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fetish shoes

Fetish Hypnosis Replacement

Can hypnosis be used to treat a fetish? A fetish is generally described as a sexual attraction towards an inanimate object or a particular, non-sexual part of the body. With a rubber fetish, a person gets sexually aroused by touching on wearing rubber garments. Leather fetish is very similar. One of the most common is a shoe fetish, getting sexual gratification from looking at shoes, handling shoes, smelling shoes.

Many years ago I had a client who had a fetish about rubber. The only thing he could remember that might account for this was a memory of having a tightly fitting rubber swimming cap when he was a child. At the time I was unable to help him, but I never forgot about him. I have always wondered at the origin of his problem.

Instant learning experience

I started thinking about this recently while I was telling someone about how I cleared phobias. He asked me where phobias came from. I explained that a phobia is an instant learning experience. An instant learning experience is something like touching a hot stove. You learn instantly that hot stoves burn and you never touch them again. However, some people don't just remember that they get burned, they get a lifelong fear of stoves. The exact mechanism of how this happens is not known.

Origins of a phobia

After many years of treating phobias it seems to me that there is a common element in acquiring a phobia. I think that the essential elements include an unexpected event, an intense feeling of threat, and the inability to get away or do anything about it. For example, bird phobia is very common.

It typically arises when a child is out with its mother, feeling safe enjoying themselves in some outdoor situation. And then suddenly they have a bird flying at them, wings flapping around them noisily, maybe even close on their hair. This generates an intense instant fear. When that is combined with the feeling of being unable to get away from the bird there is a potential to generate a phobia. The phobia is easily cleared by getting the person to experience the feeling of fear again, and then using metaphor replacement therapy to change the fear into something else.

Origins of a fetish

I believe that a fetish is simply the opposite of the phobia. Instead of experiencing an intense fear, I think the person gets a fetish by experiencing an intense sexual pleasure while doing something else, and the two things get linked.

Just as a phobia can be acquired from just about any random experience, so can a fetish. My old client with the rubber attraction probably at some point felt a strong sexual urge while simultaneously experiencing some rubber object. The two get linked in the brain in the same way that a phobia gets created. From then on any time the person experiences something made of rubber they are instantly reminded of the sexual feeling associated with it. I believe that this is the origin of a fetish.

Removing a fetish

If I am correct in this, then it suggests that a fetish can be removed in exactly the same way that a phobia is removed. Clinically, all one would have to do is to get the person to experience the positive feeling they get from their fetish object. Then apply metaphor replacement therapy to their representation of the feeling. Then change it from a positive feeling to a neutral feeling. That is exactly what hypnotherapists do with phobias. You take the negative feeling, represent it in some way, change the representation,  and the fear disappears. I see no reason why it should not work to change pleasurable feelings.

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invisible woman

The Invisible Woman problem eating

Why can't you lose weight?

It is strange how so many people remain overweight, but are always the same weight. They stay much heavier than they want to be for years and years with barely any variation. You would think it would be just as simple to lose weight once,  and stay at that  lower weight in the same way. The Invisible Woman gave me an insight into why some people just cannot lose it.

My client had been on every diet ever published, had tried fasting, had tried everything – but none of it worked. She always ended up eating when she didn't have to. Something would make her feel miserable, and she would reach for the comfort food. She said to me, "It's not that you want to be overweight, it's just that you don't care".

I spent some time exploring why she didn't care. She could not give me an exact answer, but it had something to do with how she felt about herself. Basically, she didn't care because she knows that whatever she does she won't be seen, won't be accepted.  So why not just do what you enjoy? Eat.

Her basic problem was "I am rejectable".  She always expects to be rejected. "I feel invisible. Nobody cares". Given that basic feeling then it is understandable why she eats, gets overweight, and doesn't care.

Origin of the Invisible Woman

I had no idea what to do, really. So I put her into trance, and decided to go with whatever developed. Once she was securely in trance, I went for what I thought was the principal problem – the feeling of being unimportant, invisible. I simply got her to focus on that feeling.

My aim was to get her to really open up to the feeling instead of avoiding it. So I asked her, "And feeling that feeling, what comes to mind?" After a while she started to tell me about a memory of coming to this country. She was a child, she did not understand what was happening, she had lost all her friends in the old country. It turned out that her mother hated being in this country.

Her mother was pressured into coming here and resented her husband for making the family relocate. The marriage began to break down, and for a lot of the time her mother just wasn't around. That little girl felt neglected, abandoned, not looked after. And then her mother died at age 12. She became a problem, instead of a little girl.

Visualizing the Invisible Woman

That explained where the Invisible Woman came from. I encouraged her to stay in the feeling. The feeling changed and grew. She said "The feeling is fear. I am like a gas bottle. I am all solid steel, and full of pressure, and about to burst".  Using her metaphor of the gas bottle, I tried to get her to imagine it breaking or collapsing. She could not see that. Then I said, " Has it got a valve?". Then I got her to imagine a tiny leak from the valve. That transformed it. Suddenly the gas bottle was emptying and pressure had gone.

She then gave me a visualization. She said "I am dressed in a fairy costume. In a room full of grownups. I am dancing and showing off. I am delightful and getting noticed". Then she said, "They are all stroking my hair".  I developed this metaphor. I told her she was dancing and spinning. As she spun more and more I suggested that little girl was growing up.

Then I put her in front of two mirrors. One was today's overweight woman, the other one showed her as she wanted to be. I was going to use the standard change procedure of moving from her one to the other. But she surprised me. She said "the fairy has touched the mirrors with her fairy wand. And I am now changed to the new picture". She had come up with her own transformation method!

My final help was to give her a visualization of  her dancing down the street in her fairy costume and into her new future. Lovely.

How do you deal with problem eaters? Leave a comment below.

 

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cannot visualize

Hypnosis for people who cannot visualize

Can't Let go of what she said

My client today discovered that his female partner was texting someone in Australia boasting that she was having sex with some other man. She explained to my client that she was actually winding up the other guy. He has accepted this explanation but cannot let it go. Every time they have an argument or disagreement he brings it up. She is now telling him to get over it, move on, or find somebody else.

He keeps thinking about the incident and can't let it go. The suggested to me that he has depression. I showed him my  dysthymia check sheet and he agreed that he is all over it. He told me that his sister is bipolar. I decided to teach him  some thinking exercises.

I started on the Tiger exercise. He immediately told me that he cannot visualise aTiger. In fact he cannot visualise anything. I tested with various things. He couldn't even visualise a circle. He said that when he thought about the Tiger what came to mind was his own cat. A fat and lazy cat. But he wasn't seeing the cat. He was experiencing the cat. He had no visual ability at all. I therefore could not use the thinking exercises. I didn't really know what to do.

Hypnosis for people who cannot visualize

I asked him what he gets when he thinks about the texting incident. He told me that he can remember the car, and her leaving her phone on charge, and him thinking there's something odd about the text he'd seen, and then checking again later. He could not visualise any of it. He was quite astonished that I could visualise things easily and clearly. He appeared quite worried by this as if there was some sort of deficit in him. But when he was talking about the incident he said "I can feel it now". I therefore decided to do metaphor replacement therapy on it.

I got him to think himself back to the incident and he quite quickly got the feeling. When he confirmed he had the feeling I asked him how big it was. "Massive". I asked them what colour it was. He said "maybe black?". He was not visualising it. I asked him "is it hot or cold?". He said it's cold. I asked him "what shape is it?". He said it's like the shape of a person, and outlined shoulders and a waist in the torso.

I asked him "can you make it a little bigger". He immediately said "no". I asked him if he could make a little bit smaller?. He immediately said "yes". Very quickly he made it so small it could fit in his hand. I asked him what would happen when it goes away. He said he could be free he could have a chance of getting her back again. He would be able to make good decisions again.
I then asked him what he wanted to happen to that thing. He said he wanted to throw it away. He imagined himself standing on a cliff and throwing this thing down. I then talked him through this thing going into the soil and rusting and turning into earth and being washed away.

I then tested him to go back to the incident and see if there was any feeling left. He could find no feeling. But he still wasn't convinced that it had gone. I talked about the process for a while and explained how it all worked.

Cannot visualize his second issue either

Eventually he said that he's got another issue. He has jealousy about an ex-partner of his wife's who in his opinion stands too close to her and is trying to upset him. He gets angry and jealous whenever he is near his wife. I asked him to go back into the feeling. He got that. I asked him "and what is it like?". He said "is like a sheet, a sheet enveloping me".

He then said that he could pull the sheet off and I got him to do that in detail. He said that he'd thrown the sheet down on the ground. I asked him to pick it up. He had it between his hands. And I then got him to do something to it. I suggested he could tear or shred it or set fire to it. He decided to set fire to it. It ended up as a small pile of ash very quickly. I got him to blow it away and sweep up whatever was left and it was over.

He agreed that the feelings had gone but was still quite skeptical about whether it would stay gone.

What I realized from this client is that I have found a way to deal with people who cannot visualize. I was really surprised at how well metaphor replacement therapy worked for someone who could not visualize at all.

How do you deal with non-visualizers?

 

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brief therapy

Brief Therapy hypnosis

I met a client today with travel anxiety problems.  He told me that he had been seeing another therapist for almost a year. This therapist had charged him thousands of dollars without creating any change in how he felt.

I find it astonishing that a client can continue charging someone week after week even though the client is getting no benefit. I find it even more disturbing that there are therapists who are so unprofessional as to encourage that. To my mind, applying the same therapy technique over and over, and producing no a significant change, is verging on fraud.

Hypnotherapy is brief therapy. In my practice, if I cannot make a definite, obvious difference in two session, then I advise the client that they may be better to find a different treatment.

Hypnotherapy is brief therapy

Hypnotherapy should be a brief therapy. The common distinguishing features of brief therapies of all types are:

1. Typically between one and twenty sessions.

2. Uses a rapid assessment to identify a core issue

3. Establishes and agrees  a specific therapeutic goal.

4. Focuses each session on that therapeutic goal

5. Active and direct interventions from the therapist.

Most common number of sessions = one

Research on therapy effectiveness investigated how many psychotherapy sessions clients actually attended (Talmon, 1990). It was found that:

(1) the modal length of therapy for every one of the therapists monitored was a single session;

(2) 30% of all clients chose to come for only one session in a given twelve month period; and

(3) there was essentially no correlation in a follow-up study between what the client stated helped them, and what the therapist thought was helpful in that session:

‘in most of the single-session therapy cases where patients reported particularly successful outcomes, the therapist appeared to have conducted a rather simple, almost dull session. In fact, in many successful single sessions, it is the patient who appears in control and sets the pace for change’ (p111).

This truth needs to be made clear to most hypnotherapists: you will probably only see the client for one session, whether you are successful or not. So you better get better at brief therapy.

 

What do you think of brief therapy? Would you go on seeing a client for years? 

 

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home invasion anxiety

Home invasion anxiety removed

I had a client yesterday who told me she needed help with anxiety. She said she had been diagnosed with Generalized Anxiety Disorder. She said she had been on anti-anxiety medication for five years. Five years ago her marriage was on the rocks, she was being made redundant at work, and a parent was seriously ill. In her own words 'she went into meltdown' and had to be put on anxiety medication. This is a fairly normal description of a cluster of life events that triggers anxiety. However, I wondered why she was still anxious five years later.

Home invasion anxiety

I asked her what she thought the cause was. She immediately said "it is all about a home invasion I had when I was a kid. I woke up to find some man sitting on my bed". She was convinced that she had dealt with that. However, her current anxiety focussed on night-time, on being left alone, and on a fear of someone harming her.

I recently read a book by Peter Levine 'In an unspoken voice'.  His belief is that almost all anxiety comes from being in a situation that you feel powerless to escape from. Not dealing with the situation properly at the time leaves you trapped in that feeling for ever. The symptoms of this client fitted that description completely.

I thought this might be an ideal opportunity to try out the therapy recommended by Levine. This treatment basically involves muscle memory. You get the client to remember the incident, if possible to get into the fear. Then you get the client to use their muscles as they would have if they had made their escape. His theory is that the fear is 'frozen' into the victim's muscles, and needs to be released.

Releasing the home invasion anxiety 

He does not mention hypnosis at all but his recommendations lend themselves ideally to application in trance. I therefore put her into trance used a modified form of regression. I took her back to the home invasion, but instead of getting her to relive it, I suggested that she focus on the feeling. Then I told her to tense and release the muscles in her shoulders, and then her chest, and so on down her body.

I then suggested that she focus on her hands, and to become aware of what her hands wanted to do. I encouraged her to make micromovements as she thought about what she wanted to do. Then I asked her to imagine what muscle movements she would do if she was to fight the intruder, or she quickly got out of the bed, or if she pushed an alarm button. I took her through various scenarios that I thought might be appropriate ways of dealing with the situation. I tried to get her to talk through what she might have done, but she was unwilling or unable to hold a conversation while in trance.

After that, I brought her out of trance, and showed her how to go back into trance by herself using self hypnosis. I did this to teach her a technique that would allow her to turn off her chronic anxiety by resetting her feelings back to a calm level.

Clearing the Home Invasion anxiety

At the end of the session I asked her what she felt about the micromovements. She told me that had felt a tingling all over her body as she tensed and relaxed. She then said that the feeling of 'waiting for something to happen' that she always had, was gone.

I wonder to what extent the 'cures' that are credited to hypnosis are actually the result of the induction that most therapists use, the Progressive Muscle Relaxation Induction? It may be that it is the progressive tensing and relaxing that are doing the work, and all the 'patter' is actually irrelevent. It is maybe something to think about?

 

What do you think of this technique? Do we hold fear in our muscles for years? Share your ideas below.

 

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smoking and mindfulness

Smoking and Mindfulness

I have been reading Alan Wells' excellent book on metacognition and depression.  It is perhaps a  bit hard for the lay person to follow. But with the academic jargon stripped out it makes a lot of sense.

He introduces the idea of Detached Mindfulness; a state of being able to observe thoughts without acting on them. He differentiates between able to experience a thought from the point of view of an observer, and experiencing a thought as some thing that fuses together reality, belief and behavior  into one unbreakable unit.

Smoking and Mindfulness

I was thinking about this in the context of how to use it to get people to stop smoking. Smoking and Mindfulness are not often linked but there may be a way to combine them in therapy. I got to wondering about how it fits into the classical psychology conditioning model. That model sees learned behavior as the result of conditioning: stimulus →  response → reward.

However all these studies were originally based on non-sentient being like clams and worms. Humans are different in that they don't have to respond instinctively to everything. If you blow a puff of air into a person's eye, they will  blink. No matter how often you do it, they never unlearn it, and they cannot not do it.

But many stimuli cause different responses in different people, so perhaps the model needs another element: stimulus → thought → response → reward.

If that is a better model of how people actually respond to stimulus then it suggests that intervention based on changing the thought should work just as well as intervention based on changing the reward.

What do you think? Share your ideas below.

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shape shifter

Shape shifter hypnotherapy technique

I had this enquiry from a therapist today:

I have a young man coming in who believes he’s a shape shifter and who has had a kind of paranormal experience with a green lizard/Shapeshifter. He wants me to regress him to that experience so that he can understand and remember more about it. He also has a lot of anger at this father, mother and grandfather. Today is the first session and I’ll simply be trying to understand more about this experience and having him experience hypnosis. I wonder if you have any suggestions that will help me at this point be the support he needs.

I replied:

It sounds like you have a very interesting client. It seems to me that he has two issues. He has fairly standard resentment and anger towards certain people, and he separately has experienced some sort of hallucination that he doesn't understand. The two may well be connected.

I would approach this by suggesting to your client that we treat it as an exploration. It would be useful to find out the exact circumstances of when he had this experience. He may have been having them for quite a long time. I suspect that if you put him into trance, and deepen him into somnambulism, he will spontaneously regress. When he is in the state of experiencing his shape shifting then you can guide him to a place in his mind where he can safely observe what is going on. The shape shifter imagery will most likely be a metaphor for his basic fears. You can use any of the metaphor transformation therapies as a way of getting rid of the shape shifter thing. Or if he wants to keep them, then you can suggest that he is able to transform them into a source of personal power.

I would go on with exploring his shape shifter experiences until he has either resolved them or come to some sort of understanding about what they mean for him.

I think you then have to address the issues of anger and resentment against his family. I'm sure you know how to deal with them so I won't comment further on that.

I think you have a very interesting case there. I wonder what will come out at future sessions?

 

How would you deal with this ? Share your ideas below.

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say nothing

Train yourself to say nothing

I got an email today from someone looking for help with their client.

I'm looking for a script that will help eliminate a person from using aahs and ands when he is speaking to groups. He strings his sentences together with and and when he is thinking what to say next he says aah. Do you have anything that would work or that I could tweak to help him?

My reply was:

I have been a university lecturer for over 40 years. Like most speakers, I too used to uummm and ahhhhh during lectures. I only became aware of it after I had to  transcribe some of my lectures. It was embarrassing the number of 'hesitation' noises I made when talking to my classes.

I set out to get rid of them and I have succeeded totally. The trick is to become aware of them. As soon as you become aware of them you can avoid standing there making noises just to fill in the gaps. I found that there are two methods you can use.

Make sure you have something to say.

The first one is to not start speaking without knowing what you're going to say. When you are a teacher or a lecturer you feel there is an intense pressure to talk all the time. You need to show that you have something to say. This in fact is not true. It is immensely freeing to be able to say "I don't know". You can then say "what do you think the answer might be?" Or you can say, "I'll do my best to find out and I will explain it in class next time we meet." Or  just say "let me think about that for a moment, talk amongst yourselves". Once you realize that that is no need to keep up the continuous flow of speech your speaking becomes much more natural.

Train yourself to say nothing.

The second thing you can do is when you don't know what to say next, say nothing. This is my preferred method. When I am searching for the next word, looking for the right phrase, or even when I got no idea whatsoever, I just pause. I make no sound whatsoever. And the great thing is, that most people don't even notice. And certainly, nobody cares.

That is by far the easiest way to get rid of the unnecessary Ummms, Ahhhhs, "youknow", 'like' and all the other fillers. So what I suggest you do with your client is to plant a post hypnotic suggestion that he will become acutely aware of every time he utters a filler noise. And that when he is about to say some pointless syllable he actually stops, pauses in silence, and gives his brain time to catch up with his lips.

I think that will be the easiest way to help your client.

 

How would you deal with this ? Share your ideas below.

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betrayed wife

The case of the betrayed wife

On New Year's Day this client discovered that her husband of many years had been unfaithful. He had been seeing other women, and had been consorting with prostitutes. She felt devastated, despairing, and depressed. She felt worthless. As soon as she sat down I asked "what would you like to have happen?". She started weeping. It was obvious she was in great distress. She told me briefly that her husband had betrayed her with other women.

Visualising her emotional distress

Since she was clearly suffering emotional pain the obvious therapy approach was to change that pain into something else. I told her to close her eyes and focus on the feeling. This immediately brought floods of tears.

However she was very cooperative and when I asked her to focus on the feeling and forget about everything else, she did so. I told her to isolate the feeling and think about it as an object.

She told me that the feeling was like some round shape. I started to develop the metaphor. She told me it was big, greyish white, hard, solid. Then she said it's a rock a stone. She said it was heavy. And it was the same all the way round. I asked her what she wanted to have happen to it. She said "I want it shattered."

I said "And what can you do when it his shattered?" She said "I wouldn't have to look at it, it wouldn't be there". More crying. I then suggested "you want it gone shattered, gone forever?". "Yes, that's right." "And what would that mean for you?" "It would be gone, I wouldn't have to see it, it wouldn't be there. " I was unable to get the usual link between the desired outcome and the emotion, but I decided to press on anyway.

Metaphor transformation therapy

By this point her eye lids were trembling and she had clearly gone into trance. I then repeated all the attributes of grey, hard solid, et cetera. I asked her if she could imagine it a little bit different. She said "yes it smaller, and it is pink". We then quite quickly developed it down into a little stone.

I said, "and what would you like to have happen to that little pink stone?" She said " throw it away." I asked her "and where would you throw it?" She said "into the water." So I asked, "what kind of water would that be? The sea, river, lake?" She said, "a river." So I talked her through what happens to stones that end up in rivers. I suggested that it would get bashed against other rocks, chips and ground down until it was like sand. I then suggested that the sand would end up on a beach and get washed clean by the waves.

Hypnotherapy for the betrayed wife

She was still in trance I decided not to take her out of it and ask her how she felt about the betrayal now. Up to this point the whole process had taken four minutes. I suspected that, based on experience from other cases, much of her problem would be based on her imagination of what other people would think of her. She was probably mortified at the thought that other people might in fact have known about her husband's behavior before she did. There is always a great deal of guilt and embarrassment in this sort of situation.

So I did a short session designed to reinforce her feelings of friendship with other people. I suggested that she was surrounded by all the people who know and love her. I suggested all these people were reaching out to her. I told her to hear them talking. There were all saying "it is not your fault. You didn't do anything wrong."

Connecting to others

I suggested that she imagine hugging all these people together and feeling all the good feelings, all their support for her. Then I suggested that she would notice different behavior from her friends. Some of them would be openly supportive, someone would feel bad about it and not know what to do. She just had to accept that different people react differently.

I emphasised that there would be a difficult few weeks ahead. But deep inside she knows that she is okay. And I repeated the mantra "you have done nothing wrong."

To reinforce the feeling of having banished the distress from the betrayal. I did a metaphor technique of getting her to visualise her distress, and then drain it away. I got her to fill the bad place where it had been with good things.

A reframing metaphor for the betrayed wife

Then I used the metaphor of being in a dark room. That new strength in her allowed her to find the door, and open it, and to get out of that dark place. When she left a dark place, I reframed it as being a new beginning. That she could now choose for herself, be herself do what is best for her.

I then linked relaxation with accepting things as they are. The more she relaxed, the deeper she went, the less value she gave all the things that had happened recently. Then I did a finger move confirmation. I used that to tell her that her own unconscious mind had heard what she wanted. Moving that finger was her guarantee that she had changed. Then I got her to send a message of gratitude to her mind. The whole session took less than 20 minutes.

I asked her how she felt about the events of New Year's Day now. She looks a little puzzled. And then she said "it really doesn't matter now."

How would you approach this case? Share your ideas below.

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bulimia hypnotherapy

Bulimia Hypnotherapy

This client asked me for bulimia hypnotherapy. I really wasn't sure what to do. Bulimia is known for being extraordinarily difficult to treat. I asked her about her history. She was very open and happy to talk about her condition. She said that at its height she would vomit three times a day. Pretty much after every meal. She ended up dangerously thin.

Her life has been dominated by bulimia. It started in her teenage years. She managed to stop on her own when she left university and had to get a new job. She felt that she would now be in control. And it worked.  When she got her first job she realized that she couldn't keep doing this and keep a job. Then she changed jobs. She had a week in between. This allowed her mind to begin to ask "what if?" And she just fell apart. She left the new job after two days and had three months off.

Bulimia Hypnotherapy

Right now she is worried that she is going back into it and vomits twice a week. I couldn't really find any one thing that triggered it or that she was worried about. Her parents had always been helpful and supportive. She could not think of anything in her childhood that might have set it off. She said in it was all about anxiety.

This gave me the idea that I might be able to deal with the anxiety directly through metaphor replacement. I asked her to think about the anxiety and what it was like just before she feels she has to vomit. She said is a mixture of anxiety and fear. I told her to focus on the fear. I got her to concentrate on the fear to allow it to come out to be aware of it. Fortunately for me it was right at the surface and she was able to latch onto the fear immediately.

I asked her where the fear was in her body. She said it was in her chest and in her head. Previous experience has shown that I cannot do anything when the client says the feeling is in the head. So I focused on the feeling in her chest. I asked her what it was like. After a while she said, "it's like a square". I said, "is it a square or a cube?" "It's a cube."

I then got her to describe the cube in increasing levels of detail. She said it had sharp edges. When I asked "how big is it?", She said "it's about the size" and gestured with her hands indicating was about the same width as her body. It was hard, cold, solid, heavy, and grey. When I asked, "and what else to know about this cube?" She said, "I have to carry it about with me."

Metaphor Replacement for Bulimia

Having established the fear as an object, it was just the case then of getting her to change it. I asked "can you imagine making it a little bit bigger?" She immediately said "yes". I asked, "and can you make a little bit bigger still?" "Yes." "And even bigger?" "Yes." "And can you make it a little smaller?" "Yes." And she proceeded to demonstrate that she could make it a little smaller.

I encouraged her to make it smaller and smaller until at some point she said "it's in my hand I can hold it". I asked her, "and what is it look like now? How has that thing changed?" She said, "has rounded edges, like a die". I then asked her what she would like to have happen to this thing. She said, "I would like to throw it away". I asked, "And where would you throw it?". "Into the ocean." I needed to make sure that she got rid of the thing completely. So I asked, "and where would you throw it into the ocean?" She said "from a clifftop".

I then said "now imagine yourself on that hilltop. Imagine you have that die in your hand, and you are throwing it off the cliff". To my surprise, she picked up a hand and made a throwing motion. I said to her, "describe what is happening as that thing goes into the ocean." She said "it's gone into the water with a splash". I wanted to be sure that the object was totally destroyed. So I said to her "what happens to things that went to the ocean?". She said "they settle on the bottom".

I could not get her to give any more detail, so I prompted her to begin thinking of how to destroy the object. I suggested that saltwater might have an effect on it. She said "is beginning to rust the surface is now mottled". I then went on to suggest that the rust would continue, it would flake off, that thing would break up into small parts. I then got her to agree that the thing would get rolled around in the waves and broken up into tiny pieces like sand. They would just be dispersed out and gone forever.

Then  I asked her to take three deep breaths and relax even more.

In that state, I asked her to become aware of her own body. I told her, "now check on around your body. Check your knees and your knuckles in your nose and everywhere. See if there's anything left of that old fear that needs to be dealt with. Or has it all gone?"

After a moment she said "it's all gone".

Her Experience of bulimia therapies

We then spent some time talking about bulimia and how it affected her life. It really is a devastating disease. She was a lovely young woman, and yet had never had a boyfriend. We talked about the various therapies that she had been involved with.

I asked her "what did you find most useful to you in those therapies?" She said "I found a form of group therapy very helpful. I met a lot of people, very ordinary looking people, who also had the same illness. That allowed me to believe that I actually was normal. There wasn't something weird about me. That I wasn't the only person in the world to do this. I also found some of the CBT exercises that I was given were useful in turning off the thoughts".

Then I asked her to check again about the fear that she had been talking about. I wanted to be sure that I had actually made a difference to her. She said, "no, it's really gone. I can feel it. I know that is just not there now."

How would you approach this case? Share your ideas below.

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