Month: September 2017

Open post
Google Diagnosis

Google Diagnosis

    A little knowledge is a dangerous thing

    I had a client come in last weekend who  reminded me of the dangers of Google Diagnosis. He told me he had OCD and wanted me to cure it. I asked him "How do you know you have OCD?" He said "I started making a list of my symptoms, and then I looked them up on Google". He went to lots of different sites and the more he read the more he was sure that he had OCD. And now he wanted rid of it.

    I started asking about his symptoms. He told me what they were. I pointed out that in fact there are many things that could be causing them. And some of the symptoms he was listing were contradictory. But he was adamant. He had OCD. Here was here to get me to fix his OCD. He wouldn't hear of anything else. OCD was it. He wanted cured. My job was to get on with it.

    Don't do Google Diagnosis

    It took a lot of patience and counselling and persuasion to get him to consider that perhaps he did not have OCD. What he actually has is a form of depression. When we went over that, he found that all of the symptoms were better explained by that. And just as importantly, there were other symptoms he had been ignoring that were predicted by the depression.

    We then sorted out a plan for him.

    But it is just too easy to get information from the Internet and half understand it, and then base your life on that. How many other people have convinced themselves that they are suffering from this thing or that thing, and are self medicating themselves into ill health?

    A little learning is a dangerous thing;
    drink deep, or taste not the Pierian spring:
    there shallow draughts intoxicate the brain,
    and drinking largely sobers us again.

    Alexander Pope (1688 - 1744). An Essay on Criticism, 1709

    Open post
    improve hypnotherapy

    Simplest way to improve Hypnotherapy?

      A simple way to Improve Hypnotherapy?

      What is the easiest way to improve your hypnotherapy results? I asked this in a discussion recently.  The group agreed the simplest way to improve hypnotherapy was avoid talking too much.

      We all do it. We are supposed to find out what the client really needs so we can plan the session. But the therapist's enthusiasm often results in talking instead of listening.

      True, hypnosis is one of the talking therapies.  You are supposed to talk. But talking therapies are based on getting the client to talk, not the therapist. Counselling is about making the client feel heard and understood. Psychoanalysis is about allowing the client to talk about their thoughts by free associating. Clean language is about removing the therapist from the conversation as far as possible. Therapists desperately want to help. But they are human too. Therapists get nervous and flustered. So the tendency is to jabber on. It is very tempting to talk about what you think instead of listening to what your client thinks.

      Silence improves hypnotherapy

      Asking the right question is a key skill. Listening to the answer is a more important skill. Sometimes saying too much is the wrong thing. Silences can tell you a lot. But too often the therapist jumps in because they don't like the silence, and feel that have to be doing something. Although some therapists feel uncomfortable with silence, silence is a very effective technique to allow the client to collect their thoughts. And if it goes on too long, the right thing to do is to ask 'and what are you experiencing now?' and let the client tell you what is going in their mind.

      Rule 1. Don't be the next person to speak after you ask a question. When you ask a question, and the client does not answer immediately, the silence can be deafening. Many therapists feel uncomfortable with prolonged silences. They panic, thinking that the question was badly worded, or the client has and understood it. So they say "What I mean is…" and either answer the question themselves or dilute the power of the original question.

      Rule 2. After a brief reply to an open-ended question, wait a few seconds before saying anything. Very often, this will prompt your client to expand on the question, to tell you things that were being held back, to open up about their worries and reservations. Clients are also uncomfortable with silences. They will usually blurt out something that they were keeping back just to fill the silence. This technique can be very useful, but don't turn it into an interrogation method.

      Rule 3. Allow some silence after you have delivered  bad news. When the therapist has to deliver some bad news, sometimes it is the therapist who feels nervous, and talks too much. If you have to tell a client for example, "you have depression", it is better to say nothing more and give the client time to process this information.

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      hard case smoker

      The hard case smoker

        Last weekend I had the kind of client we all dread. The hard case smoker: Someone who didn't believe that he could give up, ever. He had tried everything. He was only coming to hypnosis because it was the last thing on the list of all the things he had tried that didn’t work. Now he wanted to be able to  show that he done everything possible and nobody could get him to stop smoking.

        He started smoking at 15. As a teenager, he was rebellious and resentful at home. He didn’t get on with his dad. He reckoned that as the youngest child his parents had expended all their energies on the older kids and he was of no interest to them. Smoking started when he joined the rugby team. He loved being part of the team, of feeling he belonged and was part of a group. He left home and joined the army. The Army made him feel included, somebody, a tough guy, always loved the camaraderie, the inclusiveness.

        He later returned home and from the moment his father picked him up from the airport they began to reconcile. As time went on they became closer, and then his father got throat cancer and died suddenly. He was devastated by this. It was in 1982 but he still feels it keenly.

        He is scared of dying and convinced that he cannot stop smoking and that the smoking will kill him, but he is powerless to stop.

        Finding a metaphor for the hard case smoker

         I ask my clients a question to establish their feelings about smoking. I say what comes to mind when I say ‘You will never have another cigarette as long as you live’?  When I asked him what he felt he said "dubious".

        I asked what smoking looked like and he said a group: him and all the group smoking. Then I decided to develop this and got him to describe the feeling he got with the group. He said the feeling was of being at peace, happy, not wanting it to end. I asked what colour that feeling was and he said red, and square. I asked if he was inside that square. He said, Yes, with all the group. Then I asked if he could drop his cigarettes and get everyone else do that too. He said he could. What has changed? He said nothing.

        So I developed that in metaphor. I got him to imagine that they all dropped all the tobacco and lighters and stuff and there was everything on the floor, ash, ashtrays, cigs etc. I asked if he could sweep it up and throw it out of the red square. He said no. So I used incrementalism and got him to put one shovel-full out and if that was OK. He said that would be OK. And then another shovel, and then more shovels, and then all the group were helping and cheering on and he was a leader and the most popular guy in the red square. He eventually cleared out all the smoking stuff and still had all his friends with him in the red square room.

        Anchoring the hard case smoker

        What was particularly interested about this process is that he had gone into trance with no induction. I notice that when I get a client to focus on a feeling, and follow that feeling they normally go into trance. As long as I do nothing to break the spell, they will stay in trace and not even notice. In NLP this is called revivification. NLP asks the client to think about a memory and get into the memory so as to anchor the feeling. Then when you fire the anchor the client goes into the feeling, in effect goes into trance. This method just starts with the feeling. 

        To finish the session I  got this client to go on a journey where he met his dad. His father released him from the smoking and told him that he could live a long and healthy life. I finished off with my standard stop smoking direct suggestions.

        It remains to be seen if this client has in fact stopped for ever, but at the end of the session he said ‘It is weird, but I feel different. When I left that square room it had changed color!’

         

        Open post
        Everything makes me nervous

        Everything makes me nervous

          Everything makes me nervous

          I had a first today with a client. The client was a tiny woman but grossly obese.  She seemed to be almost as broad as she was tall. She was also excessively nervous and fidgety.   And that was the problem she wanted to deal with: anxiety. Anxiety makes her overeat. She said she had been anxious for as long as she could remember. I asked her "what make you anxious?" She said, "Everything". I assume that this was a joke, but she told me she was deadly serious. "Everything makes me nervous."

          So I started to look for the reason for the anxiety and the overeating. I expected that there would be something in her childhood. So I got her to tell me about situations where she feels nervous generally, and any specific situations where she felt nervous today. She couldn't find any. She just said "everything makes me nervous."

          I started to talk about her overeating and what she might do to prevent anxiety. I outlined some situations where this or that might happen. As she thought about these, she began to get visibly anxious.  

          Not how to deal with anxiety

          She reached down the side of the chair to get her handbag and put it on her lap. Then she opened it up and said to me 'Do you mind if I eat?' I thought I had misheard. I asked her to repeat what she had just said. To my surprise, she took out a packet of cookies. Apparently she carries around a bag of butter cookies everywhere she goes. She nibbles on one every time she feels anxious. My questions were making her feeling anxious right now, so she wanted to start eating a cookie while lying in the chair talking about overeating!

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          weird dreams

          Weird Dreams

            Last night as we put the light out I was about to say to my wife 'sweet dreams' when I realized that 'sweet dreams' is actually the last thing you would want to wish on someone.

            What weird dreams are for

            The purpose of dreams is to allow the mind to resolve things that have not been resolved during the day. Dreams also are an outcome of processes by the unconscious mind. All dreams are expressed as metaphors. This is why then seem so bizarre. Each element is a symbolic representation of something that is held in your mind and the action of the dream represents the interaction between different parts of your mind. The essential aspect of a specific dream is that everything represents you, every part of the dream is a part of you.

            My Weird Dreams

            I recently had a weird dream of having to go into a large multistory building. Outside was an Indian looking couple in a four poster bed with rich drapes hanging down. Around the couple was a large group of angry people. The couple in the bed were looking very apprehensive. But I felt compelled to leave them there and go into the building. Inside the building I got lost in a confusing mess of different rooms, stairs, lifts etc. While trying to find my way out I realized that the couple in the bed were going to be stoned to death. I thought that I had to get out and stop it but I couldn't find the way out.

            Eventually I did get out and back to the place but the crowd had gone and there was just a huge pile of rock there. I thought to myself' 'well, there was nothing I could do about it really, it is not up to me to interfere in other people's cultures' and I went on my way.

            Analyzing weird dreams

            This sort of dream is full of violence and feeling trapped and is the exact opposite of a 'sweet dream'. However what the dream represents is two parts of my mind. One part is not longer useful to me in living my life: old ideas, self beliefs and outdated rules. That part is represented metaphorically by the couple in the bed. I suspect they were 'Indian looking' because that represented 'foreign' in my subconscious.

            The other part of my mind wants to get rid of those old beliefs, feelings or whatever: represented by the angry crowd. I got lost in the building as a metaphoric way of not interfering consciously in the cleansing process.

            It only through this type of dream that you make changes in your mind and learn and mature. The person who first came up with the wish for 'sweet dreams' didn't know what they were talking about.

            Open post
            Nervous Bowels

            Nervous Bowels

              Many people have Nervous Bowels. This client was a lovely woman, elegant, composed, and with a terrible secret. She gets immediate diarrhea every time she has to meet someone.

              It is not uncommon for people to get shaky bowels whenever they think they're going to be judged. It happens to sportspeople just before they have to perform. Entertainers get it before they go onto the stage. Most people feel some sort of unpleasantness in their gut in the face of a stressful situation.

              Living with nervous bowels

              In this case the client had been pretending for years. She had a high level position in education and was widely respected for her skills. But she had been hiding the need to rush to the toilet every time she was introduced to someone. After some questioning, it became clear that this was not a normal case of stress induced diarrhoea. This woman could happily address the groups of people. She  had no problem with public speaking. She could facilitate small group meetings, and do it very well. Interacting with two people was OK also. But the prospect of talking to just one person sent her running for the bathroom.

              After some investigation I discovered it was really about the fear that she would have to leave the other person alone. In her mind, this was unacceptably rude. So her fear was that she would be called away to something else and have to leave the other person on their own. It was really about what that other person would think of her for doing that.

              I tried to get to the cause of this. She said she had a great childhood. She could find no reason for this anxiety. The only worry she could find was that she was very nervous about her own parenting skills. However I could not find any direct cause for why leaving one person alone should generate these feelings.

              Treating nervous bowels

              I decided to use metaphor therapy on her feelings of anxiety. I asked her to put yourself into the position of being forced to speak with one person. The objective was to get her to go into the state so that I could work directly on the feeling. She tried and could not get into the feeling without being there.

              So I put her into trance. I did a simple metaphor therapy about allowing her unconscious mind to search for the source of the feeling. Her unconscious mind found the source of the feeling and pulled it out of its hiding place. Then her mind took that thing and broke it open. The contents turns to liquid. I told her the liquid was pouring down inside and leaking out through the soles of her feet until it was gone.

              Clearing the problem

              This metaphor triggered something, because she started crying. I use that to associate into her feeling of distress. I then asked her to focus on the feeling and describe what object it most resembled. She told me it was like a brown ball full of moving clouds of black. I worked on this representation and got her to shrink it. She was able to shrink it until it was the size of a golf ball. But she was completely unable to get it to go any smaller.

              From experience, I know that this is her unconscious mind resisting my attempts to get rid of it. So I changed the metaphor.  I asked her if she had ever sliced a tomato. Slicing a tomato is something that everyone has done. It is easy and familiar. The moment that I said it, she was no longer stuck. She told me that she was now able to slice the golf ball. I then told her to think about dicing vegetables or something like that, as she got rid of the thing completely and she got rid of the thing completely.

              I have no idea what the origin of the problem was, and neither does she. But by using metaphor therapy we were able to get rid of it completely.

              The origin of her nervous bowels

              After talking about the process and the outcome for a while, I asked again about her upbringing. Now that her unconscious mind had removed whatever it was, she told me a different story about growing up. It turned out that she had a not so good childhood. She had an adopted older brother who caused problems in the family and bullied my client. Her mother expected perfection, that my client felt she could never deliver. Her mother was into Guiding, and loved rules, and discipline, and expected nothing else from her children. I suggested that she didn't have to look very far to find the source of her anxiety, and she agreed.

              Open post
              retraining-unconscious-beliefs

              Retraining unconscious beliefs

                I had an email from a therapist about retraining unconscious beliefs.

                I have a client who is limited movement in her left side from some childhood illness, yet when I do ideomotor questions she always responds with her left hand. She has shown me out of trance how little she can move her finger....basically she can't.

                What can I do with this, what does it mean?

                Retraining unconscious beliefs

                If I understand you correctly, the client has limited voluntary use of her left hand but can use it in trance. I believe this means that she has been told by somebody long ago that she is not able to move that hand. She has believed that, and still beliefs it. Therefore she has not been able to move it.

                Put her into trance and get the bad hand working with ideomotor suggestions, just as you have been doing. Then, still in trance, get her to open her eyes and see the hand moving. Ask her to confirm that it is moving, that it can move. This should be a revelation to her unconscious mind. It will cause her mind to rethink what it can do with her left side.   Suggest to her that because she has witnessed this, it means that she can now begin to exercise that hand until it becomes fully functional again.

                Other techniques for Retraining unconscious beliefs

                You can also use other techniques. For example, when she in trance and after moving the finger, ask her if you can talk to the unconscious mind. If she agrees, ask her unconscious mind if it will agree to giver her back the power of movement. Stress that this has to be done gradually and carefully, at the right pace for her. If not, ask the unconscious mind why it it is restricting her movement. You should be able to persuade it to allow her to get back full movement.

                Another technique would be to take her back to the initial event. Find the scene where she it told or concluded that she cannot move that side. Then use Inner Child work to re-imagine the event and give her a way to be able to recover the movement she lost.

                Open post
                cycle of addiction

                Cycle of addiction 

                  Cycle of addiction

                  The cycle of addiction explains why people cannot stop smoking. But it does not explain why smokers who abstained for many years suddenly start again. I had a client today who has got me re-thinking  everything I know about smoking. 

                  This client smokes 25 to 30 a day now but was able to give up for a year. He started again about twelve months ago after a breakup with his long term girlfriend. He came to see me because a few weeks ago he broke up with the latest girlfriend as well and had started smoking really heavily.

                  I suppose the simple answer is to learn to keep his relationships going. That is not likely to happen, but it got me thinking about why this would start him smoking again. It is well known that stressful events trigger smoking in current smokers, and often make ex-smokers start again.

                  Cycle of learned behavior

                  The basic psychology of learned behaviour is CUE-RESPONSE-REWARD. The person gets stressed, lights up, and then feels better. That is the cycle. The addiction comes when the cycle changes to CUE-ANTICIPATION OF REWARD-RESPONSE. The smoker gets a stress cue, immediately thinks of the reward, wants the reward, and then lights up to get the reward. If the smoker does not get the reward, that is, if the smoker does not immediately light up, then the lack of expected reward turns into a craving aimed at making the person do the response. If the smoker does not get the response the result is either anger or depression.

                  Most smoking therapies focus on the CUE: teaching the client how to ignore the cue. Some focus on the RESPONSE: change how the smoker behaves, suggesting other things to do instead. Some focus on the REWARD: changing the effect of smoking into a bad taste instead of the reward.

                  But the smoking problem is really in two parts: stopping smoking, and not starting it again. The time between these two points can vary from five minutes to five years.

                  Is stopping smoking actually a two step process?

                  But this analysis got me thinking. If the smoking is the response to cue, then you have to look at the cues. The cues are well known: time of day, finishing a task, having a break, getting away from a stressful situation, eating, drinking, after sex, and so on. These are the cues for the current smoker. They are not the cues for the past smoker. The ex-smoker goes through all of these without smoking. So what is different that makes an ex-smoker into a start-again-smoker?

                  My clients tell me that it is almost always some sort of stressful life event. Every smoker gives up before having the next one. Most smokers don't want a next one, so they are in effect forced into it in order to deal with their stress (which may be purely internal). The required level of stress for some people is trivial, and for others it is high. For successful ex-smokers the required level is very high, so high that they don't start again ever. For others there is some level of stress they cannot deal with, some level that will trigger the smoking behaviour again.

                  If that is the case then would it not be better to teach the client how to deal with life event stress as part of the therapy?

                  Open post
                  multiple personality disorder

                  Multiple Personality Disorder

                    The origin of multiple personality disorder

                    This week I have been reading an extraordinary book about another extraordinary book - "Sybil". Sybil was about a young woman who had been so horribly abused in childhood that she escaped into fantasy. She created sixteen different personalities, most of whom knew nothing of the other personalities. Sybil could do things in one personality and be completely unaware of having done it when she was being dominated by another personality. This was the origin of  Multiple Personality Disorder.

                    Sybil sold six million copies, and was turned into a successful film. On the way it created the entire industry of finding and wrestling with multiple personalities. Therapists all over the world discovered that their clients too had multiple personalities, and some made stellar careers from studying multiple personalities. Multiple personality became firmly fixed in the public mind. Dissociative Identity disorder became a standard psychiatric term.

                    It turns out that Sybil was a complete fabrication designed simply to make money from a gullible public. The book was written by an unscrupulous therapist and  a sensationalist journalist. It set out to shock and titillate in order to sell the maximum number of books.

                    Repressed memories don't exist either

                    Multiple Personality Disorder has been totally discredited. But the history of psychotherapy is filled with disorders that don't exist, and that say more about the therapist than about their clients. Everyone accepts the reality of repressed memories. Except that there is no evidence for anyone anywhere ever having repressed anything. I have had people challenge me on that statement, but none have ever been able to point to any concrete evidence of repressed memories, other than stories.

                    The same thing happened with the whole recovered memories of sexual abuse in the 1980's. Thousands of therapists discovered that their clients had been horrifically sexually abused in childhood and had forgotten all about it for fifteen or twenty years. Except that it never happened. Hundreds of innocent men went to jail for imaginary offences.

                    The same sort of thing surfaced briefly about demonic possession, until rational people demanded that the sanity of the therapists be measured. Then the whole thing gradually went away. Until a few years ago, homosexuality was listed as a psychiatric disorder.

                    And there is the Alien Abduction thing. How anyone can take these stories seriously is beyond my comprehension.

                     But then, given that millions people contact fortune tellers, believe in spirit guides and go to shows where mediums contact the dead for them, perhaps these things will always be with us. 

                    Open post
                    Perfect childhood problems

                    Perfect Childhood problems

                      Yo-Yo Dieting

                      I had another interesting client at the weekend. She told me "I am tired of sabotaging myself". This woman was heavily overweight. She told a familiar story. She could not control her intake of food. For years she had been yo-yo dieting. Her weight drops by ten kilos, and then thinks that she can now do what she wants to do, and goes back to eating.

                      Eating problems are always due to unhappiness, so I always start by asking about the client's upbringing. This client said that she had been spoilt and gets on really well with her parents. Every time a client tells me they had an idyllic childhood, my heart sinks. I hear warning bells go off in my head. Anyone who had a perfect childhood would not be sitting in my office. I know they are lying to themselves, so I start probing.

                      Perfect Childhood Problems

                      Soon the client was telling me that her strongest memory from childhood was her brother going away to boarding school. She was left feeling devastated, empty and lonely. Then it turns out he went to boarding school because their parents went overseas for three months. Oh, and she was placed with a couple who mistreated her and she was terrified her parents were never coming back. Oh, and yes, the parents went overseas nearly every year, and parked the kids with couples they hired to look after them.

                      And when they were home, the parents had freezing silences and sulks that lasted for days. And her sister has anorexia. And her brother was always the favorite until he stopped doing so well at school and he got rejected. And she was sent away to boarding school. And she is terrified to this day of being abandoned, of not having anyone, of not being good enough. She has to be constantly pleasing people, making other people happy. Apart from that it was a perfect childhood!

                      It is always amazing how people can refuse to examine their own life. It is so easy to convince themselves that everything was lovely, because the truth is too painful to contemplate.

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