Smoking for attention

This client could not stop smoking. She went into hospital recently with some sort of pulmonary obstruction. She did not smoke or even feel like smoking when she was in hospital. But the moment she left hospital she started back smoking.

Clearing the need to smoke

I got her to think of a picture of her feelings about smoking. She said "It is a huge cigarette rammed into my gob". I used this as material for a Metaphor Replacement Therapy. I got her to describe the cigarette she was picturing. "It is black and brown. It is being pushed down into my throat." "I can't breathe." I asked her "What would you like to have happen to that huge cigarette rammed into you gob?" She said "blow it up. Or shred it." I asked "which do you prefer?" "Blow it up" So we did. She blew it up in a great explosion. Bits were floating through the air and she could breathe.

I then asked her to check if there was anything left of those feelings of smoking. She said "there are still some cravings."

Working on her cravings 

MRT on her feelings of cravings. So I asked her what the cravings looked like. She said they were there in her chest. They were "black with a bit of yellow. Not that big." I encouraged her to start making changes to the images she was getting. "Getting more yellow." The yellow was getting stronger, but she could change the image more than that.

I was thinking of lungs and the image of balloons came to my mind. I used this imagery to convert the cravings into black and yellow balloons and get them to rise up into the sky. She was comfortable doing this. They shrank and went up and popped in the air.

I finished with some direct suggestion about "feeling good, capable, worthwhile, having a role in the family and so much to look forward to, etc."

Then I gave her images of flicking a switch, going through a closed door, changing clothes, and suggested she would find the right thing to represent how she was changed.

Smoking for attention

We started talking about her upbringing and why she felt bad about herself.

Her mother was a total slut, she went out drinking, fighting, totally ignored her children,  but brought her daughters up to be complete prudes. She mentioned that her mother and other men were into voyeur sex and all sorts of things. She mentioned a rumor that her supposed father might not be, and her grandfather was the real father. Nobody knows.

We talked about smoking. She smoked since she was fourteen. "It was surprising that I kept at it, because is made me really sick. So sick my grandmother had to nurse me. It was lovely."

I then suggested that perhaps she kept on with the smoking because that was the only way she ever got any attention? She thought about that and said "You know, I think you are right". She then told me about moving to a new school and pretending to be sick so that she could have time with her mother. "Maybe I am smoking for attention". "I have felt rejection all my life."

This client hated smoking when she started, they made her sick. But being sick meant she got attention.

Smoking for attention maybe a common reason for smoking.