit it is just not worth it.

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sexual dysfunction depression

Sexual dysfunction and depression

Sexual dysfunction depression

I saw man today who reported that he has intermittent erectile problems. He he has been experiencing the problem frequently quite recently, although he has had it occasionally all his adult life. He is very worried that this is going to ruin his relationship with the woman he has only been seeing for a few months.When the relationship started, in order to avoid any problems, he would take Cialis and that ensured that everything worked okay. Previously she lived in a fairly distant town and he visited her mostly on weekends. The woman is now living with him and so the opportunity for sex is more frequent also. 

As well as that worry, he revealed a deeper issue. Some weeks ago, they went out drinking, and he got very drunk. According to his partner, at some point he said "I would rather f*** a rat than some fat bitch like you." He has no memory of this incident at all, and has never done anything like it before. So he is deeply concerned about this. And of course it put him off side with his partner big time. So this has made him even more concerned that if he is unable to perform sexually, then she is going to take this is as confirmation of what he really thinks about her, and she will leave him.

He has been to the doctor and had all the tests and everything seems to be okay physically. So the problem must be something psychological. I asked him what was going through his mind when he wanted sex, but couldn't perform. He said "it's like I always have something running through my head at the time like a song you can't get rid of. I can't focus on the thing because of this distraction."

Finding the psychological reason

I asked him "would you say that your mind is always busy?" He agreed. I asked him "do you find yourself dwelling on things that happened in the past?" He agreed with that too. I asked him "do you get irritated when people don't do things they should do? Like bad driving behaviour?" "Yes", he said. "I get really annoyed at other drivers' bad behaviour. It happens every day."

It was fairly obvious from this that he actually has depression. I asked some more probing questions and it became quite clear that he has dysthymia. Like most people with dysthymia, he had no idea that he had it. And no idea that it was affecting his behaviour in many ways.

I explored with him aspects of his behaviour since he was a teenager. And as we looked into it more and more, it became more and more obvious to him that much of what he was doing was in fact a reflection of his dysthymia. He then revealed that his brother has depression. And that uncle. Thinking about it, many members of his family showed quite clearly behaviour consistent with low-grade depression. 

H0w Dysthymia affects behavior

I then addressed one of the common issues with depression, which is perfectionism. Most people with dysthymia have high expectations of themselves, and of other people, and get irritated when these expectations are not met. It is quite likely that is sexual dysfunction is related to this. One possible mechanism is that he thinks about the fact that it might go wrong, and that would lead him to deep embarrassment. The more he thinks about the possibility, the more anxious he gets, which leads to exactly the thing he doesn't want. He is actually worrying himself into erectile failure.

The same mechanism would explain his outburst when he was drunk. Alcohol removes inhibitions. I would speculate that some point during his drinking binge, he began to dwell on his sexual problems and how he felt about that. In his drunken state that would have accelerated into an overwhelming feeling of frustration, and he just lashed out.

So the next stage is to help him deal with the way he thinks. Normally three or four sessions are enough to get rid of most of it. I am quite positive about the outcome.

 

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