Category: Smoking

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Smoking Diagnosis

Smoking Diagnosis and Treatment

    Smoking Diagnosis

    I had an email today from a client who wants a smoking diagnosis.

    Good morning Dave!
    I’ve just made an appointment with you for two weeks’ time, and wanted to check in with you about it ahead of time. 

    I see that appointments are about an hour long. Does this session include a bit of a ‘diagnosis’? As you’ll know better than anyone does, people smoke for a variety of reasons and I want to make sure that my reasons to smoke would be taken into account. 

    For example, I had a hypnosis session yesterday, but it didn’t work because it was about hypnosis to relax instead of smoking to relax, and I don’t smoke to relax anyway—so my real reasons to smoke were neglected. 

    Does that make sense to you? I hope you can reassure me!

    Smoking Diagnosis is essential

    My reply was:

    When I deal with smokers, to me the most important thing is to find out why they smoke. In fact I will not go forward with a hypnosis session until I am completely satisfied and I know why they smoke, and it's also obvious to the client why they smoke.

    If I don't know why you smoke, then I really can't do anything much for you in hypnosis. Treating someone for relaxation is only going to work if relaxation is their problem. People smoke for thousands of reasons. I had one this morning who smokes on the anniversary of her daughters death. But this year, unlike other years, she wasn't able to give up as normal. So in that case I dealt with the cause of the stress that was keeping her going, and did some work to let her let go of her daughter.

    Smoking is always complicated. Smoking is always about emotion. I believe that tobacco is not addictive. I believe it is the process of smoking that is addictive. Many hypnotists treat all smokers the same. I do not. I am constantly fascinated by people's behaviours and why they do things.

    So yes, the first thing I would do is to explore with you why you smoke, and what you get from it. Only then can we have a reasonable chance of getting you to change your behavior. Every behavior is a positive purpose. My job is to find out what that purposes and redirect it.

    I look forward to meeting you.
    Dave

    Client's view of Smoking Diagnosis

    Hi Dave,
    Thank you for your very thoughtful reply.
    I’m so glad you think that tobacco is not addictive, and I’m frustrated that so many professionals believe that it is nicotine that causes smoking addiction. I know that’s not the case for me.
    I feel reassured by your reply, and I’m looking forward to my session with you.
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    Stop Drinking Start smoking

    Start smoking to Stop Drinking

      Start smoking to stop drinking

      My client was an events manager who cannot stop smoking. He says that when he stops he gets cravings. He read the Alan Carr book one time, and stopped for three years. Then he started again.  Nothing unusual about that.

      He stopped himself smoking for four months. Then he deliberately started again in order to be able to cut down on his drinking. He works in the hospitality industry and tended to binge drinking because it was available all the time. He thought that if he started smoking, he could stop the drinking. Apparently it worked. He did stop drinking but now he is smoking, and he can't stop.

      Patterns of smoking

      The pattern of repeatedly starting smoking, then stopping, and then starting again is a good indicator of Black and White thinking. A lot of smoking is caused by B & W thinking. I suspected that this client was smoking because he had high expectations and a touch of depression.

      I showed him the list of symptoms of dysthymia, and he said that he recognized parts of his behavior in every section. We discussed this for a while. I explained how dysthymia is a common form of depression, and affects many parts of your life, including your habits. I told him it was mainly an inherited problem, and he likely got it from his father or his mother.  He told me that his father in fact is an alcoholic. And it was clear that his father has all the symptoms as well.

      Inheriting Smoking

      I explained that his father probably had dysthymia. We spent quite a lot of time going over how his behavior fitted perfectly with the drivers of dysthymia. This all came as a revelation to my client.

      He could now see that many of the things that he was using as excuses or reasons for his own behavior were in fact not true. Depression was a much better explanation.  He confessed that he had long worried that he might have depression. But refused to go into it, because he was even more worried that he might have schizophrenia!

      He recognized that his dad was driven by some sort of 'demons'. At some level he feared that he too had these demons. And didn't want to end up an alcoholic as well. Having dysthymia as a rational explanation was a great relief to him.

      Ending stop smoking to stop drinking

      I did a standard hypnosis session aimed at helping him deal with his emotional problems. Once he has stabilized his behavior he will be ready to tackle the smoking. One step at a time. The real issue is not that he felt he had to start smoking to stop drinking. The real issue is that same unconscious behavior was driving both, as it had with his father.

      He was amazed and delighted by hypnosis and the calming effects of trance. He said that "I want to come back and do this every week". Great.

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      drinking problem

      Problem Drinking Bind

        Problem Drinking Bind

        My client came because she is having problems in her relationship with her husband. This is making her feel very bad about herself. This is a follow on from our previous session. She originally came because of problem drinking and couldn't control it.  I now learn that her husband has depression and is blaming her for everything goes wrong in his life. She is reacting to this tirade of blame by drinking.

        And when she drinks she is saying things back to him. He is then taking the things that she says, and throwing them back in her face.

        And the process is deteriorating. He is deep in depression and throwing out any kind of insult to her that will make him feel better. He is only interested in how he feels right now. He is unhappy, nothing works, he is fully depressed.

        Problem Drinking Bind

        He is attempting to trap her by saying "I can only change once you have changed". Then he makes it impossible for her to  change. He says that he won't change until she stopped drinking, but she is drinking in reaction to his behavior in the first place. They are busy building a negative circle. They are in a problem drinking bind. The more depressed he gets, the more he hurts her, and the more she drinks to escape it. But drinking makes her lash out at the unfairness of it all, and he feels justified in blaming her for that. He won't change until she does, and she can't change because of what he does.

        So now she is reacting to what he is saying by blaming herself. He is triggering feelings from her childhood. Growing up, she got beaten for no reason, and nothing that she did was right. So these unjust accusations are sending her into panic mode. Reliving  all these feelings are making her drink at night. And so the cycle continues.

        The way out of problem drinking

        I told her that she had done nothing wrong. Her husband is a victim and she is a victim. She needs to stop reacting to him with intellectual analysis. She needs to start putting up a shield project to protect herself from all the things that he is throwing at her in his pain.

        I told her that perhaps the best way forward is to get some sort of pharmacological solution. Not for her, but for him. He needs to get some medication to help him deal with the pain that he feels. As soon as he is begins behaving rationally again she can get into the pentathlon of exercise, diet, thinking challenges, socialisation and planning. That is the way out for her.

        She knows how to do that. But she has been so focused on her own pain that she hasn't really thought about how to get out of this thing.

        Sometimes the way to fix yourself, is to fix somebody else.

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        smoking yourself to death

        Smoking yourself to death

          Smoking yourself to Death

          Today I found yet another reason for smoking: Smoking yourself to death. This client could not stop smoking. She tried, and it worked for a few days, and she just had to start again. It is a very common smoking pattern. It is always because of some underlying psychological problem.
          Normally, I can talk to the client, dig into the childhood, and find out what is so threatening that she needs to smoke to escape from it.

          In this case, when I started digging, the most horrific story of family violence and abuse emerged. My client grew up in an ethnic minority household. Everything was deeply religious, and secretive, and closed to outsiders. She described growing up in a family where her mother was mentally unstable. Nothing and nobody was ever good enough for her mother. Her mother was totally wrapped up in herself. She had no interest in the children. As a little girl my client felt rejected and worthless, and was constantly told "Shut up and be quiet. Stop making it all about you!"

          Overcoming inter-generational abuse

          Eventually, my client learned why there was always a cloud of secrecy around the family. Her mother was the result of incest. Because of the huge taboo, her mother married the first man who would have her. He turned out to be a wife beater and drunkard.

          So she grew up in this dysfunctional household, emotionally abused by both her mother and her father, and ended up convinced that she was worthless and stupid, and constantly told she was no use to anybody.

          And yet, somehow, she overcame all this. She got married and had children. Her children were loved and cherished and gradually she began again. Through heroic efforts she got an education, went to university, and became a schoolteacher. "If I am a teacher, I can't be dumb!"

          Reason for Smoking yourself to Death

          She was doing well in her family life and her work life when a catastrophe happened. She learned that her own husband had been sexually abusing two of her daughters for many years. My client had no idea it was going on. Nobody believed her. "You must have known something was going on." She was devastated.

          They immediately divorced and she began again as a solo mother. Her daughters grew up, married, moved away and started their own families.

          And then to her horror, the whole cycle started again. It turned out that one of the relatives of her daughter's husband had started sexually abusing one of the granddaughters. This caused the whole extended family to split into factions. The whole issue of sexual abuse and incest was brought up again and again, fingers were pointed, wild accusations made. And now nobody is comfortable talking to anyone. Most of my client's daughters will not talk to her at all. And to top it off, my client has now been forced economically to move in and share a house with her mother.

          Nothing to live for, might as well keep smoking.

          She feels her life was ruined. A wonderful family that gave her fulfillment and happiness has been torn apart by sexual abuse. She now blames herself for not seeing her own daughter's abuse, and her granddaughters abuse. Nobody loves her, or wants her. Now she has no role to play, she is barred from seeing her own grandchildren. Her daughters are alienated and won't talk to her.

          The outcome is that she feels she has nothing to live for. She is consumed with guilt, and regret, and can see no way out of it. So she actually said "I'm smoking because I don't want to be here any more". I couldn't believe my ears. I said, "You are smoking yourself to death?". "Yes, that's right. I don't deserve to live".

          Hypnotherapy Response

          She wasn't suicidal, but she saw smoking as an acceptable way to kill herself slowly and get out of this bind. Well, I wasn't about to allow that to happen. The basic problem appeared to be displaced guilt. So I started on therapy to allow her to see her situation for what it was, and clear away any blame. The session went very well and I think I have been able to get rid of that feeling that "is crushing my heart ".

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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 because a friend suggested 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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            smoking procrastination

            Smoking Procrastination Fear of doing it wrong

              You never stop learning in this business. My smoking client today said she loved smoking but had to give up because it was affecting her health. I asked what she loved about it and she told me that it calmed her down. It turned out that she had anxiety all the time. Smoking was how she self medicated. She actually had smoking procrastination.

              Smoking Procrastination

              I discovered that she came from an alcoholic family. This led me to suspect that she would have some form of depression and I started probing gently about that. When we got to the questions about Black and White thinking she said that she was a procrastinator. She would stay in bed in the morning and her husband would bring her cups of tea. And with every cup she would have a cigarette. She said that sometimes she would stand in front of her clothes closet and not know what to put on, so she would have a cigarette and think about it.

              I traced this to the perfectionism associated with B & W thinking. She agreed that rather than take a decision that might be wrong she would put it off: smoking gave her an excuse to drag it out by another ten minutes. I think that she was fearing the wrath of her parent and wanted not to commit to anything in case it was the wrong action. In childhood when she got things wrong  she would get shouted at, and an argument would ensue.

              It seemed that she was mainly smoking to avoid taking action. If she didn't do anything then there was no danger of anything that would trigger those old feelings of fear. This fear of doing things wrong was also the source of her ongoing lifelong anxiety.

              Have you dealt with procrastination? How can it be overcome? Share your ideas below.

               

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              switching to vaping

              Should smokers be switching to vaping?

                Many smokers are switching to vaping. Most assume that the change will be beneficial. By switching to vaping they are trying to avoid the well-known health problems of smoking tobacco. But is vaping actually better for you? And how exactly?

                A recent pilot study looked into what effects vaping has compared to smoking. It only investigated a small number of people but it is the first research into smokers versus vapers. It suggests that vaping actually is better for you. But for a very surprising reason.

                Switching to vaping

                The study looked at the bacteria living in the gut of people who used vaporizers and people who smoke tobacco. The study found that participants who used vaporizers have the same gut bacteria as non-smokers. But the tobacco smokers had a significantly altered gut biome.

                The term "gut biome" refers to the total collection of bacteria, viruses and fungi living in your gut. We all have trillions of bacteria working away inside us. Most of them are harmless, some of them are potentially hazardous, and a very large proportion of them are actually essential for good health.

                Scientists are realising more and more that we have a symbiotic relationship with all the critters that make their home in our intestines. It is becoming clear that the gut biome can have significant health effects. Gut bacteria have been shown to influence obesity, depression, confidence, and even some quite severe mental health issues. So a healthy biome is of critical importance to everyone.

                More research will have to be done but the initial results are intriguing. Who knew that smoking could adversely affect the bacteria living inside you?

                 

                Source: https://www.eurekalert.org/pub_releases/2018-04/nu-van042718.php

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                weirdest reason for smoking

                Weirdest reason for smoking

                  Today I had what I thought was a very ordinary, normal client. But she actually had the weirdest reason for smoking ever.

                  She wanted to stop smoking. Then she gave me a long list of all the things that were going wrong in her life. This was all delivered in a quiet monotonous voice. She sat there with her head down, avoiding eye contact and radiating unhappiness.

                  Smoking to respect grandma

                  She knows that she has depression but chooses to do nothing about it. Her mother died a few years ago. The issues she had with her mother were never resolved. She loved her grandmother. Her grandmother was the best and brightest thing in her life. And all her memories about her grandmother include her grandmother smoking. The client said that part of the reason why she smokes is to honor the memory of her grandmother. Somehow, if she stops smoking, this disrespects her grandmother.

                  She wants to have a child, so she thinks it would be best if she stopped smoking. On the other hand she fears that she might be too old to have a child. Overall, I felt this client's despair. I really wanted to help her.

                  There was no point in trying to address the depression, because she's already said that she is not going to do a thing about it. So I did what I could with standard stop smoking therapy. To my surprise, she went into trance quite easily. I later learned that she had done a lot of meditation in the past, which would explain it.

                  Different realities

                  I took her through a series of hypnotic metaphors and visualizations. In trance I got her to look at her own reflection in a pool of water. I encouraged her to look at the reflection as if she was someone else. I encouraged her mind to consider different perspectives, alternative realities and to re-evaluate her own role in life. She was taken to a place where all her friends and relatives were assembled. There she proclaimed that she was changing, that she was stopping smoking, improving her lifestyle. And she outlined what her goal was and how she was going to get there. Among the people gathered there were people who had been a bad influence on her life in various ways. She identified those and banished them from the place.

                  Ego strengthening

                  I then did a series of ego strengthening statements. I sought out her personal beliefs and tried to establish a connection between her body, and her soul, and her mind. By the end of it, I had really pulled out all the stops and done everything I could to get this woman to a good place.

                  I brought her out of trance, and asked her how she felt. She told me that she felt relaxed and clearheaded and was seeing everything differently. And that was a problem.

                  Weirdest reason for smoking

                  She then told me one of the most extraordinary reasons I've ever heard why someone smokes. She said that she smokes because it "fogs her mind". When she doesn't smoke, she has "a sharp mind". Having a sharp mind, seeing everything clearly, means that she sees all the faults of others. Noticing those faults makes her angry at them. So she becomes unpleasant, and unsocial. And that's why she smokes, so that she can get on with people.

                  So my work with her was the exact opposite of what she wanted!

                   

                  What is the weirdest reason for smoking you have heard of? Share it 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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                    smoking again

                    Why do people start smoking again?

                      I have had some interesting clients this week. One of them was a woman who came to see me to stop smoking six months ago. It was a success but then suddenly she just felt that she had to start smoking again.

                      She stopped smoking completely for about five months. She told me that she felt a wonderful sense of freedom. What worked for her was my hypnotic suggestions that she would feel as if she had never smoked. She had no cravings, no weight gain, no desire at all. The result was that she could mingle with smokers and be completely unaffected.

                      Start smoking again

                      But then someone close to her died. She went to the ceremony and felt totally devastated, understandably. On the way home she felt the emotional wrench so bad that she stopped and bought a packet of cigarettes, and smoked one, and then a second. She didn't think the cigarettes helped. But she just felt compelled to go on. It was the only thing she could do. So without wanting to, she had started smoking again.

                      I have never understood how this happens. How can a sensible person who hates smoking and has stopped for months allow themselves to start again?

                      Why do people start smoking again?

                      I have interviewed many people who have done this. Sometimes they have not smoked for years, in one case for seven years. Yet given a big enough emotional jolt, their instinct is to reach for a cigarette. I have never seen any explanation of this phenomenon that makes any sense to me.

                      I think the hypnotist who cracks that problem will become world famous. I'm still trying.

                       

                      Why do you think people start again after a long time? Leave your comment below.

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