Taking the Patient's History

Information gathering is an important stage in the therapy session and it is also

an ideal time to build rapport and build trust. This Unit will teach you how to
approach this.

1. The presenting problem may not be the real problem.

Sometimes, when Patients enter therapy, they may be afraid to talk about the
problem they are most concerned about. Instead they talk about some other
peripheral problem that is affecting their lives because they are too
embarrassed to talk about their main problem. Often they dare not risk
presenting the problem immediately because they are afraid that if therapy is
unsuccessful then all will be lost. Sometimes they may want the therapist to test
his skills on a less important problem to check out the therapist's ability to help
or to see if they, as a Patient, can respond to treatment. Whilst successful
treatment of a peripheral problem is a good way of ratifying the therapist's skills
before the serious work begins, the withholding of information by the Patient
puts the therapist at a disadvantage. Problems rarely exist in isolation and,
where more than one problem exists, they are usually associated with each
other in some way. It is important for the therapist to know about all aspects of a
Patient's problems and to see how they are related and may be reinforcing one
another.

A woman in her forties came to see me and seemed reluctant to talk about
herself. She was overweight and looked drab. She finally said that she wanted
help to lose weight. Her weight problem had apparently started in her teens, yet
none of her family had been overweight. She had three brothers, one sister and
a psychotic mother and she was no longer in contact with her father. She was
seen for a number of sessions over a period of six weeks and despite a few
pounds weight loss during the first week she did not respond to any intervention
with hypnosis. Despite her failure to lose weight she appeared to still have
confidence in me and kept all of her appointments.

After about 10 sessions of unsuccessful therapy she told me she had been
abused as a child by her father. Over the next six sessions we worked together
on her feelings about her father and the abuse. The weight problem was never
mentioned again, yet slowly, as she seemed to come to terms with her feelings
about the abuse, she started to lose weight. I didn't actually notice at first, I just
noticed that she started to take pride in her appearance. It became clear to me
that by becoming overweight as a teenager she had discovered a way of
making herself unattractive to stop her father abusing her. Her fear had
generalised itself to all relationships with men and she was never able to lose
weight because of her unconscious fear of being abused again. As soon as she
was able to learn how to trust men, initially by trusting me, she was able to lose
weight.
She was lucky, because she somehow recognised her potential to overcome
her problem with me as her therapist and she continued treatment. She could
easily have lost confidence in therapy when all of her attempts to lose weight
failed repeatedly and then never had the confidence to tackle her abuse
problem with another therapist.

2. You should not assume that there is an underlying problem but you
should be open to its possible existence.

Throughout therapy and especially when you are interviewing the Patient for the
first time, you should keep your mind open to other possible problems which
may lie behind the presenting problem. If you feel there is a secondary problem
then you should ask open ended questions and not suggest in any way to the
Patient your suspicions about other possible problems. Remember, the Patient
may need time before they are willing to talk about their real problem. If they
have an undisclosed problem, and if you try to rush them, they may clam up
altogether and you may never see them again. Whenever possible you should
let the Patient set the pace, especially at the beginning of treatment.

3. The Patient may not be aware of the underlying cause of the presenting
problem or aware of any other underlying problem if one exists.

Sometimes although the Patient is not deliberately withholding information, they

have no conscious awareness of a different problem to the one they are
presenting. However a different problem does actually exist and is at the root of
the presenting problem. Any attempt to suggest this to the Patient will usually
result in some kind of resistant behaviour on the Patient's part. Most problems
have some underlying cause. The cause may no longer exist in the person's
everyday life. The cause may have only existed in the person's childhood,
however the symptom continues in every day life. Sometimes problems can be
solved simply by working on the symptom, because the cause has burnt itself
out many, many years earlier. Where the cause still exists in the person's life
then the cause has to be dealt with along with the symptom.

4. Sometimes Patients have a need to hold onto a problem.

There are benefits to be had from having some symptoms. A Patient may get
used to getting attention from family members when they have their symptoms.
Sometimes making the problem disappear also means losing the attention that
has been gained because of the problem. When there is some benefit from
having a problem the benefit is usually called a secondary gain. A secondary
gain is some kind of benefit that happens because of the Patient's symptom or
problem. The secondary gain has hitch-hiked itself onto the presenting problem.
When helping a Patient solve their presenting problem you should attempt to
identify secondary gains and deal with those at the same time. The needs that
are being met by the secondary gains have to be met in some other way by the
therapist.

5. Do not place emphasis on the word "problem" by repeating it too often.

Here, within the context of this course, we can use the word "problem" as many
times as we wish. However, in a therapy session the therapist shouldn't keep
repeating the word "problem" to the Patient. The word "problem" has negative
connotations. Instead, the therapist should emphasise positive changes in the
person's life. The therapist should always be optimistic and confident in the
Patient's ability to change.

6. Do not give advice, interpretations or solutions at this stage.

At this point you are still gathering information, verbal and non-verbal, and with
such little information you should not be giving advice to the Patient. As a
Hypnotherapist you should not be giving advice anyway. Any solutions will
usually be suggested in the form of metaphors, analogies, tasks or with indirect
suggestion. Advice or interpretations given too early in therapy will probably
mismatch the Patient's beliefs or needs. When attempting to identify a solution
the therapist should look for patterns. By taking in as much information as
possible the therapist should be able to identify patterns regarding dates,
behaviours, actions, etc.

7. Look for conflicting non-verbal behaviour.

When Patients communicate they communicate on two levels: consciously and

unconsciously. They will often say something and at the same time they will use
a non-verbal gesture, expression or behaviour that sometimes conflicts with the
words they're using. An example of this is a Patient who says something at the
same time covering their mouth with their hand. Another example would be
someone who literally digs their heels in when being asked to respond to a
particular question. A third example would be a Patient who shakes his or her
head when saying "yes".

8. You should attempt to elicit the problem behaviour/symptom or evoke

the feelings.

When Patients enter therapy they expect action. The therapist doesn't do
therapy based on the words that the Patient uses, but rather with their
behaviour or symptom. If possible you should attempt to get an example of the
symptom. You need the raw materials of the problem to work with. If you have
good materials you can do good therapy. So for example, if a Patient says they
are afraid of spiders, you should ask them to close their eyes and imagine a
spider and bring on the feelings. This will give you an example of the
physiological change that occurs when the Patient has the problem. If the
Patient's presenting problem is a fear of meeting people and being asked
questions then the therapist should ask questions to attempt to evoke the
response in the Patient. So when doing this, or attempting to evoke a symptom,
the therapist should explain what he is doing to avoid losing rapport with the
Patient.

FORO

When I meet a new client, he starts to complain about his problem and he tries to sell me his story. If I buy it, I
become part of the problem. So I listen more to the client than to his story which is only a subjective
interpretation. Even when his story involves emotions, they are mentally created.
The best place to start, is to rephrase what is said and what is not said:

 rephrasing what is said:

o client: "she wants a baby"
o me: "she wants a baby?" (or in short "a baby?")
 Rephrasing what is not said:
o client: "she wants a baby"
o me: either "you are happy with that?" or "you are worried about it?" depending on his facial
expression.

Rephrasing what is not said is a kind of "mind reading" but stated as a question. Either I guessed right and the
client feels understood or I guessed wrong and he corrects me. In both cases, he goes from a mental level
(subjective interpretation sustained by his belief system) to an emotional level. In the meantime, the client starts
to get out his bad transe and gives me most of the information I need to work with him.
Anyway, it is not important for me to understand his problem, it is much more important to understand the client
(as a person) and to let him understand himself and his problem differently, i.e. from an open point of view (a non
neurotic one).

I try to get the client discribe what he feels in the present about what happened in the past, this creates a
dissociation. Most of the time, the client will experience an emotion in the process but it is a kind of emotional
release and not a suffering experience.

When the client feels understood he moves from a "complainer" or a "visitor" to a "customer" of the therapy.

Feel free to try it. This is only a suggestion as I am only an hypnotherapist.

This is my first post, please forgive me for my english grammar.

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Hello everyone,

One thing that I do, after I have gone through informationg gathering in order to re-construct the patient's history
for therapy purposes, is to have the client giving me feedback.

This feedback has two purposes, firstly to make sure that I have understood correctly a number of important
facts (dates, names, places, behavioural descriptions, felt symptoms, etc.) related to their history and secondly,
verify the client's treatment priorities in order for me to be ahle to set congruent therapy objectives that I will be
posing the client next.

Often times, this feedback process serves not only to correct mistakes in my understanding of certain things, but
also to deepen on what are the real concerns of the client
I have seen on numerous ocassions that some therapists just go through the information gathering phase, then
make their "diagnostic" (without letting the client know) and start doing therapeutic work according to the
objectives they think must be met, without having any client feedback.

What do you think?

Best,

Joseph

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When working with a patient, it is of vital importance to remain totally non-judgemental, especially when taking
their history.

When I was younger, I worked with a therapist who judged my behaviour and actually made fun of it in a teasing
sort of way. That was the very last time I went to see them. It was emotionally abusive and I knew that I would
not let them do that to me ever again!

But it was also a good lesson for me to see what not to do with clients.

We have to be prepared that during the process a persons secrets come out. I frequently hear people saying "I
have never told anyone this before" I always tell them that it takes great strength and courage to talk about these
things. I always make sure that I remain totally compassionate towards them no matter what it is they bring to the
table.

The patient deserves only compassion within the clinic enviroment that is not tainted with judgement.

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If you don’t already know, how about learning how to cross match and cross mirror?
So if you want to match breathing rate, you could raise and lower your foot, or hand, or
elbow in time with their breathing.
If you want to cross match jerky eye movements, you could move your hands in a jerky
way when explaining something.
If the client clenches their hand or hands at a difficult point in the history taking, you
could try clenching your feet or your lower legs, or even your buttocks.
As you will remember, it’s the unconscious that you want to pick up on the mirroring
and matching signals, not the conscious mind. Literal “copying” of gestures and
physical behaviours no matter how subtle you try to be will often be picked up by the
conscious mind. Something you would want to avoid if you could.
What other things do you think could be cross matched and cross mirrored, and how
would you do it?
James
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Patient History - Identifying The Problems & The Underlying Causes

Your patient will tell you what they think is the problem and probably offer as number of explanations for the
cause.

Milton Erickson always said that the patient will unconsciously tell you what the real problem is within the first few
minutes even if they do not consciously know themselves. You have to be highly receptive to what they tell you.
For each of their reported symptoms, you need to establish a complete patient history of a problem
When a symptom first appeared and what else was happening in their life at this time
When it was at its worst and how frequently it occurred then
How often it occurs now
Under what circumstances it occurs: with a particular person, in a particular place or at a certain time.
Is there a common trigger that sets off the problem.
When it doesn't happen
How the symptom happens - the exact sequence of events
How long does it last
What else is happening at the same time
What is happening in their family and relationship life currently and historically - any patterns?
The occurrence of any traumas in their life
If they have had medical or psychiatric treatment.
Are they currently taking any medication or receiving any other treatment (you should check this befor they see
you - but always recheck in the session)
What do they think about their problem and what do they think has caused it
Once you have the complete patient history then you will want to summarise this information for them and ask
them if there is anything they might want to add or correct.
While you are taking the patient history then you will trying to identify the following:
What is the real problem (or problems)
Is there a deep underlying problem that needs to be identified. Do they need to know about it or can you work on
it without their conscious knowledge.
Secondary gain - Does the problem actually have an advantage for them so that they are hanging on to a
particular behaviour? They may or may not be aware of this if asked.
Are they unconsciously supressing a problem or a possible cause because they find it difficult to consciously
deal with it?
Ecology - Are they best left with the problem if you suspect that dealing with it could be more problematic and
possibly traumatic?
Look for mismatches between verbal and non-verbal behaviour
Establish what is their normal body language - how do they show signs of tension, stress, dishonesty, deflection
or emotion
If it is safe to do so then you should have them demonstrate or elicit from them the problem behaviour. It is very
useful to know exactly what happens. Have them describe the problem in detail and relive an event if it is not
traumatic.
You should also be careful about how you ask questions
Do not use the word 'problem' if you can help it
Do not give any opinions, advice or judgements of any kind
Do not interpret anything for them - discovering things themselves, even if lead by you is much more powerful
and effective
You will then need to establish exactly what the patient would like to happen. What they hope to achieve from the
specific session and overall from treatment. You may want to give them feedback on what you think is realistic or
if you think that the problem is not exactly how they perceive it. You can offer them an initial assessment if you
believe that this will help or that their expectations are unrealistic or misguided.

High Quality Information Gathering

It is important to know how to gather high quality information about problems

and symptoms. You are looking for patterns in behaviours and the when, where
and when not of the symptom. When I first started doing therapy I would ask all
of these questions slowly and very clearly. With experience you will learn how to
ask these questions in a much more conversational way.

1. Identify when the problem first started.

You will need, if possible, to identify the date or the time in the patient's life
when the problem first started. You should also identify significant times in the
patient's life when the problem has been at its worst. It might also be useful to
identify any times prior to the problem starting when the Patient felt similar
feelings.

2. Identify how often it now occurs.

You should also identify how frequent the symptom or behaviour is. You might
also like to identify where it occurs and with whom.

3. Identify the duration.

You need to know how long the symptom or behaviour lasts.

4. Identify when it does not occur.

It is equally important to identify the times in the patient's life when they haven't
had the symptom. This is especially important when the patient had expected to
have the symptom or problem and it hadn't occurred. This will give you valuable
information.

5. Identify the sequence of steps in the symptom or problem behaviour.

Every symptom or problem behaviour has a beginning, middle and end. You
should attempt to identify the trigger that starts off the problem and all of the
steps that exist whilst the problem is occurring. By recognising the sequence of
events experienced as feelings, pictures, sounds or actual experiences the
therapist will have valuable information with which to work.

6. Identify any other events occurring around the time of the start of the
problem.

The therapist should also identify any other events, happenings, experiences or
traumas that have occurred at about the same time that the problem first started
or developed. Maybe one of these events has indirectly triggered or started the
problem.

7. Identify family relationships and peer relationships.

Therapy should also identify how family and friends view the Patient's behaviour
or symptoms. The symptom may only occur in the presence of certain family
members. By identifying the relationships between the Patient and the people
around the Patient the therapist will gather valuable information.

8. Identify general beliefs about the problem.

The therapist should also gather information about the Patient's general
subjective understanding of the problem. Often this information will be vague
and when this is the case the Patient will be usually be limited in his ability to
communicate specifically why the problem exits.

9. You should summarise the problem.

Towards the end of the information gathering stage it is always useful for the
therapist to go over the important points raised. Many Patients want to know
why they have their problem. The therapist's job is to help the Patient overcome
the problem and this is often done without really ever knowing why the problem
first existed. If a Patient insists on knowing "why", the therapist should consider
whether there is any possibility of identifying the real cause. If he considers it to
be difficult, the therapist should suggest to the Patient that the cure is the
primary concern and that the why and wherefore can follow after, if necessary.

10. Identify the Patient’s outcomes.

After summarising, the therapist should identify what outcome the Patient wants
from the therapy. Sometimes the outcome desired by the Patient isn't the same
outcome desired by the therapist. Sometimes the therapist may have to achieve
both outcomes if they are different and both beneficial. Usually both can agree
on the same outcome.

Time Distortion.

1. In hypnosis time can be contracted and expanded.

Time distortion was one of the first hypnotic phenomena to be explored by Milton
Erickson. Erickson applied time distortion in an experimental setting to identify how
much time was required by Patients to accomplish tasks which normally would involve
many hours of work. I believe that he was looking into the possibility of accelerated
learning; however he didn't actually acknowledge this openly. Patients can be given a
task and told that they should believe fully that they have been working on this task for
a number of hours. The therapist then gives the Patient only a few minutes of real time.
The subsequent distortion of time under hypnosis allows the Patient to gain the
experience normally associated with training of a longer duration. Naturally no person
can store information that literally takes time to comprehend. It is not possible to give a
Patient the task of reading a book and only give him a few minutes in the hope that he
will retain information normally acquired over a period of hours. However for the
revision of information or learning it is possible to convince a Patient under hypnosis
that they have revised a certain topic area which would normally take hours to revise. It
is possible to do this because the Patient stores the original information at an
unconscious level. The revision process is just a means of bringing this information to
the surface. The retrieval of unconscious information is often difficult at the conscious
level in normal waking reality because of the effort involved by the Patient. However if
the Patient is asked to allow the process to occur unconsciously in a trance then the
information is readily available. If this is suggested within the context of a time
distortion exercise then the Patient believes consciously and unconsciously that the
outcome of accelerated learning has occurred.

2. Contracted time distortion is a common spontaneous hypnotic phenomena.

When people go into hypnosis their perception of time changes. Most Patients, when
asked after trance has been terminated how long they have been in trance, will
normally state that they believe their trance experience to be that of only a few minutes.
However in reality normally this trance time is considerably longer. It's rather a pleasant
surprise for Patients to realise that they have been in a trance for much, much longer
than they thought. This form of time distortion is useful in ratifying the trance
experience at the end of the therapy session. Usually what happens is that the Patient
becomes so absorbed at times during the trance experience that they have amnesia for
selected areas of the trance. When they think back at the end of the session they can
recall only those portions of the trance that they are able to recall. The recalled
sections of trance experience total only a few minutes. The other aspects of trance are
forgotten.

3. Time distortion is useful for accelerated learning, desensitisation and pain

control.

We have already talked about the application of time distortion for accelerated learning.
It is also possible to use the technique as a desensitisation process. The therapist asks
the Patient to re-experience a traumatic event or fear in slow motion. By giving the
Patient control over the speed of remembering or replaying an event, the therapist
gives the Patient more control and responsibility in their own treatment. It is possible for
the Patient to freeze frame the replaying of an event. Alternatively it is possible for the
Patient to speed up his perception of time. In pain control it would be appropriate to
suggest that the duration of the pain speeds up. Also the Patient can be encouraged to
allow the comfort between the pain to increase in duration.

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In his book WordWeaving - The science of Suggestion , Trevor Silvester talks about the natural trance
phenomena of time distortion.

The subjective quality of time means that it can be distorted in a number of ways. A person who believes that she
is stupid may achieve ten good things in a day, but looking back will recall only the one mistake she made. The
bad event is 'stretched' to make it a 'bad day', and the good events are compressed to the point where they can
be forgotten (amnesia). The same will be true of relationship issues. A couple coming to see you will not be
remembering the successful and happy ten years they have had together. If questioned they will fly through that
period in seconds. Their focus will be on the last three months, and each will be able to catalogue in minute
detail the shortcomings of the other during that period.

There are many uses for time distortion. You can make negative moments pass more quickly, just as you can
make positive events last longer or appear more often. I have found this to be one of the most useful TP of all,
because if you can get the client to perceive the problem as happening less often, or lasting less time, it
suggests to him that the problem is changeable. An example is a client I had with OCD. She had to check
everything sixteen times - the light switches, the front door, everything. Initially I worked on reducing the number
of times. This worked well, her compulsion reduced to four times for a while, but then gradually returned. I tried
something else. Instead of adjusting the number of times I played with time itself. I introduced her to the idea of
the unconscious being able to process 2,000,000 bits of information per second, while we can consciously work
only much slower. In trance I suggested that in the time it took her to check something twice consciously, her
unconscious can have checked it sixteen times. So her unconscious can continue to have the compulsion - just
so quickly that she is no longer aware of it.

Accelerated learning techniques are becoming increasingly more necessary in this modern world. Learning through time
distortion is harnessing the subconscious through conscious direction. "Instant" mental calculators and high speed
readers (over 2,000 wpm) experience a sense of time distortion as information flashes through their mind in only
seconds. Through self-hypnosis, you too can learn to review information in a time distorted fashion.

.......As an example, one concert violinist put herself into a self-hypnotic trance and through self-induced time distortion
practiced her music in several different ways. By "playing" the difficult spots mentally, it helped her finger memory to
improve in speed and accuracy. She was able to review long pieces over and over in very brief "world" time periods,
and her technique and technical performance improved strikingly.

.......By repeating memorized material in a time distorted fashion, valuable associative patterns can be firmly established
and conscious recall becomes more available. Using time distortion, problems can be reviewed and approached from all
angles in a matter of seconds. Hypothetical lectures, appointments and scenes can be laid out in your mind, prepared
for and visualized in a brief amount of time. Kinesthetic body movements in gymnastics or the martial arts can be
reviewed in this way as well. Doing 'instantaneous' calculations and high speed mathematics can be learned with time
distortion. In a similar way solutions to everyday problems can be achieved effortlessly and quickly. By simple trusting
your subconscious mind, you establish a better awareness and faith in your own abilities.

.......As Einstein pointed out, time flows at different rates for each person. Some people have experienced their whole
life flash before their eyes in a matter of seconds just prior to a sudden death-risking situation. Also dream researchers
have discovered that a one minute dream sometimes feels like hours to a dreamer. In one experiment, hypnotized
subjects were given imaginary tasks to perform in their minds -- like designing a dress and preparing a complicated
meal. They were tricked into thinking they had an hour to accomplish their tasks, but they really had only 10 seconds.
After 10 seconds had elapsed in world time, the hypnotized subjects experienced intricate and accurate detail in their
inner perception that seemed to them to be a complete hour! Given the same tasks in the waking state often stymied
them so badly that they couldn't think of a single dress design and actually prepared a meal in a very disorganized
fashion. A posthypnotic interview revealed that the subjects experienced no difference in their "thinking" and that at no
time did they feel hurried or speeded up. Time distorted thought thus seems to have superior clarity to normal conscious
thought beset with constant distraction.

Milton Erickson was interested in the perception of time during the hypnotic process, he experimented with this
phenomena and its application on accelerated learning.
Time distortion has a good application on learning tasks that need much practice and rehearsal such like music,
acting, sports and developing of professional skills. Also can be used for pain control, desensitisation and
accelerated healing.
We as hypnotists, able to manage time distortion can use this techniques to become better in what we do, using
techniques like DTI (Deep Trance Identification) combined with time distortion we can acquire and practice and
develop our skills.
Other time phenomena possible during hypnosis are regression or progression and they both can be used as
therapeutic resources.
Time distortion is also used to convince clients that they had been in trance.
Physicists know today that time is not a linear constant, and perception of it is relative to individuals is a
subjective matter. We invented machines to count time and standardize our use of it.
The fact is that what we consider real is only an mental image of what we perceive, is just thought. Our entire
reality is just thought, interpretation of perception.

Favourite Activity and Leisure Trance Inductions

People enjoy participating in leisure activities for many reasons but not many people
realise that one of the main reasons they enjoy it so much is because they enter a
trance state as part of the activity.
1. Every leisure activity induces a state of receptivity.

Most people enjoy leisure activities. One of the reasons for this seeming
addiction to leisure pursuits is the associated state of receptivity that
accompanies every leisure activity. All activities are naturally trance inducing.
For example, dancing and sports have a trance component in the same way
that watching television or listening to music has a trance component. Because
leisure activities are desired and experienced by most people, most people are
familiar with the trance experience associated with them. However Patients are
not usually aware that this particular state of reverie or trance is the same state
required for hypnosis. By asking the Patient to think about their leisure activities
and informing them that the state associated with their leisure activities is the
required state for hypnosis the therapist is helping the Patient realise that they
are already qualified to experience hypnosis.

2. Trance can be induced by recalling the leisure activity.

The therapist should give analogies about trance experience in everyday life.
Analogies about ensuing trances that happen spontaneously when one
daydreams or watches television can actually re-induce a similar trance state in
the Patient. Alternatively, the therapist can direct the Patient to recall one of his
own leisure activities.

The therapist should judge whether an explicit request to recall a familiar leisure
activity is the best way to re-induce trance or whether a more indirect approach
based on the therapist's own leisure interests is more effective. What might
work for one Patient may not work for another.

3. Different leisure activities produce different trance states.

The trance states associated with sports are different from those associated
with watching TV and other similar activities. The sports trance is a focused
concentration on an activity where all of the senses are tuned acutely towards
the activity. The TV trance however is a turning inwards type of trance where
the senses are relaxed and not focused externally. Generally speaking,
activities such as watching TV, listening to music, reading a book, painting a
painting are better for inducing hypnosis than the more highly concentrated
types of activities.

4. Trance is state-bound to contexts and associations.

All activities are state-bound. By state-bound we mean that a Patient enters a

particular psychological and physiological state whenever they carry out some
activity. When they move from one context or activity to another the
psychological and physiological state changes. When they then return to the
same activity at a later date they also return to the same psychological and
physiological state. This is true of hypnosis. When a Patient re-enters trance he
re-enters the same psychological and physiological state that occurred the first
time he went into a trance state. By asking a Patient to recall a leisure activity
we are re-evoking its associated state enabling the patient to automatically
recall the same feelings. Therapists should always remember this principle of
state bound experience whenever working therapeutically.

5. Examples of leisure activity trances:

Daydreaming.

Watching television.

Listening to music.

Reading a book.

Concentrating on a task.

Enjoying a sport.

Listening to a lecture.

Dancing.

Performing music.

Painting, drawing etc.

6. Contraindications of utilising leisure trance.

Some people experience trance states when driving a car. The therapist should
avoid using the driving trance experience as a hypnotic induction and also avoid
discussing it in case the hypnotic trance is indirectly associated (anchored) with
future driving.

If Patients have driven to a session it is usually a good idea to also suggest that they
re-orientate fully before driving home. Associations between hypnotic trance and
everyday leisure activities should only be drawn when those leisure activities do not
involve danger.

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Eye Accessing and Rep Systems

1. People 'think" using their sense Systems.

All information that passes from external reality to internal reality has to pass through
the sense systems. As you look around, the information that you see passes from
outside through your eyes into your brain, the same is true of hearing and feeling, smell
and taste. All thinking occurs in the sense systems. Without the ability to see and
visualise inside of the head it would impossible to think in pictures. Likewise it would be
impossible to talk to yourself if you were unable to hear language. All thinking is
processed in this way. All problems are represented by Patients in their sense systems.
This is why it is possible to change a person's beliefs about their problems by changing
the way they represent their beliefs in their senses.

2. Sense systems are called representational Systems.

In NLP terms sense systems are known as representational systems because the
experiences are represented inside the person's head. A representation actually
means a copy. The experience as experienced by the person inside of their head is not
the actual experience itself. The experience in reality occurs outside of the person's
head yet is represented in the brain. In fact the word "represented" if divided with a
hyphen to read re-presented explicitly describes the process.

3. Representational systems can be recognised by watching people's eyes

movements.
NLP has identified that people move their eyes in certain directions related to the sense
system they happen to be using at the time. It is suggested that when people look up to
their left they are visualising memories. When they look up to their right they are
constructing pictures. When people move their eyes down to their left they are talking
to themselves. When they move their eyes down to their right they are having feelings.
These four primary positions are known as accessing cues. It is suggested in NLP that
by observing when and where Patients look as they communicate, the therapist can
identify the particular sense system the Patient is operating in. For example if the
Patient is talking about a particular experience and is looking up to his left the therapist
can conclude that the Patient is seeing the memory being talked about. If the Patient is
looking down to his right whilst talking the therapist can conclude that the Patient is
feeling what he is talking about.

In addition to these four primary accessing cues, additional accessing cues have been
observed as follows: looking straight ahead usually suggests that the person is
visualising but not in any specific past or future context. Looking to the immediate left
suggests that the Patient is hearing sound with a past orientation. Looking to the
immediate right suggests that the Patient is imagining sounds from a future context. In
addition to this it is suggested that people who spend most of their time looking
upwards either left or right or defocused ahead, are visualising. That people whose
eyes move from left to right whilst communicating are auditory. And lastly that people
who spend most of their time looking down to their right whilst talking are primarily
kinaesthetic.

Whilst there maybe some people who have a preference for one system over another
for most activities, most people seem to be able to shift from one sense system to
another depending on the topic of conversation and the context in which they find
themselves. If the theory that people were biased primarily to one system over another
were true then all artists should be visual, all musicians should be auditory and all
masseurs should be kinaesthetic. However this is definitely not true: artists will talk
about how they feel about their work as will musicians. One could argue that an artist
may have developed a certain kinaesthetic preference over other senses through every
day life experiences from childhood long before they acquired the skills of an artist.
This would certainly lead to the individual being able to process kinaesthetically the
experience of art.

Certainly skills, traits or strategies learnt from childhood tend to dominate throughout
life. Intervention made at later stages in life can change the person's way of processing
however the intervention had to be sufficiently strong to make the person change
dramatically from one major preference to another. It is probably more likely that most
people can operate in all sense systems and shift from day to day and from context to
context depending on what is happening at that given place and time.

This observation of sensory preferences at given times during communications can

allow the therapist to learn more about the Patient and his problem, for example:
a) to identify the sense system at the time and therefore have a deeper understanding
as to how the problem being discussed is being processed.
b) by identifying the sense system, to communicate in (that is to feed back the
vocabulary) by using sensory based predicates that match the sense system currently
being used by the Patient.
c) to recognise any incongruency in the way the Patient represents the experience, for
example talking about feelings whilst looking down to the left indicating an internal
dialogue, thus suggesting that an internal dialogue is closely associated with the
experience of feelings, giving the therapist an indication that perhaps an internal
dialogue is triggering the kinaesthetic.

4. Representational systems can be recognised by watching people's postures,

gestures and minimal cues.
It is suggested that people who are visualising change their physiology in the following
way: their breathing appears to be higher in the chest. The voice is higher, faster with a
somewhat breathless quality. They draw pictures in the air with their hands as part of
their gesturing. Their posture is upright sometimes with tension in the shoulders. And
their skin appears often pale with a tightness around the mouth. When people are
auditory their breathing seems to be in the middle of the chest the voice is even and
rhythmic.

Their head often resting on a hand with their head tilted almost as if they were talking
on the telephone. Their posture often is asymmetrical with normal skin colour. People
who are kinaesthetic have a breathing low in the stomach with a voice which is deeper
and slower with gestures that are solid holding or gripping. Their posture is often down
sometimes round shouldered with muscles relaxed. The skin colour often appears
flushed. It is suggested that if the therapist looks out for these particular shifts in
minimal cues and identifies a correlation with the movements of the eyes then the
therapist can gather from this observation that the Patient is accessing one of these
particular sense systems at that particular time.

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Identifying Verifiable Goals

How will you know when it has happened?

Many Patients enter therapy, get better, yet not know that any change has
occurred. A Patient needs to know how things will be different when they are
better. If a Patient makes changes yet has no way of identifying that these
changes have occurred, they will never know that they have got better. So it is
important for the therapist to help the Patient identify some way of knowing
when they have reached their outcome. Often this will be a change in the way
they feel. It might also be a change in the way they see things. It might also be
a change in the way they look. It is very important to identify how the Patient will
know that changes have occurred. Some people become "Professional
Patients" in that they seem to spend their whole time going around from one
therapist to another. Although, for some this is a way of getting attention or
building up a network of "caring friends", for many it is because they cannot
recognise the changes that are happening to them.

I knew of one Patient who had lost weight so successfully with a colleague of
mine that she had told all of her friends about her wonderful "cure". I was
horrified when I saw her because she was very thin. Her friends had told her
that she would become Anorectic but she didn't understand what the problem
was. She had lost weight and that had been her plan. The trouble was that she
had gone too far and had passed beyond her healthy weight because she
hadn't specified her goal to start with. If her therapist had asked her to state her
desired weight before the treatment began he would then have realised that her
problem was one of obsession and not obesity. He could have then added
some clause to the therapy contract whereby she agree to receive help with her
obsessive dieting in addition to her perceived eating problem.

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Past Life Therapy

The 'therapy" part of the past life experience is when the Patient discovers that an
ailment that they have in their normal waking life seems to have stemmed from a
similar ailment or experience in a past life.

For example, a Patient might regress to being an archer and discover that in that past
lifetime they were killed by an arrow in the neck. Quite often the class of death or injury
in a past life corresponds to a present day symptom.
If the therapist suggests that the symptom perhaps developed in the past life and so
should really be left behind in the past life experience when the Patient returns to the
here and now, the symptom may often disappear completely by itself when the Patient
returns to his present day reality.

So the Patient who originally complained of tension in the neck muscles and
subsequently experienced himself as the archer discovers on coming out of trance that
his neck tension has gone.

This is usually the therapeutic value of past life therapy. Whether it is real or not, only
fantasy, a metaphor for the Patient's problem, an early recovered memory of some
historic experience read about at school or an inherited memory genetically passed
down through ancestors, it doesn't really matter as long as it works.

As long as the Patient is happy and comfortable with the concept of past lives and is
willing to let go and appreciate whatever their unconscious dishes up for them it is a
valid therapeutic approach.

Those Patients who have almost an obsession about reincarnation and firmly believe
that they must have lived before often prove to be the most difficult subjects to work
with whilst the skeptical tend to experience more vivid and dramatic regressions. This
is possibly because the over enthusiastic tend to try too hard consciously and so
prevent themselves for experiencing the gifts of their unconscious.

The Past Life Process

 The therapist does not have to believe in actual past lives in order for the
Patient to benefit from a past life experience.
 The induction is simple and is based on visualisation.
 Ask the Patient to find themselves in some safe place they know.
 Ask them to notice whether it is day or night and to tell you.
 Ask them to look up into the sky and discover themselves floating up onto a
cloud in the sky.
 Tell them to take their time floating above the earth orbiting the world. Seeing all
of the different countries below.
 Ask them to sense the countries that feel unconsciously drawn towards or
repelled by.
 Throughout this process give repetitive suggestions for comfort and deepening
of trance.
 Ask the Patient to first choose a country that he feels drawn towards and to float
down into a body in that country without paying too much conscious attention to
the choice.
 Ask the Patient to tell you when he has floated down into that country.
 Ask the Patient to answer the following series of either/or questions:

1. Is it daytime or night time?

2. Is it warm or cold?
3. Are you inside or outside?
4. Are you alone or with someone?
5. Are you a man or woman?
6. Are you young or old?
7. What season is it?
8. What are you doing?
9. Do you have a family?
10. What religion are you?
11. Hear someone call your name, what is it? etc.

This process should be continued until rich detail is brought out. Be careful not to
influence the Patient yourself by suggesting things that they can see. If they seem to be
short of data or dry up you can move them either forward or backward in time to a
different time in their life.

Significant dates are a good starting point. Marriage, birthday, death. Most Patients
experience dying as a pleasant experience which often has quite a calming affect on
the way they view death after the session.

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Values, Criteria and Beliefs.

People have beliefs, they place value on their beliefs and these values determine what
is important to them (criteria).

Patients give away their beliefs about themselves and others every time they speak.
Our beliefs are formed early in childhood. Beliefs are like rules. People think they
should or shouldn't do certain things. When asked why they believe this they may not
be able to respond, however despite this, they continue to stick to their beliefs. It would
make sense to assume that beliefs are reinforced through reward. However this isn't
always the case. Someone who believes that they will be scared by entering a certain
situation isn't getting a reward every time they enter the situation. So the reinforcement
of a belief isn't contingent upon reward.

The reinforcement of a belief is contingent upon its realisation. The Patient expects
something to happen and therefore looks out for it. By giving attention to the possibility
of its occurrence it is more likely to occur thereby reinforcing the belief that it will
happen again. This applies to both positive and negative beliefs. Even though beliefs
are formed in childhood they can he altered as the person grows.

Sometimes beliefs can be altered in a dramatic way through some very challenging
experience. Sometimes beliefs are altered slowly through the process of gradual
change, usually induced by new circumstances chipping away at the Patient's earlier
belief system. When a Patient has a positive belief they place value on this belief.
When a Patient has a negative belief they place value on not having the negative
experience. These values determine what is important for the Patient.

A positive belief will be highly valued and therefore will dictate what is important for that
person. A negative belief will place value on the avoidance of the negative experiences
and thereby dictate what is important for the person also. The things that are important
for the person are then usually arranged in some kind of hierarchical order, this order is
known as the person's criteria.

A Patient's criteria can change depending on context. In some situations one thing may
be more important than another yet in a different situation these priorities might
change. This is why a Patient can have a problem which seems more severe in one
context than another. It's important for the therapist to identify the beliefs that lie behind
a Patient's problems and future expectations.

By identifying the beliefs the therapist can then identify what the Patient values in life,
whether they value positive things, or value avoidance of negative things, or a
combination of both. Once the therapist has identified the beliefs and values of the
Patient the therapist can then recognise what is important for the Patient in their life.
Their criteria will dictate their behaviour. Once the therapist has identified their criteria
and how that criteria differs in different contexts, the therapist will know how to motivate
the Patient towards better health.

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Double Binds

1. Double binds give an illusionary choice.

Double binds are one of the most effective indirect language skills we have available
for inducing trance or encouraging therapeutic change in therapy. The double bind
appears to give the Patient a choice, however, the choice is only an illusion. The
pre¬requisite to structuring a double bind is the embedded presupposition that
something will occur. When the Patient is asked to choose between two or more
alternatives it is already presupposed that the behaviour being suggested by the
therapist will occur as a result of either choice made by the Patient. For example to ask
"do you prefer tea or coffee?" is to presuppose that the person is going to drink.
Because the question doesn't ask whether the person wants to drink, but is more
concerned with what kind of drink, the Patient answers the question without being
aware that they have committed themselves to drinking something.

2. Binds give the Patient a conscious choice.

Binds are questions that can be answered consciously by the Patient. For example to
ask "do you want to go into trance in this chair or that chair?" the therapist is asking a
simple question which can be answered consciously. However, the decision to sit in
one chair or the other effectively binds the Patient to the task of going into trance
regardless of which chair is chosen. So here we can see a simple bind for trance
induction that can be answered consciously by the Patient. Sometimes when the
therapist asks the Patient a simple bind question the Patient can reject either choice
because the decision is made at the conscious level. With double binds Patients
usually find themselves choosing unconsciously without resistance.

3. Double binds give a choice that can only be answered unconsciously.

A double bind requires that the response or choice be made at an unconscious level.
For example to ask "are you going deeper into trance as you inhale or you exhale ?" is
to ask that the Patient become aware of changes in his trance experience that are
contingent upon inhalation or exhalation. Here we see a presupposition that the Patient
is going to enter trance. In order to answer the question the Patient has to pay attention
to the changes in his internal state. These changes can only occur on an unconscious
level. So he has to wait for the hypnotic response before he can answer the question.
The actual experience of waiting and focusing attention inward in order to answer the
question is in itself trance inducing.

4. Conscious/unconscious double binds are the same as double binds but

emphasise the dissociation between the conscious and the unconscious mind.
Suggestions such as "you can remember certain memories and your unconscious mind
can remember others, which come first?" require the Patient to not only wait for an
answer at an unconscious level but emphasise the difference between conscious and
unconscious processing. In therapy it is always useful to separate the unconscious
from the conscious mind to avoid:
a) sabotage on the part of the conscious mind.
b) recall of communications directed solely to the unconscious mind. or to promote:
c) structured amnesia for traumatic experiences or memories repressed at an
unconscious level.
Many of the forms of hypnotic suggestion are designed to dissociate the conscious
from the unconscious mind.

5. Examples of binds:
"would you like to go into trance standing up or sitting down?"
"do you prefer to have your hands on your lap or on the arms of the chair to go into
trance?"

6. Examples of double binds:

"do you begin to feel a numbness in the fingers or in the back of the hand first?" "will it
be the right or the left hand that lifts first all by itself?"

7. Examples of conscious/unconscious double binds:

"if your unconscious wants you to enter trance your right hand will lift otherwise your
left hand will lift".
"I can talk to you (conscious) and I can talk to you (unconscious) and you
(unconscious) can respond without you (conscious) knowing how you are doing it."

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Time Line Therapy

Time Line Therapy.

Here the therapist suggests to the Patient that he imagine a road, thread or path going
off into the distance that represents his past. It might even help to ask the Patient to
imagine a similar path going into the future (usually the opposite direction). Some
Patients sense that their past and/or future goes off to the left or right whilst some
Patients have a preference for a past or future from behind them or leading out in front.
Once the Patient has identified the direction of his past the therapist asks the Patient to
discover himself looking down onto the path and then to follow the path into the past.
The Patient is asked to notice any grey or dark or significant areas on the path and
then to step down onto the path at that place and identify where they are. Most of the
techniques of dissociation and sub-modalities can be used with this visualised
regression technique as they can with all of the regression techniques.

The path is easy to visualise for most Patients and so is quite an effective vehicle for
revivification work. The therapeutic value of the technique really comes from the
addition of the standard hypnotic techniques of dissociation and re-writing memories.
The path technique itself, as with all regression techniques, is only a vehicle for
recalling memories and is not therapy.

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Matching And Mirroring Posture

1. Matching a Patient's body posture will enhance rapport. When people are getting on
well together they tend to sit in the same position as each other. You will often see this
in social situations. When people talk to each other they tend to adopt the same
posture. When people walk down the street together, as long as they are the same
height and build, they tend to walk in step with each other. Because people naturally
mirror each other when the relationship is good, therapists can mirror Patients to
enhance rapport.

2. Mis-matching the Patient's body posture can break rapport.

Likewise by deliberately positioning ourselves so that we are not mirroring or matching
the Patient, we can break rapport. The difference between matching and mirroring is
simple. Mirroring is literally mirroring back the person's body image. Matching is
following the person's movements and doesn't require an exact mirror image. You
might like to experiment matching and deliberately mis-matching people you know, to
find out what happens to the conversation.

The Uptime Downtime Induction

The Uptime Downtime Induction is based on a shifting of awareness combined with

eye fatigue.
Firstly the Patient is asked to focus all of his senses externally - to brighten up his
visual field and sharpen up his focus with his eyes focused on one spot just above eye
level. He should also tune in his hearing to external sounds and be very sensitive to his
tactile feelings. When you are certain that the Patient is directing his attention
externally you should ask him to slowly close his eyes once you have counted from one
to three. On the count of three he should close his eyes. You should then ask him to
relax his visual, auditory and kinaesthetic senses and to visualise some well known
relaxing place. He should let his muscles relax and develop the feelings and hear the
sounds he associates with his relaxing place.

Once the Patient is focusing internally you should ask him to try and open his eyes
once you have reversed the count. You then count backwards from three to one and
emphasise the difficulty in opening the eyes. The Patient should then be asked again to
try and sharpen up his senses in turn. This pattern is repeated with the Patient closing
and opening his eyes whilst simultaneously shifting his awareness from internal to
external awareness and back again until this eyes are too tired to open again.

Understanding the Patient's Metaphors

When Patients talk about their problems they often "give away" information about the
possible cause of their problems. They do this verbally and non-verbally. Patients are
not aware that they do this because they are often not aware of the cause of their
problems. The knowledge of the cause may be hidden from them at an unconscious
level, however, they communicate their unconscious knowledge indirectly through the
things they say and do.

The difference between Verbal and Non-verbal Metaphors.

Verbal metaphors are stories that parallel life situations. Stories are normally verbal
accounts of chains of events and a verbal metaphor is story where the chain of events
follows the same pattern as a real life situation. Therapists use metaphors in therapy.
They tell Patients stories that parallel the Patient's problem but then suggest a
therapeutic outcome. These are called Therapeutic Metaphors.

Patients also use metaphors.

Patients tell stories to the therapist in order to explain how they see their problem. Their
stories are illustrations, given to the therapist to make it easier for him to understand
the Patient's problem. Patients also use a different kind of metaphor. This is called a
non-verbal metaphor. They use this kind of metaphor without realising that they are
doing it. Non-verbal metaphors are stories told with gestures, facial expressions and
changes in voice tonality etc. Non-verbal metaphors do not parallel a real life situation.
Instead they parallel what is being said verbally by the Patient at the time.

Non-verbal communication is made up of gestures, facial expressions, changes in

posture and alteration of autonomous processes like breathing or pulse rate etc. There
are many types of non-verbal behaviour and most of these happen unconsciously, but
can be faked consciously by many people. This rarely happens in therapy however,
unless the Patient is deliberately trying to sabotage the therapy.

The Patient usually unconsciously alters these non-verbal behaviours while talking as
they act as a running commentary on the Patient’s unconscious thought processes. As
the Patient's thoughts influence his emotions and his emotions influence his physiology
it is possible to see a direct link between what the Patient is thinking unconsciously and
his non-verbal communication. When the Patient speaks he can’t help but comment
non-verbally on what he is actually thinking unconsciously. It is this direct physiological
response to what the Patient is thinking unconsciously that we call a non-verbal
metaphor and what we need to pay attention to.

We are looking for congruity and incongruity.

Does the Patient’s non-verbal behaviour match what he is saying or does it mis-match?
If you train yourself to observe the mis-match (incongruity) between the verbal and
non-verbal communications you can gain further insight into the Patient's unconscious
perception of the causes of their problem. It is important to remember that the
conscious and unconscious mind are very different and the unconscious will often have
completely different motivations, even different beliefs from the conscious mind.

When the Patient makes a statement but appears to contradict himself non-verbally
you should mentally note this incongruity and you should look to see if the patient
repeats the incongruity later in the session. One example of an incongruity is not really
enough for you to determine the course of therapy for the Patient. You ideally need
several examples of an incongruity to begin focusing on that particular area of the
Patients explanation. If possible, attempt to identify patterns in the Patient's behaviour
that indicate a mis-match between what they are saying and what they are thinking at
an unconscious level. It is the therapist's responsibility and obligation to the Patient to
develop his own observation skills so that can easily recognise these non-verbal
metaphors.

The American comedian Woody Allen is an observant commentator on non-verbal

behaviour. As a director he has developed the ability to recognise slight changes in
facial expression which can change a verbal statement from positive to negative or
imply an entirely and comical meaning. He uses his observation of non-verbal
metaphors to coach his actors so they can model these subtle meta-communications.
Many people remember a clever scene from his film Annie Hall when the two actors
were exchanging comments yet simultaneously thinking the opposite of what they were
saying. Allen illustrated this by putting the contradictory thoughts into sub-titles.

Often the Patient will make a gesture, expression or movement of some kind when
talking about a particular topic. Whatever physical behaviour you observe you should
consider it to be relevant to what is being said. For example; people usually nod their
head unconsciously when saying the word yes. Even when you tell someone that he is
doing this it becomes quite difficult for them to stop their head nods because it is so
automatic. Their non-verbal behaviour in this instance is congruent with their verbal
communication. If they shook their head when saying yes it would be incongruent.

In therapy we are looking for both congruency and incongruency because this tells us
whether the Patient's account of his problem, as he understands it, is correct. If he is
congruent in giving his account then we can most likely trust his account of the
problem. If however, he is incongruent, then we should doubt the accuracy of his
account, even if he believes his account to be entirely true. The incongruency occurs
because there is an unconscious disagreement with the Patient's conscious verbal
account of the problem. The Patient's unconscious mind is disagreeing with the verbal
account.
This happens because the unconscious mind tends to be much more honest and literal
in it's communications about the cause and patterns of the Patient's problems. It also
happens because it has access to much more data about the problem than the Patient
has at the conscious level. Non-verbal metaphors, once recognised, are very easy to
recognise time and time again. The following account of a very successful series of
therapy sessions with a family illustrates the importance of non-verbal metaphors in
deciding a therapeutic course of action.

Case Example
Joseph was a friendly yet slightly nervous teenager with bright red hair that he had
dyed himself. He looked as though he should have been fronting a punk group. His
immaculately dressed middle aged mother wouldn't have looked out of place alongside
an American President. She had dragged her son in for therapy because she believed
that he was mixing with the wrong people. She wanted me to use hypnosis to make
him dislike his friends and "come to his senses”. When Joseph first came to me he had
great difficulty answering questions without first looking at his mother for approval.
Towards the end of the first session when his father came into the room Joseph
couldn't make any decisions at all. He preferred to look at the floor for most of the time.
Whenever he was reprimanded for not answering my questions, by either his father or
his mother, he would look from one parent to the other for approval before answering.

Despite his difficulties with responding he did remarkably well in therapy, luckily without
any attempt on my part to create an aversion for his friends or by getting him to see
sense. Within 5 sessions he had moved out of the family home and had secured a job
for himself. He had cut his hair and had dyed it dark blue. Both of his parents were
surprisingly relieved that he had left home, if a little nervous of his ability to cope, and
over the following months slowly ceased to be so controlling and dictatorial in their
communications with him.

While living at home Joseph had led a life of confusion and uncertainty caused by
being told one thing by one parent and often the opposite by the other parent. Not
knowing what to do to please both parents, he did whatever he was told at the time
according to whichever parent was in front of him. He would then do the opposite if
another parent took charge. Many times he had been punished in turn for not obeying
either parent and had not learnt to ever have faith in his ability to make decisions on his
own.

My therapeutic outcome for Joseph was to get him out of this triangle as quickly as
possible. The problem was that he was unable to decide whether to leave home and
how he would handle it if he did. The mother wanted him to stay for his own safety but
would have preferred him to leave as long as he didn't mix with the "wrong sort". The
father wanted him to leave so that he could be more independent but would have
preferred him to stay a while longer so that he had more time to find the right job.

His therapy worked so well and I was surprised that he managed to work things out for
himself so quickly. I think that he had been planning his escape for some time and that
all he had really needed was a caring yet responsible therapist to give him permission
to flee from the grasp of his well-meaning parents. The fact that I held his parents back
from sabotaging his efforts at independence also helped. He did remarkably well, yet
throughout the therapy he hardly spoke. His parents did nearly all of the talking while I
watched him staring at the floor nodding and shaking his head in unconscious
agreement or disagreement at what was being said. His head movements seemed to
be out of his awareness. When he did speak he continued to communicate with his
head movements, though often they would directly contradict what he was saying
verbally.

By paying careful attention almost exclusively to his non-verbal communications I was

able to understand the dynamics of the relationship between the three family members
and design a task that would create an opportunity for Joseph to leave home and start
to re-structure his decision making abilities. During the sessions, whenever he
verbalised a response, it would match whatever he consciously believed his parents
wanted to hear at that time. But his non-verbal response always matched his true inner
wishes. His non-verbal communication was my guide throughout Joseph's therapy.
Without it I wouldn't have been able to really understand, so quickly, the patterns that
were causing the problem.

In the above example, the Patient had developed a strategy for saying whatever he
thought people wanted to hear. This was his way of protecting himself. His verbal
communication, and that of his parents, (because it could be heard by everyone
concerned) was conscious. His head nods however, (because they were not noticed by
the Patient) were unconscious. Noticing a mis-match or incongruity between the
conscious (verbal) and unconscious (non-verbal) communication gives the therapist an
indication of where the Patient's problem may be situated in their life experience.

Whenever there is incongruency you should pay attention to the content of the verbal
communication at that point. In the above example the incongruency was often
between his head movements and what his parents were saying or what he himself
was saying consciously about himself. The verbal content, whether it is about the
problem itself or something seemingly unrelated to the problem, is important at this
stage in therapy.

The Patient is emphasising, by his incongruity, that his unconscious mind contains
conflicting information to what is being said and that the Therapist needs to follow up
what the unconscious is trying to communicate rather than what the Patient is
consciously trying to say at the time.

Contextualising Change

Do you want this change in all contexts?

Generally speaking it is usually desirable for Patients to have their changes
occur in all contexts. However there are exceptions to this. For example if a
man wishes to be more assertive at work you may well be able to help him
achieve this but unless you put constraints on the contexts in which he is
assertive, he may well also be assertive at home. This new assertive behaviour
may lead to a break-up in his marriage. It is important for therapists to identify
all of the contexts in which the Patient requires his new behaviour and only help
him achieve this in all contexts if it is ecological to do so.

One of my sons was taught by his Nanny to throw his toys against the wall if he
tripped over them. Blaming the floor for his fall was her way of distracting him
away from the pain or embarrassment of falling over. I was horrified to see him
doing this because I didn't like the idea of him being taught to blame others for
his own mistakes. Very shortly afterwards he started hitting his friends and his
parents whenever he made a mistake or fell over. I quickly stepped in and
corrected his behaviour by threatening to sack the Nanny. She soon put him
right and forgot that he used to do it.

Her attempts to help him in the context of that particular time frame were fine,
but she never looked at how that behaviour could affect him within the context
of relationships or within the context of adult life. So when you consider the
other contexts in which your Patient has to live do not only think of the contexts
that exist at present. You should also consider the Patients future contexts as
well.

One way of doing this is to Future Pace. Future Pacing is the name given to the
principle of getting your Patient to step into their imagined future and try on their
new changes. The Patient is asked whether the changes seem to "fit" and
whether any adjustments need to be made. Future Pacing can in fact be applied
at any time throughout therapy as a way of checking that the intended
therapeutic outcomes are congruent with future contexts. Usually Future Pacing
is done at the end of the therapy session to check whether the Patient feels that
the therapy has worked. However it also fits in well with this particular
questioning skill.

Organic Metaphors and Symptom Based Metaphors.

As part of their non-verbal story telling, Patients will often include, gestures,
movements or "throw away” comments about physical symptoms when talking about
their problem. The Patient will usually be unaware that there is any connection between
the gesture or comment and the content being talked about at that time. For example, a
Patient may make a "throw away" comment about the muscular tension in his
shoulders as he is talking about having taken on a new job which "carries" additional
responsibility. The Patient might be saying indirectly that he is carrying the weight of
the world on his shoulders at work and that this is producing physical tension in the
shoulders. Patients can either draw attention to an organic metaphor through direct
touch (massage) or by mentioning it, usually the Patient uses touch without being
aware they are doing it.
The Patient may not recognise the relevance of the comment about his shoulders as
he talks about his work. Alternatively, rather than commenting on the tension in this
shoulders, he may just rub or massage his shoulders for a few moments without
realizing it as he is talking about work. The pain in his shoulders is called an organic
metaphor. It is a symptom of the problem and the Patient is using the commenting or
massaging as a way of communicating a message to the therapist, which says; "I am
having difficulty carrying all of this responsibility at work".

You should not assume that all of the Patient’s gestures, aches and pains are organic
metaphors that comment on what they feel at an unconscious level. You need to see
the behaviour (gesture, pain, itch, etc) repeated a number of times in relation to a
particular topic of conversation before concluding that it is a possible organic metaphor.
One example demonstrated at a particular point in the therapy may raise your
suspicion but you should not assume anything until you see it repeated when similar
topics are being discussed.

Autonomous physiological changes such as sweating, hyperventilation and coughing

fits, if occurring at specific times during an interview, can also be classed as organic
metaphors in that they are communication that whatever is being discussed at that
moment is relevant for the therapy.

Case Example
To further illustrate how we can identify and learn from the observation of organic and
non-verbal metaphors I give you this example of a successful first session interview
with a very chatty and attractive modern business woman in her late 2Os. Jean, who
with her hair tied in a French knot on top of her head, looked a little like a 1960's
French film star, wore a white button up collar blouse and pleated navy skirt. She first
sat on the edge of her chair but soon re-positioned herself more comfortably as the
session progressed. The day before, she had telephoned me requesting an urgent
appointment. During her visit she complained about her work. As she complained
about her workload and fellow workers she appeared to be in control of her feelings
and she sat in what appeared to be a comfortable posture and made appropriate yet
relaxed gestures that matched what she was saying.

She appeared to be congruent in what she was saying in that she clenched her fists
when talking about her frustration over a certain deadline she had to meet and she
relaxed back in the chair when she thought of having completed it in near future. It
would have been very easy for any therapist to be fooled into thinking that her
problems with stress were genuinely related to pressure at her place of work. Yet when
I asked her how she felt about reducing her work load or changing her job she
adamantly refused to accept any of these possibilities stating that she lived for her
work. This gave me a clue to where the cause of her problems may lay. When I asked
her about her home life she took on a rather rigid, posture attempting to look
comfortably relaxed, brushing her hand back through her hair, looking up and smiling
and then picking bits of cotton off of her skirt. Her verbal report about her home life was
positive. She talked about how there had been some difficult times in the past but that
these had now been resolved and that she felt very positive about things. Her language
was vague yet positive with an emphasis on how things were now "better than ever
before" and that she "couldn't wish for a better life".

It was obvious to me that she was consciously trying to look at ease but was giving her
true unconscious feelings away through her nervous non-verbal behaviour, her vague
language when talking about the past and her emphasis on "things being better. I was
fascinated to know what "things" had been like in the past before they had got better.
When I asked her she casually said "oh, you know, the things that happen when you
first get married". When I pushed her a little further she said well that's in the past now
and then she looked at me with one of those "let's drop this shall we" kind of looks. So
to appear to match her needs at that moment I told her that I was very interested to
know about her life in the present. She looked more relaxed. But then when we
approached the subject of her relationship with her husband, she casually yet quite
firmly started massaging the back of her neck as she talked about how wonderfully
supportive he was. She seemed unaware of her behaviour and I deliberately did not
comment on it.

If I had of commented on it she might have then sabotaged her unconscious

communications and I would have lost my therapeutic advantage gained in the session.
When I asked about the physical symptoms of her stress, she complained mainly of the
pain in her neck that seemed, to her, to come and go for no apparent reason. Further
questions from me about her husband produced more neck massage from her, to
which she still seemed to be unaware.

Although she never ever got as close as saying that her husband was a pain in the
neck, it was obvious to me that her massaging of the area of physical tension in her life
was an indirect unconscious communication that the cause of her problem lay with her
relationship with her husband and that this may have been caused by unresolved
relationship problems in the past. Of course, it could also have been caused by her
relationships with people at work or any other relationship difficulties or concerns. It
turned out that my first observations were correct and that her husband had had a
number of affairs when they had first got married and had told her about them each
time afterwards. Although they were both older now and he claimed to have changed
she had never been able to trust him. As she was so busy at work she had been
unable to pay as much attention to her husband and she was worried at an
unconscious level that he might start straying again. In fact she later said that she had
felt, although she had dismissed it, that he had had several affairs since he had first
promised that he would remain faithful to her and that her work took her mind off of her
problem. So she had put herself in a double bind.

In this case study we can see that a combination of non-verbal behaviours indicated
unconscious unease about the Patients relationship with her husband. First there was
the incongruency between the fact that she urgently requested an appointment and her
actual account of her problem when she attended the session. During the session
there was a lack of incongruency when she spoke of her stress at work. She appeared
so congruent and believable that she seemed to be covering something up. Her
behaviour was incongruent with the context. The incongruency was really between the
way she described her problem and its perceived cause as being work related and her
absolute urgency to see me for therapy in the first place. I suspected that the problem
was not simply work related because her description of her problems at work just did
not match the urgency with which she requested an appointment.

Secondly, there was the verbal incongruency between her account of her problem as
being work related and her statement that she lived for her work. I couldn't understand
how, if she were telling the truth, she could on the one hand, complain so bitterly about
her work yet state that she lived for it. Any attempt to get her to reduce her workload or
change job on the understanding that her problem was work related would have failed.
She really did live for her work, it was her escape from the worries of her relationship
and the more overworked she was the easier it was not to think consciously about her
husbands possible infidelity.

Then there was the incongruity between her apparent relaxed posture as she talked
about her home life and her nervous gestures and fidgeting. This was paralleled by the
mis-match between her verbal emphasis on everything being positive and her
avoidance of talking about the past.
Lastly there was the incongruity between her statements about her husband being
wonderfully supportive and the organic metaphor of her intense massaging of the back
of her neck. The fact that her main physical symptom of stress was a pain in the neck
suggested in my mind that her problem was related to her husband in some way. It was
only later after much more questioning that she was able to identify for herself that her
problem was caused by a fear of her husband's potential infidelity. This insight she
discovered for herself. I did not suggest it to her.

She had put herself into a double bind by working harder to avoid the anxiety of
thinking about her problem but this had prevented her from consciously keeping an eye
on her husband's behaviour. This then created more anxiety which eventually drove
her to seek therapy in such an urgent manner. This is not an uncommon pattern.
Through avoidance the problem had worsened until she could not stand it any longer,
yet even then, while in therapy, she continued to avoid addressing the cause of her
problem.

Crystal Gazing and Multiple Screens

Patients can be asked to see important life experiences in hallucinated crystal

balls or on multiple movie screens.
This technique is excellent for Patients who are confused or lack direction in life. They
can be asked to go into a trance and then hallucinate either a group of crystal balls or a
number of movie screens on which they see various important life events. Usually the
Patient is asked to allow their unconscious mind to choose the events that are the most
relevant to their problem.

Patients are dissociated whilst viewing.

Because the images are either in crystal balls or on multiple movie screens the Patient
is dissociated from the actual kinaesthetic of the experiences. This allows them to
safely review early life experiences without too much stress.

Patients re-organise or take stock of their life experiences while and / or after
viewing.
Usually the Patient is able to move forward in life having reorganised or taken stock of
their previous life experiences. In a sense the Patient is allowed to sort through old
files. Often they throw out certain aspects of their life that are no longer useful. In
addition to this they may re-group certain life experiences. Sometimes just being able
to identify a number of life experiences simultaneously, helps the Patient recognise
patterns in the way that they behave. The recognition of patterns allows them to either
reinforce the patterns if they are therapeutically useful or alter the patterns if they are of
no therapeutic value.

Life experiences can he positive and/or negative.

Reviewing positive life experiences can be as therapeutic as reviewing negative
experiences. Sometimes Patients will not have had many negative experiences, in fact
they may only be in therapy because they lack direction. In this case it can be very
rewarding sorting through the files. Most Patients see both negative and positive
experiences however - negative experiences in some crystal balls and positive in
others. The experience of simultaneously seeing and comparing the negative and
positive along side each other can be very therapeutic.

Viewing can he done with eyes open or closed.

The Patient's ability to hallucinate crystal balls and multiple screens depends usually
on their hypnotic ability and the depth of trance. Asking a Patient to hallucinate with
their eyes open usually requires a relatively deep state of trance. Sometimes Patients
literally hallucinate floating crystal balls. If you think that the Patient is unable to
experience this kind of phenomena it should be suggested that they see the crystal
balls in their mind's eye. By keeping their eyes closed they will be able to visualise the
crystal balls or movie screens quite adequately. It is my experience that those Patients
who are able to hallucinate with their eyes open usually find the experience more
rewarding and more effective.

Non Verbal Inductions - Erickson’s Handshake Induction

Trance can be induced or implied non-verbally.

Milton Erickson developed a non-verbal handshake induction technique that utilised the
principles of confusion and distraction. This induction is based on a number of specific
steps - specific to the therapist but confusing to the Patient.

Step One.
The therapist shakes hands normally but instead of pulling his hand away at the end of
the handshake he holds on a little longer than is expected. This minor violation of the
accepted duration of the handshake is enough to cause an inner cognitive
(transderivational) search. The subject is a little confused and doesn't know whether to
pull his hand away or keep it there. Confusion develops (in the mind of the Patient)
about who should terminate the handshake. Because the therapist initiated the
handshake there is an unspoken assumption that the therapist will also break contact.

So the Patient waits silently with his attention divided between what the therapist is
saying (even if it is unrelated to hypnosis) and the feelings in his own hand. He is
paying attention to the hand so that he can know when it is appropriate to release his
grip yet, at the same time, is trying to appear to be interested in listening to the
therapist.

Step Two.
If the therapist then lowers his voice the Patient has to listen even harder and for a few
moments forgets to pay attention to his hand. When the Patient is trying to listen harder
he will most likely lean forward a little and his eyes may de-focus and his pupils dilate.

Step Three.
When the therapist notices this he should start to release his grip very slowly and in
such a way that the Patient doesn't notice at first.

Step Four.
The therapist should then start to gently move his index and little finger and thumb so
that it very lightly strokes the Patients hand. The index finger strokes the Patient's inner
part of the wrist whilst the little finger strokes the underside of the wrist and the thumb
strokes the back of the hand. This behaviour should distract the Patient away from the
therapist's voice and cause further confusion.

Step Five.
The therapist can now add further confusion by changing the content of his speech and
introducing an ambiguous question. This should be asked in a searching and
meaningful way so that the Patient is once again distracted back to the therapist's
voice and has to think of how to answer the ambiguous question. This sends him even
deeper on inner search to try and figure out how to answer.

Step 6.
At this point the Patient should be fairly confused and the therapist can slowly release
his grip and give the Patient's hand two or three ambiguous pushes from side to side
and up and down to promote catalepsy. At this point the Patient may look down.

This is OK. Even if the Patient doesn't look down the therapist can now reach down
with his right hand and slowly lift the Patient's other arm into the air. If the Patient just
allows this to happen easily and the therapist senses that it will continue lifting by itself,
he can let go and allow it to continue lifting into a full arm levitation. If the arm is heavy
the therapist can lift it higher and into a position where it can develop arm catalepsy or
just let it drop by the Patient's side. If the Patient has not looked down the therapist can
either indicate with his eye movements that he wishes the Patient to look down
at his levitating, cataleptic, or dropping hand, or suggest this verbally. The Patient will
then look and either watch or develop eye fixation.

If the therapist then wants the Patient to close his eyes, a simple non-verbal downward
pass of the Therapist’s hand in front of the Patient's gaze should be enough to produce
eye closure. If for any reason the Patient is still looking at the therapist he can suggest
eye closure non-verbally by modelling an ensuing trance. He does this by slowly
closing his eyes several times and slowing down the lid closure a little with each
subsequent eye closure.

As the Therapist applies the above technique he should also practice eye defocusing,
smoothing out of muscle tone, eyelid closure and shifting posture while slowing down
the breathing. These can all be applied with the verbal induction. The therapist should
always be modeling ensuing trance while using the verbal trance inductions. By using
both verbal and non-verbal approaches the therapist is utilizing all of his skills to help
the Patient enter the most receptive healing state.

Ideo Motor Signaling

Ideo-motor signalling is the name given to a technique whereby a movement of

the Patient’s finger is used to signal an unconscious communication – typically a
yes or no response.
The Therapist asks the Patient’s unconscious mind to lift one finger for a “yes" answer,
and another for a "no" answer. Sometimes the Therapist indicates on which hands the
fingers will be or sometimes it is left for the Patient’s unconscious to decide. The
responses can either be on the same hand or on different hands. It is most common to
use both hands – maybe a yes response from a finger on the right hand and a no
response from a finger on the left hand. It is usually easy to tell when a patient is
faking. An unconscious finger signal is slow with minimal movement at first and it can
often be a little shaky. A conscious response is a direct, conscious and a more or less
immediate lifting of the finger. Ideally there should be no conscious participation on the
part of the Patient and often Patients are unaware of the finger movements as they
happen.

Ideo-motor movement can also be an unconscious movement of the head, foot

or other part of the body.
Sometimes when a Patient has been asked to allow their unconscious mind to move
their finger, they also nod or shake their head without realising it. Because head
nodding and shaking is a part of our everyday non-verbal behaviour it can happen quite
naturally and unconsciously. In trance the unconscious head nods are different from
conscious everyday head nods. In trance they are usually very slow and barely
noticeable. If a Patient nods their head in a very enthusiastic and conscious way then
the response is consciously generated and should not be relied upon, it is just the
Patient answering consciously and the responses are based on the Patients usual
conscious understanding. Sometimes there may be an unconscious movement of the
foot or hand as well, or a twitch in a face muscle. These are usually unconscious. It is
rare for these to be consciously generated as most people do not deliberately use this
part of the body to communicate.
There is usually a delay in an Ideo-motor response.
There is usually quite a delay between the therapist’s question and the Patient lifting
the finger, especially at the start. This is because the Patient has to process the
question unconsciously, search for an answer unconsciously, and then move the finger
unconsciously. This process gets faster as the Patient answers more questions and the
process becomes more familiar. The therapist can encourage the finger to lift with
indirect suggestions and notice the initial slight twitch of the muscles in the back of the
hand.

An Ideo-motor can often be a very minimal movement.

With some Patients you may only see a twitching of the muscles in the back of the
hand or a finger shifting from side to side and a full lift make not happen or take much
longer to happen. This is of no concern. The twitch in the muscle is hard to fake and so
is a very good indicator of a genuine unconscious response. It can be used as an
alternative to a full finger lift. I often will only need that small twitch as a response as
this saves time and energy. However beware, sometimes a movement may occur in
one place during one session and during another session occur in another part of the
hand. So you need to develop your observation skills to notice these subtle minimal
movements.

An Ideo-motor response is always evoked at the unconscious level.

The whole purpose of using Ideo-motor responses is to communicate with the part of
the Patient that knows more about the problem than they do. By communicating
directly with the unconscious mind the therapist is able to call upon the Patient’s
unconscious resources for problem solving. A certain amount of negotiation can be
done between the therapist and the Patient's unconscious mind in this way although
the answers are limited to yes and no. The Patient need not have any conscious
awareness of the communication as it is happening and he will often forget that it did
happen. Usually Patients can remember that the fingers moved but can’t remember all
of the answers.

Limitations of Finger Signaling

Any attempt at evoking direct answers, especially detailed answers via finger
signalling, is severely limited because the fingers can only answer "yes" or "no". Often
keeping track of the answers obtained with ideo-motor responses can be challenging
for the therapist. So when getting answers with finger signalling the therapist should
ideally write down both the questions and answers on a sheet of paper. Sometimes the
responses can be quite confusing and contradictory because the unconscious mind
has its own sense of logic and a written record of the session will help sort out this
logic.

Unconscious Confidentiality
Keeping a clear written record of the responses as the session progresses will
definitely help you to keep track of the unconscious communication, but it may not be
advisable to show the Patient the written record afterwards, as it will often contain
confidential information shared about the Patient by his unconscious.
Cross Matching

Cross-matching a Patients body posture will enhance rapport.

When people are getting on well together they tend to sit in the same position as each
other. You will often see this in social situations. When people talk to each other they
tend to adopt the same posture. When people walk down the street together, as long
as they are the same height and build, they tend to walk in step with each other.
Because people naturally mirror each other when the relationship is good, therapists
can mirror Patients to enhance rapport. HOWEVER – if you match all of the time it can
seem very obvious. Imagine crossing and uncrossing your legs every minute with an
anxious Patient – it would be very noticeable.

Cross matching is the indirect mirroring of behaviour in another system or part

of the body.
To cross match another person the therapist has to first identify what behaviour he
wishes to match, for example the Patient's breathing. The therapist then identifies
some way he can match the pattern or rhythm in the Patients breathing without actually
using his own breathing. For example by swinging his leg in rhythm with the Patient's
breathing, or gently swaying or nodding his head. Be careful though, as movements
such as swaying or nodding the head can sometimes be misinterpreted by the Patient.
Nodding the head could be interpreted as agreement with what the Patient is saying
and swaying could be interpreted as nervousness on the part of the therapist. So
whatever behaviour you choose to use as your means of cross matching it should be
"content free" to void it being misconceived.

Cross matching should be subtle.

Any overt hand gestures, for example, might be recognised consciously by the Patient,
because they are directly in the field of vision. Generally speaking most Patients are
unaware of others matching unless it is excessive. This is because it is everyday
behaviour. Only when the therapist matches or mismatches in a very overt way does
the person notice this technique being applied.

In therapy the therapist should attempt to match the Patient as subtly as

possible.
The matching can continue throughout the therapy until the end of the session but to
finer and finer degrees, becoming more subtle as the session progresses. Cross-
matching symptoms or breathing abnormalities is obviously inadvisable. Even if the
Patient doesn’t think that the Therapist is mimicking the Patient directly he might
unconsciously pick up on it, Secondly if the cross-matching is too precise the therapist
may even start taking on some of the Patient’s symptoms!

The My Friend John Induction

The "My Friend John" Technique is an Induction disguised and as an Analogy about
another Patient.
Erickson created the "My Friend John" Technique where the therapist describes a
hypnotic induction that the therapist applied previously with a different Patient whose
fictitious name was John. As the therapist describes the induction he directs
suggestions (embedded in the analogy) more and more towards the present Patient.

The Patient initially feels that the therapist is only talking about the Patient called John
but then slowly realises that he is also going into trance himself. Because the therapist
is talking about someone else rather than the present Patient, the present Patient has
no resistance to going into trance. The Patient just finds himself slipping more and
more into trance in an analogous fashion.

The "My Friend John" Technique allows the therapist to feed back the Patient’s
minimal cues.
As the therapist describes the induction, he also pays attention to the ensuing trance
developing in the present Patient. The therapist notices minimal cues developing and
includes these minimal cues as part of his way of identifying when his imaginary friend,
John, was going into trance. By indirectly feeding back the minimal cues to the Patient,
the therapist indirectly induces hypnosis in the present Patient.

The Patient initially does not realise that it is the changes in his own minimal cues that
are being described, but as soon as he feel trance developing, he usually either lets go,
and enters a pleasant comfortable hypnotic state or arouses and wakes from the
session.

The "My Friend John" Technique indirectly teaches the Patient how to go into
trance.
As the therapist describes the induction, which is obviously a successful induction as
described, he also instructs the Patient indirectly on exactly what to do to achieve the
same hypnotic state as the friend called John. Sometimes the Patient may find it a little
confusing or amusing, but with such specific instructions on how to go into trance, and
no obvious induction directed to the Patient, the Patient finds it hard to resist going in to
trance. The Therapist can even include the current Patient’s sense of confusion or
amusement in the description of John’s induction to further compound the effectiveness
of the induction. If the current Patient makes an effort to bring himself out of the
ensuing trance, the Therapist can also include this in the description too.

John’s Induction
Any kind of induction can be described as long as it is simple enough to describe and
can be replicated easily by the Patient. As the Therapist gives the analogy, the Patient
will usually experience eye fatigue. The effect of this is that the patient goes in and out
of light trance states as the Therapist is talking. The Patient may pull himself out of it
briefly, only to feel the eye fatigue happening again, without quite knowing why. There
comes a point when he realises that he is responding to the hypnotic suggestions in
the analogy. This serves to ratify to the Patient that he is highly responsive to hypnosis,
otherwise, why would be going into trance before the actual induction has started.

The Uptime / Downtime Comparison

The eye fatigue and pulling oneself out of the ensuing trance is very similar to the
Uptime / Downtime Induction, where opening and closing the eyes induces fatigue in
the eyelids and feelings of going deeper into trance. This same principle of trance
ratification and deepening is an integral part of the My friend John Induction. Indeed the
two techniques can be integrated. Through a process of continually opening and
closing the eyes the Patient becomes tired. The difficulty in keeping the eyes open,
reinforces the Patient's belief that he is going into a trance state, yet without having
been told to do so directly.

Stephen Brooks’ Cellular Healing Therapy

Patient's have the resources for healing themselves at the cellular level.
The Patient has the ability to heal himself with his immune system. This is a natural
process that
normally happens unconsciously. By communicating directly with the Patient's
unconscious we can
get it to focus more directly on the part of the body that needs healing.

We have all heard stories of how a mother has been able to lift a heavy car off a small
child and
been able to access incredible strength just at that moment. With cellular healing we
tap into this
same unconscious potential and utilise it for healing. We use cellular healing mainly for
treating
internal physical damage and to help Patients with terminal illness and similar
physiological problems.

Cellular Healing utilises a number of standard hypnotic principles.

These principles have long been accepted as a traditional component of hypnotherapy
and they are
as follows:

 Ideo motor signalling for communicating with the unconscious mind.

 Dissociation of the conscious from the unconscious mind.
 The introduction of a therapeutic model to give structure to the therapy session.
 The release of early life traumas and negative learnings. The release stage of
the therapy is crucial.

General Therapeutic Structure

The therapist communicates with the Patient's unconscious via ideo-motor signalling.
This enables the therapist to work directly with the unconscious without interference
from the Patient's conscious mind. This is a very important principle in cellular healing.
The Patient must experience his unconscious acting independently and answering
questions in an unconscious involuntary manner. Many Patients' find it hard to accept,
at the conscious level, that hypnosis can help boost their immune system or
communicate with their body’s healing mechanism at the cellular level. They may try
and convince themselves that this is possible as they desperately want it to be
genuine. Despite their willingness to co-operate with the approach in general some
Patients often still hold a doubt in the back of their mind, so dealing with this doubt is
very important. If the Patient is able to experience their immune system communicating
via their unconscious mind and involuntary finger signalling they suspend their doubt
long enough for their unconscious to initiate the healing process. The resulting
physiological change in body sensation that occurs during or shortly after a session of
cellular healing usually ratifies the therapy and often eliminates the doubt altogether
thereby clearing the way for further in depth healing to occur.

The stages of the Cellular Healing process are as follows:

1. Induce hypnosis.
2. Set up an ideo motor response.
3. Give suggestions that states of health and the effectiveness of the immune
system are influenced by our everyday life experiences.
4. Tell the unconscious to maintain any learning it has made from stressful
situations.
5. Regress the Patient to the first experience they had that may have negatively
influenced the strength of the Patient's immune system.
6. Ask the unconscious mind to store any learning made from these negative life
experiences without storing the damaging or depotentiating effects of the
experience.
7. Ask the unconscious if it is willing to release the experience so that it no longer
influences the immune system in a negative way.
8. Tell the unconscious to release the experience. This is usually accompanied by
non-verbal signs of emotional release.
9. Ask the unconscious to find the next significant time something happened that
influenced the immune system in a negative way.
10. Tell the unconscious to release this experience.
11. This process is continued until all negative experiences have been released.
12. Ask the unconscious whether there is any reason why the immune system
cannot now re-generate the white blood cells to their maximum healing
potential.
13. Ask the cells to re-generate and start healing the Patient.
14. Ask the unconscious how long it will take for the Patient to be healed to the
maximum level of healing. You can ask whether will it take longer than one
day?". If the answer is yes then ask "will it take longer than two days?" and so
on until you reach the anticipated day. If the unconscious is working in terms of
weeks or months rather then days then ask using these increments.

Please note: all of these questions are asked with ideo-motor signalling whenever
possible.

ooooooooooooooooooooooooooooooooooooooooooooooooooo

Sometimes Patients are vague when they communicate.

Patients who are able to communicate clearly do so by describing things in an objective
way and often in behavioural terms: "When I lift my arm it won't reach any higher than
my chest and I feel a pain in my right shoulder." This communication is very specific
and easy to understand. The problem is that Patients rarely talk like this. They are
more likely to say. "This problem really bothers me, I have difficulty with my arm and I
need you to help me with it." Their communication is non-specific. Often this is because
they assume that you understand their language.
When a Patient says he is depressed he assumes that you understand him although
depression can vary from patient to patient. When a Patient says he is anxious he also
assumes you know what this means too. Often the Patient doesn’t know how to
describe his problem or symptom, because he has never had to before. There are
many well-meaning therapists who nod their heads in agreement when a Patient
describes his problem in this way and they never challenge the Patient’s
communication. We must learn to challenge what the Patient says when we don’t
understand fully what they are saying. If we don’t we will build up a false picture of the
Patient’s problem.

Take this as an exercise: At home I have a vase with a flower in it. Can you picture
what kind of vase it is? Can you see the flower? How accurate do you think you are
with your guess? The chances are that you are wrong. Yet therapists often base their
therapeutic approach on conclusions formed by the same kind of guesswork. What is
more, usually the Patient is less specific than I am with my description of my vase and
flower.

Nominalizations.
Patients often use negative nominalizations to describe their problem. The word
“anxiety” is a nominalization and patients use it because they believe that you know
what it means – specifically. Negative nominalizations are generally not useful although
positive nominalizations are useful. Therapists use therapeutic positive nominalizations
such as “transforming”, “exploring” and “potential” as part of hypnotic inductions and
therapy and these are good. Likewise, in other professions, nominalizations are often
used as communication short cuts. In industry for example, a nominalization may be
used to describe a difficult technical function, for example, the word “combustion”
describes a process. As long as everyone knows what combustion is then the word can
be used over and over and everyone will understand without the need for a long and
technical explanation. In finance the word "profitability" describes a process of
accumulating profit. We don't need to know how, when and where profit has been
accumulated to understand that profitability means making more money. So the
nominalization of “profitability” can be used with confidence because everyone knows
what it means. In therapy when listening to our Patients we can’t be so certain
however.

Do not assume.
It is easy to assume that if one Patient is helped with a certain technique then a second
Patient might be helped with the same technique, but it isn’t always the case. Yet it is
common for many therapists to assume, because it is a kind of short cut. The
therapist's perception is to blame. Two people never have exactly the same problem or
symptom and the contexts are often different. When a new Patient comes in and
complains of the same problem as the previous Patient it is never exactly the same
problem because it is not the same Patient. Every Patient is different. Some of the
principles that worked before can be employed with the new Patient but not necessarily
the same techniques. People are individual and have different needs. The therapist's
job is to identify those needs and change what he is doing to meet the needs of the
Patient.
There are far too many therapists trying to pigeon-hole Patients and trying to get the
Patient to fit the model of therapy they are using. Why? Maybe because they have
invested time and money in their own training and feel it must be right and so use it on
everyone. It’s OK to not know what to do next, to feel free to go against the theories
taught and develop the flexibility and willingness to change the treatment modality to
meet the needs of the Patient.

You should develop a keen ear for Nominalisations.

You should listen for those words that describe a process but lack specific content.
Look at the following: " I am unhappy, I can't communicate with people, I am anxious
and worried about my depression getting worst, I just can't concentrate on resolving the
issues in my life." What does it mean? The person is clearly not feeling good about
himself but he is not telling you anything specific. How can you possibly begin to
understand what he feels like when his communication is so vague. Yet we nod our
head in agreement and start applying our therapy.

Let's break the communication down into specific chunks that can be analysed and
hopefully utilised in therapy. Firstly, what does he mean by "unhappy'. When is he
unhappy, where does it happen? Is it all of the time, even when he is asleep? What
does it feel like? Where does he feel it? In his whole body, his chest, his big toe? You
need to get very specific information to be able to understand the patterns in the
Patient's life. You need to understand the cognitive patterns and the behaviour
patterns. The problem has not happened to the Patient, he has created the problem
and is maintaining it by the patterns in his thinking and behaviour. By discovering the
patterns you are also discovering how the problem is being maintained. We are not
really interested in why a problem developed, even thought the Patient is. We are more
interested in how it developed and how it is being maintained. The answers to these
questions are in the patterns of thought and behaviour.

So let's look at this Patient's communication again. "I am unhappy, I can't communicate
with people, I am anxious and worried about my depression getting worst, I just can't
concentrate on resolving the issues in my life." Now lets pull it apart. These are the
important words we need to challenge: Unhappy, Communicate, People, Anxious,
Worried, Depression, Concentrate, Resolving, Issues and Life. Notice that it's nearly
the entire communication. It is so non-specific that we could have a field day taking it
apart. If the Patient were to say nothing else we could still spend the rest of the therapy
session just pulling apart this communication and using it as a starting point for opening
the door to the unconscious specific details that lay behind the Patient's problem.

All the Patient is doing here is giving us a very rough outline of his problem. It may be
that he doesn't have any better understanding, or it may be that he is deliberately trying
to sabotage his own therapy by not being more specific. Just look at these words and
ask yourself what questions would evoke more information if these words were
challenged. Unhappy, Communicate, People, Anxious, Worried, Depression,
Concentrate, Resolving, Issues and Life. If you start each of your questions with a
"where, when, what, who, how, and (if you must) why, you will start to get specific
information. Bear in mind that by asking "why" you may just get another string of
Nominalisations as “why” often just brings up beliefs rather than facts. Just look at how
many different questions you can ask about the word "anxious":

Where are you anxious?

In what context?
In what place geographically?
In what part of your body?
When are you anxious?
Daytime or night time?
All the time?
Does it come and go?
How long does it go for?
How long does it last when it's here?
Have you felt this before, where, when, how long for etc.?
What does it feel like?
Does the feeling change?
What is the sequence of feelings?
What happens first, next, last?
Who knows about this?
How do they deal with this?
How do you feel about them?
How long have you felt this?
How did it start?
How do you deal with it?

Specific information helps you identify the patterns in a Patient’s thinking and
behaviour.
It may be that from your questions you discover that the Patient only feels anxious
when they are in a certain place and that this then only happens when they have to
communicate in front of a specific person. You might also have found out that the
"issues" he mentions are specific events in the past involving a person with similar
characteristics to the person currently appearing to cause the anxiety. At all times keep
your eyes and ears open to the Patient’s two level communications and start to gently
challenge any negative nominalisations.

Developing Advanced Strategies to Deal With Failure

What could go wrong?

Patients sometimes sabotage their success. If we ask the Patient "what could
go wrong?" we can get a better idea of any sabotaging strategies the Patient
may have. When we ask the question we are not actually suggesting that things
might go wrong, we are attempting to recognise, ahead of time, any situations
that might trigger a re-occurrence of the problem. This question is very similar to
the question "What has stopped you from changing in the past?" the main
difference being that this new question is about the future. Because it is about
the future, Patients often find it easier to answer because they don't have to
remember the unconscious ways they used to sabotage. Here they are being
asked to be creative and imagine how things could go wrong. However, both
questions will often bring up similar answers because the imagined responses
are usually based on how they did it unconsciously in the past.

When you ask this question you are attempting to identify patterns of sabotage.
By recognising these possible occurrences ahead of time, the therapist can plan
ways of either avoiding the situations which allow sabotage to happen or giving
the Patient resources with which to handle the situation in a better and healthier
way. If this question is asked a second time at the end of therapy (as a kind of
future pacing question) the answers will most likely be different from the first
time because the Patient will then have, ideally, the resources to prevent any
sabotage.

I should discuss here whether it is advisable to actually use the word "sabotage"
with Patients. Some Patients will react very strongly to the word as if it were an
accusation. Others will see it as a rational explanation as to why they relapse or
cannot get better and will use this definition to guard against further sabotage.
Generally, Patients with a long history of psychotherapy or who are at all
aggressive, opinionated or defensive should be handled very carefully and the
word sabotage should not be used. Patients new to therapy who also appear
fairly flexible and are quite open to new ideas can benefit from hearing and
subsequently using the word. However like everything in therapy, the rules are
there to be broken.

You might be surprised at first by how many different ways Patients have of
sabotaging therapy. Asking "what could go wrong?" usually brings up a whole
list of ways they might prevent themselves from getting better. Usually they
don't recognise that these ways of preventing success are of their own making.
They will usually blame other people or contexts. It is your job to make them
realise that these "events" that seem to suddenly step spontaneously in the way
of success are in fact attempts on their own part to allow their own success to
be sabotaged. Patients sabotage in two ways. They either do something directly
that gets in the way of success or they do it indirectly by allowing something or
someone else do it for them and then deleting their awareness of how they
have in fact created the situation.

For example, a Patient wanting to lose weight might sabotage directly by going
to the refrigerator in the middle of the night. Or they might sabotage indirectly by
creating a context where someone else feels compelled to buy them chocolates
and they, therefore, are obliged to eat them or risk offending the accomplice.
When Patients are able to generate lots of alternative ways of sabotaging
therapy or excuses for explaining why they cannot get better you should
investigate their secondary gains more closely. When Patients have problems
they try and cope and this creates secondary gains. Sometimes Patients even
invite the problem into their lives in order to have the benefits of the secondary
gains.
You should look closely at their level of motivation in association with their
degree of secondary gain because secondary gains reduce the level of
motivation for therapeutic change. You have to either change the secondary
gains by finding equally rewarding substitutes or remove them by re-framing the
Patients beliefs about the value of the secondary gains. When Patients create
lots of examples of how they cannot get better you will notice that some
examples may seem quite ridiculous. For example a Patient sabotaging a diet
might say "When my children can't manage to eat the cakes I have bought for
them I just have to eat them myself because it would be such a waste of money
to throw them away". The possibility of saving the cakes for the next day or
simple buying less cakes doesn't seem to occur to the Patient. This is an
example of indirect sabotage where the Patient deletes their awareness of their
own sabotaging strategy.

The Early Learning Set Induction

The Early Learning Set is a hypnotic induction combined with age regression that is
also used to access resources. It utilises memories of very early experiences as its
foundation. The Patient is encouraged to relax and recall times in his life when he
learnt to do something difficult for the very first time.

Erickson’s Application
Milton Erickson often used the experience of learning to walk as his main Early
Learning Set Induction. He would explain in great detail the experience of moving the
various muscles in the body to shift the weight and balance from one leg to another. He
described in great detail the experience of falling down and trying to get up again only
to fall down again, all in order to take that first step. Other early learning experiences
he utilised were trying to tie a shoelace, learning to skip with a skipping rope and trying
to write your name. It is important that the early learning experience be explained
slowly and in great detail usually over several minutes. The Therapist uses Serial
Suggestions to describe the early learning experience, slowly building up the memory
of the difficulty in learning the task being described.

Age Regression
When the Patient experiences the Early Learning Set induction they sometimes might
spontaneously regress back to an earlier age as they re-call the experience.
Sometimes the regression is not complete, it is a revivification – recalling the memory
with pictures, sounds and feelings but still with an awareness that the patient is in the
here and now in the therapy room. When the regression is full and complete and the
patient is completely orientated to an earlier age and without any awareness of being in
the present the Therapist must proceed with some caution. In such cases the
technique should not be used with patients who might abreact or have had unpleasant
early life experiences.

Accessing Resources
Embedded within the induction is the message that many times in our childhood we
have been faced with seemingly difficult tasks that to a child appear insurmountable.
Yet, despite seeming this way at the time, we were able to overcome these difficulties.
Example for Therapy
An example of an Early Learning Set might be as follows: "There was a time when you
did not know how to write your name. You knew you had a name yet you did not know
how to write it. Someone might have told you that those squiggles on that piece of
paper were your name. Yet however hard you tried you couldn't quite believe that it
was your name. Your name had a sound that you recognised but it didn't yet have a
shape. Before you could begin to write your name you had to learn to hold a pencil.
You had to discover which hand would hold that pencil. You had to learn how to apply
just the right amount of pressure with that finger, that thumb and where to rest your
hand when holding that pencil. At first, the tip of that pencil just wouldn't write straight.
When you wanted it to go to the right it would go down and when you wanted it to go
up it went to the left. You changed the position of your shoulder so that your arm would
be in a better position to hold that pencil. You leant forward and you stuck your tongue
out between your teeth and concentrated so hard you were unaware of anything else
around you. Time seemed to pass without you noticing and you patiently learnt to move
that pencil in a straight line. Then came the first letter of your name. Then the second
and so on. To a child this was a big insurmountable task yet you overcame this and
now you take writing your name for granted. You can wonder what other things you will
learn that you will later take for granted. It is so easy to forget the things that were
difficult once they have been overcome and are now in the past."

Sensory Based Predicates

Patients use sensory-based words that represent the way they are thinking at the
time.
Every person “thinks” by using their senses in order to understand and make sense of
the world. We take information in through our senses and we process information
internally inside our head, in our sense systems. Our vocabulary has developed sets of
sensory based predicates which relate directly to what we experience in specific sense
systems. A predicate is the term given to a particular word that is generated to describe
a sensory experience. For example, the predicates: to see, to view, to look, etc belong
to the visual system. It is believed that when a Patient talks about his experience and
uses specific predicates such as I see or I hear, he is actually thinking in pictures
and/or in sounds that relate to the predicates being used.

Therapists can feed back predicates to build rapport.

It is suggested that if a therapist identifies the particular language predicates that the
Patient uses and then matches them by feeding them back, that is, to repeat them, the
Patient feels a stronger rapport with the Therapist. By feeding back these words the
therapist aims to convince the Patient at an unconscious level that he also is seeing
and hearing in the same manner. This simultaneous seeing and hearing suggests then,
to the Patient, that both parties are in rapport with each other. We don’t know whether
the feeding back of predicates and the subsequent rapport that follows is the result of
matching of ways of thinking, or simply the matching of language.

Sensory Limitations.
It is believed that Patients who have a limited predicate vocabulary and who are unable
to express themselves verbally using predicates from all sense systems may be limited
in their ability to access resources or process information from unused sense systems.
For example, a person who talks using only auditory predicates may be stuck in this
particular sense system because of an inability to communicate or think in other ways
(senses) and may not be able to visualise particularly well.

Sensory System Utilization

Therapists may be able to help a Patient develop new insights by encouraging the
Patient to remember their problem in each of their sense systems using, for example,
internal dialog, feelings and pictures and then asking the Patient to talk about their
experience using predicates from each sensory system. These new insights may give
the Patient access to new resources and more choices about how to behave in the
problem context.

Other Influences on Predicate Vocabulary

Some Patients may be limited in their vocabulary because of their education, or
because they have learned their vocabulary from their parents and peers. So before
assuming that the Patient is trapped in a particular sense system or is blocking their
experience in some way, the Therapist needs to consider other possible influences on
the Patient’s inability to talk using other predicates.

Rapport Building with Predicate Matching

The Patient’s predicates can be repeated by the Therapist to build rapport. This is most
effective when the Patient is able to communicate using predicates from most sense
systems because by pacing the Patient’s predicates as they switch from one to
another, the Therapist is implying that there is also rapport at the cognitive level.

Examples of sensory based predicates

VISUAL
See, Picture, Imagine, Bright, Sparkling, Perceive, View, Focus, Shimmering, Clear,
Clarify, Hazy, Blurred, Bleak, Dull, Image, Misty, Fuzzy, Foggy, Speculative, Hue,
Hindsight, Obscure, Reveal, Panoramic, Magnify, Glassy, Huge, Minute, Steamy,
Colour, Dim, Shady, Cloudy, Stormy, Precipitous, Distant, Brilliant, Radiant, Blinkered,
Blindfolded, Gloom, Doom, Starry-eyed, Tunnel-vision, Outlook, Transparent,
Translucent, Opaque, Fluorescent, Glaze, Small, Big, Glimmer, Rainbow, Vision, Vista,
Hallucinate, Dream, Perspective, Visualise, Landscape, Deep, Bleak, Light, Dark,
Perceptive, Flash, Proportion, Reveal, Telescopic, Kaleidoscope, Shimmer, Shine,
Glossy, Huge, Bright light, Bright spark, Flash of inspiration, A flicker, I see red, Seeing
ahead, I've gone a blank, See through, Draw back the curtains, Rose coloured glasses,
See the horizon, Blind spot, Draw up agenda, Sketch out/Map out my future, Clear as
crystal, Looks like...., To reflect, To mirror, Mirror image, Eyeball to eyeball, A sight for
sore eyes, Black and White, Visual aid.

AUDITORY
Hear, Sound, Pitch, Tone, Volume, Noisy, Buzz, Raucous, Ringing, Loud, Soft,
Listening, Whisper, Speak, Whistle, Hum, Drumming, Bell, Rattle, Song, Lilt, Band,
Music, Orchestrate, Crescendo, Crashing, Musical, Harmony, Still, Echo, Rustle,
Resonate, Twang, Jingle, Jangle, Clatter, Pitter-patter, Chord, Amplify, Scream,
Bellow, Roar, Screech, Yell, Squeal, Silence, Thunder, Drone, Reverberate, Discord,
On the wavelength, Announce, Broadcast, Talk, Tick, Crying Shame, Interpret, Click,
Clear, Bang, Beat the Drum, Tune in, Fade, Note, Rhythm, Whisper, Crack, Moan,
Clarity, Whine, Shriek, Quiet, Overtone.

KINAESTHETIC
Feel, Pressure, Stress, Settled, At ease, Relaxed, Cushioned, High, Oppressed, Under
the weather, Oh top of the world/things, Up in the air, Flat on the Floor, Down in the
dumps, High as a kite, Ecstatic, Away with the fairies, Touched, Detached, Tired, Tread
the boards carefully, Walking on eggshells, Delicate, Fragile, Robust, Determined,
Fidgety, In bits, Hurt, Cold, Over the edge, Low, Sharp, Feel Beaten, Tender,
Succulent, Soft, Clingy, Funny, Back to the wall, Burdened, Trapped, Hemmed in,
Heavy handed, Swamped, Drowning, Dependent, Abandoned, Gutted, Fighting fit,
Tight, Fragmented, Drifted, Sexy, Things are moving, Pain in the arse, Raises my
hackles, Empty, Slimy, Flip my lid, Heavy, Touch, Caring, Sick, Dull, Pressure, Wound
up, Drag, Rushed, Intense, Heavy as lead, Spacy, Feel grey, Tight, Centred, Closed,
Handy, Thick, Put upon, Tense, Twitch, Anxious, Jumpy, Angry, Moving, Floating,
Light, Elated, Show, Cool, Happy, Excited, Stuck, Sharp, Overwhelmed, Sensitive,
Blunt, Cracking up, Breaking apart, Up tight, Falling to Pieces, Over the edge, Snappy,
Feeling high/low, Flexible, Under par, Drained, Exhausted, Depressed, Out of/In hand,
Burdened, Out of control, Sick of it, Makes me want to throw up, Gut feelings, Makes
my flesh creep, Electrified, Sets my teeth on edge, Grates on me, Makes me feel
creepy, Slide into things, Collapse, Break down, Feels empty, Things are a bit slow,
Feel cold inside, Slippery slope, Mixed up.

Ambiguous Predicates
Some predicates are rather vague and harder to fit into any particular sense system.
Context then determines which class of predicate they are. For example the word
“sharp” can refer to auditory: “a sharp sound”, kinaesthetic: “a sharp point” or taste: “a
sharp taste”. You should attempt to identify predicates that fit into more than one sense
system and then check them against the other predicates being used in that particular
communication to determine which sensory system they are related to.

Examples of predicate-based statements

Visual:
“It looks good to me”
“I can picture it”
“From my perspective”

Auditory:
“It sounds good”
“It's as clear as a bell”
“I ask myself”
Kinaesthetic:
“It feels right to me”
“I can handle it”
“I am under pressure”

Open-ended Suggestions

Open-ended suggestions offer the Patient a number of mutually appropriate choices

and so are similar to binds and double binds in that they give a choice. The difference
being that open-ended suggestions give a number of choices rather than just two. The
Therapist gives suggestions that include several kinds of response, each of which are
appropriate and acceptable as a response to the suggestion. Here are some examples:

Open Ended Suggestion for Trance Induction

“Your hand can lift, move to the left, the right, press down or stay as it is as you go into
trance". Here we see an open-ended suggestion related to hand or arm levitation as a
trance induction. The Patient's unconscious mind is free to move the arm in whatever
way it wishes, however notice that even no movement is included as a valid response.

Open Ended Suggestion for Therapy

"Will you smoke ten, eight, five or only two cigarettes a day as you practice your self
hypnosis?" Here we see an open ended suggestion applied as a therapeutic tool to cut
down on smoking rather than used for trance induction or evoking hypnotic
phenomena. This open-ended approach uses a post hypnotic suggestion that appears
to give the Patient a choice of how to respond, however there is a presupposition that
the Patient will cut down on the number of cigarettes smoked regardless of which
number is chosen.

Open Ended Suggestion for Trance Experience

"You can dream, imagine, picture, or visualise, any memory you like". Whichever
choice the Patient makes, whether to dream, imagine, picture etc., he has to visualise
an image of some kind.

Open-ended suggestions are given to evoke unconscious responses because they are
based on questions that can only effectively be answered by the unconscious. Despite
this, the conscious mind sometimes thinks it can make an independent choice, despite
the responses requested being only reliable if given by the unconscious. Because
several choices are given, the conscious mind has difficulty in choosing between the
illusionary choices and so waits for an unconscious response.

Resource Accessing

Observation and Utilization are two important principles in Indirect Hypnosis. The
Therapist needs to observe in order to utilize. So at some time in the therapeutic
process the Therapist needs to observe whether the patient is able to access the
necessary resources for problem solving.
In our approach to hypnotherapy, we believe that most Patients have within them the
resources to be able to change. Whenever possible we attempt to identify these
resources, if possible, before therapy starts, if not, this is done as part of the
information gathering as the session proceeds. The therapist's job is to help the Patient
apply their resources to their own problem and in many cases we will help the Patient
access several resources so that their combined strength is such that it can heal the
Patients problem. Sometimes we will stack the Patient resources, one upon the other
so that they can integrate and be more powerful. Stacked resources are a series of
good feelings literally stacked one upon the other. The therapist should continue
stacking the positive resources until the positive feeling is stronger than the negative
feeling.

Patients are usually not aware that they have unconscious resources because they are
hidden at an unconscious level. Patients usually try to get better by applying their
conscious resources to solving their problem but as this is not enough, they usually fail,
and this is why they enter therapy. Because the Patient continually applies conscious
effort to trying to get better, the unconscious resources become more and more elusive
because the conscious effort of trying gets in the way. It is similar to not being able to
remember a name. The harder one tries the more elusive the name becomes. Then
when the person stops trying the answer presents itself from the unconscious. So in
therapy we utilise this naturally occurring process and encourage the Patient to stop
trying to get better and instead trust that their unconscious has the resources needed
to help them.

There are a number of different ways of accessing resources. Usually we request that
the Patient’s unconscious mind search through all past positive experiences and
identify resources that the unconscious considers appropriate for treating the Patient’s
problem. We usually ask the Patient’s unconscious mind to let us know when a
resource has been found and this is indicated by a signal such as an unconscious head
nod or finger signal.

If no resources can be found, we have other choices. We can talk about resources that
other Patients have discovered and share these ideas with the Patient by offering
analogies or imply them within a metaphor. We can also give the Patient tasks so that
they have to access their resources in order to carry out the task. The Ambiguous Task
Assignment is also approach that can be used to evoke unknown resources from with a
Patient. Patients often find as a result of carrying out an ambiguous task that they
remember skills and talents that they had long forgotten. They remember positive life
experiences. Sometimes the task itself can lead the Patient to experience resourceful
experiences that they never thought possible.

Another way of identifying resources is to look at exceptions to the rule and to identify
times when the problem did not occur even when the Patient expected it to. As this will
usually point to some kind of resource. The therapist asks the Patient to remember
such times and then investigates what was different on that occasion. Another
approach is to look at contexts. The therapist attempts to identify a context where the
problem could not happen. Either because the Patient would not allow it to happen or
because he would be unable to experience it happening.

Stephen Brooks Facial Symmetry Calibration

Over time Patients become weathered by difficult life experiences and the accumulated
mental stress can be observed in their facial symmetry. The stress shows itself on the
face in the form of frowns and lines etc. and the deeper unconscious affects of
experience in the right and left hemispheres of the brain show on either side of the
face. It is generally believed that the right side of the brain influences the left side of the
body and visa versa. If the therapist trains himself to calibrate to either side of the face
he will notice a difference between the facial expression from right to left and therefore
the affect of right and left hemispheres on facial symmetry.

The right hemisphere is generally considered to be responsible for creativity,

imagination and spatial experience, so we can conclude, as these are also the qualities
of the unconscious mind, that the unconscious mind is more active in the right
hemisphere. The left hemisphere is responsible for analytical thought and reasoning,
language etc. and so we can conclude that, as these are the qualities of the conscious
mind, that the conscious mind is more active in the left hemisphere.

With this as our theoretical model, we can determine the influence of both conscious
and unconscious processes and the stress experienced in either hemisphere by
looking at the differences between the right and left side of the face. To train yourself to
do this you need to get a piece of paper and cover one half of a person's face so that
only one side is showing. You should then, without judging or making any interpretation
in terms of the emotional quality at this stage, calibrate and get a sense of the
“weathering” on that side of the face.

You should take a mental picture of the exposed side of the face and mirror image it.
Imagine the person with both sides of their face the same as the exposed side. Once
you arc able to look away and maintain an accurate mirror image of that side of the
face in your mind, you should then cover up the previously exposed side of the face
with the paper and calibrate on the other side of the face.

You will usually notice quite a different expression on the right side to the left side of
the face. You may be tempted to make an interpretation such as "this side looks more
worried, tense, dishonest" etc. This is not appropriate until have more information about
the person and actually know what their normal facial expressions relate to in terms of
emotions.

As the therapy session progresses and you learn more about the Patient and their
emotions you can start using your interpretation as a starting point to work
therapeutically with Patients using the interpretation as a way of opening up discussion
about their problem. For example, you might think that the unconscious (left side of the
face) looks scared. You can start asking questions about the problem in relation to fear
without actually telling the Patient where you picked up this interpretation.
The use of a piece of paper to cover half of the face is only for training purposes, when
you use facial calibration in a therapy session you do not use the piece of paper to
block out one half of the face, you should do this in your own mind. The more
frequently you practice the technique the more unconsciously competent you will
become.

Stephen Brooks Insertive Eye Contact

The Insertive technique utilises two simultaneous communications.

People always communicate on two levels, verbally and non verbally. Usually the non
verbal aspect of a communication is unconscious. When people have a particular
message to convey they usually use words and gestures and facial expression. In
addition to this they change the tonality of their voice to imply meaning or emphasise
certain aspects of the communication. The Insertive technique is a technique whereby
the therapist puts emphasis on certain portions of the communication to make them
stand out. However this standing out process should not over emphasise the particular
areas to be emphasised. For example the therapist might say to the Patient "have you
ever wondered what it's like to feel relaxed?" If this question is given in an ordinary flat
tone of voice there is no emphasis on any part of the communication. However if the
therapist changes the pitch or tonality of the voice when he comes to the words "feel
relaxed", then this portion of the communication will stand out from the rest. This is
known as an Embedded Command. However it should not stand out so obviously that
the Patient is aware of it at the conscious level. It should only stand out at an
unconscious level so that the Patient is unaware of it consciously. This principle is the
essence of the Insertive Eye Contact Technique.

The therapist makes suggestions and inserts into the suggestions quite powerful
authoritarian commands. So in fact two communications are occurring simultaneously:
one directed to the conscious mind (the entire contents of the suggestion or statement)
and one directed to the unconscious mind (the Embedded Command). It is quite an art
for a therapist to develop this technique in a very casual conversational way, however if
practised it can be effective for the Patient.

The conscious and unconscious communication is verbal and the unconscious

communication is emphasised non-verbally.
The words, that is the meaning of the suggestion, is understood consciously and
unconsciously by the Patient. However the emphasis placed on the important
Embedded Commands is made non-verbally. The Embedded Commands can be
emphasised with the raise of an eyebrow, or a smile, or a change of tonality, a change
of volume, a touch on the back of the hand, or any number of non-verbal behaviours
which are consistent.

At an unconscious level the Patient's unconscious mind recognises the pattern of

association between certain commands and a touch on the back of the hand for
example. Without the Patient's conscious awareness he starts to respond to the
inserted commands without knowing how. He in fact had no awareness that the
commands are being inserted and emphasised.
A good way of perfecting this technique is for the therapist to write out many, many
different forms of hypnotic suggestion and then choose various commands within the
suggestion that can be emphasised. The therapist need only then practice
emphasising these in the most natural way for the therapist. As long as you are
consistent the Patient's unconscious mind will pick up these suggestions and respond
automatically.

The Insertive technique can be applied to the conscious and unconscious mind
of one Patient.
We attempt to separate the conscious from the unconscious mind. This follows a model
developed by Milton Erickson. The assumption is that the Patient has a conscious and
an unconscious mind and that these operate both interdependently and independently.
For example a Patient will be able to operate consciously in the normal world yet would
not necessarily have access to all of his life experiences at that particular time. His
memory stores the information of his life experiences at an unconscious level. The
therapist can mark out communications to the unconscious and the conscious mind by
putting emphasis on the portion of the communication that is directed just to the
unconscious. The unconscious mind starts to pick up the patterning. This technique
allows the therapist to deliver two simultaneous communications one to the conscious
mind and one to the unconscious mind of the Patient. Ideally, when using hypnosis, the
therapist needs to communicate to the unconscious mind without any conscious
interference on the part of the Patient. The Insertive technique is a very useful
technique for emphasising purely unconscious communication meant only for the ears
of the unconscious.

Stephen Brooks Insertive Eye Contact

With Stephen Brooks Insertive Eye Contact the therapist uses the natural behaviour of
looking from one eye to another when talking to another person. It is not unusual for a
person to explore the face of the other person when talking. The difference with
Insertive Eye Contact is that the therapist is very calculating when he looks at the either
the right or left side of the face. Usually, because the conscious mind is believed to be
more active in the left hemisphere the therapist directs all of his communications,
meant for the conscious mind, to the right side of the Patient's face.

When then emphasising a particular part of the communication destined for the
unconscious mind, the therapist then shifts his gaze for the duration of that
communication, to the left side of the Patient's face. The left side is associated with the
right hemisphere and the unconscious mind. So the therapist is literally "inserting"
suggestions into the unconscious mind via the left side of the face. Although the left
side of the face is "wired" neurologically to the right hemisphere the eye is not. The eye
is "wired" to both hemispheres. So you should not make the mistake of believing that
you are communicating to the eye. You are only looking at the Patient's eye because it
is socially appropriate and a natural thing to do. The Patient's eye picks up the direct
communication with that side of the face and so delivers the message to the relevant
hemisphere and the part of the mind processing the suggestions. Most important of all
is that you are consistent. This requires some practice but is worth the effort as this is
one of the most effective indirect hypnotic induction techniques I have developed.
Hypnosis for Pain Control and Anaesthesia

Pain is a signal
Pain is experienced for a purpose. It is usually a signal or message saying, “please
look after me”. Pain is a way of reminding the Patient to take care of a particular part of
the body. Even psychosomatic pain is a message.

Pain Removal or Re-interpretation

In most cases the Therapist should not attempt to remove pain entirely. Instead he
should change the way it is perceived by the Patient, and hypnosis is one of the best
ways of doing this. Patients can be taught to re-interpret their pain as a different
sensation and to develop an attitude of not being bothered about the discomfort rather
than developing total anaesthesia for what is an important signaling system. The only
time when it might be appropriate to remove pain altogether is when the Patient is
receiving surgery or has a terminal illness, or similar circumstances.

Pain is a psycho-physiological experience

Patients experience pain mentally and physically and hypnosis can be applied to bring
about both psychological and physiological changes. Patients perceive their pain
according to how it is classified, so a Patient's perception of acute pain will most likely
be different from their perception of chronic pain and this will influence their
expectations regarding recovery. The Patient’s perception of pain can also be
influenced by time and context; they will have remembered pain, present pain and
anticipated pain. The Therapist can change this perception with amnesia, dissociation
and other hypnotic phenomena that can separate the experience of pain perceived as
memory, actual experience or expected pain.

Definitions of Pain – Acute and Chronic Pain

A Patient experiences acute pain through injury or surgery. Acute pain has a beginning,
middle and an end. The Patient can see an end to the pain after the healing process
has occurred. Chronic pain is different because it is an ongoing experience. Chronic
pain is the term used for pain experienced in illnesses of an organic nature such as
terminal illness. Patients experience the remembered pain of yesterday, the actual pain
of today and the anticipated pain of tomorrow as part of their psychological perception
of chronic pain. The therapist needs to identify whether the Patient has chronic or acute
pain before deciding on an appropriate treatment approach.

Referred Pain
Sometimes Patients experience a pain in one part of the body from a cause in another
part of the body, this is known as referred pain. It is important for therapists to identify
the source of referred pain and find out the cause before attempting to alter the
Patient’s perception of the pain. When the Therapist is not medically qualified to make
a diagnosis he should always refer the patient to a Doctor before proceeding.

Psychosomatic Pain
When no obvious physiological cause can be identified the therapist (or Doctor) should
also test to see if the pain is psychosomatic. With psychosomatic pain there is no
physiological cause for the pain although the pain is felt in a real way. Most Patients
who request psychotherapy for pain have already been diagnosed as psychosomatic
by their Doctor. In some cases the patient has been told that the pain is “all in their
mind”. You must be sympathetic because the Patient does experience real hurt even
though the pain is psychological.

Psychosomatic pain is different from chronic and acute pain. Its purpose is not to
protect an injury or alert the patient to an organic illness, it is a message or a cry for
help at a psychological level. It is an hysterical response to a problem, maybe from the
past, and sometimes abreactions are helpful in evoking the source or cause of the
psychosomatic pain, but should only be attempted with some experience in this
approach.

Sometimes psychosomatic pain occurs in a specific part of the body because of

convenience or a physical weakness in that part of the body. For example, a Patient
who, when a child, had aching feet which excused him from participating in sport at
school might find himself having pain when walking as an adult, should his
unconscious later have the need to produce a convenient psychosomatic pain as a cry
for help.

Organic Metaphors
Sometimes a pain may occur in the body in the form of an organic metaphor (such as a
pain in the neck) – please see the unit on Organic Metaphors.

The Hypnotic Treatment of Pain

Changes in pain perception should be induced gradually, starting with a part of the
body, such as he hand as this is easiest to achieve for most hypnotic subjects and can
then be spread to other parts of the body as the patient’s confidence in hypnotic
anaesthesia develops.

Glove Anaesthesia
The Patient is first asked to recall naturally occurring anaesthesias that have occurred
in the Patient's life. Memories of waking in the night and with a numb arm, playing with
snow etc can be brought to mind to initiate a re-experiencing of these contexts (see
“analogies” below).
Using repeated hypnotic suggestions the Therapist then induces “glove anaesthesia”
by repeating suggestions for changes in sensation, temperature and numbness in one
hand. Analogies can also be given to help the Patient feel as if the hand is wearing a
thick glove. These suggestions are continued until the Patient confirms that the hand is
numb. When numbness is achieved, the Patient is asked to place the numb hand onto
the painful part of the body and transfer the numbness into that part of the body.

Time Distortion
If the Patient has alternating periods of comfort and pain, time distortion can be used to
change the Patient’s perception of time by expanding the periods of comfort and
reducing the periods of pain. See the unit on time distortion for more information.

Dissociation
The Patient can be asked to imagine seeing himself as if he were another person. As
the Patient looks at himself as another person with the pain, he has the experience of
being free of the pain. If this is carried over post-hypnotically into the everyday life with
a good hypnotic subject the person will have a profound sense of being separate from
their own reality. While this is a technique that can be applied to hospitalised Patients
or those with terminal illness it is not appropriate for Patients needing to function
normally in everyday life as they may become disorientated.

Analogies
Therapists can tell stories to the Patient about times when the Patient would have
naturally had an anaesthetised hand, for example the experience of waking up in the
night and discovering that the arm is numb having been slept on. Another might be the
experience of throwing snowballs. Another approach might be to describe the process
of becoming hardened or insensitive to pain. The therapist can talk about runners who
develop blisters on their feet while running and then how these blisters harden so that
pain is longer felt. The therapist is suggesting to the Patient that they develop a
resistance to the pain by being exposed to it, this is a utilisation technique. This re-
framing is actually including the pain as an educational tool for the purpose of pain
relief. The therapist can tell stories about other Patients who have been successful with
pain control. A Patient who wishes to learn self-hypnosis for pain-free childbirth can be
told about the ease with which an earlier Patient achieved the same results. If the
actual induction and hypnotic phenomena is described in detail then the Patient will
develop the same pain control spontaneously as they respond to the indirect
suggestion.

Visualisation
The Patient can be asked to visualise the pain and visualise some way of combating it.
For example if the pain is a stabbing pain, the Patient can be asked to visualise
cushioning the stabs with cushions. By numbing the pain and deadening it with
visualised cushions the Patient can bring about a change in their psychological
perception of the pain. If the patient is asked to describe their pain they will usually give
a representation that suggests a way of working in this way, for example, a throbbing
pain suggests that it has a rhythm, so the therapist can aim to change the rhythm, slow
it down etc. A burning pain suggests that it is hot, so the Therapist can think of
visualisations that would cool it down. Likewise for stabbing, dull or angry pain etc.

Distraction
The Patient can be distracted from the pain by finding things to do as an alternative. By
distracting the Patient from the discomfort, his attention is re-directed. Analogies can
be given about how much easier it is for headaches to disappear when one is
distracted or absorbed in something else instead of sitting and concentrating on
wanting the headache to go.

Re-framing
Another approach would be to use the Reframing of parts work technique as a way of
re-framing the pain. Since pain is a signal or a message the therapist can ask the
Patient to develop the creative abilities to generate alternatives to pain as a way of
meeting the needs of the signal (see Six Step Reframing).
Pursuing Relevance

With the increase of popular psychology articles in magazines and the

acceptance of popular myths and beliefs about the causes of problems, many
Patients feel they already know what kind of information the Therapist is looking
for, and the Patient will often describe their problem using interpretations gained
from these sources.

Always pursue relevance.

Patients will often give the Therapist a lot of irrelevant details based on their misguided
interpretations and, if given the freedom to do so, may continue to talk throughout the
session about their beliefs and interpretations. The Therapist's task is to intervene and
challenge the irrelevancies in a gentle and non-evasive way or risk losing track of the
therapy. Suitable questions might be; "yes but how is this relevant?" asked in an
enquiring way and with no implication of blame or ridicule.

Beliefs

Patients usually believe that their interpretations are correct and that the
irrelevant information is relevant or at least worth sharing if it can help the
Therapist to understand the problem better. If the Therapist only listens without
intervening, the Patient might indirectly feel encouraged to embellish his
interpretation further and this will inevitable reinforce the Patient’s belief in his
interpretation. So it is very important that the Therapist intervenes when the
Patient’s communication is based purely on interpretation, so as to re-direct the
Patient towards a more realistic appraisal of the cause of his problem.

Using other behaviours or incidences as a reference

The Patient might also wish to talk about other behaviours or incidences that
they feel relevant to their problem. If these are not immediately relevant to the
problem then they should be noted, maybe to referred to later in the sessions,
but not pursued unless they subsequently appear to be connected the actual
problem.

Encourage Patients to suspend judgement.

Patients should be encouraged to hold back their interpretations, assumptions

or judgements until such time that more information is available. The
information referred to here is, of course, unconscious information. Whenever a
Patient suggests that they know with certainty the cause of various situations
that are subjective, the Therapist should introduce doubt.

The Therapist should also suspend judgement

While the Patient is being encouraged to suspend judgement, the Therapist

should also suspend judgement. Many Therapists tend to jump to conclusions
utilising past experiences with other Patients as a reference. It should be
remembered that every Patient is unique.

Obtain a balance

The Therapist should play down negativity, and in some cases very high
expectation, in favour of a more neutral approach if the Patient's attitude might lead to
failure.