Hypnotic Inductions

The first step of hypnosis, a hypnotic induction is the process that a hypnotist uses to put the client into a state where they are more open to suggestion (known as trance). There are many types of inductions.

1. Relaxation technique

Why do therapists ask to “make yourself comfortable” and provide a cushy leather couch to lay down on? It’s more than a common courtesy. Relaxation is a common method used by therapists and a beginner hypnosis technique. If the client is relaxed, they may fall into trance and the mind is open to suggestion. They are more likely to talk to you and be open to indirect suggestions. Here are some common methods of relaxation:

• Make yourself comfortable
• Lay down
• Count down in your head
• Controlled breathing
• Relax & tense muscles
• Speak in a soft tone

2. Handshake technique

Milton Erickson – the father of hypnotherapy – is famous for using the handshake technique as a way to induce hypnotic trance. Handshakes are the most common form of greetings in our society. The handshake technique shocks the subconscious by disrupting this common social norm. Instead of shaking the hand normally, the hypnotist would interrupt the pattern that our mind has established by grabbing the wrist or pulling the subject forward and off balance. With the pattern interrupted, the subconscious mind is suddenly open to suggestion.

3. Eye Cues

There are two spheres of the brain – the right manages the more “creative” and conscious side and the left the “practical” and subconscious. In any conversation we look for feedback from the listener to see how they react to our statements. Watch the subject’s eyes. Are they looking to the right, accessing the conscious or the left to the subconscious? Are they fixated on one object in the room? If they are accessing the subconscious, you can make a suggestion that they are not consciously aware of.

Advanced Tip: Insertive Eye Contact

Reading the eye movements of a listener is a common use case. But did you know that as the speaker, you can also perform a hypnotic induction on the the listener with your eye movements? This new technique was developed and tested by Stephen Brooks.

Watch this video on insertive eye contact to learn how.

4. Visualization

Visualization can be used both to induce trance and to make suggestions. For example, ask your subject to recall a room they are very familiar with. Imagine every detail in that room: the floor, the shape of the windows, the painting on the wall, the smell, the light. Then, move onto a room they are less familiar with. As they struggle to recall the exact details they open the mind to suggestion.

Advanced Tip: Use visualization to recall positive memories and associate them with a rewarding behavior, or to change one’s perception of a negative image.

• Positive images and experiences (wedding, kid, birthday, graduation)
• Discard bad images (maybe throw them in the trash)

5. Arm “Levitation” Technique

With this classic Ericksonian technique, the client begins by closing their eyes. They are asked to notice the difference in feeling between their arms. The hypnotherapist makes suggestions as to the sensations in each arm. For example they might say the arm feels heavy or light, hot or cold. The client enters a trance and may physically lift their arm or they make simply believe in their mind that they have lifted the arm. Either way, the induction was successful.

Advanced Tip: How To Hypnotize A Client With Arm Levitation

6. Sudden Shock/Falling backwards

Proceed with caution! Similar to the handshake technique, a subject finding themselves shocked can enter into a trance. I would never advocate causing any physical pain to a subject, but Erickson once demonstrated this by stepping on a woman’s foot and following it with a suggestion. A milder version would be the “trust falls” that you may have heard of or participated in at a team building event. The sensation of falling backwards shocks the system and opens the mind to suggestion, however, one must be certain they will not drop the subject.

7. Eye Fixation

Have you ever found yourself “zoning out” and staring at an interesting item in the room while someone is talking? Did you completely miss what they’ve said? You may have been in a trance.

Any object of focus can be used to induce trance. The most famous examples are the “power pendulum” or a “swinging pocket watch” – although these two objects are now associated with hokey stage hypnosis. You’re more likely to fail and encounter resistance using these objects, due to their reputation.

Nonetheless, there are two secrets behind eye fixation. First, the object keeps the conscious mind occupied, opening the subconscious to suggestion. Secondly, your eyes get physically tired when they fixate or move back and forth.

Example: Try looking up at ceiling for a few minutes (without bending your neck). The eyes naturally tire and begin to close.

8. Bodyscan

A popular method for self-hypnosis. Starting at the top of the body with your eyes closed, scan down slowly from the head to the feet. Notice every sensation – your breath expanding the ribcage, chair on your back, the pain in your elbow, each finger extended, the feet on the ground. Repeat the process from bottom to top. Continue scanning up and down until you enter trance.

Advanced Tip: The body scan can be stacked with other hypnosis induction techniques such as countdown breathing and relaxation to increase effectiveness.

9. Countdown Breathing

You may have heard of controlled breathing for meditation, but it can also an easy form of self-hypnosis. Here’s how it works:

• Close your eyes and sit upright in a chair, arms on your lap.
• Breathe deep through the nose and out through the mouth.
• Using slow controlled breaths, countdown from 100.
• Each exhale counts as one interval.
• At the end you may be in a trance. If not continue the exercise counting down from a higher number.

Hypnotic Suggestions

A suggestion is the desired behavior to be performed by the client. Post-hypnotic suggestions are delivered after a hypnotized person enters trance – a state in which they are more open to influence. There are two schools of thought for suggestions.

10. Indirect Suggestion

Erickson was a champion of indirect suggestion. It is a favorite of certified hypnotherapists because this method puts the control in the subject’s hands rather than those of authoritarian – respecting the patient’s boundaries and clinical ethics. Further it has proven more effective for subjects that are resistant or skeptical of trance. Rather than “order” a subject to relax (direct suggestion), one could say:

“You might wish to close your eyes, when you are comfortable.”

Learn more about Ericksonian Hypnosis

11. Direct Suggestion

In conversational hypnosis, a direct suggestion is an explicit command to perform a certain action. Though powerful, it is sometimes viewed as unethical because as the authority (a doctor or hypnotist) you hold power over the client. The client does not control the decision to change behavior with this method. The Stanford Prison Experiment was an infamous example of using authority, obedience, and direct suggestions to manipulate subjects.

Here are some classic direct suggestions:

• “You will go to sleep”
• “You will stop smoking”
• “You will lose weight”

12. Voice Tone

The tone of your voice is particularly useful when making suggestions. This can double up with other techniques (like relaxation).

“You might wish to become relaxed”

In the above example, the word “relaxed” is spoken softly and elongated. On the contrary, you can make a direct suggestion loudly.

“You will STOP smoking!”

Another perfect pair for voice tone is the confusion technique. The therapist could vary the tone of voice from whispering to shouting, speak with a different accent, or use a lisp, to confuse the subject.

13. Hypnotic trigger

There are many forms of hypnotic triggers. A trigger reminds the subconscious of a desired action or feeling which was suggested under hypnosis. Here are a few examples:

• Opening eyes
• Sound of a bell
• Snap of fingers
• Clap of hands
• Standing up or sitting down
• Opening a door

Here is how a hypnotic trigger could apply to agoraphobia:

“When you open a door, you might see your loving family on the other side.”

Reading Body Language

14. Nonverbal Communication

Hypnotists are experts at nonverbal communication – from reading a client’s body language to conveying your own non-verbal suggestions. While a client could be saying one thing consciously, the subconscious mind could tell a completely different story. Here are a few examples of how the subconscious might affect body language:

• Facial expressions
• Body posture
• Voice tone
• Pacing
• Eye movements
• Arms crossed
• Head nods
• Covering face

Advanced Tip: How To Become An Expert In Non-Verbal Communication (with case example)

15. Cold reading

You might have seen psychics, mediums, stage hypnotists, or mentalists perform a “cold reading” on TV for entertainment purposes. Though it’s generally too direct to use with a client, you might use cold reading at a party or a networking event. Here’s how cold reading works. For example, if the subject is not smiling, the hypnotist might ask:

H: “Are you sad?” – Start by asking a general or vague question from observation.

S: “Yes” – If they reply no, reset and ask another vague question.

H: “Has someone left you?” – Drill down and ask a more specific question. This could be a relationship or a pet or a family member.

S: “Yes! How did you know my cat fluffy died?”

16. Warm reading

With a warm reading, you make a statement that could apply to anyone:

“You feel happy when you are surrounded by friends.”

17. Hot reading

The most difficult type, because you need to have some prior knowledge about the person. Let’s say their family member contacted you and told you that the person was involved in a traumatic event. When you meet them, you might focus on using the “regression to a cause” technique because you have prior knowledge about the past event.

Triggers & Advanced Hypnotherapy Techniques

18. The Swish Pattern

Submodalities can be used in “the swish pattern” – a neuro-linguistic programming technique used to associate or dissociate the client with certain behaviors. The five senses are considered modalities (taste, smell, sight, touch, hearing). A submodality is a subset of these senses. Here are some examples of submodalities:

• Bright or dim?
• Large or small?
• Color or black and white?
• Loud or soft sounds?

The Swish Pattern begins with a visualization. Once the client is in a trance the hypnotist identifies one or two submodalities (brightness, size, etc). The undesirable action is large, focused, and bright in the foreground, while the desired action is visualized as small and dim in the background. In the time it takes you to say “Swish” (the method’s namesake) the desired image rapidly becomes bright and large in the client’s mind.

19. Misdirection

We see misdirection used in the real world, sometimes on a daily basis – from politics to entertainment. The prefix “mis” means wrong and “direction” is attached to it, meaning the audience is being lead in the wrong direction. There are two types of misdirection – one is literal and the other is of the mind.

A familiar demonstration of the first would be a magician distracting people by waving a wand in his left hand and then performing a sleight of hand with his right. While the audience is misdirected, the magician sneaks a card up his sleeve giving the illusion that it has “disappeared”.

Misdirection can also be a visualization:

“As you become anxious, imagine you are relaxing on a beach”

Here, a subject dealing with anxiety is misdirected to the visualization of themselves on a beach. The hypnotist has directed them from an unpleasant image towards a pleasant one.

20. Reframing

Usually done as a metaphor, reframing allows you to change the perception of an experience in the client’s mind. For example, imagine you have a client that wants to lose weight. They stay inside and play video games all day. You could ask them to describe the process to “level up” their character in the video game – what they do, how long it takes, how strong the character is at the beginning. And then, “reframe” the process of losing weight in their mind by comparing it to the video game.

“Losing weight is like leveling up your character in a video game. You start slow and train every day. You don’t see much difference at the beginning, but over time your ‘character’ becomes stronger and stronger.”

21. Regression to cause

First the client enters a deep trance where they can experience events as if they were actually there (also known as somnambulism). The therapist uses visualization to create an “affect bridge” where the client experiences an event for the first time again. Once the cause is identified the hypnotherapist can make suggestions and reframe the situation.

22. Future Pacing

The opposite of regression, when a subject is asked to visualize themselves taking the proper actions and behaviors in the future. Rather than look back into the past for an underlying negative event, you look forward to an event with positive emotions.

“Imagine you are done with your speech and the crowd is cheering. You feel accomplished and relieved.”

23. Anchoring

When we record a memory, all of the senses and emotions are associated. These are “anchors” in your memory. Perhaps the client has anchored the behavior of cigarette smoking with a break, meal, sex, chatting with friends and other pleasurable feelings. The hypnotist can suggest new anchors for more positive behavior.

24. Betty Erickson’s 3-2-1 Technique

Betty Erickson was Milton Erickson’s wife. She developed her own method for self-hypnosis known as the 3-2-1 technique. The procedure starts with your eyes open. You take note of 3 things in the room that you can see, hear, and feel. For example: you might see a painting on the wall, a table, and a clock. You might hear birds outside the window, the hum of a refrigerator, and the clock ticking. You might feel the pressure of the chair on your back, your feet on the floor, and the warmth of the sunlight through the window. The process repeats focusing on 2 items from each sensation, and then 1 item (hence the name 3-2-1). Then, you close your eyes and start over by visualizing 3 objects from each sense in your head. Again you count down. Once you’ve reached the last item, you will be in a trance.

25. Incrementalism

Making a tiny change is the stepping stone to a much large one. For example, if a client is trying to lose weight, daily cardio may be too big of a leap. Instead, you could suggest they start with a small increment: take the stairs for one floor and then hop in the elevator as they typically would. The next week, two flights of stairs. Eventually, they will have worked up to the larger goal and overall better behavior.

Another example: Go to the gym once a week for 5 minutes. The commitment is so small it’s impossible to fail. You will likely end up staying for more than 5 minutes, incrementing the duration and amount of days over the course of a month.

26. Parts Therapy

In theory, all behavior is positive in some way. The subconscious may justify one negative behavior with a positive one. An agoraphobic may not leave the house because the subconscious aims to protect the body from the dangers of the outside world. A smoker may harm their body physically in order to seek pleasurable conversation with other smokers outside.

The mind is made up of multiple parts. With parts therapy, the hypnotherapist communicates with the behavior part to better understand why an action is being taken. Then they would communicate with the creative part of the mind to come up with another solution. In the example of the smoker, perhaps there is another way they can satisfy the need for social interaction – a book club, a bowling group. The therapist then uses future pacing to reinforce the positive behavior.

27. Metaphor

Metaphors are therapeutic and memorable. Erickson loved to use metaphors in his books and teachings. Here are some classic metaphors:

• Your body is a car. Give it the right fuel and it will perform well. If you neglect the maintenance and fill it with poor fuel, and it will break down.
• Your mind is like a river that is ebbing and flowing. You can stand on the bank of the river and watch it go by or you can try to swim against the current.
• You are a mountain – strong, impenetrable, and tall.

28. Hypnotic Bind

The hypnotic bind is a favorite amongst parents and presents the “illusion” of choice with an either/or question. Here’s one example:

“Would you like to brush your teeth or take a bath?”

Advanced Tip: Use the double bind to present two options for the same desirable behavior:

“Would you like to go to bed in 10 minutes or 20 minutes?”

Either way, the child is performing the desired action of going to bed.

29. Hypnotic logic

Under trance, a client interprets statements very literally. If you ask the client “Can you sit up” they will respond “Yes”. We call this hypnotic logic.

You can use hypnotic logic along with suggestions like so:

“You can lose weight because you are successful”

Although being successful doesn’t necessarily mean you’re able to lose weight, the statement is taken literally.

30. Affirmations & Positive Thinking

An affirmation confirms a positive thought. For a client with body dysmorphia, you may have them repeat back under trance “I am beautiful” several times.

31. Reconnections

Memories fade over time. While that might be good for someone with a negative experience, positive experiences can also fade.

Abilities, just like memories, can be forgotten as well. An agoraphobic may forget that there was once a time they had the ability to go outdoors.

As a hypnotherapist you can help bring these positive memories and abilities back using rehearsal and visualization with the client.

Bonus: Want even more hypnotherapy techniques, with step-by-step videos? Check out our online hypnosis courses.

Stephen Brooks live Streaming Interactiv/course/online-hypnotherapy-course/e Online Diploma in Compassionate Ericksonian Hypnotherapy. Accredited Practitioner Diploma Training for students wishing to qualify as hypnotherapists and be registered to offer hypnotherapy to clients / patients. ENROLING NOW

COMPASSIONATE ERICKSONIAN HYPNOTHERAPY utilises naturally occurring trance states to help client’s overcome problems in a caring and compassionate way. Thanks to recent discoveries in neuroscience, we now understand more about how and why hypnosis works and what happens within the brain when people practice mindfulness. As a training organisation running courses in hospitals and universities we have always looked to science for explanations about hypnosis, meditation and the mechanism behind its effectiveness. Where we originally only had our assumptions and observed experience, scientific evidence is now proving that hypnosis, mindfulness and therapy based on love and compassion can affect the brain and thought process. Science is now underpinning the training we have been offering for the past 40 years.

To understand how hypnosis works we need to look at how the brain processes information about the world around us. Our awareness of what is happening in the world at any given time occurs within our senses, and our sensory experience is based on past memories, future expectations and what we believe to be our present experience. These sensory experiences are evolving and changing all the time through synaptic connectivity (LeDoux 2002, Synaptic Self and Doidge 2007, The Brain That Changes Itself). In effect, the brain continually updates and changes what we think and believe.

Memories and future expectations are thoughts and not based on actual present experiences. This means that it is possible to use the therapeutic intervention of hypnosis to change those thoughts and expectations. We have all had the experience of believing that a memory was accurate when in fact it has become distorted over time and is no longer an accurate representation of a past event. Likewise when we imagine the future, we can see it in many different ways. So we can easily understand how, with hypnotic suggestion given in a caring and compassionate way, we can change our memories and expectations of the future (Hull 2002 – Hypnosis and Suggestibility, An Experimental Approach).

Our experience of the present moment is actually not an experience of the present moment at all. Buddhist psychology has taught this fundamental principle for 2600 years, but modern day western psychology has taken a long time to accept this, but now does so. What we feel to be our present experience is actually a representation of something that occurred a fraction of a second before. Basic physics tells us that sound and light waves travel at different speeds. As a result light waves reach our eyes faster than sound waves reach our ears. Over time we have got used to this difference and so pay no attention to this discrepancy. But then there is another delay, because once the information reaches our eyes and ears it then has to travel to our brain before we can experience it with our senses. Of course, this happens very quickly, so quickly in fact that we have come to believe that what we are experiencing right now is occurring in the present, but we are continually living in the very recent past; a fraction of a second behind the present. Using this understanding of how we experience reality, Compassionate Ericksonian Hypnosis can change our perception of our present experience, and help us overcome problems effectively and quickly – by utilising these Buddhist principles now confirmed by neuroscience.

Compassionate Ericksonian Hypnosis doesn’t actually change the present – it can’t, as the present moment has already passed. Instead, it changes our perception of what we believe is the present. We then act upon the suggestions given to us in the therapy session and so behave differently. As we act upon the suggestions, given in hypnotic states, we believe that our new behaviour too is happening in the present. In fact, we are also observing our new behaviour a fraction of a second after it has happened.

This brings us to the next question, how can we decide to do anything if we are always living in the past, and what about the question of free will, are we actually in control of our destiny? Recent scientific research from the field of neuroscience now suggests that all of our everyday decisions are made unconsciously and that the belief that we are consciously making logical calculated decisions is an illusion (Wegner 2002 – The Illusion of Conscious Will and Hood 2012 – The Self Illusion). This supports Stephen Brooks’ theory of why and how Compassionate Ericksonian Hypnosis works, in that it confirms that suggestions given in sessions appeals directly to the unconscious mind and bypasses conscious critical thinking. In other words, Compassionate Hypnosis helps us communicate directly with the part of the brain that controls all of our behaviour. To do this effectively it needs to bypass our conscious critical thinking, and this is why the practical skills and techniques of Compassionate Hypnotherapy are built on a solid foundation of Ericksonian Hypnosis, as Ericksonian techniques are much more effective than traditional hypnosis techniques. This allows us to create hypnotic suggestions and therapeutic interventions using the language of the unconscious mind delivered with compassion and love.

Through research we now know so much more about hypnosis, mindfulness and the power of compassion to heal. We now know how to induce hypnosis in a loving and empowering way, instead of the dominating approach of stage hypnotists or old fashioned authoritarian hypnotherapists. Over the years the advances have been significant and as a result, our graduates qualify with a much deeper understanding of how to help their patients and clients, and as Compassionate Ericksonian Hypnosis is highly conversational and indirect, practitioners can easily offer therapy as an adjunct other forms of therapy.

Our next Practitioner Diploma in Compassionate Ericksonian Hypnotherapy is available for enrolment now.

Every therapist faces the problem of having clients with low motivation. Yet, therapists are rarely taught how to specifically motivate clients to achieve outcomes. Most training is based on using therapy techniques to overcome problems, however, if the client is unmotivated to get better then therapy techniques are not as effective. One approach to motivating clients comes from the work of Milton Erickson. His Ericksonian hypnosis approach to motivation is based on the concept of tasking clients. Tasking involves giving homework or behavioural challenges and tasks for the client to carry out between therapy sessions. These tasks are often given while the client is in hypnosis as the trance state acts as a kind of glue or adhesive to make the suggestions given by the therapist more likely to be taken on at the unconscious level. So here we see hypnosis being used to motivate clients to carry out tasks which then, in themselves, increase motivation to succeed at therapy. Tasks work by creating a change in the Patient’s routine which bring about a change in the Patient’s behaviour and therefore a change in the way the problem functions.

Tasks are given to interrupt habitual patterns of behaviour or thinking.

Sometimes a task may be given to directly intervene in a pattern of behaviour that normally maintains the problem. At other times tasks may be given that seem to be unrelated to the problem. Despite seeming unrelated, carrying out the task usually brings about a new understanding and the new understanding or realisation may then allow the Patient to look at his or her problem in a new light.

Tasks usually require that the Patient do something different.

For a task to be compelling and interesting is should be quite novel. It should involve a new behaviour or an alteration of an existing behaviour that is appealing in some way. Patients should be intrigued by the nature of a task and so be motivated to carry it out. Some tasks may be quite simple and some quite bizarre and so must be presented to the Patient in a way that makes it acceptable or of benefit.

Tasks are often metaphorical in nature.

Many tasks have the same function as metaphors. For example, if a Patient has difficulty in making decisions, sorting priorities or organising himself he could be given the task of clearing out his attic. This kind of task is metaphorical. While cleaning out the attic he also is developing the strategy for cleaning out his own internal unconscious attic. This kind of task can often work surprisingly well. When the task is metaphorical in nature the Patient should never be told directly what the outcome of the task is meant to be.

Tasks can have simultaneous overt and covert outcomes.

Often the Patient will ask for a rational explanation for carrying out a task. Usually we do not explain the reasoning behind a task in case the Patient disagrees and tries to sabotage it, so if the Therapist gives an explanation it should be based on an overt outcome that makes sense and is reasonable to the patient while the real or covert outcome remains secret. If the Patient knows the real outcome of the task he or she may sabotage the task or even decide that it’s not worth carrying out. High quality tasks may have many different outcomes. Tasks may be metaphorical in nature, or involve new therapeutic behaviour; they may have overt or covert outcomes or have specific intentional outcomes as well as being diagnostic.

Patients often reject tasks given to them by their Therapists.

Quite often when people are given advice they choose to ignore it. Because tasks are often a little bizarre, some Patients, when first hearing suggested tasks, reject them. The only way to avoid this is either to offer tasks which are more realistic or set up a process whereby the Patient feels compelled to accept the task.

Make a reward contingent upon the completion of the task.

One way of making your task more compelling is to make sure the Patient has some kind of reward. Sometimes this reward can actually be given as an excuse for doing the task, that is, the real reason for doing the task is kept secret. Maybe it is kept secret because the Therapist knows full well that if the Patient understands the particular outcome wanted by the Therapist then the Patient will not complete the task. So the Therapist offers some reward or some valid excuse or reason for the Patient doing the task thereby making it more compelling.

Offer alternative but unreasonable tasks with the same therapeutic outcome.

Another way of making a task more compelling is to first offer alternative deliberately unreasonable tasks that the Therapist knows will be rejected by the Patient. Usually this is done in threes. The Therapist first offers an unreasonable that, if accepted, will accomplish the therapeutic outcome. The Therapist makes sure that the task is sufficiently bizarre or unrealistic so that the patient feels inclined to reject it. Having rejected this first task the Patient feels less like rejecting a second time.

The Therapist then offers a second task which could also achieve the same therapeutic outcome is accepted. This second task is not so bizarre as the first one and could well be completed by the Patient but is still likely to be rejected. The Patient rejects this task too, although in some cases the Patient may accept it.

The third step is for the Therapist to offer the task that he wants the Patient to carry out. By now the Patient has rejected two suggestions by the Therapist and is ready to accept a third. This occurs partly because he feels sorry for the Therapist and partly because he feels guilty. When the Therapist presents this task it is entirely reasonable and the Patient feels more compelled to accept this task Because the Therapist projects this as the third choice the Patient feels more compelled to carry it out, especially as this task is presented as the last possible alternative. Before the Therapist presents this last task he makes sure that the Patient realises how successful this task has been for other Patients in the past. This makes it even more compelling for the Patient to carry it out.

Overcome objections by using the experimental frame.

In the event of a Patient rejecting the third task which might happen from time to time, the Therapist should propose that the Patient carry out the task as a form of experiment. Usually if a Patient rejects the task or shows some hesitancy there may be an unconscious awareness on the part of the Patient that a) the task may not be appropriate, b) the task may not be powerful enough, c) the Patient genuinely doesn’t want to do the task. In the first two examples, by offering the task in an experimental frame, the Therapist is suggesting that if the task is not appropriate or not powerful enough then it will not work. However if the Therapist does this he should not put too much emphasis on this point, he should appear confident.

Example of how to deliver a task.

Problem: The Patient wants beautiful hair but has unconscious hair-pulling habits.

The therapeutic outcome:To make the behaviour conscious so the Patient has a choice about whether to pull the hair or not. (At the moment the Patient pulls her hair but is unaware that she’s doing it).

Alternative tasks to offer:

1. Cut hair short (most likely to be rejected).
2. Tie the hair back at all times (next most likely to be rejected but possibly accepted).
3. To deliberately gently pull the hair at set times of the day (least likely to be rejected and probably the most therapeutic).

If the Patient chooses to cut her hair short it certainly will stop her pulling it however it’s not really appropriate and is very likely to be rejected. Tying the hair back is more appropriate, however because the Patient is very proud of her hair and wants beautiful hair it’s unlikely that she’ll want to tie it back. By asking the Patient to deliberately pull her hair at set times we are actually prescribing the symptom. The girl is pulling her hair anyway so to get her to pull it in the same way but at set times we are actually making the behaviour conscious instead of unconscious. The outcome is for her to become consciously aware of when she has the problem. By becoming consciously aware of when she’s doing the behaviour she then has the choice of saying no. We could offer the girl the contingent reward, this is the reward that she thinks she’s getting by doing the task and this could even be given as the excuse for giving the task. For example if the Patient is told that she should carry out the task so that she could learn about the texture, the length, quality and thickness of her hair and that she has to do this at specific set times of the day we are in fact indirectly making the symptom an asset. We tell her to pull her hair gently, we tell her to pull it hard, we are in fact telling her to continue having the symptom.

Now she is then no longer pulling it in a random way unconsciously. She is now pulling it deliberately to identify the texture, the thickness, the length, the beauty of her hair. Because her outcome is to have beautiful hair she will feel more motivated to carry out the task. The excuse has to be given in a very convincing way. If she rejects the task then we offer the task again in an experimental frame. We tell her that we would like her to carry it out as an experiment, we would like her to become aware of the quality of her hair before we start doing therapy. It’s unlikely that she will be reluctant to carry out the task under these terms. If the Patient rejects this task then alternative approaches to therapy or alternative tasks should be created.

Ambiguous Task Assignments

Usually a task has a specific outcome. The Therapist knows the change that he wants for the Patient and designs a task to achieve that specific outcome. Sometimes however, the Therapist may feel that he and the Patient lack information or resources to achieve that outcome. In these cases the Therapist can prescribe an ambiguous task assignment, which although ambiguous, has the specific outcome of getting the Patient to give his own interpretation of why the task was given and an account of any insights gained while performing it. So although there is a specific outcome, the information and insights gained from that outcome is not known until the task has been performed. The task is a diagnostic tool and this class of task is called the Diagnostic Task. It helps the Therapist gather further information for the next step in therapy. Sometimes an ambiguous task can actually bring about psychological change within the Patient and might even solve the Patient’s problem this is called a Therapeutic Task.

Sometimes we may be faced with not knowing what to do to help a Patient.

There can be any number of reasons for this. Usually it is because we do not have enough good quality information about the patterns that have either caused or are maintaining the problem. If the Patient does not communicate enough information we can usually apply our questioning skills to evoke enough good quality unconscious information to get us started. The problem seems to be at its most severe when the Patient gives us too much information and we end up getting confused. Sometimes Patients want to give us as much help as possible and so throw everything they can at us. All of their pet theories, old wives tales and interpretations from a multitude of sources are thrown into the melting pot. What the Patient is actually doing is creating the same kind of confusion in the Therapist that they experience themselves. The last thing we want is to be as confused as the Patient.

One way of stopping the Patient from contaminating unconscious information is to give him a task that cannot be understood rationally by the conscious mind. By tying up the cognitive processes of the conscious mind with some task and requesting that the Patient wait for some kind of explanation to surface at an unconscious level the Therapist is teaching the Patient to trust his unconscious thought processes and creativity for problem solving. An Ambiguous Task Assignment is such a task. The Therapist asks the Patient to do something that may seem irrational or out of context but although the Patient may perceive the task to be irrational or unrelated to the problem he must be told that the Therapist has a very good reason for prescribing the task. The Therapist suggests that the task is directly related to the cause or maintenance of the Patient’s problem and that it will therefore lead to new insights about the problem. The Patient is instructed to go off and perform the task and then to consider why the Therapist gave him the task and to be aware of any insights. Usually, the Patient will perform the task and then spend time, often while the task is being performed, wondering what it all means.

This process sets up an inner search through all of the unconscious data concerning the Patient’s problem and then, hopefully, pops one or two insights into conscious awareness. There is a parallel between this kind of tasking and that of Zen Buddhist Masters who give their novice monks unusual tasks or riddles to solve in the expectation that realisation or enlightenment will occur.

There are three different classes of ambiguous task assignments:

• The Diagnostic Task – an ambiguous task assignment that brings about insights and unconscious information.
• The Therapeutic Task – an ambiguous task assignment that can actually resolve a Patient’s problem.
• The Diagnostic Therapeutic Task – an ambiguous task assignment that can immediately resolve a Patient’s problem because of insights and unconscious information.

The classification of the task is determined by the outcome achieved by the task. If the Patient gains insights but retains their problem, the task is a diagnostic task, if the Patient’s problem disappears because of performing the task the task is a therapeutic task. When a problem disappears immediately because of insights the task is a combined diagnostic and therapeutic task.

Creating Ambiguous Task Assignments

Both classes of task are created by the Therapist spontaneously, without any conscious effort to link the tasks to the structure of the problem in any way. For example, for a Patient with erectile dysfunction the Therapist might say “Go and catch six fish and throw one away”. The task is not consciously related to the problem in any way. Another equally valid but spontaneously created task for the same problem might be “find a cloud, will it to vanish, and don’t look away until you have made it disappear.” I have just made up these tasks while writing this, there is no conscious connection to any Patient with erectile dysfunction that I know of and the tasks were chosen because they were the first thoughts that came to me when I decided to create them. The fish task is probably related to what I ate last night and the cloud task is related to something I have taught myself to do.

Unconscious / Unconscious Ambiguous Task Assignments.

When the trainee therapist first learns to create spontaneous ambiguous task assignments the tasks are usually consciously and unconsciously unrelated to the Patient’s problem. Over time and with experience, the Therapist will develop the ability to communicate more effectively at an unconscious level directly with the Patient’s unconscious mind and to create appropriate tasks that only appear ambiguous. Initially the tasks will continue to appear ambiguous to both the Patient and Therapist but eventually they will only appear ambiguous to the Patient. The Therapist will still create them spontaneously, even to the point of not knowing what the task is as he is explaining it, but will know immediately consciously why his unconscious has chosen that particular ambiguous task once the task has been prescribed.

One of the benefits of prescribing ambiguous task assignment is that both the Therapist and Patients’ unconscious minds learn to communicate with each other independently without the conscious involvement of either person and with limited conscious awareness on the part of the Patient.

People ask me where I get my ideas for tasking clients. Well they mostly come from everyday life. As and when interesting things happen to me or people I know, I make a mental note of them for use later.

So I catalogue many different experiences and events that occur to me personally, or that I hear about, see or read about. Then, when I am in a session with a client, my unconscious will just present me with a relevant task for the current client. So the choice is not random and not conscious, it is chosen by a part of me that knows, or senses, what is exactly right at that moment.

Sometimes I might change the task a little to fit the client and their circumstances, but often it is presented very much as it surfaces from my unconscious. The same process occurs when I create a metaphor. Metaphor and task creation are very similar. The unconscious taps into the huge database of life experiences that I have logged previously (this now happens on a day to day basis as an unconscious process) and presents one task or metaphor (or several) to the client.

Often I am as surprised as the client with what I say. That is always a delight, and I have learned to trust that my unconscious knows best within the specific context of therapy. It is a kind of intuition. But intuition cannot happen all by itself, there needs to be massive prior exposure to the area that one wishes to be intuitive about. Then it functions by itself. It’s the same as learning any skill – through repetition we learn to let go of the conscious effort involved in trying, and allow our unconscious mind to take over the responsibility. It’s no big deal, everyone can do it, it just requires commitment to practice.

Sometime the unconscious can’t seem to come up with a relevant task, or at least one that makes sense to the conscious mind. In these instances I give the client an ambiguous task. It’s these tasks that interest me more than others, because they often work, despite their almost ‘magical’ appearance.

Here’s one that could have come straight out of one of my therapy sessions, but it is a cure for headaches from the middle ages: “When you enter a city, collect pebbles that lie on the road in front of the gate, as many as you want, while saying to yourself that you take them as a remedy for your headache. Attach one of them to your head and throw the others behind you without looking back.” Pure magic (in more ways than one).

There are many other ways to increase motivation using hypnosis, especially with the Ericksonian approach, and there are some problems that are harder to resolve than others because of the nature of the problem and the degree of motivation required by the client has to personally take responsibility for resolving their problem. For example, clients with a lack of self-esteem or confidence tend to also lack motivation. Likewise clients who have been referred therapy by a third party rather than deciding to attend themselves. Often clients present themselves for therapy but because of benefits they have received in the form of secondary gains through having their problem, they lack motivation to participate fully in the therapy. In such cases the therapist has to address the secondary gains and find some way to replace them with something healthier or similar so that the client can feel more motivated to let go of their problem.

Even when a problem is potentially life-threatening clients can still lack motivation. For example a heavy smoker may feel reluctant to quit because of their dependency, and despite presenting themselves for therapy show a degree of resistance to help. Even if told by their own GP that they should quit, the idea of smoking causing severe illness and even death can still seen far away in their minds. With such cases the hypnotherapist has to increase the emotional intensity of the negative consequence of maintaining the problem to increase the motivation to change. The same can be true for other problems where there is reluctance or resistance to change. Sometimes this reluctance is not intentional but is active at the unconscious level.

I remember client who wished to lose weight. Everything we tried failed to work. It was only when we discussed her relationship with her husband that I realised that she had a fear of looking more attractive. Her relationship with her husband was not good sexually, they had children and so stayed together mainly for the family. At an unconscious level she realised that if she became more attractive she would be tempted to have relationships outside of the family. Her instinct to maintain the family unit and take care of her children was preventing her from losing weight effectively because this might cause her to leave her husband and upset children. In this instance I stopped offering therapy for weight control, and instead asked her to invite her husband into the therapy. We then worked through the issues within the relationship and resolved these so that she was able to feel comfortable and more loving towards her husband. This required changes on the husband’s part which he agreed to and completed. After we had resolved these relationship problems she started to lose weight without any further intervention from me.

So motivation is not just contingent upon the client themselves taking the conscious decision to commit more thoroughly to outcomes. It can also require hypnosis work at the unconscious level to free clients from patterns of behaviour in which they are trapped in some way. I like to tell my clients that motivation is similar to momentum, in other words, it moves us forward. And to move we need fuel, and emotion is the fuel that motivates us and helps us move forward. Without the emotion to move we just stand still. And this is why when offering tasks or challenges to our clients in therapy we need to make the task an emotional experience. Without the emotion there seems no purpose to the task, and without purpose there is no learning or insight on the part of the client.

An Article about how techniques for inducing hypnosis have changed over the years – from the Independent Newspaper, England by John McCrone.

Hypnosis can be explained as a form of self-induced sensory deprivation…well perhaps.

Hypnotists with swinging fob watches are out. Far more effective ways of putting people into a trance have been discovered which, with their employment of confusion and word twisting, are not too far removed from brainwashing techniques. Yet while the practice of hypnosis has made considerable strides of late, science is still uncertain whether the phenomenon even exists.

Hypnotism has been studied for over 200 years. For a long time, the only way known of putting subjects into a trance was to get them to focus on a spot on the ceiling or a monotonous pendulum while the hypnotist commanded them to fall asleep. However, this “authoritarian” method has since widely been replaced among hypnotherapists by an indirect technique pioneered by the US therapist, Milton Erickson. Today, a hypnotist uses a careful manipulation of the conversation they have with their clients to “lead” them into a trance state.

As Stephen Brooks, director of the training group, British Hypnosis Research, explains it, there is none of the traditional mumbo-jumbo that used to be the hypnotist’s stock in trade. Instead, the aim of modern techniques is to drop hypnotic suggestions casually into the conversation. The patient’s attention is first directed inwards by asking them out of the blue if their hands feel heavy or if they can remember some pleasant holiday. This relaxes the subject and the hypnotist can then drop hints into the conversation about the sort of experiences the patient should expect to feel under hypnosis; sensations such as weightlessness and involuntary behaviour.

Finally, when the patient has been led into a deeply relaxed state – one so relaxed that the critical faculties have been dulled to a small point of consciousness – the hypnotist starts confusing the patient with non sequiturs and apparently pointless remarks. Confused, but too relaxed to struggle for understanding, the patient’s tendency is to seize hold of almost anything the hypnotist then suggests as their new hypnotic reality.

The technique is much like brain washing in relying on confusion followed by the planting of a new belief system. However Brooks stresses that brain washing relies on much more brutal confusion techniques such as terror and isolation, and is carried out with quite different aims in mind than those of a therapist! That at least is the modern practice of hypnosis – and a method highly successful at overcoming resistance as most patients never realise that the therapist has switched from ordinary conversation to the hypnotic induction. However, what about the science behind hypnosis?

There is a strong body of scientific opinion that would say the many people experiencing Ericksonian hypnosis – or its more highly packaged derivative, Neuro-Linguistic Programming (NLP) – are merely feigning a trance state to please the hypnotist. A combination of social pressure to perform and everyday knowledge about the way hypnotised people are suppose to behave, are enough for cooperative patients to fake the experience. Like being drunk, even people who have never touched a drop usually can do a good job of acting tipsy.

This hypothesis that hypnotic trance states are merely feigned was taken up enthusiastically by researchers in the 1980s, particularly in Canada. Their methodology was to take two groups of subjects, one whom believed themselves hypnotised and one whom had been told to fake a trance, and then test them for how similarly they behaved. Astonishingly, the fakers could even match the hypnotised in demonstrations where they had to ignore pain – although it is true the fakers were never tested with something like the tooth root canal extractions which some hypnotised patients can withstand.

The non-state theorists – researchers such as Nicholas Spanos of Ottawa and Graham Wagstaff of Liverpool University – did much to dispel many of the old myths about hypnosis. It was found that apparently vivid memories recalled under hypnosis were as liable to be imagined as real. Proof of this led to a Home Office warning in 1988 against the use of evidence gained under hypnosis. Other evidence, such as experiments showing that subjects with induced deafness or amnesia could still respond normally in carefully designed experimental tests, seemed to prove the non-state theorists’ case that no special trance state exists. But a few years ago, neurologists using brain scans and other monitoring devices started coming up with support for the belief that hypnosis is a genuinely altered state of awareness.

A key feature of the trance state is the ability of subjects to experience intense hallucinations at the suggestion of the hypnotist. These visions have none of the paleness of ordinary imaginings and are as vivid as dreams. David Spiegel of Stanford University in California placed hypnotised subjects in front of a screen of flashing lights. The lights were known to trigger a characteristic pattern of activity in the visual cortex, the patch of wrinkled brain on which visual sensations are mapped out. When the hypnotised subjects were asked to imagine a cardboard box blocking their view of the screen, the electrical activity disappeared. The hallucinations seemed so intense that they “took over” the visual cortex, the inner reality erasing the evidence of the senses.

Other neurologists have found similar evidence for brain changes. Dr John Gruzelier of Charing Cross Hospital in London has discovered a dampening down of neural activity in the left and frontal regions of the brain – areas responsible for language-driven abilities such as thought and planning. Dr Gruzelier is due to report his latest work at an Italian Hypnosis Society conference in Venice this month; a meeting at which several other papers on the neurology of trance states will be presented.

Dr Gruzelier says it is still early days for a full explanation of hypnosis but one line of speculation is that hypnotised subjects may be “switching off” their critical faculties in a similar way that everyone has to shut down their conscious minds as they fall asleep at night. Insomniacs will know how difficult it can be to stop the nagging flow of thoughts that stem from their inner voices, the part of the brain wired for producing sentences. Sleep research has shown that when we fall asleep, the lower brain pumps out natural tranquillisers to block the normal traffic coming from the senses. Gradually, we are cut off from our eyes, ears and body.

The lower brain’s blocking of sensory traffic produces a state of mental isolation similar to the sensory deprivation of a floatation tank. In this state, any internally generated images tend to take on a hallucinogenic reality. Cut off from real sensations but not quite asleep, the visual cortex will seize on stray thoughts and images, expanding them to fill the mind. This gives us what are known as hypnagogic sensations; the swirling lights and strange visions we often have at the point of sleep. It also gives us dreams during the periods of the night when we become aroused enough to skirt the boundaries of wakefulness. In dreaming, the brain is awake enough to produce images but too relaxed to think coherently and we drift for a while in a jumble of imagery.

Under hypnosis, a similar state is achieved. A hypnotic trance is not like sleep because the lower brain is not pumping out the chemicals that bring true oblivion. But the hypnotised person has put him or her self into a sort of waking dream by deliberately cutting off almost all outside sensations and putting their language centres on hold. It is notable how the hypnotised person’s voice becomes very faint and responses monosyllabic. Both the old-fashioned authoritarian induction and modern confusion techniques work by making the subject focus inwardly and so causing them to shut out sensations of the outer world. The subjects are also prompted to still their inner voice and to drift in a state of uncritical imagination. The hypnotist can then “reach in” with his own voice and control the experiences the subject is having by triggering the desired images with words. Asking subjects if their hands feel light literally plants such an idea in their heads. Yet because the subject’s own speech centre has been by-passed, there is no feeling of a command being issued and an action willed. The subject has handed over all responsibility for the guidance of thought to the hypnotist.

The evidence may not be all in, but the signs are that hypnotic trances are genuine altered states in so far as they are accompanied by real changes in blood flow and electrical activity in the brain. However the surprise is perhaps that the state is largely self-produced and not all that different from day-dreaming, meditation or falling asleep. What gives hypnosis its unique power is there is a second wide-awake voice standing by to take control just at that point when we relinquish our own.

(This is a version of an article that appeared in The Independent (Copyright, John McCrone, March 1991).

As a professional psychotherapist, you may be wondering where you can find the best information to help improve your client outcomes and grow your practice. I’ve compiled a list of the 14 best psychotherapy blogs.

Each blog was hand-picked based on the quality of content and frequency of updates (minimum once per month).

1. Psychotherapy.net

With over a dozen PhDs contributing to this blog, there’s a substantial variety in content. Some articles focus on how to handle real life client situations situations while others are actual interviews with professional psychotherapists.

Favorite post: Intuitive Therapy

2. Dr. Deb

A top psychologist and practicing psychoanalyst, Dr. Deb is know for her work in treating depression. My favorite part about Dr. Deb Serani’s blog is her use of multimedia to present information, such as videos and infographics. She is also an accomplished author. Her latest book is titled, “Depression In Later Life: An Essential Guide.”

3. Psychcentral

Living up to it’s name, Psychcentral is THE central place to find blogs about mental health and psychology. In fact they have 50+ active blogs on a variety of subjects. If you count the retired ones it’s over 100.

4. GoodTherapy.org

Good Therapy’s missions is, “Helping people find therapists. Advocating for ethical therapy”. They have a massive website with hundreds of frequently updated articles. Professionals seeking new clients should apply to be included in their therapist finder tool.

5. Mark Nakell

Mark has been an individual and couples counselor with his own practice for over 30 years. He primarily writes about “life changing” events and how to deal with them.

 

6. CounselingResource.com

The unique part about this website is the quizzes and self-tests. You may be able to apply some of these tests to your own patients. Also check out the “Ask The Psychologist” section.

7. Vantage Point Counseling

A Dallas based group of therapists who blog about sexual issues, relationships, and addiction.

8. OCD LA Blog

The OCD Center of Los Angeles is the #1 authority blog for the latest information about obsessive compulsive disorder. The problem I find with most blogs in this area is they only cover the “Pure O” definition. But OCDLA discusses related types and disorders in depth, such as HOCD and Dermatillomania.

9. Dr. Bridgett Cantrell

With an emphasis on helping veterans and active duty service members with mental health issues, Dr. Cantrell has been the owner of a Cantrell Counseling for over 15 years, an expert witness for PTSD cases, and a published author.

 

10. Dr. David Allen

A blog that discusses family dysfunction and mental health issues. David Allen M.D. is the professor emeritus at the University of Tennessee Health Center and the author of two books: “How Dysfunctional Families Spur Mental Disorders” and “Psychotherapy With Borderline Patients.”

 

11. Psyblog

Dr. Jeremy Dean specializes in anxiety and depression by adding his commentary to the latest news and studies in these fields. He has also written several e-books on those subjects and holds three higher-education degrees.

 

12. Jodie Gale

Jodie has over 500 hours of clinical experience – a requirement for her master’s degree in Psychosynthesis Psychotherapy from Middlesex University – along with multiple certifications. Jodie has helped hundreds of women and children through her busy practice. Her blog focuses on reviewing books about relationships, body image, and psychotherapy.

13. Gretchen Rubin

While Gretchen isn’t a psychotherapist per-say, she publishes relevant content on The Happiness Project. This New York Times best selling author of the book “Better Than Before” and is releasing a new book called “The Four Tendencies”, which is about using personality profiles to make other people’s lives better.

This actually has to be my favorite “listen” instead of “read” because she has a podcast where she interviews readers and experts!

14. Progress Focused

Coert Visser blogs about “The Progress Focused Approach” to psychology. This was awarded as one of the top 100 psychology blogs as well.

Here are 3 different hypnotic induction techniques. The first is based on utilizing a person’s leisure interests, the second is a more structured technique that many hypnotherapists use, that we have refined to make it more effective, and lastly, a technique based on utilizing a previous trance state to re-induce hypnosis.

Trance Inductions Utilising Leisure Interests

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.

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.

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.

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.

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.

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.

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. Or if you want an ethical hypnotic induction with more of a structure try this:

Hypnotic Induction Using a Visualised Staircase

First time your suggestions with the Patient’s breathing.

As the Patient exhales you should give suggestions for going deeper into trance. If you are counting, then each number that you count should be associated with an exhalation. By telling the Patient they can go deeper with each number, indirectly they will be helping themselves to go deeper simply by breathing. You do not have to count with each breath, you may prefer to count every’ other breath. This will give you the opportunity to intersperse suggestions along with the counting. By counting and pacing your suggestions with the Patient’s breathing you will be reinforcing rapport.

You should utilise all of the Patient’s sensory systems

Because the Patient experiences hypnosis with his visual, auditory and kinaesthetic sense, your induction should have visual inputs, auditory and kinaesthetic inputs. The staircase induction consists of a journey, one step at a time, down a flight of twenty stairs. As the Patient takes this journey he hears the sound of the therapist’s voice, he sees each Stair in front of him, he feels each stair under his foot. You should encourage the Patient to experience this induction in all three sense systems. At the bottom of the stairs the Patient can see a door, this door could be to the left, it could be in the centre or it could be to the right. There are not three doors, there is only one door. The therapist should ask the Patient to notice where the door is. By asking the Patient this it will get the Patient to become more absorbed in the experience. Behind the door is a room with a comfortable chair and as the Patient sits down in the chair he can see a small cinema screen on which appears a very relaxing scene.

During the induction you should slow down your voice, lower your volume, lower your pitch and deepen your tonality.

These changes should occur gradually as the induction progresses. The therapist starts the induction at normal volume and tempo etc. At the deepest part of the trance the therapist should have the maximum alteration to his voice. By changing his voice in this way the therapist is matching the Patient’s experience of going deeper into trance. This also helps the Patient anchor the trance experience to the therapist’s voice. In future sessions the therapist need only talk in this special way and the Patient will start to go back into trance again.

You should appear confident and take your time.

As you are pacing your suggestions and counting with the Patient’s breathing it will be difficult for you to rush. It’s very important that you give the Patient as much time as is necessary to experience the trance state. When you talk to the Patient you should appear confident and knowledgeable. If you communicate doubt through hesitation or lack of confidence then the Patient will pick this communication up. This will cause a loss of rapport and a lack of trust. So always appear confident and take your time.

You should bring the person out of hypnosis by reversing the induction procedure.

This principle doesn’t apply in every case. But in the case of the staircase induction it is very important. It is also a way of learning all of the steps of the staircase induction. When the therapist decides to bring the Patient out, usually after about five minutes, the therapist will ask the Patient to watch the picture on the screen and then to experience standing up from the imaginary chair the Patient is seeing in the trance state and to walk out of the room, out of the door and slowly come up the stairs. As the Patient comes up the stairs the therapist can count backwards from twenty to one. Remember that when there are twenty stairs the therapist counts from one to twenty to go down into trance and from twenty to one to come out of trance. When the therapist counts from twenty to one to bring the Patient out of trance he should time the numbers with the Patient’s inhalations this time. Likewise the therapist’s tonality, pitch, volume etc. should change in accordance with the depth of trance as the Patient comes out. The therapist’s voice should get louder, the tonality should harden, the pitch should rise until the voice sounds perfectly normal as in everyday conversation. When the trance has been terminated thank your Patient and ask for their experiences. How about something very simple – if the client has been hypnotised before:

Hypnotic Induction Based on Recalling a Previous Experience of Hypnosis

Trance can be induced by recalling appropriate trance contexts and associations.

By talking about previous times when the Patient actually was hypnotised the therapist can help the Patient re-access the appropriate psychological and physiological state associated with the earlier trance experience. The therapist requests that the Patient remember what happened in the hypnotic context thereby bringing back memories associated to feelings, the feelings are directly the result of the change in psychological and physiological state induced by the recall of memories of the trance. This is possibly the quickest form of hypnotic induction available. Simply by requesting that the Patient recall a previous trance the trance is re-induced.

Always use a positive and successful example of a previous trance.

When you first meet your Patient, ask them if they have been hypnotised successfully before. Ask them what it was like and whether it was beneficial. If the previous experience was positive then you can use that induction as a re-induction procedure. All you need to do is ask the Patient to recall the trance induction as you slowly feed back their words, re-capping the stages of the trance induction and compounding their experience by emphasising their minimal cues.

Rapid Inductions

What is all this talk about rapid inductions? It seems that everywhere you look on the Internet you see people offering to teach “rapid inductions”. What does a rapid induction demonstrate other than the hypnotist’s need to prove that he has the power to put someone into hypnosis quickly? It’s about the hypnotist’s ego, it’s not about helping the client. I see very little therapeutic benefit in putting someone into hypnosis in such a controlling way.

Our approach taught at British Hypnosis Research is based on respectfully helping clients resolve their problems for themselves at an unconscious level, and with the hypnotherapist’s role perceived as an observer of the therapeutic process. We want our clients to leave the therapy session believing that they were responsible for their changes themselves and that they don’t have to submit to someone zapping them into an altered state, taking over their mind and reprogramming them to be someone else. We want to empower clients, not dis-empower them.

Rapid inductions, direct and authoritarian hypnosis techniques and stage hypnosis is for entertainment only and has no place in a responsible hypnotherapy practice. If you want an effective yet indirect and respectful hypnotic induction technique, learn how to put clients into trance with the above techniques.

When a Patient attempts to give you information he is likely to have thought out very carefully what he wants to say prior to the session. Usually this is based on what he thinks you want to hear. When you meet your Patient there will be certain things that you will want to hear also, however these may not be the same things that the Patient thinks you want to hear. This means that a certain amount of the Patient’s information will be contrived. Patients seek help from a therapist because they feel that they cannot help themselves. Yet when they ask for help they have to use the same vocabulary and concepts to describe their problems that have previously not been helpful in solving their problems. This puts Patients at a disadvantage because they can only talk about their problems from their own limited frames of reference.

This blog post will teach you how to observe and understand non-verbal communication so that it naturally becomes part of your everyday way of seeing how people interact. It will help you understand someone’s motives, beliefs and thoughts as it will allow you to compare what a person is saying verbally with what they are saying unconsciously non verbally. This skill is essential for anyone in the caring professions where empathy and rapport is important. Understanding a client or patient’s true feelings opens doors in communication allowing people to feel confident in sharing more about themselves and their problems..

You will need to make a commitment to watching how people communicate, and so it will take time. But the effort will be worth it as you will be able to understand people much better and make more informed decisions, especially in therapeutic contexts.

Calibrating to Positive & Negative Response Cues

When a Patient attempts to give you information he is likely to have thought out very carefully what he wants to say prior to the session. Usually this is based on what he thinks you want to hear. When you meet your Patient there will be certain things that you will want to hear also, however these may not be the same things that the Patient thinks you want to hear. This means that a certain amount of the Patient’s information will be contrived. Patients seek help from a therapists because they feel that they cannot help themselves. Yet when they ask for help they have to use the same vocabulary and concepts to describe their problems that have previously not been helpful in solving their problems. This puts Patients at a disadvantage because they can only talk about their problems from their own limited frames of reference. It is your job as a therapist to observe the Patient very carefully as they talk and ask the right questions to get new answers that can then be used to help the Patient. Many of these answers will not come neatly packaged as words, many will be in the form of gestures, changes in muscle tone, alterations in respiration etc. The non­verbal aspect of their communication will usually not be contrived in the same way as their verbal account. It is difficult for a Patient to deliberately manipulate their non-verbal communication because it is usually unconscious and therefore natural. When Patients communicate they give non-verbal signals related to the content of their verbal communication. You should really learn to pay attention to the non-verbal communication as often this information will give you important clues about the nature or cause of the Patient’s problem and how it is being maintained.

When I first started practising as a therapist I would often sense that some Patients were not being totally honest with me. At the time I didn’t know how I knew this, I just felt it. I would often have an uncomfortable feeling when they said something

I that didn’t seem quite right. Many times I just wanted to stop them and say “wait a minute I don’t think you really believe that”. I always used to kick myself when I didn’t probe deeper because (usually ) those particular sessions didn’t really get anywhere. I had to learn to trust my intuition. Intuitive learning is only possible through experience. You cannot be intuitive about a subject you know absolutely nothing about. Continual exposure to a subject and risk taking within the boundaries of that subject will teach you to be intuitive. What I was noticing during my early training was incongruency in the Patient’s behaviour. I was picking up unconsciously a mis-match between what they were saying and the way they were saying it, however I didn’t realise how I was picking it up at the time. Through disciplining myself to pay attention to the fine details of communication I was able to realises how I was doing it and then streamline my observation skills further. Initially I started by re-playing the audio tapes of sessions and listening to exactly what the Patient had been trying to say. I took apart every word and listened to any changes in voice tonality, significant pauses and hesitations. I did this because I thought at the time that the Patient’s communication was mainly verbal. I then realised that tonality and hesitation were really non-verbal aspects of the communication because they contained actual content. They were forms of expression that were telling me how to interpret the content of the communication that I heard through the Patients actual words I found this “taking apart” process so useful that I decided to do it with the other non-verbal aspects of my Patients’ communications. Therapists could not buy video cameras then so it all had to be done whilst it was happening. This was very difficult at first because I kept losing track of what my Patient was saying because I was paying so much attention to what their hands or breathing were doing. However I eventually mastered it and then it became automatic.

Non-verbal communication is usually unconscious

When the Patient communicates he is unaware of his non-verbal communication. However this non-verbal communication usually mirrors the verbal content. If non-verbal communication mis-matches the verbal communication it suggests incongruity. Incongruity is a mis-match between the conscious and unconscious understanding of the problem. For example, a Patient may be thinking of one thing, whilst at an unconscious level be “thinking” another; he may be totally unaware of his unconscious representation. When he communicates, his unconscious mind delivers the non-verbal component whilst his conscious mind gives the verbal component. Therapists should pay attention to both aspects.

You may have heard someone saying of another person “Oh he’s a dead give away” or “I can read him like a book”. These are phrases which describe a person who is totally unaware of their non-verbal communication to the extent that they have no control over it and others can see what they are really trying to say. These people usually have difficulty lying because their non-verbal communication mis-matches their verbal communication so much.

As therapists we are not blessed with this kind of person as our Patients. In fact often our Patients will be doing everything they can to control how they communicate. Despite this, their non-verbal communication will usually be reliable if you can actually see it. This is because non-verbal communication is hard to control consciously, even for Patients wanting to safeguard their secondary gains.

I knew someone who used to lie a lot. I noticed that when they lied their mouth would twitch at one corner. You might think that having seen this tell talc sign I should have keep it a secret from them so that I could catch them out. I was more interested in just stopping them from lying. So how did I do it? I told them how I knew they were lying. I told them about that little twitch. From then on, any time they started to lie their mouth would twitch and they would become acutely aware of it happening. The harder they tried to stop it twitching the worse it would get. Eventually they had to stop lying. The conscious mind has difficulty controlling the unconscious mind.

Patients comment non-verbally on what they are saying.

The therapist should think of the non-verbal communication almost as a running commentary on what the Patient is actually saying. A positive phrase or statement accompanied by a negative facial expression demonstrates incongruity between the thinking at the conscious and unconscious level. The therapist should attempt to think of the non-verbal aspect almost as a subscript to the main communication. I had a Patient who kept putting her hand over her mouth every time she talked about her husband. It became so obvious to me that I found it funny. I had difficulty stopping myself laughing every time she did it. It was quite subtle in that most people would not have noticed it. She was totally unaware that she was doing it. You can learn to recognise incongruities by watching for repeated gestures or movements. Sometimes it may be an aggressive voice tonality that is repeated or even a kind of facial expression that seems wrong. You need to see at least two examples of it occurring before you can call it a pattern. Once you have identified it keep a mental check to see how often it occurs and when. There will be some part of the verbal communication that triggers it usually. As with the above example of the woman talking about her husband. These non-verbal signals are also kinds of metaphors that may even tell you how the Patient really thinks about the subject they’re discussing. The woman who was covering her mouth each time was saying “I don’t want to talk about this”. So her hand over the mouth was an indication to me that a. she didn’t want to talk about her husband and b. her husband was connected to the problem in some way and c. This was one of her ways of communicating non-verbally that I should look out for in the future. If I had seen her cover her mouth when she talked about holidays for example, I could then wonder if maybe the combination of her husband and her holiday are somehow responsible for her problem. Or whether the hand over the mouth is just a general mechanism to protect herself. Of course you shouldn’t get carried away and think that all non-verbal signals are an unconscious message. A hand covering the mouth sometimes is a way of covering a embarrassing teethe smile. Or a Patient sitting with their arms folded might mean they are cold (not defensive as many non-verbal communication books suggest. All non-verbal communication has to be seen in context to b understood properly

Non-verbal communication is more reliable than verbal communication.

Whenever there is incongruity the therapist should believe the non-verbal component of the communication rather than the verbal component.  As the non-verbal component is unconscious it is more likely to be honest. This doesn’t mean that the Patient is deliberately attempting to lie. The Patient may consider that he has full conscious understanding. However, his unconscious mind knows different (and usually better).  Patients reveal their inner feelings so well with non-verbal communication that it is often possible to identify what a Patient is feeling or even thinking simply by paying attention to their non-verbal cues. By noticing a Patient’s facial expression when they’re talking about positive things and their facial expression when talking about negative things it should be possible for the therapist to identify whether the Patient is thinking positively or negatively in the future simply by watching their facial expression.

This skill is well worth developing as many Patients are not aware at a conscious level of what is troubling them at a deeper unconscious level and their non-verbal cues give away clues as to what might be wrong. Ideo-motor signalling and automatic writing are two hypnotic techniques for evoking unconscious communication and are also non-verbal communications. The only difference being that they are deliberately induced by the therapist rather than presented naturally by the Patient although both classes of these hypnotic phenomena can appear spontaneously during trance.

I had a Patient once who complained about being depressed. She was very unkempt, dressed like a tramp, looked as if her hair hadn’t been washed for weeks and used the most foul language I have ever heard. Throughout the interview she seemed unable to be specific about what was troubling her. Much of the time was spent looking at the floor. I noticed that whenever we spoke of her depression she would pick and scratch an unpleasant sore on one of the fingers of her left hand. I also noticed that when we spoke about men she would literally dig her heels into the carpet. Questions about sex or violence would produce more picking of her sore and digging in of heels. After about an hour of getting hardly any verbal responses to my questions I decided to challenge her “Why don’t you tell the f***ing bastard to get the f***ing hell out of your life?”. She suddenly burst into tears and said “Because I love him, the f***ing bastard”. It turned out that she was being regularly being beaten up b\’ her husband. She wanted to get rid of him but was still in love with him. She had removed her wedding ring some months before but still felt that it was there on her finger. Her sore was caused by the continual picking of the place where her ring used to be as if it were still there The digging in of her heels could have either been a sign that she was scared to talk about her problem or that she was frustrated with her dilemma.

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.

Matching & Mirroring Breathing

Your clients breathing will tell you a lot about their inner state and how they are feeling. If they are talking calmly but breathing fast then they are probably holding something back. There are a number of ways you could deal with this, you could challenge them (not good) or better still get them to slow down their breathing so it matches what they are saying, they will then feel more comfortable to share what they might be holding back.

Matching on a minimal level helps enhance rapport

Therapists should train themselves to pay attention to the Patient’s breathing. By matching the same breathing pattern as the Patient the Patient unconsciously identifies that the therapist is “in harmony” with the Patient. By matching the breathing in this way the therapist can then start to slow down his own breathing. The slowing down process will help the Patient slow down his own breathing. This indirect approach to helping the Patient relax happens at an unconscious level. Naturally, the therapist shouldn’t match a Patient’s breathing if it is unusual or problematic in any way. For example if the Patient is asthmatic and breathing in an accelerated or difficult fashion. Matching a Patient’s breathing is essential when inducing hypnosis. When Patients go into trance they like to maintain contact with the therapist in some way. In fact the trance experience is exclusive for the therapist and Patient.  By matching the breathing of the Patient the therapist maintains this communication with the Patient as they go deeper.

Matching And Mirroring Posture

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.

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.

Matching the Patient’s voice tonality, tempo, pitch and volume enhances rapport

Matching the voice to an extreme could be perceived as mimicking so this should be avoided as this would break rapport. The therapist has to pace exactly the changes in tempo and pitch and decide to what extent he should match the Patient’s voice so as to avoid any interpretation of mimicking.
Matching the voice tonality, tempo, pitch and volume of the Patient serves the same purpose as matching the breathing. The Patient unconsciously feels safe with the therapist. By matching the voice the therapist is saying that it’s OK to be the Patient. This is important when Patients come in troubled and concerned about their own self image or personality. It’s reassuring for the Patient when the therapist feeds back these minimal cues. It normalises the Patient’s problem to a certain extent.

Copying a regional accent or dialect should usually be avoided however as this may be difficult to maintain in the future, especially if the therapist were to somehow meet with two patients from different backgrounds at the same time. Accents suggesting a particular class background can be lightly modeled but not mimicked. So a slightly nasal twang could be matched, or for example an East London accent could be lightly matched, but to break out into a broad Scottish accent when you patient is from Scotland would be ridiculous.
The therapist should wait for a few minutes at the start of the session to identify what aspects of the Patient’s voice can be matched, and then gradually introduce these aspects in his own voice. This method mirrors the naturally occurring changes that occur in voice tonality etc when people are developing close rapport.

Cultural Pattern Matching is the skill of feeding back a verbal pattern that is a part of the Patient’s regional background. If the patient is talking in a strong regional accent, he will quite likely also have associated verbal phrases that are common to that region and that he uses quite frequently. For example, some young people with a very strong London accent, often punctuate their communication with the word “right?” or “you know what I mean?” at end of each sentence. The therapist can feed these back to help build rapport. Again, overuse will be perceived as mimicking.

Sometimes matching the Patient’s expectation of what the therapist’s voice will sound like is more important than matching the Patient’s actual voice. For example if the patient is expecting an authoritarian therapist and believes that this is important (maybe the Patient is very quiet and submissive and responds best to being told what to do), it might be better to match this expectation rather than match the Patient’s voice.

Matching and Mirroring Facial Expressions

In addition to breathing, voice tonality, tempo, pitch and volume, the Patient also demonstrates many other non-verbal changes. These non-verbal changes are known as minimal cues. Some minimal cues can be more difficult to spot than others.

The most obvious minimal cues to look out for are changes in muscle tone. This can be noticed in the facial muscles. You will often see a Patient “smooth over” when talking about past remembered experiences of a pleasant nature. When the Patient thinks about unpleasant memories muscle tension can also be observed. The therapist should identify these minimal cues and match them if possible. By doing this, the therapist is showing recognition of the Patient’s needs and maintaining rapport at an unconscious level. The Patient recognises, without knowing it, that the therapist is in tune with the Patient’s experiences.

Because the Patient sees the therapist demonstrating similar minimal cues, he believes that the therapist understands his situation.  All of this communication occurs at an unconscious level. This unconscious communication is occurring all of the time in every day interactions.

Matching Other Minimal Cues

Other minimal cues that can be matched are: pupil dilation, sweating, eye watering, changes in blink rate, changes in skin colour, changes in pulse rate, changes in head position, eye movements similar to eye accessing cues and swallowing. These usually accompany shifts in sensory awareness from external to internal reality as in day dreaming.

Matching Pupil Dilation

To match pupil dilation the therapist can practice de-focusing on objects and remembering the sensation so it can be repeated at will. It is also possible to dilate the pupil by focusing intently on an object. A very effective way of learning pupil dilation and contraction is to use light. Light contracts the pupil and darkness dilates the pupil. If you stand in front of a mirror with a candle in a dark room and bring the candle close to your face you will see your pupils contract and dilate as you move the candle close then away from your face. You can practice this so you can recognise the difference in sensation.

If you bring the candle close to one side of your face, that pupil will contract while the other dilates. You can practice this so you can recognise the difference in sensation between the right and left eye (contracted / dilated pupils). If practiced regularly the you should be able to train yourself to contract one pupil while dilating the other!

Weird Matching (why not?)

To match sweating, the therapist can hold his breath (without being seen to do so). To match eye watering the therapists can avoid blinking. To match skin colour the therapist can recall embarrassment etc.  To match pulse rate the therapists can match breathing. To general response attentiveness the therapists can put himself in and out of trance accordingly.

Trainee hypnotherapists need to know when someone is going into trance or is already experiencing hypnotic trance, because when people go into hypnosis many changes occur, and the hypnotherapist needs to utilise these changes. These changes should always be noticed instantly by the observant therapist. These changes are called Minimal Cues. These are the identifiers of hypnotic trance. The changes below do not always happen in every hypnotic subject but most will be seen at some time during the trance experience.

Eyefixation.

One of the main principles of hypnosis is to capture attention. If you are telling a compelling story or are using direct eye contact the subject will often de-focus their gaze and have their eyes fixed on either a random place in the room (maybe visualising the story you are telling) or on your eye contact. In these cases you will often see a lack of blink reflex and open eye catalepsy (inability to blink or close the eyes).

Pupil dilation.

When the subject’s eyes defocus you will see a relaxing of the muscles around the eyes and, depending on the amount of illumination in the room, pupil dilation.

Change in blink reflex.

Often the subject’s blink reflex will start to slow down. This is a sign that the subject is going into trance. You can utilise this slowing down in two ways:

1. You can match the movement of your own eye blinks to that of the subject and then gradually slow down your blink reflex to non-verbally suggest to the subject that their eye lids will shut.
2. You can associate a hypnotic command such as “deeper”, “heavier” or “comfort” to their eye blinks. By repeating the command each time they blink, even if it occurs in mid-sentence as you speak, you will be associating, unconsciously, the feelings related to the commands, to the eye blink. This will induce further blinking and then eye closure.

Rapid Eye Movement

When people dream their eyes move rapidly back and forth from left to right. They are visualising images associated with their dream. The same phenomena happens in trance. Often you will see REM (Rapid Eye Movement) when you ask the subject to visualise something.

Eyelid Flutter

Some subjects develop an eyelid flutter. This is an automatic response in some people and does not indicate nervousness of any kind. If the subject is concerned about it you can utilise the flutter as a ratification of the trance by commenting on how this particular phenomena is characteristic of a good hypnotic subject.

Smoothing of facial muscles.

The muscles in the face will usually smooth out and the patient will appear more attractive. They will lose signs of tension in their face and their jaw or shoulders may drop a little. Sometimes subjects hold on to the tension in their jaw or shoulders and you may need to encourage them to relax these muscles with some gentle indirect suggestions.

Slowing of respiration.

The subject’s breathing will usually slow down and may get deeper. If the breathing becomes too laboured they may have fallen asleep, in which case you should gently wake them and start the induction again. Usually they develop a nice slow comfortable breathing rate and you can associate words like comfort and deeper to this rhythm to encourage these feelings. It is better to associate these words with the subject’s exhalations as the body is naturally relaxing more on the out-breath.

Reduction of the swallow reflex.

People normally swallow about once or twice every minute. In hypnosis this swallowing can stop altogether. It is not unusual to find a subject not swallowing for half an hour. If the swallow reflex does not stop altogether there is usually at least a slowing down of the reflex. If you see an increase in swallowing it is a sign that the subject is a little nervous.The increase in swallowing is not caused by an excess of saliva but by a dryness in the mouth. This dryness is caused by apprehension or fear and the swallowing is generally a conscious response made by the subject to prove to themselves that they can still swallow comfortably. Sometimes very nervous subjects get quite concerned with this difficulty in swallowing. If this is perceived then you should re-assure the subject without placing too much emphasis on the difficulty they are having.

Body Immobility.

The subject will also develop a comfortable immobility in the body and limbs. They may adjust their position once or twice to get comfortable but after that they usually relax into a comfortable position. If the subject continues to fidget they may be nervous or the chair may be uncomfortable. If they are nervous you can give suggestions that they need not go any deeper into a trance than is right for them at that moment.

Inner absorption.

When people daydream they appear very absorbed in their inner thoughts. They will often demonstrate all of the above Minimal Cues. So inner absorption is a term used to describe the collective cues of trance.

Response Attentiveness

You can usually tell good hypnotic subjects by watching for their minimal cues. Pupil dilation is a good indicator of trance responsiveness. The term “Response Attentiveness” describes the collective minimal cues of trance. In the context of a therapy session you will see the Patient “drift off” from time to time during the conversation. This is usually accompanied by a shift in the facial expression, a softening of the facial muscles, sometimes looking away, de-focusing and a slowing of the respiration. When you see this special combination of cues you can encourage trance to develop further by going in to your “trance style” of communication. The Patient will associate your shift in communication style with their shift into an altered state and its associated minimal cues.
You should look for head nods and signs of agreement. Within the context of a group conversation you can usually identify the most responsive hypnotic subjects by watching for a combination of pupil dilation and head nodding. Assuming that their pupil size is not due to a medical condition or medication, the person with the largest pupils who is also appearing to listen intently by nodding their head is the most likely hypnotic subject.

Communicating with the Unconscious

In hypnotherapy there is pre-supposition that the Patient has a conscious and an unconscious mind.

Of course this is only a model. This model has evolved from the early Freudian concept of the unconscious being a seething pit of repressed memories and experiences revolving around sex to the more humanistic perception of theunconscious mind being a reservoir of resources and skills to be nurtured and treasured. In hypnotherapy we include a bit of both of these poles.

We see one of the functions of the unconscious as being the security guard of traumatic feelings and emotions. In this mode the unconscious holds back some experiences and memories to protect the Patient from pain. Whilst these experiences and memories may be negative they are not necessarily caused by early sexual experience.

One of the unconscious mind’s other functions is to store and sort positive experiences and memories. It is from this “store” that the therapist takes his ideas for therapeutic interventions. The third function is to oversee the bodies autonomous processes and healing mechanism.

Therapists prefer talking to the unconscious rather than the conscious mind.

The conscious mind contains the Patient’s learned limitations. These limitations often get in the way of successful therapy. After all, if the Patient knew consciously how to get better, why would they come to a therapist. Despite this obvious revelation many Patients like to participate consciously in their own healing or treatment. It is only natural that Patients should try and help themselves through conscious effort. So the therapist also has to educate the Patient about the functions of the conscious and unconscious mind and play down the former whilst praising the latter. Analogies About the Patient “taken for granted” abilities such being able to write their name without effort or tie a shoelace without thinking serve to highlight the enormous competency and dexterity of the unconscious mind.

Some Patients have difficulty with the concept of mind.

As the mind is physically elusive it is often had for analytical type Patients to accept it as a reality. Of course they are quite justified in doing so as it is only a model after all

– designed so that we can write books about it. With these kinds of Patients is useful to talk about the mind in terms of brain. The brain has two hemispheres. This is fact. It is also fact that the two sides of the brain have different functions. Each controlling different cognitive processes, behaviours and emotions. The right brain is seen as the creative, dreaming and imaginative brain whilst the left brain is seen as the analytical, logical and reasoning brain. In terms of conscious I unconscious processes we can suggest that the right brain is more likely to be the centre of unconscious process and the left brain to be more responsible for conscious thought.

Because the body is wired to the two hemispheres cross laterally we can also surmise that one side of the body, the left side, is more closely linked via the right brain to unconscious processes. The reverse being true for conscious processes.

Most of the language skills we use in indirect hypnotherapy are designed to appeal to the unconscious mind.

Whilst we will often tell the conscious mind to “go and do something else” whilst we work intimately with the Patients unconscious. By working more closely with the unconscious (right brain) of the Patient we hope to bypass the conscious resistance or sabotage sometimes introduced by the Patient’s conscious doubts about the method of treatment. Patients are most persistent in wanting to help themselves, and the therapist, resolve the issues they bring into therapy. Only by developing an honest relationship with the Patient’s unconscious cognitive processes can we truly hope to work therapeutically without interference from the part of the Patient that has perhaps created their problem in the first place and certainly is an ongoing participant in its maintenance.

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.