Website all my own work. It has some 500,000 words and many links to check. If you find mistakes I would be pleased to know.

Articles written by me on Hypnotherapy, Psychotherapy, Smoking, Love, Memory, James Braid, Anton Mesmer, Panic Attacks, Sexual Problems, Circumcision, Humour, etc.

The following is a list of the article titles with a brief description:

James Braid An account of his favourite induction method.

The Defensive Persona The Defensive Persona The Defensive Persona is a system of behaviour, emotions and thoughts that a person activates when feeling threatened. It is very valuable to recognise when people are evoking such a persona, and the process can be illuminated by animal analogies.

When the problem is smoking: And how to use hypnotherapy to stop it.

Hypnotherapy as De-Hypnosis: The view that in some senses where stage hypnosis is aimed at putting in suggestions to limit conscious self-control, hypnotherapy aims to do just the reverse

Practical Psychotherapy: Interview and Diagnosis A short piece on useful questions to ask at the diagnostic stage of a session,

Iatrophobia Induced by Circumcision: A case of a man's fear of doctors rooted in childhood circumcision. Also deals with the process of foreskin re-growth.

All You Need Is ... ? : Love is a four letter word often neglected by psychotherapy. Here we emphasise the value of the many forms of love.

Lover or Hypnotherapist?: A case of a woman who left her boyfriend because he treated her too much like a client!

Memory: Dealing with what happens if a memory becomes full! and other reflections.

The Technique of Editing Mental videos: How one can dramatically change symptoms by treating traumatic memories as videos that can be edited and thereby improved.

What Mesmer Believed It is often thought that Mesmerism was an early form of hypnotism. In some practical ways it was. But its theoretical background is totally different.

Mr. Bean the Therapist an account of how humour can be used to great effect in therapy.

Humour: A collection of jokes funny and not so funny about hypnotherapy and psychotherapy

A novel hypnotic induction: In which we supposedly invoke a primitive reflex whereby touch at the back of the neck produces deep relaxation and responsiveness.

Only adults have panic attacks A particular view of panics.

Dealing with Sexual Problems in the Male: And ways of treating them.

Anecdotes of use in therapy Stories that have a therapeutic point for certain cases.

A variety of little tips on specific cases: A variety of small tips on particular problems.

A couple of poems:

Rebirth - a Sonnet: A sonnet.

Good Advice: A poem on the theme of the great harm that can be done if advice is not tailored to the life.

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What is abuse?

Written in response to a client who asked the above question.

Abuse is the wrong or inappropriate use of something, which will lead to damage or harm.

We may consider the various ways in which a person may be harmed and associated abuses.

Physical abuse is the inflicting of physical damage and hence severe pain on a person.

Emotional abuse is the exerting of emotional pressures on a person in such a way as to harm them.

Sexual abuse is the inflicting of sexual actions or influences on a person contrary to their inclinations.

These three are perhaps the areas of abuse which are most commonly mentioned. But it is quite easy to list other forms. For example:

Mental abuse: (brainwashing is a form of this) the imposing of ideas or thought on a person with no regard for his or her own existing thoughts.

Functional or behavioural abuse: (slavery is a form of this) forcing a person into patterns of behaviour with no reference to the individual's own needs or desires.

Dietary abuse: (the common "You'll eat what I give you!" but often self-inflicted, as in anorexia) the forcing of a person into an eating pattern which has no regard for the needs of the body.

The theme which runs through all of these abuses is a total disregard for the inner needs of the person. The individuals who perpetrate such abuses are typically concerned only with themselves, their own needs, own feeling or own ideas.

The sexual abuser is concerned only with his own sexual needs, and not those of his victim; the physical abuser is only concerned with his own anger or need for domination and is oblivious of the feelings of his victim; the emotional abuser is concerned only to feel better, and if this is at the expense of making another feel guilt, fear, misery or inadequacy so be it, the mental abuser is concerned only to promulgate his own ideas, with no doubt about his correctness: the thought that they may damage another does not cross his mind, and so on.

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Summer 94.

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Anecdotes of use in therapy

IN YORKSHIRE there was once, in days gone by, a strong man, well over two yards high and weighing nearly three hundredweight, who went around the county Fairs challenging all comers to a trial of strength. "Ah'm t'strongest man in t'country. Ah'll lift ony man off his feet" was the challenge. And once he had got his bear-like arms firmly planted around the ribs of the challenger, there was no doubt about it: no-one had a chance.

His fame spread and soon everyone in Yorkshire knew him. Some said, though not to his face, "Aye. Strong in't arm, but thick in t'head," and it was true that he was not noted for brains. But soon it became rare for anyone to face the certain disgrace of facing him in his lifting contest.

Then one Fair day a young man came up to him and said lightly,

"So, you think you can lift any man in t'county?"

"Aye," he replied, looking down in surprise, "Aye, Ah can!"

"I don't think so."

"Ah CAN!"

"No you can't. I know a man, and a Yorkshire man, too, that you can't lift off his feet."

"Just show him to me. Ah'll soon have him off t'ground."

The young man pointed straight at the heaving chest in front of him, "Go on then. Show us. You will never lift THAT man off his feet."

The giant paused for a moment, then deliberately wrapped his arms around his own chest. He flexed his muscles and made his famous upward jerk that had had hundreds flying up into the air. But nothing happened. He tried again.... and again. He heaved and he strained for hours, as the crowd grew and jeered and mocked.

When night came he had still not succeeded and crept of the field in a state of total humiliation. He broke down completely, and could never again face the world.

An anecdote does not have to be true to be truthful. I often tell the above to men whose problems are a result of two internal systems fighting against each other. It might be, for example, as simple a thing as one part fighting desperately to give up smoking and another to carry on. It is also a common pattern in a lot of stress, which can be seen at times as a person struggling with himself, or with an impossible task. The above little story can be very successful in raising a smile and lowering the tension.

For how can a man be stronger than himself?

Another little picture which is useful in describing a similar problem runs as follows.

Imagine a public speaker. He has a microphone in front of him. A few yards further forward are the loudspeakers. A powerful amplifier is tucked away out of sight.

Now picture what happens when a small boy in the audience, bored by the address, inches the loudspeaker around so that it is facing more and more towards the speaker. At first little seems to happen, except that the talker seems to himself to be getting louder. Then, quite suddenly, a critical stage is reached, and the microphone starts to pick up and amplify the sound from the loudspeaker. The speaker is deafened by the resulting ear-shattering shriek.

Tell a client that his mind is the microphone, and his symptom is the loudspeaker and he will get a good idea of the positive feedback loop that so often keeps a problem in existence long after it should have died away.

I have told the following story to a truck driver who has spent half his life tense with anxiety that he might have another breakdown. His first was at eighteen years old, and no-one told him what had caused it.

There was once this cocky young truck driver, as happy as Harry, until the day his engine suddenly blew up on a busy motorway and it resulted in a nasty crash.

After he recovered he went back to driving, but gone were his carefree ways. He was now in a constant state of anxiety in case he made the same mistake again.

The trouble was that he did not know what the mistake had been.

"Perhaps I am travelling too fast?"

"I feel unhappy on motorways, maybe I would be safer on secondary roads?"

"It never happens to anyone else. There must be something very wrong with my driving."

And all the while his body was getting more and more tense with anxiety; he was worrying so hard that had little time to think about road conditions and started having small accidents, which only reinforced his feeling that he was a terrible driver. He stopped going to transport cafés because he thought that the others would be talking about him behind his back. His sleep suffered, because even at night his brain kept on trying to find a way out of his problems. His marriage suffered. His health suffered.

He thought he was going mad.

Then by chance he happened to meet the mechanic who had dealt with his truck after the accident.

"Hmm. Nasty one that. You were lucky to get out of it alive. Funny you didn't spot the overheating in time."

"What?"

"The overheating. A water hose had perished. You lost all your water. The engine overheated and blew."

It took some time for this to sink in.

"Do you mean that if I just keep an eye on the temperature gauge it'll never blow again?"

"Yep."

The driver walked away a new man. His mind could at last rest. An occasional glance at the dash was all that he had needed during all those years of needless worry. In a matter of weeks he was whistling again, joining in with the other truckers, and all his old cockiness returned.

My client saw the moral of this story easily, as a trucker himself, and left the session lighter in heart - I had also explained to him in simple terms what had gone wrong with HIM the first time, of course.

Where do these anecdotes come from? I analyse the problem in terms of abstract functional systems, as described elsewhere, and then think of another embodiment of the same abstract pattern that the client can relate to vividly, understand easily and remember well.

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Winter 93.

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James Braid

This year we celebrate the one hundred and fiftieth anniversary of the publication of James Braid's seminal work, "Neurypnology: Or the rationale of nervous sleep considered in relation with animal magnetism." (London: Churchill, 1843.Bib) In this book he gave the world the word Hypnotism and its derivatives, and dismissed, by means of acute experiments, the claims of the Mesmerists that some "magnetic" force passes from the operator to the subject.

This book is well worth reading, but here we will just look at his induction method.

TAKE ANY bright object (I generally use my lancet case) between the thumb and fore and middle finger of the left hand; hold it from about eight to fifteen inches from the eyes, at such a position above the forehead as may be necessary to produce the greatest possible strain upon the eyes and eyelids, and enable the patient to maintain a steady fixed stare at the object. The patient must be made to understand that he is to keep the eyes steadily fixed on the object, and the mind riveted on the idea of the object. It will be observed, that owing to the consensual adjustment of the eyes, the pupils will be at first contracted: they will shortly begin to dilate, and after they have done so to a considerable extent, and have assumed a wavy motion, if the fore and middle fingers of the right hand, extended a little separated, are carried from the object towards the eyes, most probably the eyes will close involuntarily, with a vibratory motion. If this is not the case, or the patient allows the eyeballs to move, desire him to begin anew, giving him to understand that he is to allow the eyelids to close when the fingers are again carried towards the eyes, but that the eyeballs must be kept fixed in the same position, and the mind riveted to the one idea of the object held above the eyes. It will generally be found, that the eyelids close with a vibratory motion, or become spasmodically closed. After ten or fifteen seconds have elapsed, by gently elevating the arms and legs, it will be found that the patient has a disposition to retain them in the situation in which they have been placed, if he is intensely affected. If this is not the case, in a soft tone of voice desire him to retain the limbs in the extended position, and thus the pulse will speedily become greatly accelerated, and the limbs, in process of time, will become quite rigid and involuntarily fixed. It will also be found, that all the organs of special sense, excepting sight, including heat and cold, and muscular motion, or resistance, and certain mental faculties, are at first prodigiously exalted, such as happens with regard to the primary effects of opium, wine, and spirits. After a certain point, however, this exaltation of function is followed by a state of depression, far greater than the torpor of natural sleep.

Reprinted from the Journal of the National Council of Psychotherapists and Hypnotherapy Register, Summer 1993.

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The Defensive Persona

This article is based on a chapter of an unpublished book - "Your Path in Life" - which I wrote many years ago.

THE LARGE THEME of this article is defensive behaviour. This is an extensive topic, and a very important one. In this article I propose only to touch on various aspects of defensiveness with an eye on how it impacts on so many of clients' problems. I hope in this way to illuminate such problems by looking at them from a particular perspective.

What do I mean by the phrase Defensive Persona?

In the Middle Ages there were in Europe men who, when in their own homes, surrounded by family and servants, were genial and courteous. But in time of war they would put on heavy suits of metal, concealing even their faces. To the outward eye there would be no similarity between this hard, shining, sword-wielding thing, and the laughing man in his bright soft clothes. He put on the armour to defend himself, of course.

Can you picture a cat sitting by the fireside? She is all soft contentment. She is totally relaxed and approachable, ready to be stroked or to purr. But see what happens if a strange dog enters the room. Instantly that soft creature becomes a taut bundle of muscles, with claws extended, teeth snarling, hair on end, eyes glaring, nerves on a hair-trigger, snarling and hissing. It is almost impossible to recognise the same creature. She acts in this way to defend herself, of course.

These two pictures will have given you some idea of what I mean by a Defensive Persona. When any person or animal feels threatened then he, she or it will start behaving in quite a new way. And this behaviour will often seem to have nothing in common with the behaviour at other times. The whole pattern of thoughts, feelings, behaviour and appearance which a person follows when they are feeling threatened is what I mean by a Defensive Persona. Normally this behaviour is dropped when the danger has gone.

Animal Stereotypes

There are many different kinds of Defensive Personae. One useful way to classify them is in terms of animal stereotypes. For example, consider the tortoise. When threatened it withdraws into its shell. And there are people like that. When they feel attacked they withdraw inside, and refuse to say anything or do anything. Like the tortoise they will only open up again when the danger has disappeared. You can sometimes find this Persona in a hen-pecked husband. A typical scene might run as follows.

His wife would like some contact. She nags at him, "Stop reading that paper. Talk to me for once." He puts down the paper; he feels more exposed and therefore threatened; he withdraws deeper into himself and says nothing. She is even more annoyed by his silence; she needles him, hoping to stir him into response. He feels more attacked: the tortoise withdraws still further into his shell. Only later, when he goes out for a drink with friends, and the threat disappears, does he come out of his shell again and becomes quite a different person. If his wife finds out, this only makes her more annoyed, and she takes it as a personal insult. Such a Defensive Persona could also be likened to a clam.

The hedgehog or porcupine also withdraws into itself, but in a much more prickly way. You do not get hurt by a tortoise's smooth shell. But if you start to prod a hedgehog you get some nasty pricks. "(S)he is prickly," we say of people like that. If you get too close to them you will often find unexpectedly sharp and pointed remarks coming your way. It is surprising because most of the time this person can seem quite inoffensive. And the clue to the change is that you must have just said or done something which has made them feel threatened. The Defensive Persona emerges, all prickly and unapproachable. There is little that you can do except go away until (s)he unrolls again. If you try to unroll such a person forcibly, then you will suffer for it, as many a young fox, with spines in its nose, will testify. The bear's Defensive Persona is violent rage. (We will say of somebody, "He is like a bear with a sore head.") Notice again that a bear can be a gentle and inoffensive creature when it feels safe and able to get on with life without interference. It is only when it feels threatened in some way that the rage comes out.

A similar Persona is the tigress, particularly when defending her cubs. Her power is formidable and she knows no personal fear. Like the bear she acts on the principle that the best form of defence is attack. If you should be unfortunate enough to know anybody like this and incur her wrath, then you are unlikely to know what hit you. Although in civilised society she may not attack you physically, she will attack with all means in her power.

I believe that it is the case that the tigress will normally simply retreat into the jungle if there is a threat to herself, provided she is free to do so. But if her cubs are in danger then she is ferocity personified. And many mothers are like that; and women who feel that they are defending someone or something that they may subconsciously equate to a child. If you attack such a person you would be foolish to expect her to back down quietly. Notice again, though, that if she does not feel a threat then she may well be as pleasant and amiable a person as you would care to meet. You may well have met a tigress in your time, or seen one on the screen.

At another extreme we have the rabbits. Their defence is to run to earth. And there are people like that. If they feel threatened they will make no defence - they just try to run away. Once they are back at home they feel fine again. Note the difference between the tortoise and the rabbit, both of whom are quite unaggressive: the latter has a strong need to remove itself physically from the danger.

Here are some other brief pictures to add to the collection. The snake, if it feels under attack, will pour poison into you. And you may know someone who has the power to say really poisonous things, which hurt for a long time afterwards.

And what about the skunk? The human equivalent might be someone who will slander you so effectively that people will stay well away from you as if you stank to high heaven.

The common phrase, "His bark is worse than his bite," reminds us of the way in which a certain kind of dog behaves. Usually you will find such a dog making a great deal of noise, barking and growling, to give plenty of warning that it is feeling threatened. Only if you continue to approach in an aggressive way will it finally bite. In this way a dog is more civilised than the bear or tigress, who are not concerned to give any warning. Does this remind you of anyone?

I am not saying that this is an exhaustive list. Neither do you have to agree with the way I have described the animal stereotypes. What I have found that is that the use of these animal labels for Defensive Personae can help people to see what is happening in their relationships enormously. I usually ask them to choose the kind of animals themselves, according to their own ideas of their natures.

Problems often arise in marriages in which the partners have different, and clashing, defensive personalities. As an example suppose that a hedgehog is married to a sheep. (Sheep always like to come together in a close flock if attacked.) If they are under stress then the sheep wants the comfort of physical closeness, but the hedgehog is determinedly turning into a prickly ball. The sheep then feels rejected, because whenever she gets close she is needled, while the hedgehog is threatened by her approach. You may wonder how they got together in the first place if they are so different. But remember that their non-defensive personalities were probably very pleasant and compatible. But married life is much easier if a sheep is married to a sheep, and both like to get close together when they feel attacked.

Marital Therapy

It is well worth looking at Defensive Personae in marital therapy. Marital problems can be about a multitude of things. But always, at some point, one partner is putting pressure on the other to change; the pressure is felt as a threat; a Defensive Persona is adopted; this is in turn seen as threatening; a reciprocating Defensive Persona is adopted; the problem escalates. If you ever get involved in helping someone with a marital problem it is important to be aware of this. Each partner alone can seem totally reasonable, pleasant and justified. It is only when you see them, if possible, in the middle of a quarrel that you get the whole picture. That infuriating whining voice, that arrogant pointing finger, that sneer, that closed look. Little things that are not seen by their owner. But they are whip lashes to the partner. These Defensive Personae may not be the root of the problem, but they certainly get in the way of solving it.

The primary point of all the above is to emphasise one of the important Facts of Life, which is:

A person behaves in quite a different way when feeling threatened.

Or to put it another way:

A Defensive Personality is quite different from the ordinary one.

Like many important truths this might seem obvious once it is written down. But if we meet someone who is being nasty, bad-tempered, irascible or sarcastic, how often do we bother to ask the question: "Is this behaviour only the result of feeling attacked?" We are all too likely to put it down to simple, unprovoked aggression or nastiness. We, on the other hand, are never guilty of this, are we? We, if we are being unpleasant and aggressive, are always acting in pure defence! With us it is totally justifiable!

Do you imagine that Al Capone, seen by others as an arch-gangster, saw himself as a villain? Towards the end of his life he is reported to have been very hurt at being attacked for what he saw as a life of "giving people the lighter pleasures". As far as he was concerned he had only ever defended himself.

The Colours of Defence

There is another way which can be used to classify defensive responses. It has less richness and vitality than the animal analogies but it is a nice way of plotting personalities on one sheet of paper, and appeals to some people a lot. It is also better as a subjective measure of the feeling of defensiveness, rather than a way of classifying the response which is visible externally.

Central to all Defensive Personae is the feeling "I AM UNDER ATTACK". Any behaviour which is not accompanied by this feeling, coloured in some way, is not, I maintain, to be classified as defensive. The basic feeling "I AM UNDER ATTACK" is surrounded by a cloud of feelings which are generally combinations of a fairly simple number of components.

If feelings were colours then we might picture anger as being red (red with rage), fear as being yellow (we call a coward yellow), and blue as frozen numbness (blue with cold). The red feeling of anger leads to aggressive behaviour - the bear or tigress; the yellow feeling of fear leads to flight - the rabbit; while the blue frozen feeling leads to immobility - the clam or tortoise. And these correspond to the three main courses of action relative to any danger: go forward, backwards or stay where you are.

Then just as we can make up any of thousands of colours by mixing red, blue and yellow paints, so you can find thousands of different emotional states which are a mixture of the above. For example if you mix red and blue you get purple, and so you could see a state of frozen or bottled up anger as purple. If there is a mixture of red - a desire to fight, and yellow - a desire to run away, you get a state with a lot of tension and often a lot of displacement activity. It would correspond to a shade of orange. Mix yellow and blue and you get green: mix fear with a frozen feeling and you can get a horrible sick fear. Finally if you mix the whole lot together then you get a dark brown or black. Such a confused state where there is no clear defensive path to follow will often lead to what would be called a black state of mind - hopelessness or depression.

This classification by colours is a convenient shorthand way of describing the emotional colouring of the basic defensive emotion - I AM UNDER ATTACK. Colours are soft-edged and flow into each other just like feelings, so there is nothing hard and fast about it. So you can say of somebody, "He will usually go yellow, but if he is pressed too hard he can move towards the red", or, "When she goes red, she calms down quickly, but sometimes she will go into a blue state which lasts for a long time."

Clients will often enjoy looking at their own emotional response to defence, as well as that of those they are involved with, in these ways. And by doing so they clarify for themselves what is happening in a very important part of their lives.

Predatory versus Defensive

The next distinction I want to make is between two broad classes of behaviour in others that can provoke a defensive response. The confusion between these two classes leads to much unnecessary conflict. It can again be approached via an animal analogy. There are predatory animals. They enjoy hunting. A cat which is after a mouse is visibly a happy creature, and the behaviour is quite different from its Defensive Persona. It is because there are predatory animals that their prey have developed various defensive strategies.

Now there are also predatory people. They will attack you because they want something from you. And you would be wise to defend yourself against them if possible. But if you think about it you should realise that nowadays most of the out-and-out predators one meets will be quite smooth operators, con-men or gold-diggers of one kind or another. They usually know better than to put others on the defensive. (There are a few muggers and the like, of course, but they form an very, very small proportion of the people we meet.)

It follows then that if someone is unpleasant it is very unlikely that they are predatory and so we are mainly defending ourselves against people who are unpleasant purely as a means of defending themselves. This kind of thing happens frequently in life and causes a lot of unnecessary distress. It can happen in society at large, more often in groups and organisations such as at work, and most often of all within families and couples.

As an example, let us follow the path of a honeymoon couple. It is their first breakfast together as man and wife. He remarks lightly, "This is the best morning-after feeling yet!" She, feeling compared with other women, is inwardly threatened, and with an edge to her voice replies, "Oh? And who was second best then?" He, reacting to the tone, and taken aback by the line the conversation is taking, snaps, "Well? And what about you and Jim then?" This remark arouses her full defensive personality. From that point the path of the quarrel will depend on their respective Defensive Personae. She may run out, or weep, or become coldly sarcastic, or verbally angry or throw the coffee at him. He, in turn, may grow sullen or morose or violent or sarcastic and so on in reply.

You will notice that they both feel fully justified in defending themselves against what they regard as the other's unjustified attacks. Notice also that there is no need to assume any deep Freudian, psychoanalytical or Transactional Analysis type basis for the problem. It is enough to see that neither recognised the defensive nature of the other's response, and saw it as totally offensive.

Doubtless readers who have done any marital counselling will recognise the pattern, even if they have never got trapped, as I have, within the pattern themselves.

Vicious Circle

In terms of the systems analysis that I have described in earlier articles in the Journal, and now more completely in the book The Principles of Hypnotherapy, we get a real problem when the pattern of behaviour of any two organic systems A and B (people, animals, groups or nations) has the following structure:

&uarr{Defensive response by A} &rarr &uarr {Defensive response by B}&rarr &uarr{Defensive response by A}

Meaning of arrows

This has the form of an increasing positive feedback loop, or vicious circle. Once the loop is started by some chance event it will continue to spiral into dangerous regions which may lead to great damage. We have seen an example between a couple. I suggest that the arms race between the two great powers in our lifetime, now mercifully on the wane, was a further example in which both sides saw the situation primarily in terms of defence against a perceived threat.

Many conflicts between neighbouring countries have the same dynamics. Each sees the other as a threat to their interests and safety. There are times when factions will arise in political parties which start to defend themselves each against the attacks of the other by counterattacking and mud-slinging: a common result is a split.

Complementary Defensive Personae

Of course not all pairs of Defensive Personae lead to the above vicious circle. At times they can be complementary and can lead to a rapid resolution of the situation. Let us look at some examples.

I will take the first from the animal kingdom. In a pack of wolves we can recognise several clearly separate Defensive Personae. One is an attacking one - teeth bared, muscles tense etc. Another is simply to run away. A third is puppy-like - a rolling over on the back to expose the vulnerable abdomen. Now the adult wolf is provided with instincts which will fairly quickly switch off an aggressive persona if the response is one of the other two, more submissive ones. Consequently quarrels will usually end without bloodshed, the moment the wolf who is getting the worse of an aggression-aggression conflict turns it into an aggression-submission one, something that happens quite suddenly.

Sometimes human quarrels follow the same pattern. In some cases aggression in the male is turned off by tears in the female, for example. In that case a quarrel may start with mutual criticisms in which both feel more and more defensive, until the woman reaches the point of tears: the switch of Defensive Persona from an aggressive adult to what looks a little like a helpless child is again typically quite abrupt. This then inactivates the man's aggressive defences and, with luck, switches on a more compassionate and mature persona, and harmony can be restored.

Symbolically we have in such cases:

&uarr{Anger in male}&rarr &uarr {Defensive crying} &rarr &darr{Anger in male}.

and so there is no longer a vicious circle. However, just to make life difficult, some men respond to tears with yet more anger, in which case tears will lead to a worse problem.

In a nutshell, the problem is that there is no guarantee that a couple will have complementary defensive patterns - and it is when they do not that we are most likely to find problems, in our own lives or that of our clients.

Territorial Defensiveness

Another very useful consideration in the analysis of defensive behaviour is that of territory. A very large number of animals need territory for various reasons and will defend it against other members of the same species. Robins, for example, are territorial creatures at nesting time. The commitment to a nesting site leads to the need for sufficient space around it to be able to collect food for the brood that is to come. If there was another robin nesting very near, then the chance of there being enough food within easy reach would be diminished considerably. It consequently pays the robin to fight off any intruder who looks likely to enter the same territory. From the point of view of the incumbent it presumably looks like a justified defence of his territory; to the intruder it looks like pure aggression. Interestingly it is the intruder who, although usually acting in a more low-key way, is actually the more predatory creature: he has a need which he is happy to fulfil at the cost of another.

But the concept of territory can be, and has been, generalised to more than simply land. Deer graze so extensively that they have no defined physical territory, but on the other hand the stag acts towards his females as if they are his territory: he will defend them against another male. The sight of another male arouses in him a Defensive Persona.

Let us look at some related phenomena in mankind. When jobs are not easy to come by, then anyone who has one is likely to feel a strong need to defend that job against others. We may thus find in a company which is "downsizing" that a great deal of internal nastiness arises, as each employee starts to think of the others as potential competitors and, therefore, starts to switch on a Defensive Persona more and more often. This can lead to a great deal of stress.

If a family lives in a small house then there can often arise a lot of conflict because there is not enough room for each individual to have free space to do what they want to. In this case there can be a lot of conflict over real territory; each defending desperately the space that they perceive as their own.

But there can be fights over more abstract territory also. One person may regard the playing of music as a part of their "territory", while another regards "peace and quiet" as a part of theirs. No matter how hostile the quarrels become, each acts from a righteous attitude of justifiable self-defence.

Intellectuals can fight with equal bitterness over intellectual territory: "That was my idea: I deserve the credit for that."

There can be conflicts of interest over land, possessions, power, money, reputation, lovers, friends and so on endlessly.

Our perspective

What I would add is that even when we are, in truth, moving in on someone else's territory we very seldom manage to recognise the fact! From our point of view we are in our territory and that other person seems to be either already, or potentially, trespassing on it. This tendency is aggravated by the fact that we tend to judge our own territory by our needs, hopes and expectations, as much as by objective current fact. The junior who had his eye on that promotion for years already feels that in some sense it "belongs" to him, and will feel that another candidate is trying to take away what is already his.

Or we may have a situation in which one group in a company is building it up rapidly, and soon comes to take that growth for granted. If there are members of the company who feel more comfortable with things as they were, they will naturally interpret this behaviour as a threat, and will act in a spirit of defence. But equally the first group will not see their own behaviour as a trespass at all, and will feel most offended by the reaction, and in turn react as if attacked for no reason.

Our blindness to the other person's perspective and our overwhelming need, as we see it, to defend ourselves, contributes enormously to conflict and tension.

In helping clients who are caught up in that sort of situation my usual practice is as follows. I first of all listen with an encouraging and supportive silence while they get the whole thing off their chest first. During this period they are probably unable to listen to anything new in any case.

The second step is for me to summarise the key aspects of the situation from their own point of view, with an emphasis on all the wrongs that have been done to them. There may well be some further points which arise out of this, and so the process of talk and summary is repeated a few times.

By that stage hurt feelings have been assuaged to a considerable extent, and I am seen to be able to take their side fully.

I will then say something on the following lines.

"Clearly this is a terrible situation, and something will have to be done about it. I am not sure what is the best thing to do, as it depends so much on knowing what he/she/they are like. The more we know about things from their perspective the easier it will be to decide how to handle the situation. I wonder if you can help me now to get an idea of what things must be looking like to him/her/them?"

I then gradually enable the client to piece together an idea of how things look from the other person's point of view. This can only be done slowly, though it is easier in some than in others. It will usually end with at least some insight into the ways in which the other person most feels threatened by the situation, and therefore induces in the client a reduced sense of being viciously attacked for no reason, and also increases their sense of power: "Well, if they have to react that strongly to little me, I must have affected them more than I thought!" The advantage of these changes is that they very much decrease the sense of defensiveness, and enhance confidence a lot. And the more confident a person is, the more they are able to alter their own behaviour in the situation to a more constructive one.

On the basis of this increased understanding of the other viewpoint, and the increased confidence, it is then usually possible to formulate changes which can lead to improvement in the situation, even if it has been going on for a long time.

Chronic defensiveness

This brings us to another aspect of the subject which is the effect on an individual of having a Defensive Persona which is, for one reason or another, more or less continuously active. Typically we would call such a person stressed. In fact one might look at all stress from this perspective and say that any organic system is stressed if it is reacting defensively for the greater part of the time.

We are all familiar with the interpretation of panics and anxieties in terms of the activity of a "fight or flight" response. But what is that response other than a defensive one? The organism is put in a state where it is going to run away defensively, or fight defensively. The reality or otherwise of the threat is unimportant, of course, compared with whether or not a threat is perceived.

Now, although it is far from being the whole of the way in which such problems are resolved, I find that it is valuable in very many cases of stress to dwell with the client on this matter of the Defensive Persona. The more they become aware of their own responses the more they are likely to be able to control them, rather than be controlled by them.

It is often valuable in such cases to enable the client to develop a conscious awareness of the wide variety of defences that are available, and the situations in which they can most appropriately be used. This will usually dove-tail with any assertiveness training techniques that you use.

A Defensive Persona which is maintained for very long periods of time can lead to all manner of problems, some of which have labels.

If someone gets increasingly into a state where they feel that everyone is threatening them then they are liable to be labelled paranoid. I often feel that this is a bit unfair to the sufferer, because it must be said in his defence that in fact most people are, if not attacking him, at least disliking him. The reason for this is simple. It is because most Defensive Personae are unpleasant at least. If anyone is in a state of chronic defensiveness then it is likely that his every word and gesture will put people off him, and they will reply with their own defensive behaviours which he will, naturally, see as a further attack.

If someone is stuck in an extreme "yellow" defensive condition then, if they approach the medical profession, there is a good chance that they will be classified as suffering from an anxiety neurosis or something similar. Someone who is too long in the "blue" may be diagnosed as a depressive. Someone who is defending himself consistently with a red state of anger is perhaps rather more likely to find himself being labelled a "psychopath" and ending up in court.

There can of course also be physical consequences of a persistent defensiveness. The person who is constantly in a "red" state of anger is likely to run the risk of damagingly high blood pressure, for example. Someone with a defence which is more in the "orange" - a rather cowardly repression of anger which is therefore internalised may well end up with ulcers. In some a characteristic response to feeling under attack is the tensing of muscles - in the neck or back for example. Chronic defensiveness can then give rise to chronic pain in these areas.

If a client reports of any symptom that it seems to go away when on holiday, then it is well worth looking at the ways in which that person reacts - mentally, emotionally and physically - to a feeling of being under threat, and also where the perceived danger is coming from. If the threat is perceived to be there a lot of the time then the distortion of the natural personality involved can lead, as we have seen, to stress in whatever area of the person is most active in the defensive personality.

With some clients it is appropriate to refer to the knight in armour that I mentioned at the start of this article. As long as he only wears the armour in battle, it must be regarded as a good thing. But imagine what happens if it rusts up and he is then unable to get it off, even when he is home from the wars, and in bed with his loving wife again. It is going to do very little for his marriage! But there is many a man who dons a metaphorical defensive armour in his daily work, and who also fails to take it off when he comes home, and so his wife is unable to come close to the real man. In both cases is it so surprising if the wife finds herself eventually drawn to a man who does NOT wear a defensive barrier all the time she is with him?

Of course it is not only men who can get stuck in defensive mode. There are all sorts of reasons - upbringing, abuse, other relationships, etc. - why a woman may well anticipate attacks within a close relationship and get locked into a defensive mode.

Trauma-Induced Defensive Personae

As an important example of how a Defensive Persona can form and last for a lifetime we may consider childhood trauma, abuse or rape. The child is often helpless to get away from such things. The best it can do is to change the way it thinks, feels or acts. It will do its best to defend itself against the pain. And the Defensive Persona it adopts will become a part of its adult personality, too. If the mother always rejected the child then it can easily grow up unwilling to form a relationship with a woman - if the defence was never to get close to one. If the father was always violent and the defence was to go into a shell, then the person is likely to be stuck with the same Defensive Persona when threatened, even when grown up. One of the jobs of the therapist is to trace back inappropriate Defensive Personae to the time they started.

Habits and Defensive Personae

We may note that many habits are also linked into a Defensive Person. Many people smoke, for example, the moment they feel threatened. It may well not be the only reason that they smoke, but it is one reason, and when it is there it is often necessary to deal with the perceived threat as part of the help in giving up smoking.

The same can apply to eating. There are quite a few people - women perhaps more than men - who will eat when threatened. There is biological sense behind this. Imagine life thousands of years ago, before there was any way to store food, and there was little way of carrying more than a few days' supply. Then imagine that a tribe was under threat - perhaps from famine, or a rival tribe. What makes more sense than for the women - who have the overwhelming priority of providing food for their babies - immediately to eat whatever was available, and storing it in the most convenient and secure form: body fat. This is not appropriate nowadays, of course, but old instincts do not die away in a hundred years or so. Consequently, helping some women to lose weight is the same as helping them to feel no longer under threat.

The retreat into drunkenness is yet another form of defensive behaviour that some people can adopt. They may find a situation too difficult and a drunken stupor gives some relief. If this becomes a response that is indulged in to excess, then we have a diagnosis of alcoholism. And I have found in my experience, which is not extensive, that tackling the problem at the root - identifying the perceived threat and the poor defensive response - can give very good results in such cases.

In all of the above problems, I suggest, the problem is better, and more permanently, tackled at the level of the Defensive Persona as a whole, than at the level of a surface symptom.

Therapy

I do not suppose that there is just one way of changing a Defensive Persona which is giving trouble, but will mention some approaches which will be familiar to readers, and help them to integrate the current perspective into their favourite approach.

We may perhaps start with Cognitive Therapy: a method which might incorporate much of the material in this article, because of its reliance on the conscious understanding of the processes involved. From that understanding will commonly flow a more conscious control over defensive processes, both within the client, and in their awareness of and response to, the Defensive Personae of others.

Another approach is via Behaviour Therapy. Here we would focus on the behavioural part of the persona alone and work to eradicate counter-productive behaviour and to institute new behaviour patterns following standard procedures.

If you find yourself using a Transactional Analysis framework frequently, then you could focus particularly on scripts which have a recognisably defensive function, and in particular on conflicts between the Child and Parent which involve, typically, some form of Defensive Persona in each. This conflict may at times be worked out within the individual, or in his or her interactions with others.

Within Gestalt therapy you would naturally be focusing on defences, perhaps getting a client explicitly to act out or externalise the Defensive Persona and expressing the defensive feelings in other ways.

Assertiveness training has already been mentioned, and contains valuable methods for replacing a negative or hostile defence of territory with a calmer approach which avoids making the other person threatened in turn. This avoids the typical vicious circle we have noted, and makes a reasoned negotiation possible.

Regression can be a valuable tool whenever it is the case that the Defensive Persona evolved to cope with a particular difficult situation in the past. It can be useful to resolve the tensions of that time, and also to contrast that situation with present-day ones, to minimise the likelihood of the old defensive patterns emerging inappropriately. Such regression can naturally be enhanced by the use of hypnotic techniques.

Hypnosis can, of course, be used to address some of the other areas involved in defensiveness. Any suggestions of confidence will typically be helpful, for example, because a feeling of confidence reduces the likelihood of feeling defensive. Positive suggestions that other people are not as hostile as is supposed can also help.

Laughter

"Laughter therapy", which was featured on a recent QED programme on TV, could also be seen as a powerful tool, for there is nothing like laughter to dissolve a sense of defensiveness. (Cf. my article, "Mr. Bean the Therapist, Journal, Spring 1995.)

As an example from my own casebook of the use of laughter in family therapy I will give the following.

The husband can enter dark moods. This frightens the wife who gets angry with him. But this only makes him worse, and so we have a classic positive feedback loop: a vicious circle.

To break this with laughter I simply asked the wife to get out her lipstick on such occasions and paint an enormous smiling clown's face on her husband. (Ericksonian's among you will love this.)

The act of doing this, and seeing his morose face transformed into a laughing clown makes her crease up with laughter. He then catches the amusement and finds it impossible to maintain his mood. And so the vicious circle is simply eliminated.

Laughter is so important, and so uniquely human, a way of defusing defensiveness that teaching clients to be able to laugh at problem situations must be very high on our list of priorities.

Finally I might mention Christian Therapy. Such an approach would draw attention to some of the basic and wholesome teachings as, "For if ye forgive men their trespasses, your heavenly Father will also forgive you." (Matthew 5.14), which will act to reduce the intensity with which we react to others' trespass on our territory. "Love your enemies, bless them that curse you, do good to them that hate you, and pray for them which despitefully use you, and persecute you," (Matthew 5.44) and "Perfect love casteth out fear," (1 John 4.18) will remind us of the truth that the most effective antidote to fear of our fellow-man or -woman is love.

Or we might quote from other faiths or people. Here is one from Martin Luther King:

Non violence is the answer to the crucial political and moral questions of our time, the need for the human being to overcome oppression and violence without resorting to oppression and violence. People must evolve for all human conflict a method which rejects revenge, aggression and retaliation. The foundation of such a method is love.

Whatever the approach, the overcoming of the use of an inappropriate Defensive Persona is central to very many of the problems to which flesh is heir.

Further Reading

The student and anyone else who might like to read more about some of the matters in this article might find the following suggestions interesting. Full references in Bib.

It is useful to have a grounding in defensive animal behaviour in this context, and a excellent starting point there could be ethologist Konrad Lorenz' On Aggression. Robert Ardrey's The Territorial Imperative, 1969, combines insights from the animal kingdom to analogous behaviour in man.

A very nice over-view of theories of international conflict, which can lead on via other references, is to be found in John L. Casti's Searching for Certainty, 1991.

Cognitive therapy was founded by Aaron Beck originally in the context of the treatment of depression. His Cognitive Therapy and the Emotional Disorders, International Universities Press, 1976 and Cognitive Therapy of Depression, 1979 are classic works.

Behaviour therapy emerged in the late 50s, evolving from earlier behaviourist theories of psychology. The seminal book was Behaviour Therapy Techniques by Joseph Wolpe in 1966. Typical techniques are desensitization and aversion.

Transactional Analysis can be approached via the classic best-seller, Games People Play, 1976.

Gestalt therapy is associated with the work of Fritz Perls, and has evolved a variety of techniques for dealing with internal personality conflicts. A starting point could be his 1969 book Gestalt Therapy Verbatim.

An idea of how Christian teachings can be incorporated into therapy is provided by Frans Brandt's book Victory over Depression.

I cannot give any references to the concept of the Defensive Persona, which I do not associate with a particular school of therapy. Neither can I cite a reference to its classification via animal stereotypes or colours, because I believe they are original with me.

Acknowledgement

I am indebted to Atheline Kelly, who not only helps enormously with the typing and proof-reading of the Journal, but also pointed out a serious omission in my first version of this article. I had forgotten to mention laughter!

This article first appeared in the Journal of the National Council for Psychotherapy and Hypnotherapy Register, Autumn 96.

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Hypnotherapy as De-Hypnosis

I FIND IT FASCINATING to watch Paul McKenna on TV on those rare occasions when I do not have an evening client and he is on.

He is clearly good at his work, and it is clear from his book that he is aware also of much of the material - such as Erickson's work and NLP - that is part of the background of the typical therapist. Yet I have found a reluctance to use the type of inductions and approach of the stage hypnotist in my own work. (And the one time I have seen McKenna work on TV as a therapist I was interested to notice that his approach was pure therapist and no stagecraft.)

In pondering on this matter I have come up with the following thoughts, which might be of interest to others.

The characteristic produced by a stage Hypnotist in his clients is a limitation of the personality. When they are acting out the suggestions made they will typically have no access to much of their common-sense background knowledge. It is interesting and amusing to watch the subjects acting on the suggestion that to put on a pair of trousers is impossibly difficult, but for this to be happen, their normal knowledge must be rendered inaccessible.

Another perspective on this is provided by the word dissociation. Extreme cases of dissociation are provided by people who demonstrate multiple personalities. In such people there seem to be distinct and non-cooperating personalities which can take it in turn to be `in control'. Each personality may have its own memories, or one may have access to those of another but not vice versa.

Some theories of Hypnosis are based on this phenomenon (Cf. Hilgard Neodissociation theory of multiple cognitive controls ). From this perspective a lot of what happens on stage can be seen as the creation of a secondary (and limited) personality in the client. The bounds of this personality are determined by the particular suggestion made, and, as noted above, it typically has very limited access to information available to the normal full conscious.

It is in the interest of the stage hypnotist to create such sub-personalities and to ensure that they are cut off and or dissociated.

Now the Hypnotherapist is also familiar with the phenomenon of dissociated mental systems. The whole theory of repression can be seen in this light as the severing (for defensive purposes) of all information about some traumatic event or events from full consciousness. Concepts such as "the child within" similarly testify to the existence of internal sub-systems which are at variance (often) with the conscious will.

But notice that in these cases what we, as Hypnotherapists, are striving for is NOT to enhance the separation, NOT to make the dissociation more extreme, but rather to reduce or eliminate it.

We are finding ways to allow the inner child and the inner adult to be closer and to love each other not hate each other behind barriers.

We are finding ways to bring repressed traumatic material safely back into consciousness by showing how it may be dealt with.

Or again, think of the many times in which you have heard a client say, "I do not feel that I am in control of ... Instead it is in control of me." In other words, we are dealing with a situation in which some mental subsystem has become independent of the system of conscious control - has become slightly dissociated.

As Hypnotherapists, what are we trying to do in such cases? Are we trying to increase the separation between the systems? Are we trying to let the conscious mind have less control? No, it is quite the reverse: we are trying to reduce the separation: to bring the subsystem back into contact and control again.

Yet again, have you not met clients for whom a problem has been started by some comment made by another to them? The words: "It is your fault!", "You are stupid!", "Sex is dirty!", etc, have stuck somewhere in the mind and been acted on ever since with all the characteristics of a post-hypnotic suggestion. And what do we do then but remove the power of those words, eliminate their quasi-hypnotic autonomous control of the person. We are effectively de-hypnotising.

All the above examples should make it clear why I say that in Therapy I find myself striving to unite subsystems, to create an integrated and harmonious whole. By contrast most of the typical phenomena of hypnosis, particularly of the stage variety, are working in quite the opposite direction: they are implanting suggestions cut off from the normal conscious personality. They want effective amnesia for normal associations when acting out a suggestion.

It is for these reasons, I think, that I do not find myself using a typical stage-hypnotist's techniques. My goals are so very different.

The great value of knowing about such techniques and the results thereof is that it gives one a great awareness of the way in which we work. If you know how to do something it is a great help if your main task is to undo such things.

It is partly for those reasons also that I am strongly against a narrow definition of Hypnotherapy as I have written elsewhere in this Journal. To my mind the Hypnotherapist is far more often using a knowledge of hypnotic phenomena to eliminate them rather than `hypnotising': creating new barriers, dissociations etc.

Of course I am aware that my ideas may be biassed by my own world view, which is one in which:

harmony is preferred to discord, cooperation is preferred to strife, integration is preferred to segregation, democracy is preferred to dictatorship, conciliation is preferred to confrontation and so on.

Finally the thing that makes me most uneasy about the dissociated hypnotic personalities on stage is that they have no sense of humour. To be fully human is to be able to laugh, especially at oneself.

This article first appeared in the Journal of the National Council of Psychotherapists and Hypnotherapy Journal, winter 94.

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Practical Psychotherapy: Interview and Diagnosis

The Disciple came into the presence of the Master and said, "Oh wise one, I am tired of my ignorance. Tell me all the right answers, so that I may also become wise."

And the Master replied, "You are right in calling yourself ignorant. Only the ignorant think that wisdom lies in right answers. The wise merely know the right questions."

ANY DECENT medical course will place a lot of emphasis on diagnosis. But I have yet to read a book on Hypnotherapy which devotes any time to this essential process, while books on Psychotherapy which do devote time to diagnosis are concerned almost exclusively with clinical problems: schizophrenia, clinical depression, obsessive-compulsive disorder etc.

We are not generally faced with such severe problems, but we ARE faced with a variety of problems and it is our job to define clearly in our minds what the problems are, so that we may find the most effective method of solving them.

In this article we will be looking at some ways of tackling this aspect of our work.

Net or line?

There are two traditional ways of catching fish: a net or a line. The two traditional ways of finding out what is in someone's mind are either the trawling technique of letting him or her talk and talk without interruption, at the end of which you hope to have caught all information of value, or the line and hook technique of asking questions. (And if you look at a question mark in a certain way it does look a bit like a hook, does it not (try up-side-down)?)

In practice we may use a combination, with due sensitivity to the inclination of the client. At one extreme I remember one client who gave me the story of her life for six hours, spread over four sessions, as smoothly as if it were a written autobiography. It would have been quite wrong to interrupt during the telling: we must always remember that there is for many a definite need to be listened to and understood, quite apart from any other help offered. At the other extreme there are individuals whose minds are so confused that it is necessary to ask some specific questions in order to tease out any semblance of order.

As a matter of technique I am going to propose a number of questions. They can be thought of as hooks with which to catch the essential information, or as hooks on which to place the information gathered by a trawling technique. As a first example of this we have:

HOOK 1. As an opening question, use "How would you like to start? Some people prefer to talk about the problem in their own words. In other cases it is easier if I ask questions. Which would you prefer?"

The nature of the problem

The only reason clients come is because there is something bothering them. But it is very important to avoid jumping to conclusions. I have lost count of the number of times I have talked with a prospective client on the phone, and after five minutes been quite confident that I understood what the problem was, only to find at the first session that I had got it quite wrong. One reason why this happens is that clients will not open up about very personal matters until they have achieved confidence in the therapist. Thus they may start by talking vaguely of stress and needing to relax, when what really worries them is a sexual problem. At times this can be reversed. One client presented her problem as being extreme masochistic tendencies in her sexual relationships, but it slowly became obvious that the real worry had to do with avoiding facing certain deep fears and insecurities. For her the latter showed weakness, and weakness she despised far more than a mere sexual deviance.

Another reason for initial problems is the different meanings that people give to words. "Paranoid", for example, means to some people something like "mad", to others "emotionally disturbed", to others it means "thinking others are scheming against me". None of these is what is meant by the word in its technical sense as, "The name given to one type of functional psychosis, viz. that in which the patient holds a coherent, internally consistent, delusional system of beliefs, centering round the conviction that he (or, more rarely, she) is a person of great importance and is on that account being persecuted, despised, and rejected." Gregory (1987)Bib.

Here are some questions which can help to clarify the exact nature of the problem, and to avoid any misunderstandings about it.

"Tell me in your own words about the most recent time when you had this problem."

HOOK 2. "What feelings did you have at the time?"

HOOK 3. "What physical sensations did you notice at the time?"

HOOK 4. "What were you thinking at the time?

The purpose of these specific questions is to build up a clear idea on your mind of the complex processes which are going on in the client. Let us take for example a person who comes stating that the problem is "blushing". This one label can stand for a variety of different problems. We might find that a particular female client blushes only in the presence of a male in authority and that it is accompanied by feelings of fear, physical sensations of trembling and thoughts that she hopes he will not approach any nearer. (We may then suspect that the problem is primarily sexual.) Another client might report that it only arises when he is about to address a large group of people, at which point he feels very self-conscious, there is a sensation of shaking in the voice and the thoughts in his head are, "I am going to make a fool of myself." (We may then suppose that the central problem is self-confidence, or similar.) It will be clear that the psychodyanamics of these two cases are totally different, and consequently any help given is also likely to be on quite different lines.

Although I have indicated one-line answers to the questions above, in practice the questions will stimulate quite a lot of information which will throw more and more light on the problem, and often show it to be fundamentally different from what it first appeared.

Origins

Problems do not generally arise for no reason. Extreme phobias of water do not arise without cause, for example. It is usually very important therefore to use

HOOK 5. "When did the problem start? Tell me about the earliest occasions you can remember."

If we find that the first time the client approached a swimming pool she nearly drowned, as happens not infrequently in the case of such a phobia, we have found out something of great importance when it comes to solving the problem.

But this question may also show up any changing patterns in the problem over the years. It is a common phenomenon for an initial problem to become confused in many ways as time passes because the worry about the initial problem can generate further symptoms which can in turn create further anxiety or depressions.

There are times, however, when the connection between the origin of the perceived problem and the real cause is not so obvious. A classic instance of this is the delayed onset of extreme distress, anxiety or panic attacks which can arise six months or more after a bereavement. Typically the bereaved person has repressed the grief for that time. More extreme cases involve the repression of traumatic material from as far back as early childhood.

In order to discover such origins the following questions (6 and 7) are very useful.

HOOK 6. "Can you think of any big changes or upsets or bereavements in the year before it started?"

It is a fact that most people find most big changes rather traumatic, but the current ethos is that we should be able to adjust to them with the ease of well-oiled machines. As a result quite a few problems arise that we, as therapists, can help comparatively easily, because they involve short-term transitions. The client merely needs some help and support while going through a change in life.

In order to find out about the possibility of earlier traumatic material being responsible the following is a very useful question.

HOOK 7. "When you are in that state, how old do you feel?"

I have a client at present who, when entering into certain distressed states, begins to behave and talk like a three year old. This is a clear indicator of what is currently being revealed as a problem rooted in extensive homosexual abuse at that age.

If it is possible to talk to another member of the client's family then material to hang on Hook 7 is usually very easy to obtain, as child-like behaviour is more easily noticed from the outside.

Why is it still a problem?

By the time we have obtained by one means or the other the answer to all the above questions we should have a very clear idea of the precise way in which the problem affects the client, and how it arose. The next really important thing is to find out why it has not disappeared.

It is always worth remembering that problems of all sorts have arisen through the ages. Psychotherapists are inclined to forget that people survived the most appalling traumas through all the history of mankind before the science of psychotherapy arose in the last century. At another level it is worth remembering that everyone on the face of the world has had the "problem" of bed-wetting. The only differences between us lies in the age at which we grow out of it. Most people are nervous in front of an audience at some age, but most who have to address an audience frequently usually overcome the fear naturally. Most people experience grief at a bereavement. But most people get over it in what we may call a natural way: i.e. without professional help.

I am suggesting that the norm is that people do overcome problems one way or other. So it is really important to find out why, in a particular client, the problem continues to be a problem. I will formalise this as a tool for thought.

HOOK 8. Why has the client still got this problem?

To remind yourself of this important point the following is a very important question to ask, for that reason and others as well.

HOOK 9. "What have you tried before, in dealing with this problem?"

This will very rapidly fish out the history of any medical interventions; whether the client has been to see other therapists and any practical ways they have tried themselves.

The most common reasons for a problem to continue are the following.

a) There may be repressed emotional material, which the client has no conscious access to, and it is the driving force behind the problem.

b) The way in which the client is thinking about or treating the problem is actually making the problem worse.

c) There are external factors in the client's life which are maintaining the problem.

We would hope to have uncovered factors a) and b) by the lines of inquiry above. The most common pattern for b) is illustrated by the father in this little story.

"This father took his little girl to the playground. She wanted to go on the swing. He let her, but stood by to make sure that she swung safely. To begin with he was happy, but then he noticed that she was starting to swing to what he felt was a dangerous height. He decided to "take control" and, when the swing was at its highest, pushed it down firmly. For a few seconds he was relieved to see the swing descending rapidly. But then, to his alarm, it rose even higher than before. He had learned nothing, however, and in his alarm he again pushed down firmly when the swing was at its highest!"

You may picture father and child together getting into a more and more frantic state with every swing of the swing.

Steinbeck, in his book Sweet Thursday writes, "There are some people who will say that this whole account is a lie, but a thing isn't necessarily a lie even if it didn't necessarily happen. There are far too many people who make their problem, whether it is anxiety, hypochondria, shaking etc. etc. worse by acting just like that father and panicking when the problem is at its peak with the predictable result of making it even worse the next time.

External causes

Let us next turn to the third big class of reasons why the problem continues: external factors. Such factors most commonly involve other people. Here is a question which will rapidly reveal problems in that area.

HOOK 11. "What do people close to you advise?"

This may seem a little indirect, but it gives a way for the client to talk about husband or wife or father or mother without seeming to blame them at all. This is quite important, for a lot of problems arise because a person does not feel that it is right to go against the feelings or opinions of a loved one. Nevertheless the answers should reveal to you the extent to which the family, friends or employers are the cause of the continuation of the problem.

Related problems

There is another potentially very important area that the above questions may fail to fish adequately. It is quite common for the initial presented problem, as observed above, to be at most part of a more general problem or problems. It is often necessary both for reasons of time, and for reasons of allowing the client to gain trust in you, to leave this area until a second session. But sooner or later it is well worth bringing out in some form the question:

HOOK 12. "If you look back over your life, would you say that you have had any other significant problems to deal with?"

This might catch significant facts like hating boarding school, a disease, an aborted child, a broken relationship, a sleep problem, sexual malfunction and so on, which the client may not think to be relevant, though they often are.

Collect your own hooks.

I have suggested twelve "hooks" or questions above. It will be obvious that they are not to be applied like an inquisition. In many cases they will remain unspoken, though we will have them in our minds in order to structure the form of the discussion. You will have many of your own favourite questions. Perhaps you are not fully aware of what they are. It can be a useful exercise to note down those that have passed the test of time. (And you may care to share them with others

The disciple said, "Thank you, wise master, thank you. I will immediately seek the right questions and then I, too, will be wise." And he left.

The Master shook his head sadly. "Once a fool, always a fool. There is no wisdom in merely knowing the right questions. Wisdom begins with understanding the answers to the right questions."

Reprinted from the Journal of The National Council of Pscyhotherapists and Hypnotherapy Register, Autumn 93.

Footnote: I wonder how carefully you read the above? Bruce Quinby CHT, in October 2008, was the first to write to me to point out that THERE IS NO HOOK 10 mentioned in the above article! This omission was in fact a simple blunder on my part. Life is full of mistakes. We all make them. We need to be tolerant of the mistakes others make. And we need to learn how to gain something from each of our own. In this case I will simply reframe the omission as follows: "The missing Hook 10 is one for YOU to think of for yourself! It may well be the best of the lot. Any suggestions will be added below."

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Good Advice

Dylan Morgan

When I was just a small boy
My father said to me,
"Destroy all weeds without delay
Or they will destroy thee."
And so with heat gun in my hand
I go out every day
And burn all weeds, and all around
That dares get in my way.
It makes me feel such virtue.
It makes me feel so good.
But my garden never seems to grow
Or flower as it should.

When I was just a little girl
My mother said to me,
"Waste is a sin, save all you can,
And you will wealthy be."
And so I have saved every crumb,
I saved up every scrap.
And nothing have I thrown away
That fell into my lap.
But now my house is far too small
I cannot move within,
And my twenty stone of body
Just will not seem to slim.

When I was just a little boy
My father I heard speak:
"Be strong, my son, and never show
Your feelings. That is weak."
And so I keep a poker face,
I keep it day and night.
And never frown nor smile nor cry.
I know that I am right.
I was strong when my wife left me,
And when I lost my friends,
And I am strong though unemployed.
I'll be strong when my life ends.

When I was just a little girl,
My mother loved me so.
"All men are dirty", so she said,
And kept me clean. And watched me grow.
And I have kept away from dirt
Each month of my life.
I never have been sullied,
No man made me his wife.
But I am sad now as I reach
The closing of my days,
That I've no daughter of my own
To teach her cleanly ways.

When I was just a little boy
My sailor Dad told me
To "Keep your room ship-shape, my lad,
Or you may drown at sea."
Now I have children of my own
I shout and storm at them
Because their rooms are such a mess:
For their own good I punish them.
But all the same their faces fall
When I come in the door.
And just today my daughter dear
Has left to be a whore.

When I was just a little girl
My mother taught her ways.
"All household dust is like the plague
Avoid it all your days."
I move nothing to disturb it
And move with greatest care.
And shout to warn the others
Of the dangers lying there.
How strange my house is dustier
Than any other wife's.
How strange the others all prefer
Any other lives.

I'm proud to be a Pharisee
I'm proud I keep the Laws
My fathers handed down to me
Perfect, without flaws.
I pay my tithes of mint and herb
My hands are clean as clean
I don't consort with sinners
No evil have I seen.
And when someone accuses me
And says my gain is loss,
He must be mad or bad you know
Fit fodder for a cross.

My father was a farmer poor
And Bible tales he told
Of sorting out the wheat and tares
Of shepherds and the fold.
I am not very clever
and rules I may not keep.
But I know that I am loved
And love each of my sheep.
And at my end my every grain
Shall enter Heaven's store.
And every tare among my grain
Be forgotten evermore.

The meaning of this poem will probably be clear to every therapist. How many times have we had clients whose lives have been crippled by having absorbed as an absolute truth about life one that is only relative? Very well-meaning parents pass on to their children the fruits of their experiences of life - or of their own parents' passed-on wisdom - with no thought for the fact that the world in which their children are to live can be very different or that their children may have very different natures and characters.

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Humour

Serious things cannot be understood without humorous things, nor opposites without opposites. - Plato.

A LECTURER on psychology was explaining to a female student the power of analytic psychology.

"For example," he said, "I notice that you always draw a line at the end of your essays."

"Yes, I do," she replied, "But what does that tell you?"

"It would indicate that when you have finished something you do so very definitely. I can deduce that when you finish a meal you place your knife and fork very neatly on the plate."

"Yes, that's true," admitted the student.

"And that will indicate that when you do the washing up you will do it completely, dry it and put it away."

"You're right!" exclaimed the woman.

"These habits in turn suggest a woman who desires to become a good wife, and is probably already in a steady relationship."

"Right again!" she replied with a smile.

"And I can further deduce that you are very loyal and faithful. You would not, for example, have a one night stand with, shall we say, your best friend's boy-friend."

"Amazing!" said the girl. "I had no idea you could know me so well from such a small thing as the way I end an essay!"

She went away very much impressed with all this and was determined to tell someone. So when she next saw her best friend she said, "Psychology is a brilliant subject. It tells you so much. For example: do you draw lines at the end of your essays?"

"No," replied her friend.

"Oh!" said the student, and then a moment later she added in a fury, "How dare you sleep with my boy-friend!"

. - o O o - .

A Child Psychologist was spending a holiday in laying a new drive to his garage. He had finished and was standing back to admire the perfect level surface when the small boy who lived next door rode up on his bike with great enthusiasm. Such was his momentum that he managed to get half way up the drive before collapsing in a sea of concrete.

The Psychologist released his anger in a furious and unexpurgated outburst which brought the boy's mother out to see what was happening.

"You, of all people," she exclaimed, "should have some sympathy and understanding - you are supposed to love children!"

"Madam, I do" he replied, "in the abstract, but not in the concrete."

Adapted from an "old chestnut" found in "Sleeping Dogs Lie" by Julian Gloag.

. - o O o - .

Solicitor: Your husband is asking for a divorce.

Woman: On what grounds?

Solicitor: On the grounds of your incompatibility.

Woman. Ridiculous! He's the one who's incompatible!!

- Morien Morgan

. - o O o - .

The following is a verbatim transcript of a client's remark - Ed.

I HEARD on the radio about this wonderful book, "Learning how to live without clutter". I made a note of it at the time. Unfortunately it has got lost somewhere in the mess!

. - o O o - .

An executive came back from an assertiveness course. It had been suggested that he place a card on his desk to remind himself of what he had learned. So he carefully wrote out:

BE DECISIVE

Then he stood back to look at it, considered it, and carefully added a question mark:

BE DECISIVE?

- o O o -

A PSYCHOTIC killer had finally been trapped by the police in his hide-out. A martial arts expert, a counsellor and a hypnotherapist all volunteered to get him out.

The martial arts expert broke open the door with a well-aimed kick and then dived to the attack. There was a sound of gun-fire and his dead body was flung out.

The counsellor then walked very slowly towards the house and began to reason with the killer. Then a single shot hit him in the leg and he fell to the ground.

Despite all warnings the hypnotherapist was determined to try, and approached the house. Ten minutes later he emerged, hand in hand with the unarmed killer.

"How did you manage it?" everyone was anxious to know. "Why didn't he shoot you too?"

"Simple. I merely regressed him to childhood: he couldn't hurt me with a water-pistol!"

- o O o -

A MAN telephoned a psychotherapist.

"I wonder if you can help with a difficult problem."

"I might be able to. Tell me about it."

"It is my wife. She thinks she is a hot water bottle. Do you think you can help?"

"Hmm. It is unusual, certainly. But I have helped worse cases. Tell me, how does the problem manifest itself?"

"Well, she spends every night warming my neighbour's bed for him."

. - o O o - .

Psychotherapist: What seems to be the problem?

Client: Well, as far as I am concerned it is my family. You see, I love books, and they think that there is something wrong in that: they say that I love them excessively.

Psychotherapist (with strong feeling): How ridiculous! They are quite wrong. It is an excellent thing to love books. I love them myself, and always have done.

Client: Oh, it is such a relief to find someone who understands! How do you like them best: boiled or sautèed?

- o O o -

Have you heard the one about the woman who went to see a Freudian analyst?

"Doctor, please tell me what is wrong with me. I was standing at the jewellers counter. He had put a lot of rings out for me to look at. Then, when he turned his back to the counter I quickly transferred some rings from the counter to my bag. Please tell me. Am I suffering from kleptomania?"

"Nein, nein," replied the analyst soothingly, "It is ein simple example of Counter Transference."

- o O o -

A woman phoned a hypnotherapist a few days after her depressed husband had seen him.

"Excuse me phoning, but I am very worried about my husband. He can't remember anything about his session with you. What did you do to him?"

"I am sure there is nothing to worry about," replied the hypnotherapist suavely, "It is quite normal to have amnesia for the hypnotic experience. Your husband was suffering from a mild endogeneous depression and so I simply repeated to him in a trance that he would be `Better and Better Every Day, Better and Better in Every Way.' It is an excellent technique. I can't see that anything can go wrong. What exactly are you worried about?"

"I see. Did you know he was a little deaf?"

"Yes, but that has nothing to do with his depression."

"But I think it may have a lot to do with the new problem. Since you saw him he has lost a fortune BETTING: every day and in every way!"

- o O o -

THE WIFE had become so domineering that her husband insisted she see a psychiatrist. The wife consented, and the couple went to a doctor. The husband waited outside, and when his spouse emerged after the hour-long session, he asked, "Did you make any progress?"

"Not much," she replied. "It took me 50 minutes to convince that man that his couch would look better against the wall."

Columban Fathers Mission, reprinted in the Readers Digest.

. - o O o - .

Small girl to mother: Let's play that I'm your Mummy.

Mother (horrified): Oh no, we can't do that, darling! I'm too busy playing your Mummy.

TM

. - o O o - .

A PSYCHOTIC killer had finally been trapped by the police in his hide-out. A martial arts expert, a counsellor and a hypnotherapist all volunteered to get him out.

The martial arts expert broke open the door with a well-aimed kick and then dived to the attack. There was a sound of gun-fire and his dead body was flung out.

The counsellor then walked very slowly towards the house and began to reason with the killer. Then a single shot hit him in the leg and he fell to the ground.

Despite all warnings the hypnotherapist was determined to try, and approached the house. Ten minutes later he emerged, hand in hand with the unarmed killer.

"How did you manage it?" everyone was anxious to know. "Why didn't he shoot you too?"

"Simple. I merely regressed him to childhood: he couldn't hurt me with a water-pistol!"

JDM

. - o O o - .

A MAN telephoned a psychotherapist.

"I wonder if you can help with a difficult problem."

"I might be able to. Tell me about it."

"It is my wife. She thinks she is a hot water bottle. Do you think you can help?"

"Hmm. It is unusual, certainly. But I have helped worse cases. Tell me, how does the problem manifest itself?"

"Well, she spends every night warming my neighbour's bed for him."

THEN THERE was the hypnotist who planted the following post-hypnotic suggestion.

"When the session is over I will ask you to pay and you will say, `That was a brilliant session. I must pay you twice your normal fee.' You will say that but you will forget everything I have said in a trance. You will forget everything I have said."

A few minutes later the subject was woken up, and the hypnotist said, "Now that is the end of the session. It only remains for you to pay me."

The subject, a Yorkshireman, replied, "Session? Ah know nowt abaht t'bloody session. Ah'll not pay good brass for nowt. Good day to you!"

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A Definition of Hypnosis?

The American Psychological Association (APA) has recently published, after much deliberation and consultation, a document purporting to be a "Definition and Description of Hypnosis" for the general public.

This document has been made the basis of a survey of the opinions of the 320-strong British Society of Experimental and Clinical Hypnosis (BSECH). The results of this survey were published in Contemporary Hypnosis (1994) Vol II, No 3. Sixty of their three hundred and twenty members replied that they agreed with the APA document. Others made a number of cogent criticisms.

The original document is reproduced below for the judgement of members of the NCP&HR, together with the main points raised by BSECH members in response. Finally there is a letter written by Dylan Morgan on the subject to Contemporary Hypnosis: the BSECH Journal.

DEFINITION AND DESCRIPTION OF HYPNOSIS

Hypnosis is a procedure during which a health care professional or researcher suggests that a client, patient, or subject experience changes in sensations, perceptions, thoughts, or behaviour. The hypnotic context is generally established by an induction procedure. Although there are many different hypnotic inductions, most include suggestions for relaxation, calmness, and well-being. Instructions to imagine or think about pleasant experiences are also commonly included in hypnotic inductions.

People respond to hypnosis in different ways. Some describe their experience as an altered state of consciousness. Others describe hypnosis as a normal state of focussed attention, in which they feel calm and relaxed. Regardless of how and to what degree they respond, most people describe the experience as very pleasant.

Some people are very responsive to hypnotic suggestions and others are less responsive. A person's ability to experience hypnotic suggestions can be inhibited by fears and concerns arising from some common misconceptions. Contrary to some depictions of hypnosis in books, movies or on television, people who have been hypnotized do not lose control over their behaviour. They typically remain aware of who they are and where they are, and unless amnesia has been specifically suggested, they usually remember what transpired during hypnosis. Hypnosis makes it easier for people to experience suggestions, but it does not force them to have these experiences.

Hypnosis is not a type of therapy, like psychoanalysis or behaviour therapy. Instead, it is a procedure that can be used to facilitate therapy. Because it is not treatment in and of itself, training in hypnosis is not sufficient for the conduct of therapy. Clinical hypnosis should be used only by properly trained and credentialed health care professionals (e.g. licensed clinical psychologists), who have also been trained in the clinical use of hypnosis and are working within the area of their professional expertise.

Hypnosis has been used in the treatment of pain, depression, anxiety, stress, habit disorders, and many other psychological and medical problems. However, it may not be useful for all psychological problems or for all patients or clients. The decision to use hypnosis as an adjunct to treatment can only be made in consultation with a qualified health care provider who has been trained in the use and limitations of clinical hypnosis.

In addition to its use in clinical settings, hypnosis is used in research, with the goal of learning more about the nature of hypnosis itself, as well as its impact on sensation, perception, learning, memory, and physiology. Researchers also study the value of hypnosis in the treatment of physical and psychological problems.

BSECH Comments

The main queries and objections raised by BSECH member to the above can be summarised as follows.

• The APA have failed to provide a clear definition of hypnosis by muddling it up with the description.

• this totally neglected the central feature of the effect on the subject.

• The statement on individual differences fails to distinguish between the experience of hypnosis and the degree of responsiveness.

• Some disagreed strongly with the sweeping statement that subjects do not lose conscious control over their behaviour. They felt it was more of an attempt to `clean up' the image of hypnosis than a statement of fact.

• The statement is too reassuring: there are dangers in the use of hypnosis if complications are not recognised.

• There was only mild questioning of the statement that hypnosis is not a therapy in itself.

• The APA statement fails to distinguish between those who do use hypnosis and those who, they feel, should.

• There are many groups of people other than `licensed clinical psychologists' who were felt to be entitled to use hypnosis. Social services professionals, medical and dental practitioners, qualified nurses, speech therapists, physiotherapists and educational psychologists and, of course, members of the NCP&HR are examples.

• Several respondents forcibly complained that what was supposed to be a definition actually ends up prescribing who should practise.

Letter to Contemporary Hypnosis from J.D. Morgan.

THE AMERICAN Psychological Association (APA) has produced a "definition and description of hypnosis" (Fellows B, Contemporary Hypnosis, 1994, p. 142).

As several respondents to Brian Fellows' survey noted, whatever it was the APA produced, it was not a definition. The reason they failed was a consequence of a categorial confusion of a nature which has been well-known since Bertrand Russell's Principia Mathematica. The essence of the confusion is the epistemological failure clearly to distinguish between a set and a member of that set. In the present context confusion arises by the use of the same word - hypnosis - to describe both a field of knowledge and one of the phenomena within the field.

We see one use in such phrases as "contemporary hypnosis", "experimental hypnosis" or "clinical hypnosis". We see the other in usages such as "hypnosis is a procedure", "people respond to hypnosis", "hypnosis has been used", "the subject is in hypnosis".

A clear way to provide the required definition, with the above distinction in mind, is the following.

Definition: Hypnosis is a particular field of human knowledge. The field (like all others) is defined by its subject matter, which is the naturalistic alteration of the functioning of cerebral, nervous and physiological systems in the human being.

The word "naturalistic" excludes the production of such alterations by means of such things as chemicals, electricity or magnetism, force or lesions.

We may add a few other useful secondary definitions:

There are certain common and typical alterations such as those involved in the production of analgesia, amnesia, atonicity of muscles, selective attention, hallucinations, age regression etc. - the standard material of the textbooks of hypnosis. These will be termed hypnotic phenomena.

There are certain common procedures which are known and practised in order to produce these changes. These are called hypnotic procedures. They have varied considerably down the years, just as medical procedures have changed. (The APA document's emphasis on hypnosis as a procedure would cast doubt on whether Braid and Mesmer were "using hypnosis".)

There are certain sub-fields of hypnosis, as of any other mature subject. They may be consistently denoted by such phrases as experimental hypnosis, clinical hypnosis, dental hypnosis, theoretical hypnosis and analgesic hypnosis, whose meanings are self-explanatory, and again depend on their subject matter. We might wish to use the phrase stage hypnosis to denote the specialised use of certain hypnotic techniques for entertainment purposes.

The following is a deduction from experimental results (as well as being implicit in the APA's statement, "People respond to hypnosis in different ways.").

There is a very wide continuum of different alterations which can be produced in different people by means of different procedures and with different goals. There is no one change which is unique to all. The use of statements such as "Hypnosis is a procedure", or "Hypnosis is a state" is therefore untenable and leads to confused thought about hypnosis.

The above approach to defining our subject avoids the many flaws of fact and logic in the APA document so well noted by BSECH members.

1) It is a clear definition.

2) It avoids the pitfall, noted by Fellows, of defining hypnosis as a procedure, without falling into the opposite pitfall of defining it as a state.

3) It does not confuse a definition with a moral judgement (yet another categorical error of the most gross kind of which the APA is guilty).

4) Neither does it confuse it with the distinct question of who should use which hypnotic techniques, where and when. Such a question is ultimately legal, and to be decided by society as a whole.

5) It avoids the other tendentious elaborations within the APA document which led to other well-warranted criticisms cited in Fellows' paper.

6) It lays a foundation for a clear description of contemporary (as opposed to historical) clinical hypnosis, if it is desired. Such a description might include in outline the more common (but not universal) current practices and the common subjective experiences.

We may further note that the definition inevitably implies that there is no hard edge to the subject. Just as physics overlaps geology, astronomy and chemistry in certain areas, so hypnosis overlaps psychology, education, medicine, religious practices and even creative fiction at certain points. It does so without losing its identity.

An elaboration of the above approach was presented at the BSECH conference, 1992, the proceedings of which have yet to be published. It may also be found in The European Journal of Clinical Hypnosis, 1, Oct. 1993.

As a final comment on the APA document it is worth remembering that "the Public" includes everyone who has not been trained in the field of hypnosis. Thus lawyers, scientists, historians, philosophers and many others who can think logically and clearly are included in "the Public". It would be a useful exercise to test the reaction of such intelligent outsiders to the APA document, put side by side with the responses of BSECH members and the above alternative definition. Perhaps they would side with the 81.5% of BSECH members who have not endorsed the APA "definition".

This article first appeared in the Journal of the National Council of Psychotherapy and Hypnotherapy Register, Winter 94.

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Iatrophobia Induced by Circumcision

THIS BRIEF ARTICLE is designed to draw members' attention to a rather specialised matter which might be relevant in cases in which a client has a pronounced fear of doctors: iatrophobia, from the Greek iatros, physician. It is also relevant to certain sexual problems in the male.

The matter came up incidentally from the accounts of a client whose primary problem lies in another direction. The evidence is quite simple, and is as follows. The client, now in his late forties, has always had an intense fear of hospitals, doctors and nurses. A simple medical inspection at school was a torment. And yet he had never been ill enough to go to hospital nor had he ever been treated for anything at all serious.

The second fact is that through his life he has had a recurrent nightmare which is essentially that of a terrible pain at the end of his penis.

The third fact is that, like many of his generation, he was circumcised in infancy.

Conclusion

I think that it is an inescapable conclusion that these facts are related. We need only suppose that the surgeon did not think that a local anaesthetic was necessary. (I am informed by Dr. Warren, see below, that in fact it is normal practice in neonatal circumcision NOT to use a local anaesthetic!) It may also be relevant that this particular client retains very vivid memories from surprisingly early ages in other ways.

The moral is that IF you have a male client with an unaccountable iatrophobia you might like to ask further questions about circumcision.

Uncircumcision

Circumcision can also create more general psychological problems in some men. Should you come across a client with these problems then he may be interested to know of a movement which has started in the States which aims to reverse the process.

The key reference is The Joy of Uncircumcising! by Jim Bigelow PhD, Aptos CA, Hourglass Publications, 2nd edition 1995; available from UNCIRC, P.O. Box 52138, Pacific Grove, CA 93950; telephone/fax 001 408 375 4326.

The process is simple in principle. Tapes are first used to pull the skin of the penis forward a little over the glans. After a few months of progress the next step is to attach a cylindrical weight of over a pound to the skin by means of tapes, to further encourage growth of a new foreskin.

Some individuals have reported great success with this scheme, which takes a year or two. Others find it difficult through soreness or inconvenience.

If a man is sufficiently distressed by circumcision then he may be motivated to take this path.

There is a doctor in this country (the UK) who has become involved in helping such men. In the course of this work he has been able to do a survey of the feelings of those who have been interested in foreskin restoration. The most common reported feelings were as follows: Sense of mutilation (74%), Appearance (74%), Lack of sensitivity (74%), Being different (61%) and Discomfort due to chafing on clothes (50%). Only one out of 38 respondents spontaneously reported the fear of hospitals mentioned by my client.

The current rate of circumcision in the UK is about 7%, which makes it quite rare, but consequently the psychological effects of feeling different are likely to be greater. Circumcision was much more common in the early part of this century, reaching a peak of about 30%, so there is a greater population of men in their forties and above who may have problems, but on the other hand the fact that so many of their contemporaries are similar should have reduced the psychological problem.

Address

In case you have an interested client, Dr. Warren's address at the time of writing was Dr. John Warren FRCP, 3 Watlington Rd, Harlow, Essex CM17 0DY

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All You Need Is ... ?

IN THE 850-page "Oxford Companion to the Mind", Logical Positivism leads straight on to Lunacy.

Perhaps it does.

Can you see what has been skipped over without mention? It is something which most acknowledge to be of the greatest importance in life. It gives meaning and a sense of wellbeing to all. Without it, life is a desert of depression and misery. It is something needed from the cradle to the grave and its presence or absence is of vital importance to the health of an individual.

The answer, of course, is Love.

In this short essay I am going to argue that one of the most important causes of problems which we as psychotherapists face is a lack of love, and one of the most important cures is therefore restoring love to a life which has lost it.

We will have to consider forms of love and also ways in which a therapist may properly ensure that the client regains it.

Love ignored

Why is love ignored not only in the above book but in so many others on psychology? One reason is the difficulty of measuring it and of evoking it under experimental conditions. It is quite easy to produce pain in someone in response to some stimulus: an electric shock will do nicely. Consequently we have a vast literature on pain and stress and fear and anxiety. But there is no clear way that love in any of its forms could easily be produced in a laboratory, nor measured if it could be.

A second reason is an almost universal fact of human psychology: we pay an enormous amount of attention to things when they go wrong, but soon take for granted things when they go right. News programmes deal primarily with wars, floods, murders, frauds, disasters and calamities of all kinds, while any good news tends to be consigned to a small item at the end. Medicine concerns itself with studying illness, so there is little literature on health. As individuals we get enormously upset about a small problem such as toothache, but seldom rejoice when all the millions of internal processes in our bodies function smoothly and without pain. It is therefore not surprising that the psychology which such a species will produce will concentrate on the problems - the fears, depressions, anxieties, compulsions, guilts, griefs and so on - and pay almost no attention to the positive things.

It is as if a clinical psychologist came across a crying baby and noted the tears and the tensions in the body; measured the abnormally high pulse rate and the hyperventilation; yet ignored the only important fact: the mother is not there. So love is not there. When the mother IS there, there is nothing for the clinical psychologist to notice, so he never needs to study love when it is present, and fills his journals with accounts only of the symptoms of the absence of love, without ever realising that love is the key to the situation.

Love is known

Love is one of the most important positive things in life, and nearly everybody is pretty clear about when they are loved and when they love, and can clearly distinguish between forms of love. For example, any mother knows what it is to love her baby, her own mother and father, the father of her child and herself. Each is a form of love and each is distinct.

If I have any hard-nosed positivists in my readership who dismiss love as being too subjective to be worth dealing with, I will argue that we can discuss love as perceived by an individual (if we can do no better) in the spirit of Dennet's heterophenomenology described in his Consciousness Explained Bib. The rest of us may be content with knowing that we have a sufficiently real sense of what love is to be able to talk about it freely.

Some examples

In order to arouse in our minds an awareness of how important love is in therapy, I will refer very briefly to some broad classes of problems that arise frequently.

Marital problems are nearly always about love. Suppose that he has been unfaithful: she feels deprived of the love he previously showed her. At times the problems are about HOW love is to be shown. He might feel that love is about what you DO, while she may think that love is about what you SAY. So if he redecorates the house but does not say how nice her new dress is, she feels unloved. At the same time she may tell him she loves him but does not want sex as often as he does, so he feels unloved.

A child may be chronically unloved. Such a child can easily grow up to be an adult convinced that he or she is still unlovable. The "Child Within" is still unloved. This can result in lack of confidence, lack of assertiveness and anxieties or possibly aggression and violence, depending on the individual.

What are the problems which accompany bereavement if not largely a result of a loss of love? The familiar signs of depression, perhaps alternating with suicidal feelings, anxieties or panics and the like are the usual consequences.

Then there are the shy recluses: those who are deprived of that form of love we call friendship.

And there are the old who lack the family and friends they once had to love and for whom, therefore, life is a misery.

We may perhaps generalise and say that in the vast majority of problems in which there is emotional distress, the lack of love either in the present or the past is a central factor. Even in problems which seem at first not to have any strong emotional component - giving up smoking, for example - the loss of love can be very important. I had one client, for example, who started to feel very distressed as she gave up. It became clear that this distress centered around the fact that as a result of an illness, her husband had withdrawn very much into himself. The nicotine somehow helped her to deaden the feeling of grief for the love that they had had. In the end she preferred to go on smoking rather than face that loss daily.

I will presume also that my readers know at first hand many forms of love and the desolation of their absence, and that there is arguably no worse form of suffering.

Solutions

All the above problems are caused by a deficiency of some form of love. It follows that the most effective solution to the problems lies in regaining the love.

A case which exemplifies this is as follows.

A widow of many years came suffering from anxiety attacks. The probable cause was the fact that her daughter had grown up and no longer had much to do with her: she no longer had someone to love. She only needed one session at that time. Was that my doing? No. It was just that her best friend had died and the widower started to lean on her, needing her love. Her anxieties disappeared for many months. She returned a second time, with a recurrence of symptoms, only when he had stopped leaning on her.

In this case the solution, albeit temporary, had nothing to do with therapy. It illustrates that absence of love was the problem: a return of love the answer.

But this leads us to focus on the question: what can a therapist do in order to return love to a person's life?

Therapeutic interventions

It must be very clear from our Code of Ethics, printed elsewhere in this Journal, that the forms of love which a therapist may show are circumscribed. Any attempt to arouse feelings of romantic or sexual love in the client for the therapist is virtually forbidden. (In rare instances and very wise hands, transference in the Freudian tradition might be encouraged as a step in a process.) Any attempt to evoke in the client some other form of love which would lead to a long-term relationship would be frowned on, as we have to aim to end therapy as soon as possible.

Later on, after we have discussed forms of love in more detail, we will see that there is a form of love which is allowed, but again it should be seen as temporary.

These restrictions, together with common sense, lead to the conclusion that the primary task of the therapist is to tackle the problems that prevent the client from feeling the love which is available in many forms in the outside world.

Forms of love

The English language, despite possessing an enormous vocabulary, is rather limited when it comes to love. As is probably well known to many readers, the ancient Greeks had four words to distinguish forms of love. These were storge, philia, eros, and agape. Following C.S. Lewis, whose book The Four Loves is an outstanding analysis of these matters, I will translate these words as Affection, Friendship, Eros and Charity. Affection to the Greeks was typified by the love between parents and children. Friendship is the close bond between two individuals with shared ideas, goals, etc. Eros is love in the sense of "falling in love", and should be distinguished from pure sexual drive or lust, because although the two are related, it should be clear to most people that each can exist without the other. Finally agape is a selfless love of others, what in New Testament Latin is Caritas, or in English is Charity, not in the sense merely of giving to the needy, but in the Pauline sense of "Charity suffereth long, and is kind; charity envieth not; charity vaunteth not itself, is not puffed up, doth not behave itself unseemly, seeketh not her own, is not easily provoked, thinketh no evil, rejoiceth not in iniquity, but rejoiceth in the truth" (1 Corinth. 13, 4-6).

Those are the familiar St. James' version words. In a modern translation we have, "Love is always patient and kind; love is never jealous; love is not boastful or conceited, it is never rude and never seeks its own advantage, it does not take offence or store up grievances. Love does not rejoice at wrongdoing, but finds its joy in the truth."

Of these four we may say that in the above sense charity (notice there is no sense of condescension in it) is a form of love that may and probably ought to exist in the therapeutic relationship. Think about it. Do not the above words describe the attitude we feel that a therapist should have? And would we not all choose a person with such love if we ourselves should ever seek help?

So we may offer agape - charity. What about the others?

Eros is contrary to the Code of Ethics.

Philia - friendship - is really of its nature a long-term thing. Real friendship depends on a slowly matured sharing of experiences and thoughts. Friends are typically walking side by side, and their talk is typically of other things than themselves. (In eros most of the talk of the couple is about themselves.) These conditions are not met in therapy, where the focus of attention is on one person, and the process should not last too long. There is the possibility that after a course of therapy is finished, a friendship may develop without transgressing the Code of Ethics, but the point here is that it is not a form of love which can be offered in therapy. If you doubt this, then I would suggest that it may be because you are giving to the everyday word friendship a meaning which is a mixture of philia and agape, and that it is the latter component that you are thinking of as being present in your relationship with a client.

What of storge - affection? Remember that the root meaning of this was in the affection between parents and children. In practice an element of this will often creep into the therapeutic relationship. This is because most adults, when they are distressed and seek help, partially regress to the attitudes of childhood and consequently they project onto the therapist the role of a helpful and caring parent. It is certainly important to be aware of this, and to be able to handle the childlike persona which can so often emerge, even without a formal hypnotic regression. But the question of interest here is, "To what extent can one show parental love to the client?"

I would answer this by means of asking another question: "Once a child is no longer a baby, may it not be comforted as well, or even better, by a kind aunt or uncle, a grandfather or grandmother?" In such relationships there is still love, but there is more of the charitable and less of the parental about it. Anecdotal evidence suggests that it is often much more useful to the child. I would argue from this that, faced with a client who is adopting a juvenile role, the therapist should not (except for very cogent reasons) adopt the parental role with all the complicated projections that might ensue, but rather move into an avuncular role with its more charitable love. Notice also that such a role is far easier to disengage from: you leave an uncle with no sense of binding ties, however pleasant the meeting has been. This is consonant with our Code.

So my interpretation of Rule 7, to "maintain appropriate social boundaries", is that as a rule of thumb the relationship should be no more intimate than might exist between a child and a compassionate and understanding aunt or uncle, grandfather or grandmother; and that the dominant form of love shown should therefore be Charity, in the sense above.

How to increase love indirectly

We have now, by means of an analysis of the forms of love, shown the way in which a therapist may give love to a client. Is this enough? Is it true that "All you need is love"? In some cases the answer is "Yes". For some clients and some problems it is medicine enough. Some of the efficacy of the placebo effect and much of the success of many "alternative" practitioners arises, I believe, from the fact that the patient or client feels loved: someone is showing deep and caring interest. The thing that is done is often far less important than that sense of being loved.

It would be quite easy to test this hypothesis. It would only be necessary to divide a large group of patients into two. One group would be given a placebo (a neutral "pill") by means of an automatic machine at regular hours. Another group would be given a pill from an identical machine by a nurse who was instructed merely to be cheerful and attentive for a minute or two, with no reference to the pill. The difference in the two cases is love. I predict that if these groups were assessed by doctors with no idea which treatment the patients had received, the second group would have done far better.

The medical profession has made enormous strides in the last fifty years, but in the process of obtaining highly reliable techniques they have tended to lose what used to be called a "bedside manner": they have lost the ability to make the patient feel himself or herself to be in caring hands - to feel loved.

Into this vacuum we find that a large number of alternative practices have moved, high on attentive care for the patient, if low on proper testing of the efficacy of the supposed technique. And, as I have said, patients benefit.

For most of us it will be an obvious fact that to be loved in any way enhances well-being. But does it follow that all the therapist needs to do is charitably to love the client?

No.

A doctor who only shows love is far less effective, if at all, in curing TB, ulcers, diabetes, infections, etc., than another doctor who is able to use the excellent specific treatments based on a clear understanding of the processes involved in the human body. In a similar manner a "therapist" who only shows love is going to be far less effective than a colleague who also has a clear understanding of the processes underlying problems in the human mind and heart.

Analysis of the paths of love

I am next going to step back a little and look at love from the outside in order to reveal some of the processes involved. In particular I will be considering love from the perspective of biological systems, in the spirit of the two articles on a systems-oriented approach to hypnotherapy presented in the two most recent Journals. This involves, in particular, being aware that love, like all other mental and emotional phenomena, is a process and not a state, is dynamic and not static. We want to know how it changes and why it changes; what is preventing it from changing for the better and how to get it to change for the better.

We can start from the forms of love mentioned above. Notice that in general each form of love is focussed on different individuals, exhibits a different form of behaviour and has qualitatively very different feelings associated.

We are generally familiar, since the advent of Transactional Analysis, with the notion that an individual may have different personae such as an adult, a parent and a child. Each may be evoked at different times, and not necessarily by appropriate individuals. In Hypnosis we may go somewhat further and regress an individual to the point of reproducing almost completely the personality and behaviour at a younger age.

In the language of systems we may regard each persona as an internal system, consisting of a more or less coherent pattern of thoughts, feelings, memories and behaviours. It is a commonplace fact that any individual can display a variety of personae: has a variety of such high-level internal systems. In cases of split personality these systems are very different and disconnected. In quite an ordinary man the difference between his working persona and his domestic persona can be very large, but he will usually be able to remember things about each life while living the other: they are not totally disconnected. The two systems are very different, but connected.

With these ideas in mind it is quite easy to think of the different forms of love in the following terms. Each form of love corresponds to a different internal system; each is activated by different people or things; each has different patterns of response; each has different feelings. Thus one internal system is activated in the presence of a wife, another in the presence of a son, another in the presence of a dog, another in the presence of a friend and so on.

Common Factors

In the first part of this essay attention has been drawn to the differences between forms of love. Next let us look at what they have in common.

The common factor, I suggest, is that each system grows or flourishes in the presence of the beloved.

This is conspicuous in the case of falling in love, where the sudden nature of the process makes it easy to see a rapid growth in that part of each individual which relates to the other. For a while there is no thought of anything else, little attention to anything else: the system which is concerned with romantic love for the other dominates the individual completely.

The love between mother and baby can arise almost as quickly (though it is perhaps celebrated less in song, as the mother usually has other things on her mind at the time). It, also, increases the well-being of the baby and the mother in a favourable environment. The love between two or more friends typically emerges far more slowly, but also helps them to grow and to feel and to be more confident. Compassionate love between any individuals "blesseth him who gives and him who takes". (I assume I am not alone in feeling better in response to an improvement in a client?)

This same pattern is visible if we descend the ladder of loves down towards likings. Although we may say "I love this food", in this sense the meaning is more of an intense liking. We may readily notice that the digestive and gustatory systems are activated by a pleasing food, or even the thought of it. By contrast the thought of something which is of no interest to us as food produces no such activation of these systems.

In a similar way, then, I would suggest that the common factor in likings is that in each case some small subsystem of the mind becomes activated by that something in such a way as to direct activity towards getting more of it. If you like roses then a chance glimpse of a rose will activate that small part of the mind which recognises roses, and this will in turn motivate you to go over and take a closer look.

Broadly speaking I would suggest that the continuum which stretches from likings up through lovings is marked by increasingly large systems. We will only say that we "love" something if it arouses such a large subsystem that we feel that almost our whole personality is involved. We are more likely to say "like" if a smaller subsystem of our minds responds, so that we regard it as more marginal to our whole selves.

But whatever the position on the continuum, the common characteristic of these phenomena is the activation of a subsystem, an activation which has the characteristics of growth, and which is accompanied by a tendency to act in such a way as to get more of the same.

Dislikes and Hates

However, we must next notice that internal systems are not only aroused positively. Our eyes can be drawn to things which are very unpleasant as well as pleasant: our minds can become obsessed with hatred for someone as well as with love.

The basic pattern here, I would suggest, is based on the following generalisation.

All biological systems become active in response to anything which will promote growth. On the other hand they will usually also become active in response to a destructive threat. Any biological system which has not evolved methods of warding off destructive threats will simply die out.

Thus any biological system from a single cell up to a society is generally responsive on the one hand to things which will enhance its well-being and things which tend to destroy it on the other. Both of these classes of things tend to produce activating responses. This leaves any given biological system totally indifferent to the vast majority of things in its environment.

Indeed we may characterise any biological system very well by simply specifying those factors in its environment (internal or external) which tend to activate it, and noting also whether the response is positive or negative: whether it acts to obtain more or less of the particular factor.

In the domain of psychology this generalisation becomes the statement that if you know a person's loves and likes and also the hates, fears and dislikes, then you will know the most important things about the person. A more complete knowledge consists of knowing how the person responds to those various factors. If one knew all of these perfectly then one would essentially have a complete picture of the personality because anything which does not activate - is of no interest to - the person is for that reason of no importance in understanding the person. Note that in particular the above implies knowing how different subsystems are activated and respond, and therefore being aware of any internal conflicts that might arise if one subsystem wants more and another less of a certain thing.

Incidentally, there is a very good reason why it is impossible to gain all that information. And that is that the act of collecting the information will inevitably change the person. If you ask, "Do you like such and such?" then you will have changed the future response to such and such, because in future there will now be a slightly greater tendency to respond to such and such by thinking, "Do I like this?" and in time this might lead even to thinking, "No, I don't." (A similar situation arises in quantum theory. If you attempt to find the position of a particle very precisely then you are doomed to failure. The more determinedly you try to pin it down, the more you disturb it, and so the less you know about where it will be at any future time.)

Unrequited and requited loves

We have now established the loves at the top of a continuum of likings, and hates at the top of a similar continuum of dislikings, and observed that the greater the part of the person that is involved in the process, the further up the continuum we place it.

Let us next observe that loves may or may not be reciprocal. It is a familiar theme in the literature of Eros that love, no matter how intense, may not be requited. The fact that foxes "love" rabbits (the sight of a rabbit activates in a positive way a very large part of the fox's "animality"), does not mean that rabbits are equally desirous of a more intimate relationship. The fact that a man sees a particular woman as being highly desirable, so that his sexual subsystems anticipate satisfaction, his domestic nature anticipates comfort and food, his personality which seems to flourish when he is attended to finds in her a suitable attendant: none of these necessarily means that she is going to find an equal attraction in him. It may well be that a particular woman finds his desire for greater intimacy as appealing as the rabbit does the fox's.

On the other hand there are reciprocated loves which lead to stable and harmonious relationships. The four loves mentioned above are generally meant in the forms they take when they are reciprocated. We see in countless species relationships between individuals which have all the outward forms of the loves: of love between parents and offspring, love between mates and love between members of a pack, though it is not easy to think of anything quite like caritas. Although we cannot, of course, comment on the subjective side of these behaviours for the animals any more than we can logically comment on the subjective side in other individuals, I think we must assume that there is at the very least a family resemblance.

Love changes

Reciprocated love changes both partners. Each grows and develops in the warm, nourishing glow of love. Like a plant opening its leaves to the warm embrace of the sun, a personality unfolds in the life-enhancing light of love.

But if the sun goes away, the plant is left with larger leaves which still need nourishment, though there is no energy to feed them. If the lover goes away, the beloved is left with a personality which has become dependent on that love. Enormous parts of the person have become changed: habits of thought, feeling and behaviour have all grown and developed in the presence of the loved one and depend on the loved one for their continued existence. Now they are all threatened.

When a love departs there is a death. How often have we heard the phrase, "Something inside me died"? It will not usually be the death of the complete individual; but the death of some part, of some subsystem, is perhaps inevitable. Any parts which were totally dependent on the love of the lover will be without the life-giving nourishment of love and will die as surely as will a plant which has been covered with a bucket.

This potential tragedy on the path of love is the inspiration and tale of so many of the stories and songs of love. And it is from this fact that we find so many psychological problems arising.

Coping with loss

A very common result of being burned is a fear of fire. One common response to having lost a love is never to love again. An individual who follows this rule is then going to deprive himself or herself of the vital nourishment that is love. One result may be depression, or a way may be found of getting some of the nourishment of love without entering into human relationships. The love of an animal can be a good substitute, a love of money or artefacts rather less so. A big snag is, of course, that animals die, money can be lost and things can be stolen, so that the same problem of coping with loss will only arise again, in a different form.

We have observed above that one of the central tasks of therapy can be seen as getting the client's feet firmly placed again on the paths of love in the outside world. The most common reason why this is not happening is some fear of the consequences of love. Our task therefore, often summarised by the following questions:-

1) How does the client respond to the loss of love?

2) What is it about these responses which is preventing the client walking again into the warmth and light of love?

3) What past experiences have conditioned these responses to the loss?

4) How can things be changed?

Jealousy

Here is a simple case, in which a young man became excessively jealous if he so much as imagined that his girlfriend was glancing at another man.

The answers to the above questions are:-

1) He first feels very hurt, and bottles the feeling up. His strong inclination is to walk away from the relationship. But there is also an anger which eventually can break out in violent accusations.

2) Neither of these responses helps the relationship. The girl attempted suicide when he left. She gets very upset by the anger.

3) When he was seven years old his mother left him. He clearly recalls her going off in a car. In fact she was, of course, leaving his father, and she came back a year later.

4) Alterations can be made to a) the subsystem which remembers the incident with his mother and also b) to the subsystem which responds in the present to the girl-friend.

a) The technique of "Video editing" (NCP Journal, spring 1993) was used. He was regressed to the incident of his mother's departure. It was replayed as he remembered it, and then re-run on the assumption that he had responded by taking the active course of walking the five miles to his sister's house, where his mother was staying, every weekend, and then had the wonderful experience of many hours alone with his mother. (He was the youngest of four and had been somewhat neglected.)

b) In the present he was instructed not to bottle up the feelings but at once to take an active path and draw his girlfriend's attention to his feelings by signalling with a tug at his ear or by calling her a particular love-name. She was involved in the therapy and agreed to respond to these signals with a hand-clasp, smile or kiss, as seemed appropriate.

The combination of these two changes ensures that the feeling of impending loss will never grow out of proportion, as in both subsystems there is the feeling that "something can be done about it".

Incidentally it would have been a mistake to attempt to use direct suggestion to eliminate all signs of jealousy. First, this simply amounts to an enhancement of the present pattern of bottling up. If bottling up for a matter of hours results in an explosion, then bottling up for weeks or months could be truly dangerous. (Recall the number of murders in which seemingly "perfect" long-suffering husbands kill their wives when a last straw tips them over the edge.) Second, the girl-friend, like many other people, feels that he SHOULD have some jealousy: it is a sign that he loves her. It was only the DEGREE that she objected to.

Responses to lost love

Each case has to be treated on the basis of its own dynamics. There is no one unique response to the loss of love. The above case illustrates merely one way in which an individual has responded to the loss of love in a way which is simply not productive. There are countless more.

The loss of love is so important to an individual that strategies have to be improvised to cope with the loss. Instinct provides some of these. Training and imitation suggest others. Most commonly we fall back on a limited number that we have been using for most of our lives.

It is possible roughly to analyse responses in the following way.

The major difference is between responses which are attempts to regain the love and those which are merely attempts to limit the damage caused by its departure.

(At a far lower level we can see a similar response at all levels of biological systems to the loss of essentials for continued activity: animals which are deprived of food may search more actively or they may, at another extreme, hibernate. Businesses in a depression may try harder to win custom or may simply lay off staff and reduce activity to a minimum.)

A. Attempts to regain the love.

In these cases the individual is typically approaching the loved one, and trying all means of regaining her or him. This may involve physical restraint, or anger - verbally or physically expressed; it may involve smiling and being ingratiating or the giving of gifts; it may equally involve a form of blackmail or threat.

B. Attempts to limit the damage.

In these cases the individual is typically going away from the loved one, and putting as much physical and emotional distance between them as possible. In order to deaden the pain, depression and anhedonia are common. Withdrawal is the order of the day. The feeling of grief may also be relieved by crying. Attempts may be made to believe that the love was not important in any case, and perhaps even that life is better without it.

The above two approaches are extremes. People are seldom at these poles, but the contrasts are useful to have in mind when you come to analyse a given person. In practice a common, and often the best, strategy is a mixture of both.

C. Mixed methods.

It is often a good idea to vary the approaches. Thus a typical pattern might be the following. First try to get the original love back directly, trying the "shouting" and the "being nice" ways. If neither works, then withdraw and limit the pain a little, while actively seeking a new source of love: find another friend/lover. At this stage it may well happen that the loved one is in turn missing you, and feels jealous of the new person. This leads to a new contact between you which may well lead to a newly deepened relationship.

I would suggest that most psychological problems arise in people who have very limited and stereotyped ways of dealing with the loss of love. Inflexibility leads to failure and disaster in dancing, in sports, in business, in thinking and in nearly all human undertakings, so it is hardly surprising that it should also apply to love. Those individuals who have a variety of responses will generally cope far better. They will know when to advance and when to withdraw and when to sidestep. They are like dancers who are able to keep step with anyone, so adroit are they on their feet.

The Abusers of Love

Another big class of problems in which these considerations are very relevant are cases of emotional abuse. We have seen above that loves at their best are requited. But we may well find cases in which one individual has an enormous need for love and compels it by one means or another from one or more other individuals. This will often happen between parents and children. Today I heard of a case, told by a woman in her early twenties, in which her mother has demanded life-long total attention from her grandmother. One result of this is that my client's childhood was drastically affected by the fact that her grandmother enlisted her help in "looking after Mum" from an early age. She never had a proper childhood. The mother dominated by means of great emotional scenes - running naked down the road etc. We may well agree that there is something wrong with the mother - perhaps there is schizophrenia - but her behaviour is that of a person who demands love and is quite unable to return it in an appropriate way.

The problem for my client is that in order to cope with this distorted life she has had to adopt a number of strategies since early childhood which have become fixed and inflexible. It will help her a lot to learn other ways of dealing with the situation, and this will be easier now that she has moved away from home and has a boyfriend.

For interest, the only suggestion I have made is that she should let her family know that her weekend visits will now end the instant that there is an emotional outburst or criticism from the mother or a criticism from the grandmother. The family have always played these great emotional games. I have in effect given her "permission" not to play if she chooses not to. I anticipate that this will result in a lot of four-minute visits. But in time they will either have to play nicer games with her or find someone else to play with them - an inexperienced therapist perhaps!

This case, also, illustrates one of our big tasks as therapists, which is to enable clients to break the mould of stereotyped responses - emotional and practical - and to help them to learn new and more varied steps in the dance of love. For love is a process, like dancing. It is not static, it is not a state.

Does it then follow that psychotherapists, who should be adept at teaching the rhythms and steps of the dances of love, are themselves masters of the arts?

I will be provocative and personal.

The provocative statements include the old, old saying: "Them as can does. Them as can't teaches." I will generalise this and say, mischievously, that the majority of workers in the fields of psychiatry, psychotherapy etc. are drawn to the fields as like is drawn to like because they themselves have - or have had - big problems in dealing with love in many of its forms. By a familiar process of external projection, they try to deal with their problems by dealing with other people with those problems. I will include Freud in these statements.

Normal people who are getting on happily with their lives and loves have, I find, an instinctive aversion to probing deep into the mechanics of the human heart and mind, rather as the average healthy person has no desire to follow the surgeon's scalpel as it probes deeper into the flesh. We should remember this salutary fact.

The personal statement is that I am aware that a part of my own motivation was my feeling of ineptitude with people. I did not understand them. I owe a deep debt of gratitude to the thousands of clients who have taught me more than the books have. They have also taught me more of the ways of charity, without which I am but as "sounding brass or a tinkling cymbal". I hope to repay the debt to others to whom I can pass on what I have been taught

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Spring 94.

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A NAME="LoverHypno">
Lover or Hypnotherapist?

No, this is not an article about sex in the consulting room. It is quite the reverse.

A woman in her mid-twenties came to me having been involved in a relationship for six months with a man who is a Hypnotherapist. She has just broken with him because she has felt steadily worse as time has gone by, as he has told her in more and more forceful terms that there is something drastically wrong with her and that she needs treatment, if not from him then from another professional.

Now let us consider the following facts. If she ever exhibited behaviour which he was not happy with, he immediately started to analyse her as if she were a client! He accumulated a dossier several inches thick on her. He probed, against her will, into the depths of all her previous relationships, back to childhood. He never suggested or accepted that there was anything wrong with him.

I asked her to imagine what any woman would feel if she were married to a doctor, and any time she felt a need for love he would reach for a syringe to inject an appropriate hormone, or if she were depressed at not seeing enough of him, he would prescribe an antidepressant, or if she were to rage he would demand a blood test because he suspected a metabolic disorder.

We agreed that no woman could stand this in a marriage.

The conclusion was that, no, she did not need treatment. She is by nature rather passionate. She will one day find a man who is also passionate, and loves her as a man loves a woman and not as a therapist cares for a client.

That was an extreme case. But surely this is a trap into which we may all fall? We get so used to thinking of people in terms of their problems, and the causes of them, that there is a danger that we continue to think in the same way outside the consulting room. I know I have been guilty of this.

What are the antidotes? There are, I think, two. One is simply to be conscious of it. To have a spouse who will speak up the minute (s)he detects it can be a great help. (Members may like to leave this Journal open casually at this page and see if someone close to them will read it and comment.)

The other antidote is to be prepared to treat clients as people not "cases": for then, too, it will be hard to treat other people as cases.

Therapists are human, and fallibly human. Yet our position makes it all too easy to succumb to the greatest of sins: the sin of spiritual pride. Let us remember that we are not better than others, that our knowledge is very imperfect and that we are constantly subject to the very human danger of projecting onto others our own imperfections. That, it seems to me, is the moral of this little case.

The young woman left, very relieved in her mind that she was not drastically disturbed, as she had been informed, but had simply reacted as any normal woman would.

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Autumn 93.

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Memory

"Indeed he knows not how to know, who knows not also how to unknow." - Richard Burton (the explorer).

HAVE YOU EVER THOUGHT how wonderful it would be to have a really good memory? Then this is a cautionary tale.

Many years ago I read (I forget now when and where!) that famous book Mind of a Mnemonist by Professor Luria of Leningrad. It is the story of a man who seemed to have a near-perfect memory. He started off with the advantage of a nervous system which presented all visual stimuli with enormous vividness. The redness of red clothes was so overwhelming and memorable that if he saw the same person wearing red one day and blue on another he found it very hard to realise that it was the same person each time.

At some stage of his life he realised that in order to recall any item he simply had to picture it in some location. His favourite form of this mnemonic device was to take an imaginary walk along a familiar street of shops, and to picture each thing he wanted to recall in order in these shops.

Anyone who has read a book on "How to Improve your Memory" will recognise such a technique as being one of the standard methods of recalling unrelated information.

Later in life the Memory Man started to do shows in which he might ask members of the audience to shout out all manner of personal details, from the names and addresses of grandparents to numbers on bank notes in their pockets. He would later be able to tell everyone what they had told him with no errors at all. How did he do that? He had refined his mnemonic technique by then to simply writing up the material he was told on an imaginary blackboard: one for each person.

Problems

Then one day the whole thing went wrong. He found that his memory was simply not working properly at all. This naturally led to feelings of distress until by good fortune he ended up in Professor Luria's office.

How was he treated? With Pills? No. Psychoanalysis? No. Luria diagnosed what we might call a saturated memory. He argued that the Memory Man had filled his memory to capacity: he was able still to recall information from every show that he had done!

So Luria simply asked the man to recall one of the blackboards and then imagine himself wiping clean the material written on it.

Case

I have always wanted to try this out for myself, and recently for the first time I have had a case which was sufficiently similar for the same diagnosis to be clear and possible.

This young man had been studying very hard for his MA in a field where information was of central importance. He had an excellent memory for facts: almost photographic, in fact. It had never let him down. Then suddenly, within a matter of days, it had all started to go wrong, so that he could not even manage to recall the simplest things. He had to write down in incredible detail how to get to my office, for example, in a way no-one with a normally fallible memory would have to.

He had thought of a number of other possible reasons for the change, but none seemed as likely as the saturated memory effect, and so I had my chance.

Of course things have changed since Luria's time. My client was very computer-conscious and I could reframe the matter as follows for him.

"You will know how computer memory works. You start with an empty disc. You can then store more and more data and it seems to absorb all you can throw at it. Then one day, quite suddenly, the disc has reached its limits. Then not only does it not hold facts, even other programs become very slow and inefficient. Now what do you have to do then?"

He replied, of course, "Delete some files from the disc."

"Exactly. And that is what we are going to do with the files in YOUR mind."

After talking around this concept for a while, and mentioning Luria's work, we looked for an image of storage that he felt happiest with. It turned out to be videos. The session proceeded with him simply leaning his head back comfortably and closing his eyes. (In other words there was no induction.)

Then in a conversational way I asked him simply to mention the first thing that came to mind. It was a minutely detailed memory of having visited a computer show.

"Now that you have played that over, is it a tape you need or want to keep?"

"No."

"Then simply stick a new white label on the tape and put it on a shelf where you know it can be re-used."

We then ran through a number of other tapes in this way. After a while we met tapes which could benefit NOT from simply been discarded but from being edited. Thus one in which he was stuffing a car full of all his worldly possessions (you will notice how he crams his life in the same way that he crams his mind) was edited to show him instead happily travelling with the minimum of baggage. This short and edited tape could be kept.

There was about half an hour to do these things in the session.

He left with no confidence that all that would work, but promising to do a bit more in his own time. (Like so many clients he had come naïvely supposing he would be "put out" and told that his memory would be fine again.) The next week he came back a transformed man. It seemed that there had been no change the first day, but after a night's sleep the improvement was already dramatic. He had continued with the simple exercise, but had modified it so that he was picturing film rather than tape.

Mechanisms

My model for what happened is the following. I suppose that the normal mind will have a system which we also find in modern computers: a procedure for eliminating from memory things which are no longer of importance. And I suppose that the reason is the same in both cases: that there is only limited space available.

This young man, from a sense of insecurity, had not only worked on the principle of keeping every thing he had in case it might be needed, also used the same system on memories.

So if, as part of the natural workings of the "file-deleting" system, his conscious mind was made aware of some memory, he would in the past apply the "keep it" rule: until there was no more storage space. The change I made was to institute a new rule whereby he would at times say "delete it" and thus release space.

What it would have been informative to do, though unethical, would be to have a first session involving a straightforward hypnotic induction coupled with a direct suggestion that his memory would improve. It is my hypothesis that there would NOT have been a dramatic improvement (and hence the client would have paid for less than my best efforts). This is because I suppose that subconscious processes would not be able to work out HOW to improve the memory. Any suggestion that the memory should become "better" could only have been interpreted by subconscious processes as, "Try to remember MORE", and never "Start to remember LESS from the past." It takes some real conscious intelligence to see that the memory could only be made better by being made "worse"!

A similar problem

Not long after the above case I had another which may not seem at first to have anything in common with it. It involved a single woman who was having panic attacks, was totally unable to relax and had had these and other problems for a period of a couple of months.

To simplify the situation to its bare bones, it is enough to note that for the six months prior to the problems her best friend had been going through a bad marital breakdown, and had confided freely, fully and frequently in my client.

(It is always useful to look at any unusual processes which precede the onset of symptoms.)

Now the problem was that my client had always treated everything she had been given by her friend as something precious: something to be kept. And it seemed to me that the problem was that she had treated all the outpourings of distress in the same light. These were feelings that were important to her friend who was passing them on to her. Naturally she should keep them: remember them!

The fact that she was able to absorb six months' worth of outbursts and distress says a lot for her friendship. But it was my feeling that such things, like the impersonal memories of the memory man, have their limits also. And so I employed a light trance to do what I am sure many members will have done: allowed her to picture herself disposing of all the bad emotions. I used the natural picture of black plastic bags, which she was happy with.

This one exercise did an enormous amount of good even at the session, and led to great further improvements. It was interesting to me to note her reaction, which can be summarised as, "You are the first person who has NOT said that I must think of myself and forget my friend. You have agreed that I should help my friend, and shown me how to do it better."

Samaritans

To some extent I owe the above diagnosis to my own past experience. Many years ago I worked for the Samaritans. I took every case very seriously, and worked hard to help. But after a while I became unable to continue. There was a distinct feeling of being "full-up" with the problems. I could not take any more, despite the fact that the hours were so much fewer than I have known since starting as a therapist.

With hindsight I can see that since then I have acquired the knack of allowing people freely to off load their problems onto me in a session, but then to let go of them immediately afterwards. I sometimes liken myself to a dustman.

"The dustman's role is essential to society. You pay him to take away and dispose of your rubbish. You feel better. Your home is cleaner and healthier. You do not pay him to keep it. You do not expect him to fill his home with it. You just want to get rid of it. In the same way I am a dustman of souls. I take the rubbish into my mind where I bundle it neatly using heavy gloves to avoid contamination. Later I will dispose of it completely. I will forget it. I will not associate you in my mind with any of the material."

Conclusions

The success of the approach in the first case does seem to validate both Luria's approach and also the basic assumption that MEMORY IS FINITE. Far from being able to remember everything, as some popular if ill-informed books are inclined to say, we can only remember a very small selection of facts. Even those gifted naturally with enormously capable memories can reach their limits.

The other moral might be that whatever the size of our memories, the mental systems we set up for handling, editing, sorting, deleting and saving onto paper are probably more important in the long run than simple raw capacity. (But perhaps this is wishful thinking in one who is conscious of having a very limited natural capacity to retain raw facts!)

The success of the second case suggests that we also only have a limited capacity to hold emotional distress within ourselves.

The moral of it is that since we therapists are merely human, it is well that we cultivate the skills of handling, sorting and throwing away emotional rubbish for ourselves as well as for our clients.

If I were running a course I would make this an explicit part of it, under the quotation at the head of the article. This quote has lived with me for decades now, and can be applied to all knowledge and all memories and all feelings.

This article first appeared in the Journal of the National Council for Psychotherapy and Hypnotherapy Register, Spring 96.

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The Technique of Editing Mental videos

A recent client made the following remarks after a session. "I feel afterwards that you are putting things into this (the left) side of my head which is then later feeding the other side." "I also feel that you are taking a video out of my head, looking at it, and then putting it back in again."

This particular client had very little education, and it was a surprise to her to learn that scientists have demonstrated that it is the left cortex which processes verbal information, and that it communicates with the right hand via the corpus callosum. The first remark is therefore evidence for the fact that she had an unusually clear first hand awareness of the processes within her own head.

We may therefore pay interested attention to her second remark. What was I doing to evoke the remark about the videos? The case history in brief was as follows. At 39, with a daughter of 10, she was terrified still of the ex-husband whom she had left a few years ago after his violence and alcoholism had proved intolerable. It soon became clear that the emotional patterns of that relationship had been laid down when she was a girl. Her father had died and an older brother had taken on his role in the most domineering manner imaginable. At one time when she disobeyed him and got a pet mouse he made her watch the household cat kill it. On other occasion he beat her with an improvised rubber whip. This incident, when she retrieved it from the recesses of her memory, was associated with all the physical symptoms of terror which had plagued her down the years without knowing why - a common result of repressed traumas.

Now, on the occasion when this memory was surfacing and she related it to me, I followed it up by getting her to imagine what would have happened if she had reported the incident and shown the bruising and told of coughing blood to someone in authority. She could imagine the effect of Teachers, Doctors, Police and Social Workers on her brother's behaviour, and how he would in future have had to treat her with great caution.

In terms of the image that she reported of the video tape it may be said that the original tape was played, observed, then edited by adding material to make it a much more positive episode, which she would be able to store wherever the brain stores its tapes. The result was a great lightening of mood, and the removal of that particular episode as a problem.

Let us now look at an earlier case in which the same technique was used. This young man blushed. It was quite easy for him to recall early embarrassing situations in which he had blushed. There was the time he had had to go to school in the ghastly purple trousers that his proud mother had bought him. There was the time he had cut his hair himself and could not bear his school friends to see the resulting mess. It was easy for him to remember the mental videos of these events, and just as easy for him to visualise the new script that was suggested to him. With the trousers, for example, he saw himself going to school and getting his friends to agree that they were appalling and then to play with him in some rough game which would ensure that they become so torn and soiled that he would never have to wear them again. Within a couple of weeks his blushing had stopped. In that case explicit use was made of the metaphor of a memory being simply a video to help him to understand what was happening.

The next case illustrates the fact that this technique can be powerful even without hypnosis. The client was a man in his mid-thirties, intelligent and successful at work, but with his wife his self-esteem was at rock bottom. His fear of rejection and the abject way in which he responded to hints of rejection were a chronic and uncontrollable problem. An overview of his life revealed that he had led a very sheltered life with Nannies and attendants until the age of five, when he was sent off to boarding school with no preparation. The natural result was that, having less worldly skills than the other boys he was the one at the bottom of the pecking order and for the next dozen years or more was forced to stay in that insecure position by the inevitable social forces that work in groups. The psychological state is one of always trying to curry favour to gain admission to the group and fear of being excluded. The natural presumption was that these many years had formed the habits which were proving so fatal to the marriage.

It was pointed out to him that if it had been the case that his father had prepared him for the change, had taught him how to hold his own and given him more experience of the rough-and-tumble of boys of his own age in small amounts before he went to school, then he would have been socially accepted from the start and would have had a different set of experiences. If he had had the corresponding set of memories then he would be behaving differently in the present. Why not change the memories? - they are after all no more than videos.

He was an intelligent and determined man. For a couple of weeks he worked away while driving his car and other slack times, imagining a whole set of new memory tapes to place in his mind - tapes which might so easily have happened, after all. I have seldom seen a client change so quickly. In that short time his feelings changed completely. That old insecurity vanished. He remains in total control of his behaviour which is now in keeping with the new videos of his past. The only problem left is that his wife has yet to find a new attitude to this changed man!

The technique is not particularly new. Milton H. Erickson in one case reports on his treatment of a woman with a low feeling of self-worth by regressing her to various ages, and at each age gets her to meet a very understanding and thoughtful man - not unlike Erickson himself - who may bring her a gift on a Birthday, or hear and applaud a recent success. She might so easily have had an uncle or grandfather who would have done this. In short he was inserting completely new video tapes into her memory. The result was predictable: she started to feel and behave as it those events had really happened and her sense of being a valuable person blossomed.

Since Erickson's time people have become very familiar with videos and so it is possible to talk to them directly and use the metaphor in which memories are effectively just like videos of the past. Their behaviour is determined by the contents of the videos they have in store. If they are prepared to change the videos then their behaviour will change too. Most people will respond readily to this explanation.

The following practical points should however be noted. Some people who have a high regard for truth will resist the idea on the grounds that the edited video is a lie. Such people must be handled very carefully. The second point is that it seems to be much easier and more effective simply to modify an existing video in such a way as to change the overall effect rather than to try either to wipe the whole thing clean, or to replace it by something drastically different. Thus in the case of the purple trousers we do not try to wipe out the whole memory, but plant a video which suggests a positive way of dealing with this, and by implication any other, embarrassing situation. Anyone who has had experience with the technique of refrhaming should find that the same turn of mind is useful for editing the videos in this spirit.

This article first appeared in the Journal of the National Council for Psychotherapy & Hypnotherapy Register, Spring 1993.

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What Mesmer Believed

MESMER'S NAME has passed into our language - an honour accorded to few. Mesmerism can even now be used almost as a synonym for hypnosis. But are they identical? What did Mesmer believe? What did he do?

Most books on hypnosis contain a page or two on Mesmer, giving a brief outline of his life and work. In this article I would like to explore his ideas in rather more detail by turning to his own words, because a man's ideas very commonly get distorted and changed in time by both his friends and enemies.

Fortunately there is a compilation of Mesmer's writings, from which all quotations will be taken. It is Mesmerism, A Translation of the Original Scientific and Medical Writings of F.A. Mesmer translated by George Bloch

It is never easy to get into the mind of another person, and when that person is separated by a gulf of two centuries and a different language it is harder still. The task is complicated yet further by the fact that Mesmer's own thinking inevitably changed in time, from his first writings in his doctoral thesis of 1766 (aged 32) to his last dissertation on his discoveries in 1799 (aged 65).

Since this latter is not only his final considered view on the subject, but is also the fullest, I will regard this as the primary statement of his views, referring only to earlier documents as they throw light on particular points.

My intention is to begin by summarising in a favourable light some of Mesmer's thoughts, so that we can see them clearly.

Scientific

Mesmer seems to have believed in God, though otherwise his conception of the universe was materialistic. It is clear that Mesmer regarded himself as being in some ways what we would call scientific. He deplored the way, for example, in which people would "refuse to examine and verify facts", and decried superstitions. He trained as a doctor.

His theory of the universe was that it is composed of a series of increasingly rarefied fluids. "Sand, for example, has a degree of fluidity; the shape of the grains necessarily forms interstices which are occupied by water; those of the water are occupied by air; those of the air are occupied by what is called ether; finally, those of the ether are filled up by a substance even more fluid, for which no name has been determined."

Elsewhere he notes that each of the three first fluids are capable of being "the conductor of a particular movement proportionate to its degree of fluidity. Thus, water is receptive to modifications in heat; air receives all vibratory movements which produce sound, harmony and its modulations; ether acts similarly for the movement of light." (He is forcing the facts to fit his theory here: the "ether" also communicates heat, and water sound etc.)

By extension his fourth, subtle fluid, also communicates movements, it "corresponds essentially and is in continuity with that which animates the nerves in the animal body, and which exists mingled and blended with the different kinds of fluids which I have mentioned". At another point he says that the most immediate action of this fluid "is to reanimate and reinforce the action of muscle fibre". He sees it in this sense as being rather like fire, or what we might call a force, and is what he seems to mean by animal magnetism.

If I were to try to communicate this framework in a modern pseudo-scientific language I would say that Mesmer believed that there exists among all the other fields which science has come to know (gravitational, electromagnetic etc.: our entire theory of the universe is today a theory of fields), another which might be called an "animate field", which is apparent in its action on living things of all kinds. When it is acting we may see it as a kind of life force.

The name which Mesmer gave to this force in his earlier days was, of course, animal magnetism. He later came to regret this because it led too many people to place too much emphasis on the word magnetism, and to believe that he was advocating little more than the application of magnets.

Intension and remission

Another important component of Mesmer's thought was that this natural force would ebb and flow. He used the word "intention" to mean the augmentation of a property or faculty, and "remission" to mean the reduction of the same. These are what I would call activation and deactivation, or others might call animation and inanimation. Thus he says that, "this action, determining what I call the alternating `intention' and `remission' of characteristics of organic matter, animates and enlivens all that exists".

He actually came to this idea, it seems, though his original belief that events on this earth were periodic and influenced by the movements of heavenly bodies. This theory was propounded in his original 18 page thesis, which was little more than a brief resumé of Newton's theory of gravitation, together with observations on the tidal effect of the moon as well as tales of how the health or illnesses of people could be influenced by the phases of the moon also.

At that stage of his life he seemed to think of the influence as being purely gravitational and that "our humors are agitated in diverse ways in their ducts, being perturbed, raised and carried far more copiously towards the head" by the same force that lifts the tides in the ocean. (This indicates how little detailed grasp he had of Newtonian science: a simple calculation shows that gravitational effects are negligible on that scale.)

He was also aware of the natural ebbing and flowing of the breath and the pumping of the heart as periodic phenomena. In particular he states that, "The workings of dilation and contraction of the vessels, on the liquor which they contain, is the cause of animal life." With this simple picture of the alternate tension and relaxation of muscles in mind he sees illness as being due to the obstruction of a flow because the muscles which are involved in the dilation and contraction are either unable to contract, or because something is acting to prevent them relaxing and hence dilating a vessel.

He terms such a condition an obstruction, "which is the most general and almost the only disorder occurring in the human body"!

If we again summarise these ideas in a more modern pseudo-scientific language we can state that Mesmer believed that all living processes are characterised by alternating periods of activation and deactivation; that the underlying cause of such processes is the animate field and that all illness is a result of a something preventing this animate field from working.

He also had a strong sense that what was called "Nature" acts to restore the natural functioning in illness, and traces this idea back to the work of Hippocrates.

In his 1779 dissertation on the Discovery of Animal Magnetism, he is explicit in stating that it is obvious that "Nature" has provided everything for the existence of the individual, including the provision of a means of preservation of life. He attributes this action of preservation to the "GENERAL AGENT, whose existence I recognize: it alone can reestablish harmony in the natural state".

Mesmer is here foreshadowing the general idea of homeostasis: that organic systems are copiously provided with feedback mechanisms which react to any departure from an established behaviour of a given system by activating a secondary system to restore it. Thus if the oxygen levels in the circulatory system drop, the heart and lungs are activated to redress the situation, and so on. However, since the medical science in his day lacked much detailed knowledge of the workings of the body (remember that Pasteur would not be born for another 23 years), he was led to hypothesise some force or power which led to the preservation of life. And it is this "general agent", of course, that he also called animal magnetism.

It is fascinating to note that in thus turning into a thing - i.e. his subtle fluid, or animal magnetism - what is really a process he is doing something very similar to what he elsewhere notes accurately to be a fault in others' thinking. He notes that "the senses only transmit to us an object's properties, character, irregularity, attributes; the perception of all these sensations are expressed by an adjective or by an epithet like hot, fluid, heavy, light, bright, resonant, coloured etc. For the sake of convenience of language, people substitute substantives for these epithets: before long, one has substantivized the properties; one says: the heat, the gravity, the light, the sound, the colour..." In fact Mesmer has followed a similar path by taking a property of living things - self preservation - and attributing it to a thing: his "general agent".

Crisis

You must next imagine with him that in order to relieve any obstruction Nature must provide a force or effort "proportional to the existing state in order to overcome it". This effort he called a crisis. The effects of this effort he calls "critical symptoms" which "are the real means of healing", whereas "the effects contrary to this effort of Nature, coming from the resistance itself, are called the `symptomatic symptoms' and from what could be called the `disease'".

We might, for example, say that he would regard the rise in temperature in a fever as being a critical or beneficial symptom insofar as it is true that it is part of Nature's way of fighting an illness. (In fact the beneficial effects of fever have not been proven, cf. Dr James Le Fanu, Patients at fever pitch, The Times, March 31, 1994, p 17.)

In a more modern language we may say that he distinguishes between signs of a departure of some bodily system from its proper functioning and those signs of the activity of a corrective system which is attempting to restore things. We may say that the greater the departure from proper functioning, the greater the activity of the healing system. What Mesmer seems to be visualising is a powerful flow of the animate field into the affected part in order to overcome a blockage.

Methods

It is well at this point to look in detail at what Mesmer actually DID, as opposed to what he THOUGHT. He is comparatively reticent about this, but in his Catechism on Animal Magnetism of 1784 we find the following question and answer.

"Q. - In what way should one touch a sick person in order for him to experience the effects of magnetism?

"R. - First of all, one must place oneself opposite the patient, back to the north, bringing one's feet against the invalid's; then lay two thumbs lightly on the nerve plexes which are located in the pit of the stomach, and the fingers on the hypochondria [region below the ribs]. From time to time it is good to run one's fingers over the ribs, principally towards the spleen, and to change the position of the thumbs. After having continued this exercise for about a quarter of an hour, one performs in a different manner, corresponding to the condition of the patient.

For example, if it is a disorder of the eyes, one lays the left hand on the right temple. One then opens the eyes of the patient and brings one's thumbs very close to them. Then the thumbs are run from the root of the nose (bridge) all around the socket.

If one has to deal with a violent headache, the tip of one thumb is brought to the forehead, the other behind the head opposite to it.

The same thing applies to all pains which are experienced in other parts of the body. It is always necessary that one hand is on one side, and the other hand is on the opposite side. If the sickness is general, the hands - made into a pyramid with the fingers - are passed over the whole body, starting at the head and then descending along the two shoulders down to the feet. After this one returns to the head: from the front and from the rear, then over the abdomen and over the back."

From this we may see that his PRACTICE is far more like therapeutic massage or acupressure or healing or than it is like hypnotism as we know it today. The way he would, I suspect, describe such modern practitioners is that they are simply (though without knowing it) enhancing the flow of animal magnetism in the patient's body: that animal magnetism is flowing from them into the patient. The nearest modern equivalent are those forms of therapy (mainly of eastern origin) which see healing as a restoring of the balance of natural energies by means of physical manipulations. Those who believe in the Chakra energy systems and in altering them by manipulations of, or near, the body are in fact far closer to Mesmer's thought and practice than is a modern hypnotherapist.

You may be surprised that there has been no mention of his famous baquet which he used in Paris at the height of his fame. In fact he was later rather dismissive of it, saying, "Assuming that I were to have a suitable establishment, I would abolish the baquets. In general, I only use these little contrivances when I am forced to."

Placebo Effect

It may be useful to explore Mesmer's world-view further by imagining how he would explain various aspects of today's attitudes to healing.

I will start with the placebo effect. It has been very well established by repeated experiments that many patients will recover from a bewildering variety of ailments if they are given a form of treatment that they believe will be effective. Furthermore these treatments will be even more effective if the doctor believes them to be effective. (But note that this by no means leads to the conclusion that ALL ailments can be cured in this way.)

Mesmer would, I presume, interpret the latter as being due to the direct action of the doctor on the pill concentrating Animal Magnetism in it. He was accustomed to finding various objects which could "store" or "concentrate" animal magnetism, and he would regard pills (active or placebo), or for that matter homeopathic medicines had they existed in his day, as being simple vehicles for his universal agent. He would, for example, concentrate the force in trees, and would find gratifying evidence for this theories in that patients would respond to the trees as they had to him, with some strong reaction such as convulsions.

What he was never able to conceive was that there could be an alternative cause.

The famous Royal Commission appointed to look into Mesmer's claims looked at the matter in a different way. They asked the question, "Suppose that the patient did not see which tree was magnetised, would he still react?" Mesmer would not feel the need to ask such a question as he had convinced himself of the correctness of his views, and was only interested in evidence that would confirm them (a natural propensity of the human mind). In fact, when the Commission arranged this little experiment they found that patients responded pretty much at random to trees if they could not see which one was magnetised.

Now I emphasise that logically the fact that SOME experiments made by the Royal Commission demonstrated NO direct evidence for a physical force of Animal Magnetism does NOT prove that there is no such thing. Equally the fact that SOME recoveries can be attributed to a placebo effect does NOT prove that no medicines have value.

But modern medicines are only accepted as effective if they can do better than a placebo in a double blind test: in which neither the patient or doctor knows if the pill contains a genuine drug or not. The onus is on other skills or theories to be equally careful in their claims. Thus if Mesmer were alive today and adhered to his idea that animal magnetism can be stored in some substance he would be invited to prove it under conditions in which there was no way in which the patient could know whether or not it had been. And this includes having it administered by someone who was also ignorant, because of the extent to which messages of confidence etc. can be transmitted by minor body movements and tone of voice.

In days gone by the Irish had unequivocal evidence of the existence of leprechauns, as a result of their experiences with distilling whisky. If they failed to scatter, as a libation for the little people, the residual liquor from the still, then they would be punished by suffering agonies and even death when they drank the whisky. What clearer proof could you need? The alternative, and admittedly prosaic, interpretation of these facts is that the residual liquid has a high proportion of poisonous fusel oil, which has a higher boiling point. This is a fact that can be ascertained by the painstaking analysis which "holistic" thinkers tend to decry.

Mesmer acted in a way which in fact helped many to health. He took this as confirmation of his theories. I doubt if he could have seen that this is not proof any more than the above story proves the existence of fairies.

Other ideas

Mesmer had many other ideas which gradually grew around the central ones above. One was that this same subtle fluid was the medium whereby what we would now call psychic phenomena could be communicated. The idea seems to be that the nervous system is particularly responsive to the "subtle fluid" and that it is therefore possible for one nervous system to work directly on another (telepathy). It was consequently possible to mesmerise at a distance. It was also possible to see at a distance (clairvoyance) and into the future (prevision) by means of the same fluid. By means of it also a patient was enabled to look inside himself and to diagnose what was wrong, what should be prescribed and how long recovery would take.

He also claimed that although Animal Magnetism is so rarefied that it may penetrate all bodies without appreciable loss of activity, it can nevertheless be reflected by mirrors, concentrated in bodies and transported. He seems oblivious to the apparent contradiction between these properties as applied to a physical substance.

A less well known idea (mentioned only once) which he postulated is that there is a contrary property in some animate bodies which actively destroys the animal magnetism in others.

History

A very detailed and complete history of Mesmerism and how it developed is given in Gauld's History of Hypnotism Bib. In this book there are details of similar ideas such as the "od" force of Baron von Reichenbach (1786-1869), the "etherium" of the American J.S. Grimes, and the "electrobiology" of his compatriot J.B. Dods which reached Britain around 1852. By that time practitioners of Mesmerism and electrobiology were travelling around giving shows for entertainment which were scarcely distinguishable in their content from those of the modern stage hypnotist, except for the way in which they explained what they were doing.

Is there a future for Mesmerism?

There will always be a future for ideas like Mesmer's in the minds of people who like the idea of a "life force" or "animate field" or similar and who do not wish to examine it too closely. Above all it will have a future in the minds of people who, like Mesmer, are unaware of the power of suggestion and belief, or of the detailed workings of the mind and body.

There may, however, be some truth in Mesmer's basic premise. There may be some field/force/power which is intimately involved in life, consciousness and health. What is certain is that we will never find out anything useful about such a thing if we cannot distinguish it from phenomena which are more prosaic.

Far from distinguishing between "magnetic" phenomena and others, Mesmer went the whole hog and attempted to explain everything else in terms of it. Thus he felt that it would lead to "fresh explanations as to the nature of fire and light, as well as to the theory of attraction (gravitation), and ebb and flow, of the magnet and of electricity", as well as "enable the physician to determine the state of each person's health and safeguard him from the maladies to which he might otherwise be subject. The art of healing will thus reach its final stage of perfection."(!!)

IF there is a force or field as Mesmer and others would have us believe then not only should it be clearly distinguished from more prosaic phenomena, such as suggestion, but the ways in which it works should be clearly determined: for otherwise how can it be used safely and appropriately? ANY agent of change can change things for the worse as well as better, and the effects are often intertwined: a short-term good may lead to long-term harm. This applies as much to hypnosis as to medicine, to suggestion as much as to antibiotics, and to "animal magnetism", if it should exist, as much as to electro-magnetism.

Mesmer writes, wisely, "Truth is nothing but a path traced between errors." The wasteland of Error is far greater than the narrow path of Truth which runs through it, and mankind is forever wandering off into it.

The trouble with human minds is that they are all too readily convinced that they are on the right path by any slight sign, and turn chance pointers into concrete sign posts. In order to keep on the path of truth we need to be very, very careful to look for all signs that we are OFF the path of truth. We won't see the boundaries of the path unless we look carefully for them. Nor is it wise to be guided by a person who cannot answer the question, "How do you know if you have left the path? What would it take to prove that you are wrong?"

Mesmer was a good man. He helped many. His ideas were based almost entirely on untested hypotheses and faulty science, but they led on to the more accurate ideas of hypnosis developed by Braid in the nineteenth century.

He would never have accepted that he could be wrong.

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Summer 94.

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Mr. Bean the Therapist

A LITTLE WHILE ago I had a dream. In this dream I was talking to the actor Rowan Atkinson in his persona as Mr. Bean, and was saying, "I believe that you are the greatest comic genius of all time."

He took it very well!

Even when I am awake it is true that I find Mr. Bean the funniest character on television at present, and I know why. There is something about his approach to every situation which is so marvellously rational and yet is so divorced from the normal human ways of doing things that it leads to the most amazing consequences: and there is an aspect of myself I recognise in this.

So if any reader detects a flavour of this in me, just say, "Mr. Bean!"

(Of course the credit must go to Rowan Atkinson's amazing ability and versatility. I find even his television commercials for Barclaycard masterpieces of comedy which I can watch and re-watch. There is so much richness of detail in them.)

But Mr. Bean can do far more than help me to laugh at myself. He can help in therapy for others also.

I have recently had as a client a woman in her twenties with very low self-confidence, she cannot get on a bus and is frightened to go shopping especially in supermarkets.

Without going into details, the simple way of seeing the cause of this is that she remains in awe of the adult world of rules and prohibitions for reasons to do with her upbringing.

Supermarket

So, we went to the supermarket (in our imaginations, of course), where we found, to our great delight, Mr. Bean at an adjacent checkout. He was being thwarted by the length of the queue and you would be amazed at the devices he thought up to get rid of this queue!

He "accidentally" got piles of baked bean cans to fall, and when people went helpfully to pick them up, he whipped a few places forwards. A well-placed banana skin allowed further progress. My client clearly saw him dropping and smashing a rotten egg (I suppose he must have brought some along for the purpose) which cleared the way wonderfully!

But one of the funniest versions (we did several), was when he "borrowed" an assistant's jacket and simultaneously acted the parts of customer and assistant at an empty till. It was almost as good as when he was his own dentist!

He had to go home by bus, of course, and this had us in stitches too! He had bought a new fishing rod which he was testing out by trying to catch and lift the hats off people in front of him (and the odd wig, too). Feeling a little thirsty, he boiled a kettle on a little portable stove on the seat beside him - one of many little devices which gave him a seat to himself. And you should have seen how the other passengers reacted when he had to crawl under their seats nearly the whole length of the bus to retrieve a boiled egg that had escaped his clutches!

Therapy

Of course the therapeutic intention of all that was simple. We are dealing with two internal systems: a spontaneous childlike nature which has been over-inhibited by a regulatory, adult system. When the adult system is external, as it is in schools, the natural method children have of dealing with it is to make private jokes about the teachers. This reduces the power of authority to over-awe. But when the equivalent systems are internal the same principle applies, and so Mr. Bean acts as a comic hero to the anarchic child within, by cocking a snoot at the power of all the internalised adult conventions.

The power of laughter

It has often been observed that laughter arises when there is a sudden change of perception, or incongruity. If we were to formulate this in general terms it would be as follows. Our mental processes are generally organised in systems, which are relatively self-contained. A child may have one system of thoughts which arise from and are involved with her friends, another with her teachers and another with her parents, for example. In addition, as therapists we are familiar with systems of (perhaps latent) thoughts which were current at an earlier age, but may be reactivated at a later.

The question I am interested in is, "What happens when two systems, which are normally disconnected, are brought together?"

The first thing we may note is that it definitely creates a lot of mental activity. The important thing then is the nature of this activity. It may come out as hostility or anxiety or other negative emotion. All these will tend to create inner tension. Or it may come out as laughter.

If two people come together they may regard their differences as something to be serious about or to be angry about, or, on the other hand, they may regard them as material for light-hearted humour. Friendship, which can easily be between individuals with quite different characters, will often have this quality. Each may gently pull the leg of the other, and it causes no ill-feeling, but rather a closeness.

Laughter dissolves barriers harmlessly.

What is true of external systems is true of equivalent internal ones. If I have two sides to myself and each can be amused at the other, they will be friends and live in harmony. If, on the other hand, they are angry with each other, then I am a house divided against itself, and cannot stand.

When I find a client who cannot laugh at life, I know that there are going to be problems. Such a person has limited options when it comes to resolving differences between himself and others and between different aspects of himself. The re-gaining of this most characteristic of human activities is often the task of the therapist.

And so, as a therapist, I am often trying to impart a humorous angle on things. Hypnotic techniques are of course a useful aid. You can create funny pictures in a person's mind that much easier. Physical relaxation is generally more favourable for humour. And, in a good subject, the process of laughter can often be activated easily.

Contrasts

I sometimes think that the source of laughter can be seen in the universal game of "Pee-Po" with a baby. Mother's face disappears. The baby's face grows solemn. The mother's face re-appears. The baby chortles with a special delight.

I theorise about this as follows. Up to that stage of development the baby's mind is so simple that every experience is simple and unitary. She is hungry or not hungry, she is hot or cold, mother is there or not there.

But the glee of the game, I suggest, has to do with the perception that mother is there and not there.

Verbal humour so often turns on the fact that a word means this (in one context) and that (in another). The joke somehow takes us from the one framework to the other. For a split second we are aware of both simultaneously, and the result is amusement.

You may have heard of the doctor who took his record-player to be repaired because the playing arm kept jumping grooves.

"I have bad news for you, doctor", the engineer said when he had examined the machine, "I am afraid your record-player has a very bad case of a slipped disc!"

When a headmaster falls on a banana skin in the school-boy's mind, there is the sudden perception that he can be ultimate authority and humanly fallible.

I am further suggesting (others probably have before me, but I have not come across them) that the reason the human race has this sense of laughter which seems to have no equivalent in other species is precisely because only we have developed a mind complex enough to hold two contrary conceptual systems simultaneously.

Re-framing

When we are re-framing something for a client we are presenting a different way of seeing some thought or experience from the one previously used. If the client fails to hold the two frames or systems of thought simultaneously, then subsequently he or she may choose one or the other according to context. But if we manage to bring them both into mind simultaneously, as in the game of Peep-po, then they become linked and there should remain a path between them. If one is unpleasant and the other pleasant the mind will then tend inevitably to move towards the pleasant one.

So in therapy, I may often be playing a sophisticated game of Peep-po. We contemplate a fearful experience such as being in the alien world of the supermarket, and then suddenly it is changed, courtesy of Mr.Bean, to a happy one. Laughter is a natural response, which I encourage. Similarly we find that something can be both a bus-ride and happy: things that seemed quite contradictory.

I have used other reframing and always laughter-provoking images with that particular client, and as she leaves, she says, "I really enjoyed that", and comes back the following week more confident and capable.

Laughter really is one of the most valuable tools in therapy. So, thank you, Mr. Bean: The Greatest Therapist in the World!

This article first appeared in the Journal of the National Council for Psychotherapy and Hypnotherapy Register, Spring 95.

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A novel hypnotic induction

TO THE BEST of my knowledge the following is a completely new induction.

The "induction" is very brief and non-verbal but has a lengthy but important "preamble" which follows. Parentheses [ ] hold explanations of what is going on, and why. Incidentally the absence of such explanations is what makes so many written accounts of hypnotic inductions disappointingly uninformative.

Preamble

This induction is best done with the subject in an upright seated position, with you, the hypnotist, standing close and on the left hand side (if you are right handed). [The reasons for this will be clear soon.]

"Could you sit comfortably, please?"

Pause while subject arranges himself.

"Do you mind my standing so close to you?"

[Standing where you are, you are invading the subject's personal space a lot. If the subject objects strongly this induction should not be used. Otherwise continue.]

"What is your favourite animal?"

[You must have the subject's attention. Questions are an excellent way of getting it. In addition it forces the subject to look up at you. This places the neck and eyes in a condition of mild strain which in a little while will induce a strong desire to drop the head and close the eyes. It also tends to reactivate an old, old experience which all of us have had: that of being a small child in school, seated in the presence of a teacher who is asking questions. This is excellent for our purposes, because if we can activate this child-like system of responses, we will find accompanying it a conditioned response to do everything the "teacher" asks.]

Ask a few questions about the subject's favourite animal. [It will almost certainly be a mammal, but it does not matter much. You are simply establishing the pattern noted above and working to establish rapport. Then you can lead on to the following.]

"A thing that always fascinates me is the way in which so many animals carry their young. Do you know what I mean?"

[What we are thinking of is the way in which the young are held by the neck in the mother's mouth. Most people have seen or know this. But it is always better practice to get the subject to volunteer it, and in the present context it encourages the `good pupil' attitude.]

"Yes. That's right. She simply grips it by the nape of the neck with her teeth, and it swings there limp and relaxed. A moment before it may have been lively and jumping all over the place. Then, the moment it is gripped, this lively creature becomes as floppy, as limp, as relaxed as a bundle of washing. Of course there is a very good reason for this. Over millions of years Nature has developed a simple reflex in the young. The moment the skin of the neck is gripped the process of switching off all activity is totally automatic. A mother cat does not have to say, `Now, be a good girl/boy.'" (Use gender of subject.) "`I am going to help you. Come with me without struggling. Relax. Be still.' The kitten immediately becomes limp and totally relaxed. You can picture it easily can't you?"

[The goals of the above are to impress on the subject a clear picture of the kitten (or other animal if it is more appropriate for the particular subject) dangling limp and happy. The underlined remarks are given a certain extra emphasis, in the manner of Erickson, because they are marking certain key feelings or attitudes which we are encouraging in the subject. These are attitudes relating to an expectation of deep relaxation, and to trust in the hypnotist.]

"You may wonder how this reflex works. Well, it is in the spine at the back of the neck that certain important parts of the nervous system are found. Technical names that you may have heard are the Ascending Reticular System, or the nuclei of Raphe. They are central to all matters to do with arousal or sleep. The activation of certain parts of these systems leads to arousal: they make you feel really wide awake. Other parts have the opposite effect: they make you feel drowsy. I say `you', but detailed experiments show that these structures are present in all people, and indeed all mammals. We have inherited them."

[All this is fact, as any decent text-book on brain function will tell you, e.g. A.R. Luria's The Working Brain Bib. We use the technical terms as it serves to underline both the authenticity of the phenomena and the wise teacher image.]

"So you can see that the minute the skin of the kitten's neck tightens, nerves immediately communicate the fact to the nerve centres in the spinal cord of the neck, and say, quite irresistibly, "Limp, relaxed, sleepy, eyes closed, just come along with me." This is so much easier than for the mother to have to verbalise it: especially since she has her mouth full!

Isn't Nature wonderful?"

Wait for at least a nod of assent. [Actually, by this time, you can expect the vocalising system to have effectively switched off. This is partly since so few cues for speech have been given for some time and partly because of the adult-child pattern which is being evoked in which characteristically the child will only reply if pressed.]

"And, as I say, we humans have the same centres in the brain as do kittens. I wonder if you have ever wondered how the kitten feels while it is being carried? Of course, we cannot ask it. But it seems to me that Nature generally makes pleasurable what is necessary. When you are hungry, eating is necessary, so it is a pleasure. Sex is necessary for the preservation of the species and is therefore also a pleasure. When you are thirsty or sleepy the necessary actions of drinking or sleeping each have been provided with their measure of pleasure. The kitten certainly looks happy. I think we may presume that since it is necessary that it be carried by the neck it will feel at least a measure of pleasure in it. And we humans have the same centres in our brains.

[Without saying as much, you can now expect that the subject is already beginning rather to envy the kitten. Recall that she or he is still having to keep eye contact with you, looking upwards at that uncomfortable angle. The image of the kitten lolling comfortably is becoming alluring. The repetition of the incantatory phrase `measure of pleasure' is due to the fact that more childlike parts of the brain seem to respond well to such things.]

"I think that if I were a kitten, then the feeling of being carried by the neck would be the following. It would start with a measure of pleasure in the skin of the neck, quickly followed by a warm all-over feeling of being cared for." Start to slow speech here into a more drowsy intonation and rhythm. [This will give the subject TIME to translate your words into internal feelings, as well as encouraging a sense of drowsiness.] "This would lead to a feeling of total, blissful relaxation, as all of the muscles of my body would go limp." Keep it s-l-o-w. When you say the word `limp' let your own muscles sag. [This will activate the system of imitation which people have.] "My head would fall forward." Demonstrate. "It would be one of the great pleasures of life. Like sleep, but not asleep." Pause. "It would be like flying." Pause. "Flying through the air with no effort. Blissful. Relaxed. Nothing could be nicer."

[It is assumed that there have been no signs of objection to any of this. If not, you are close enough to spot any fleeting expression of disagreement, which you will have asked about and gently overcome. By now there should be signs that the subject is agreeing with everything (slight nods, or that open-eyed stare that we know so well) and taking it all in. We can now move on to the next stage.]

In a brisker tone say, "Now, that reflex in one which can be used to induce hypnosis in one of the most rapid and pleasant ways possible." [Why brisk? The subject has been getting very relaxed. If you now seem to be trying to get him or her to wake up a bit, there will be a reluctance, which will be active for the next minute or two. This reluctance will help to pull down the level of arousal very quickly when you want to. The other advantage of briskness is that the subject's mind has to work so hard to keep up with you that there is no time to analyse what you are saying. The stage hypnotist uses this a lot.]

Still in a brisk and confident tone say, "Indeed there are some people who think that hypnosis is NOTHING BUT the correct activation of this reflex in the spinal chord. Some hypnotists do this tediously with words. I will show you, if you like, how much easier it is to do it like the animals. With your permission I will gently stroke the skin of your neck. You will at once feel relaxation coming over you. Your head will fall forward. You will feel wonderful. Would you like that?"

[Remember clause 5 of our Code of Ethics. Permission must be obtained from the client in advance if you are to touch.]

Assuming that the answer is "yes" - probably by means of a nod - you may then proceed to the "Rapid Induction".

Induction

With a warm hand you gently place thumb and forefinger on either side of the neck towards the back, and gently draw the skin backwards. The client will allow the head to fall forwards as you continue, gently and rhythmically. (You may cue this response by means of a slight forward pressure.) Note the breathing, which will become slower and deeper. You will also note a limpness in the limbs. The subject will not speak. The eyes will close, though you will not readily be able to see this. YOU DO NOT HAVE TO SPEAK during this process, which could go on for a few minutes. On the other hand you could reinforce it by verbal suggestions of an obvious kind: references to sharing the feelings of the kitten, relaxation and so on.

You may then get some feedback by taking your hand away and saying, "Now tell me what that was like?" The client will lift his or her head (in order to speak). Listen to what is said, seeking the key description. Then say something on the lines of, "Good. You see how easy it is. But I am sure that you can enjoy an even deeper feeling of (key word)." Then hold the neck again.

[What you are aiming at is the conditioning process of repeated reinforcements, which is common to many inductions.]

This may be repeated a few times before you declare, "Now you are in a deep and wonderful hypnotic state," and continue towards whatever hypnotic response you are next aiming at: which I presume is on the path to affecting some specific system which has been giving trouble.

DISCUSSION

I have heard it said that Peter Casson has claimed, "I am the quickest hypnotist in the world. But I have the slowest introduction."

An untutored audience, watching the above, will not see the overwhelming importance of the preamble. To them the induction will have started at the point where the neck was grasped.

It will APPEAR that you are using a brilliant new discovery, based on the hardest scientific evidence. We all KNOW that animals have that reflex, don't we?

But let me make it clear that although the above induction WORKS, (I invented for and demonstrated it at, one of our Leeds University courses in Advanced Hypnotic Techniques, to illustrate a point) I do NOT know if the hypothesis that it works by means of activating a deep and natural reflex is accurate or not. At the risk of being tedious this is the same point I have made in my article on Mesmer. The fact that something works does not mean that it works for the reason that the practitioner claims.

We cannot ever prove that a hypothesis is TRUE, but we can at least find out if it is FALSE. The weak spot in the argument is the assumption that we retain the reflex that is found in many mammals.

We could test the hypothesis in humans as follows. It should be strongest between mother and small child. (This is the rationale for working to induce a child-like frame of mind in the client.) We would need some mothers, who do not know exactly why we are asking them to cooperate, to hold and stroke their children in a variety of ways, one of which is the method of stroking the neck. It is important that the mothers have NOT heard about the disputed reflex, as they may well communicate feelings of relaxation to the child unconsciously. We would ABANDON the hypothesis if there were no clear evidence that stroking the neck clearly produces more limpness than stroking other parts for any age group of children.

If the initial results were favourable we would have to check it with a double blind system, to eliminate the possibility that those who are supervising the training of the mothers and assessing the results are themselves unconsciously biassing the results. If the results from either the first or the second series of mothers and children did not produce clear, common sense evidence that the neck stroke is betterthan other contact for relaxating a child then I WOULD ABANDON THE HYPOTHESIS. It is this ability to ABANDON an idea which does not stand up to experience that is, I feel, the hall mark of sanity.

As it is, the above induction MAY work by activating such a reflex, but it will be clear from my explanations that the preamble is powerfully involved in activating all sorts of mechanisms in the subject's mind. Suggestion is very powerfully at work. Activation of a child-adult relationship is there. Straining of the muscles of neck and eyes is there. All these will, we know, act to produce the result required. I knew, therefore, that it would work before ever trying it, whether or not the reflex is present. I know, furthermore, that if an audience has seen this method working on one subject, then they will be yet more inclined to follow suit.

What a lot of alternative practitioners do not seem to know is the extent to which their preambles and peoples' prior expectations are involved in their results.

CONCLUSION

If this approach suits your style I would be interested in hearing from you how it works with more people than I have yet had a chance to try it on. (Which have been few as yet: I do not see it as the best approach for most clients in the therapeutic context, and I regard it as unethical to use any but the most appropriate induction on a client simply for the purpose of experimenting with a new one.)

This description can stand as a model of the amount of explanation of the purpose of any element which I would like to see included in the description of a hypnotic procedure.

It may also serve to illustrate the fact that just because some practice works reliably IT MAY NOT BE DOING SO FOR THE REASON CLAIMED. It also gives an idea of HOW to go about seeing if a hypothesis should be abandoned.

The most important ability in a housewife who desires a clean and healthy home is knowing when and how to throw rubbish out: to abandon things. That is common sense. The most important ability in a person who desires a clean and healthy mind is knowing when and how to throw rubbish out: to abandon ideas. That also is common sense.

Or, as the famous explorer Burton put it so much better in The Tinkling of the Camel Bell. "Indeed he knows not how to know who knows not also how to unknow."

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Summer 94.

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Only adults have panic attacks

THERE ARE many books for the general reader about panic attacks, often of a very high quality. But they all seem to miss a very important, and at times the most important, feature of them. Because of this they fail in their job of helping the sufferer to understand in a useful way what it may all be about, and even more do they therefore fail to give the most useful advice to the sufferer.

Before going any further let us be clear in our minds what we are talking about when we are talking about a panic attack. We are not talking about fright pure and simple. If I am threatened by a man with a gun I will experience fright. But this will surprise no-one. Everybody will suppose that it is natural to feel fear in that situation. The feelings I have will be labelled "fear" by myself and by others. If, on the other hand, I am in a queue in the supermarket and I feel the same feelings then they will be labelled a "panic attack".

These examples illustrate the following definition.

A PANIC ATTACK is a feeling of acute fear which seems out of proportion to any present cause.

Of course the feeling of fear is accompanied by a variety of physical effects. There will generally be adrenaline production and an increased heart rate. There may well be sweating, hyperventilating, trembling, a tendency to get cold feet, dry mouth etc.. Each person tends to have a slightly different pattern of response, but the central experience is a feeling of FEAR.

How do we distinguish Fear from Panic? We must have some internal standard of what is appropriate in a given situation. A Fear that seems out of proportion is labelled Panic.

A frightened child

Next let us consider a scenario in which we see a frightened small child: a two year old, perhaps. The exact age is not crucial, the important feature is that it is too young to have internalised any idea of how appropriate a fear (or indeed any other emotion) is to a situation. Notice therefore that from our definition the child can never be said to have a panic attack by its own assessment. What about by another's assessment? How many mothers label their children's fears as panic attacks? The answer is surely, "None". CHILDREN DO NOT HAVE PANIC ATTACKS!

They experience fears of course, and a frightened child can be considerably more frightened than an adult because there has been no opportunity to learn to control the fear at all. Any mother knows her child's fears. Some seem readily understandable, like a fear of loud noises, others, like a fear of a certain person or place, may seem less so. But we do not generally impose strict criteria of what is appropriate: we accept that a child might be frightened of all manner of things. There is therefore almost no possibility of saying that a particular fear is badly out of proportion for a child and so no danger of labelling its fear a panic attack.

By this stage I have simply tried to present a very striking fact, which is obvious enough when it is stated, and perhaps does not seem to take us very far. However there are other dimensions to this idea, as we will see. But first I am going to take what may seem to be a diversion and give two examples from my case book of very clear cut panics. They are clear cut at least in part because the sufferers came to me within days of the attacks, and so there had not developed the fear of panics which itself tends to aggravate the matter in so many cases.

Two cases

The first case concerns a man in his early forties. He is big, strong and has a black belt in Judo. He runs his own building business - not a job for a weakling in any sense, and lives in a tough neighbourhood. He is scared of nothing.

Then one day he was approached by a little runt of a man who, with the courage of too many pints inside him, started to swear at my client. And my client panicked! He could not move. He was trembling and sweating. His voice was a high-pitched falsetto. He thought he must be going mad. You might like to think what treatment would be appropriate.

The second case concerns a woman, also in her forties. She, also, had run a successful business - a restaurant, in her case - but after a divorce she had decided to make a fresh start as a Driving Instructor. She had driven all over Europe with total safety for many years and had clocked up an enormous milage. But almost as soon as she got into the car for her first lesson in Instruction she went to pieces! She was tense. Her mind seemed to forget everything she had ever known. She could scarcely control the car at all. She tried desperately to force herself back into control, but with no success. She panicked. What is the appropriate treatment?

Let us revise the broad methods which might be used. We might think of post-hypnotic suggestions to the effect that the panics in these two cases should not recur. We might think of progressive desensitisation: though without hypnosis it would be hard to find a series of progressively less foul-mouthed drunks! We might think of breathing exercises. We might wonder if, in the second case, there were repressed after-effects of the divorce, or whether, in the first, if there had been a build up of stress in the builder. Some might turn to acupuncture or homeopathic remedies.

I did none of these things. I asked myself, "I wonder when this feeling arose, naturally, before?" (For the value of asking the right questions see the article on Interview and Diagnosis.

Within a few minutes we had discovered that when the builder was a young boy of perhaps four years of age his father had often come in drunk from the pub and then sworn at him if he were still up. At that age, if your drunken father, who is well over six foot high and strong, comes and swears at you, then you NATURALLY tremble with fear, you NATURALLY sweat, you are NATURALLY fixed to the spot and you NATURALLY speak in a falsetto voice - it is the only one that you have. In short you feel fear pure and simple. It is not a panic because it is in proportion to the cause.

The drunken runt had quite accidentally triggered off what amounted to an age regression, and reactivated a childhood system of response, which was no longer in proportion to the cause and so amounted to a panic.

What did I find out about the woman? The obvious question there was, "And how did you react the first time you took a driving lesson?" The answer, as anticipated, was, "I was eighteen, and was in a terrible state." In this case, the stimulus of being again in a car with a stranger who was to instruct her had evoked an earlier system of responses - an age regression to 18. She was scared the first time, with the not unnatural fear of a strange situation, and so fear arose the second time also, but this time it was not appropriate and so became a panic.

You must explain

It is worth noting that in these two simple cases it was ENOUGH TO EXPLAIN WHAT WAS HAPPENING. No other treatment was necessary. The clients went away totally relieved in mind, with complete understanding and knowing that there was nothing seriously wrong. The builder knew that he now only needed to contrast the present drunk with his remembered father and the spell would be broken. The Instructor knew she need only treat herself as she would any other nervous eighteen year old, instead of shouting at herself, and her confidence would return quickly. But all too often people do not get rational explanations. Then, whatever other treatment is given, there remains the lurking thought, "But will it happen again? I do not know why it happened. Perhaps it will crop up somewhere else? Perhaps I am cracking up? Perhaps I am under too much stress? Perhaps... Perhaps... Perhaps?" And such thoughts are the most fertile possible bed in which to cultivate little anxieties until they turn into full-grown panics.

These two examples have been chosen to demonstrate a common theme in first panic attacks.

The pattern

The pattern is this. An adult has experience E. This is similar to some sensitising experience S, which happened a long time ago, most usually in childhood. Experience S was accompanied by a NATURAL level of fear. Experience E evokes a similar fear, but it now seems unnatural, not least because judged by the adult's standards it is out of proportion to the apparent cause.

One enormous therapeutic benefit of pointing out to the client the connection between E and S is that it makes it possible to reframe the idea of how natural the fear is. People start by saying, "Well, no-one else is frightened of E!" But then this is changed to, "Yes, no-one else who has NOT HAD EXPERIENCE S is frightened of E," from which it clearly follows that, "Everyone who HAS had an experience S is frightened of E." It therefore becomes normal: a fear and not a panic and is much more easily coped with.

With these ideas in mind we next come to a very important consequence which has enormous importance when it comes to the question, "What is the best way of dealing with panic attacks?"

The answer which now seems obvious is, "Treat the person's emotions as they would best be dealt with at the age of incident S, NOT of incident E. For example, when the lady above treated herself with the patience she would apply to any other eighteen year old, the problem passed.

So much well-meaning "help" is totally misguided because it is directed to the adult, who at the time of panic is adult only in part, and not to a frightened child which is the dominant part. If a child is frightened in a supermarket it does not help to snap, "Don't be silly. You should be quite happy here on your own." The best treatment is a warm hand to take it to a familiar place of safety. No sensible adult uses cold reason with a child who is frightened. It needs simple reassurance and understanding and perhaps a warm drink.

Gagging reaction

I had one client who had just moved up to Leeds to be with her boyfriend. Within a short time she got into a dreadful state - full of dread that she was going to die because she could not eat. This was a pattern that had happened at other times in her life and caused enormous problems. A simple systems analysis revealed that fear triggered a gagging reaction to food, so that she was unable to swallow any. Being unable to swallow triggered a mental system which was, "If I don't eat I will die." And that thought in turn triggered off fear, thus closing a circle.

It turned out that most of this pattern had been established within the first year of life. She had had swallowing problems. She had been taken to an alien environment (the hospital). She had naturally been frightened. So an association had been established between a strange environment, fear and not swallowing. Coming to Leeds, a environment strange to her, had triggered the pattern off.

Feeding bottle

Treatment was simple. First, the mechanics were explained, so that she could see that she was just reliving the feelings of a small child. Second, she was instructed to treat herself like one: go home, curl up in a duvet, play soothing music or chat about simple things, and drink warm milk from a feeding bottle, which she could buy in any chemists. (The cleverness of this is that it subtly undermines that mental system which equated not eating to starving to death. She could, in fact, swallow liquids, and everyone knows that babies, who can ONLY drink milk, do not die!)

The result of these simple interventions was total relief of her symptoms within a day. In fact she drew the line at using the feeding bottle, but the idea had done its work.

This illustrates graphically the principle that the appropriate treatment is as close as possible to that which would be best at the regressed age. If one is doing hypnosis in this context it best to make it very cosy: the warm blanket; the bedside story anecdotes; the warm parent comforting away the fears. The idea is simply to recreate some of the key features of what would have been a perfect antidote to the fear for the child. If one is not using hypnosis explicitly, there must nevertheless be in mind the idea that there is a frightened child who needs reassurance, kindness and sympathy.

Some readers will readily relate these ideas to the notion of "The Child Within". However, that concept originated in the field of therapy with people who had suffered abuse or similar in childhood. Here I am drawing attention to something which is far more general. We can all meet experiences E which will cause a reactivation of earlier, and therefore usually childlike, patterns of response. Under those circumstances we become like children again in some ways, or if we want to put it more technically, a partial dissociation is established between at least two parts of the mind. One part is the present day persona and another part is the reactivated child-like persona. There may in addition be secondary effects, such an internalised parent: this manifests itself as the adult trying to quell the child within by using the approach which the child's parents used. (You may recognise how this establishes a connection with Transactional Analysis - "Games People Play", Berne Bib etc.)

Finally let me add that it should not be thought that this mechanism is the ONLY cause of panics. We may cite, for example, another large class, which can be seen as a natural response to being in an inappropriate environment. The model here is that of a wild animal taken into captivity. It will naturally feel high levels of fear. People, too, can feel high levels of fear in a strange environment, but since they think, "Other people are at home here. There must be something wrong with me - my feelings are inappropriate," they turn a fear into a panic. Of course this might also trigger off a regression to a bad experience of fear of a strange place as a child, but this is not necessary in order for a panic to arise.

Another big cause of panic is, as has been indicated above, thoughts in an adult like, "I have a problem. I may have another panic." This is often the primary mechanism in panics after the first because such predictions are self-fulfilling, though again there can be an element of regression.

We may now go back to the original idea, that children don't have panic attacks. We may now see that it is not totally true, in the following sense. If we looked very closely at a child's fears, then we might well be able to isolate some which are in fact out of proportion, and for the same reason we have cited: that the fear response has been conditioned by a still earlier fear. However, for a young child it remains true that there will be no inner judgement as to the appropriateness of the fear, so it cannot be conceptualised as panic. The child will usually also benefit from greater tolerance of its fears by adults and a greater chance of the fear being treated at a level appropriate to a child's fear, which will dissipate the fear more readily.

SUMMARY

• A PANIC is a fear which seems out of proportion to any present cause.

• ONE major reason for such an attack is that the stimulus is actually activating a system of response to a similar thing which happened a long time ago.

• This can be thought of as an age regression.

• It can be helped enormously by treating the problem at the regressed age rather than the real age.

• For the client to understand the mechanism is itself a weight off the mind, because worry about the mysterious can breed further problems.

• When a "first" panic comes out of the blue, this mechanism is very high on the list of possible causes.

• Subsequent panics are often a simple result of autosuggestion. "I've had one. I'll have another."

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The Child Within

I was given the above, framed, by a lady client who knew at first hand the suffering of the Child Within. It meant a lot to her. She had cut it from a magazine, and did not know the author. If someone knows who it was I would be pleased to acknowledge the source.

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Winter 93.

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Rebirth - a Sonnet

Wearied by tasks that tax the soul
I walked up Ilkley Moor one winter's day,
My adult cares for company; no thoughts
In mind but money, work and sex. No play.
The clouds hung close around, the wind grew chill
And threw against my cheek the icy rain.
I turned the other. And upon that hill
All other thought was taken from my brain
But "Climb!" I climbed, obeying the command. The cairn
loomed close, then shone in brilliant sun
As parting clouds revealed a magic land
In which to laugh and jump and shout and run.
For thus the clouds of worldliness are torn
To make a child again: to be reborn.

A poem has many levels of meaning, as does therapy. One meaning, relevant here, addresses the problem: how does one who claims to heal the minds of others keep a healthy mind himself?

I count it as one of my great blessings to live in the Yorkshire Dales, so that five minutes walk can take me out onto the healing moors, where all things find their true perspective and where lungs and body find the natural health in which alone a healthy mind can dwell.

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Autumn 93.

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Dealing with Sexual Problems in the Male

IT IS NOT UNCOMMON for men to come along to a therapist with one of the two most common problems in the area of sexual dysfunction: a failure to achieve erection and premature ejaculation.

In this article I will be describing the main lines of approach that I take to such problems which have seemed to be generally effective. Readers may compare them with their own methods and possibly suggest improvements.

This article may perhaps be of more value in the absence of any guidance in this area from some of the primary books on clinical hypnosis: Gibson & Heap's Hypnosis in Therapy, Hartland's Medical and Dental Hypnosis and Milton Erickson et al's Medical and Dental Hypnosis. The best book I have come across was, in fact, written one hundred years ago and is The use of Hypnosis in Psychopathia Sexualis by A. von Schrenck-Notzing, M.D. translated by C.G. Chaddock M.D. in a new publication by the Julian Press of New York in 1956. This is in some ways surprisingly up to date, but I have not drawn extensively on it in the following.

Diagnosis

The first stage is, of course, asking the standard questions about the problem (Cf. the article Practical Psychotherapy: Interview and Diagnosis). The most important ones being:

Q. Can you tell me about the first time you had this problem? and

Q. Could you please me about how you think about it in the times between lovemaking?

Why is the question about the first time important? First of all we want to make certain that the problem does, indeed, have a psychological root: there could be medical problem involved. So we want to look at the first time to see if, indeed, the failure to achieve satisfactory intercourse has a clear rationale.

Examples of how a problem might start are the following. A young man on holiday has already had sex that day with one woman, and then finds himself in bed with another to whom he is not in any case very attracted. He fails to get a satisfactory erection. (Is anyone surprised by this?) Another young man has sex for the first time in his girl-friend's parents' house, where he is very nervous in case her parents return. He ejaculates prematurely. (Is this very surprising?) A third has had far too much to drink. And so on.

Physical causes for impotence include syphilis, diabetes, alcoholism, drug addiction, strokes and other damage to the nervous system. It is, of course, probable that such causes will have been diagnosed earlier by the client's GP, but we should be aware of them and ask specifically about them if we do not have a clear initial cause.

The second reason we want to find the reason for the first occurrence is to limit the worry from which the client is typically suffering. By the time he comes for help he has usually worked himself up into a condition of great concern about the matter, and thinks things are far worse than they are. It is psychologically very reassuring to know the answer to, "Why have I got this problem?"

Feedback loop

Now we come to the second major question: what the client is thinking between times. Typically it is some variation on, "There is something wrong with me. I am a failure. I must try harder next time. I am afraid that it will happen again next time."

What we know, of course, is that thoughts of this nature have the effect of increasing anxiety and of increasing the chance of the failure arising again. But yet another failure simply pours fuel on the flames and the pattern of thought and worries grows stronger, which in turn leads to a greater and greater chance of failure and so on. Such a vicious circle, or increasing positive feedback loop, is responsible for very many psychosomatic problems as has been described in more detail in book elsewhere on this site: The Principles of Hypnotherapy.

It is this vicious circle which has been responsible for the continuation of the problem. And it is this circle that we have to weaken and then eliminate.

Other questions

Naturally one looks briefly at the entire sexual history, some of which may well be relevant, and also takes a quick look around other aspects of the client's life: "Any problems with work?" "Any bereavements? Illnesses? Worries of any kinds?" "What job do you do?" (Often a useful cue to the kind of language one will use in the session.) "Did you have any problems as a boy?"

First Step

The first step I take to change things, after at least twenty minutes of analysis around the questions above, is usually to see if the client accepts the following story.

"Now it seems to me that this is what you have been telling me. You had no problems worth mentioning until the day when... (the first incident is described in detail) ... where things went wrong as they would have for anyone else because of (specify the reason).

IF you had known that reason at the time, then you would not have thought any more about it. There would have been no worry about it. The next time you made love it would therefore have been as if that unlucky incident had never happened. It would have gone well. You would then have remained confident and happy. And it would have continued to go well. You would not be here today."

It is actually a big step forward if the client runs through this in detail in his mind and accepts it. It puts the thing in perspective.

If the client does NOT accept this outline story then I take it as an indication that I have missed something, and further questioning is necessary to find out what that is. Such cases are then treated on their own merits, but they are comparatively rare. (An example that comes to mind was a young man in his twenties who had yet to achieve successful intercourse. The pattern there seemed to be simply one in which each stage of sexual development and experience had been delayed by several years, and what was required primarily was a certain amount of visualisation and encouragement of the next step.) In this article I will assume, however, that the outline story is accepted.

The more detail and time that is put into the above story the better. Indeed it can form a very important part of the treatment to proceed as follows. (Cf. the article on Editing Mental Videos.)

"I would like you now just to close your eyes and sit comfortably and think about what I am saying. You are as you are today because you have memories of certain failures. You have accepted that if you had realised at the time the natural cause of that first incident then there would have been no more problems, only successes. You would then have only memories of successes, and would be free from worries and problems. We are therefore going to take the disappointing memory tapes out of your mind and over-write them with successful ones.

"Start by re-living the first. (Questions and answers are used to keep me aware of what is being thought of.) That is fine. Now picture yourself smiling afterwards and thinking, `That could have happened to anyone. I will certainly avoid that mistake again.' Now move on to the next bit of memory, and run it through your mind, from the time you started to think about sex to the time it was over. (Again listen to the account.) Now, you can see that it went wrong because you had got yourself into a state beforehand. NOW run through that again, but get it right this time. In the run-up picture yourself as you would have been if you had handled that first incident right: confident, feeling good... Then imagine it all going well, just as it should have. (Let him run it through.) Now, how does that feel? The answer is typically "good".) Now we will go through all the other memory tapes editing them to be the way they should really be. (And do that in detail also.)"

Control

The above will usually go quite a long way to reduce the power of past failures. But I find that there is another point which is very often worth paying a lot of attention to. Very many men seem to suppose that they should be able to control their sexual performance in the same sense that they can control the voluntary muscles of the body. It is seldom put into words, but concealed in their attitude is the idea, "I should be able to maintain an erection at will and to reach a climax at will." Furthermore there is often concealed in this idea the further one that, "And it has nothing to do with the woman"! This second sentence, put as bluntly as that, may seem ridiculous to many men and most, if not all, women. Yet, if you analyse the patterns of thought that clients get into, it amounts to that.

Now such an attitude is not at all helpful when things are not working. If you give anyone responsibility for something over which they have no control then it is going to lead to increasing anxiety and a sense of failure. If the man feels that he is responsible for aspects of his sexual performance that he does not, in fact, have conscious control over, then it will inevitably lead to increasing anxiety and sense of failure. We therefore would like to remove from him that sense of responsibility.

It will be apparent to readers that for him to go for "treatment" to anyone will help him in this way. It is a way of saying, "I cannot control this. You are now responsible for making me better." Whether the expert referred to is a doctor, or aromatherapist, or acupuncturist or hypnotherapist makes no difference here. In each case the fact that the expert accepts the responsibility takes some of the pressure off the man and gives room for improvement. I suppose, however, that it is only the psychological specialists who are consciously aware that this is a part of the treatment.

I will generally take further steps to remove the responsibility in some such way as the following.

"You know that dogs do not have these problems at all. Evolution has been working for millions of years to give them a fool-proof sexual system. Nothing happens until they smell a bitch on heat. The effect of the bitch and the effect of the bitch alone causes them to become sexually active and to do the things that have come naturally for millions of years. They are of course too stupid to start to think about the possibility of failure. They are too stupid to think about their performance. They are too stupid to think about themselves at the same time as they are aware of the bitch. They are too stupid to make a mess of things.

"In the same way our sexual behaviour was designed in a world where it was supposed that we would not be clever enough to think about ourselves at the same time as the woman. It was supposed that the attractions of the woman would be enough to command our whole attention, and simultaneously arouse us in the appropriate way.

"But it will be obvious to you that from a time hours or even days before the meeting, right through to the time in bed, you are doing little but think about yourself. If you think about her it is only to worry about what she is thinking about you, and you are back thinking about yourself again. This is NOT what nature intended. Over the millions of years of evolution nature never supposed that after she had gone to all the trouble of making women and sex so attractive you would still be more interested in yourself than in your partner!

"So in future you are going to forget yourself. You will first and last be paying attention only to your partner. You will notice the fragrance of her hair, the sweetness of her lips, the softness of her skin. You will notice her. You will allow your body to notice hers, and to move in response to hers, and to become aroused in response to arousal in her.

"Just as sailor knows that it is the presence of the wind that swells his sails, and he can do nothing without it, so you will realise that your sails will swell in the wind of sensory delights blowing from her to you. And the sailor times his voyages by the tides, and waits until the tide is high before casting off. And you too will be aware only of the rising tide of her passion and will not cast off onto the sea of ecstasy until that tide is high.

"You will stop thinking about yourself. It has done nothing but harm. You will stop thinking about yourself. It has poured sugar into your patrol tank. You will stop thinking about yourself. It has caused the computer of your sub-conscious to crash. You will stop thinking about yourself and think and sense and feel nothing but HER."

The idea behind the above is that sex evolved in the context of the coming together of two systems. Primarily this is two sets of genes, and secondarily the two organisms that carry them. Until our spare mental capacity evolved, sexual behaviour in one was activated only by certain cues in the other. In a simple form the primary pattern in mammals is:

&uarr {sexual cues from female} &rarr &uarr{sexual behaviour in male}.

Meaning of arrows

In most mammals the sexual cues from the female start with oestrus, and are often primarily olfactory. In our species pheromones are still active but at a much reduced level and we rely more on other signs of receptiveness.

If the male renders himself unable to perceive those cues from the female then he incapacitates virtually all the natural internal systems of his body which are designed to ensure that intercourse proceeds with mutual satisfaction. One of our tasks is to prevent this happening, as I hope that the above illustrates, in a rather more poetic way.

The female point of view

Men are nearly always far more concerned about these matters than are their partners. If the rest of the relationship is fine then most women are not very concerned. I would suggest that for the minority who get angry about it something on the following lines is responsible.

If her rather confused feelings were to be put into words they might run as follows.

"Things are not going right. Why not? If he loved me they would. If he loved me he would be aware only of me. And things would go right. So he does not love me. He is not with me in bed. He is thinking/feeling about someone else. He is being unfaithful. That is infuriating."

And the kernel of truth in this is that he is NOT properly aware of her, he is thinking of someone else: himself. Her rival is not another woman but another man, and that man is lying beside her!( Now it is a normal (and often helpful) thing for a woman to be angry with her rival: she may well be able to drive her away. But if her rival is her partner then things can get badly messed up if her anger is expressed. In fact we usually get into a vicious circle:

&uarr {woman's anger} &rarr &uarr {man's sexual activity} &rarr &uarr {woman's anger},

which simply makes things far worse.

Other techniques

Although the above are the two main strategic lines of approach that come up in these problems, we may note other minor techniques which can at times be useful.

I will sometimes do a fist levitation until the arm is erect in order a) to enhance the useful effect of transferring the responsibility for an erection away from the man and b) to demonstrate that what is believed in will happen. The moral is that if he believes an erection will not happen then it will not.

Visualisations of future successful lovemaking is a normal part of treatment: though with a emphasis on getting his focus of attention in the right place.

Suggestions of confidence and that all will be well are of course also normal.

If the problem is that of premature ejaculation then the rather obvious idea that to make love twice in a matter of hours, with a much more delayed ejaculation the second time, is one that sometimes has not occurred to the client, but can remove a lot of anxiety.

If there are other specific worries, then they may also have to be dealt with. One of the more important is if the man has financial troubles. This hits his self-esteem hard and it may be hard to do very much about the sexual problems unless the financial ones improve first.

At times there are relationship problems of some other kind that are being reflected in the sexual problem, and then, of course, it may be necessary to do some counselling with both partners for a while in order to resolve those first.

Summary

Although there may be contributing causes the most common pattern in sexual malfunction in the male is the following.

The problem begins with an initial incident. The man then begins a vicious circle in which preoccupation with his problem leads both to a failure because be is expecting it and to a failure because he stops attending to the woman, thus depriving his body of its natural activating cues. This failure simply increases the preoccupation.

The solution involves the following main steps.

1) Demonstrate that the initial incident had natural causes.

2) Let him see and feel how much better things would have been since if he had realised those causes at the time.

3) This results in him no longer thinking of failure as inevitable.

4) Get his attention off himself and onto his partner.

5) Get him to visualise successful implementation of this change.

This article first appeared in the Journal of the national Council for Psychotherpay and Hypnotherapy Register, Autimn 95.

SCHRENCK-NOTZING (op. cit.) "It is necessary to so influence the patient that he is not constantly pre-occupied with himself."

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When the problem is smoking

This article is a response to a letter in the NCHP&HR Journal from Edward John McClurg. The parenthetic remarks in the article have specific relevance to Mr. McClurg, a tutor in Quality Management Systems, though others may find them illuminating.

I AM NOT GOING to describe a technique for dealing with smokers so much as a methodology: the broad lines of my approach. It should be clear as you read on why this is so.

In dealing with a smoker my first assumption is that I am dealing with at least two systems. One, which is usually the greater, is the part which has determined to stop smoking. The other is the system which is controlling the smoking.

(A business parallel is to take the former as an enlightened Management who has determined to implement a new BSI standard, and the latter as a department which is stubbornly sticking to the old "tried and trusted" ways.)

My first job is to ASK THE RIGHT QUESTIONS - a task I emphasised in my article on Diagnosis. I cannot make intelligent changes until I know the answers to the following questions. (The equivalent managerial questions are in brackets.) The order is not significant.

* How does it feel when you want to smoke, and how does it take place? (Could you introduce me to the department that is giving the trouble?) These stand for a whole string of questions directed at getting a firm idea of the smoking subsystem (the problem department) that has somehow to be changed.

* A further question on these lines is: Is the subsystem based on ideas, feeling or habits? I.e. Is it more like a voice saying, "You need a cigarette", or a feeling of needing one, or simply an habitual action. (Is the subdepartment acting according to rules, or on gut feeling or on sheer force of habit?)

* How have you tried to stop? (How have you tried to implement the change?) It is obviously helpful to try to discover what has been tried and WHY is failed.

* What are the advantages of stopping? (What are the advantages of implementing the standards?) This question must be asked of the non-smoking will and also the smoking subsystem (Management and the recalcitrant workforce.)

* What are the advantages of continuing? (What are the advantages of not implementing the change?) Again ask both parties.

It is possible that you will only get honest answers from the smoking subsystem in a trance. (You may only get an honest answer from the workforce when you have their trust and the Manager is not breathing down your neck.)

* How and why did you start smoking? (How and why did the current work practice originate?)

* What do your family/friends feel about the smoking? (How is the key department affected by outside pressures from other businesses etc?)

The above are simply a selection of the more central questions. I also devote time to getting to know other things about the person. Of particular importance are their interests, professions etc, because you can put things over much better if they are related to things they know about. (Just as I am trying to put the ideas in this article over in a way which I hope will mean a lot to Mr. McClurg, as a tutor in Quality Management Systems.)

Broadly speaking, you know the most important things about a person if you know the things to which they will respond, and how they respond. It does not matter if the response is favourable or unfavourable. Things they do not respond to are irrelevant in any brief therapy. (The important thing about a company or department is the things they respond to and how.)

There is a world of difference between a pregnant woman stopping smoking for her baby and an aggressive businessman stopping for his own health. Their minds are very differently organised; their motivations are very different; the similarity of goal conceals an enormous difference in the tasks.

(There is a world of difference between changing things in a company like The Body Shop and changing things in Saachi and Saachi. Their managerial structures and styles are very different; their motivations are very different: the similar goal of applying a certain standard conceals an enormous difference in the tasks.)

Only when I have spent at least half an hour on this preliminary task do I begin work. As I have been going along I have, of course, been noting down promising lines of approach. And many of my questions will have been devoted to checking out whether these will work or not.

(Only after a detailed study of the organisation and the problems involved in the company will a consultant begin to make recommendations. But he has been noting promising lines as he goes on, and many of his questions have been devoted to clarifying or eliminating these options.)

Discussion

I will then discuss what steps the client is able to take without needing much help. (Find out what the Management might be able to implement easily without much help.) Often there are obvious things which have been overlooked: for example suppose that a person smokes by habit in the toilet only since an ashtray has been installed. The removal of the tray will stop that part of the habit easily.

In many cases the bulk of the task lies in this area of things that can rather easily be changed by conscious effort, if you know how. (In many cases most of your changes are to management style rather than to the actual functioning of a particular department.)

Notice that there is no ONE piece of advice. Each person may have failed to notice a different specific point that could easily be changed. Erickson once noticed that a retired policeman always bought his cigarettes from a store next door. By getting him to agree that it would be better to walk across town to buy them he reduced the habit enormously. But it is unlikely that this specific technique would work for many clients.

Induction

I seldom waste time on inductions which focus on some irrelevant subsystem such as hand levitation, eye closure, formal relaxation etc etc.

(As a consultant I seldom bother to make changes to any systems other than those centrally involved.)

I will begin with a theme of great interest. This may well be smoking itself.

Just lie back comfortably, close your eyes, and start to think as vividly as possible about wanting a cigarette.

I will then ask detailed questions as the client goes through the whole process of smoking a cigarette, to hold his or her attention on the process.

On the one hand this gives great insight into the attractions of smoking - the only pleasure for one woman was the sight of the smoke in front of her eyes. On the other hand you will find it acts like any other attention focussing induction. All other subsystem close down; relaxation ensues; there is total absorption in the functioning of the internal system of smoking and the hypnotists voice; that subsystem opens up in the face of my non-judgemental questions.

(Just let the rest of the company have some time off, and let me just watch the way in which this particular department functions at present. The consultant then watches and asks questions. On the one hand he finds out in great detail what is happening at present. On the other hand he is at the same time getting the company functioning in a way which makes it easy to change. The subdepartment is listening to him; it is not distracted by messages from all other departments; it begins to open up and trust him.)

This stage may go on for five or ten minutes (five or ten hours) or longer.

I next start to make suggestions. (The consultant then starts to make recommendations.) My preferred style is not to use the bludgeon, but to put things in a way which seem perfectly natural to the particular systems I am working with. It is for this reason that there is no one way. For example, with a pregnant woman it is often very easy to get her to visualise the face of the unborn baby: this activates a very powerful system of protection for her child. When she thinks of smoking, the baby's face cries. When she stops, it laughs. You may repeat this several times. This "technique" obviously is quite unusable in a businessman.

(It is generally better, wherever possible, to get a consensus rather than to use brute force. There is no one recommendation that applies in all cases. In one subdepartment money is a powerful motive, in another it is job security, in another is may just be that intangible, morale.)

In practice, then, I never make the same suggestions twice in the same language: everything is subordinated to the overwhelming importance of the unique personality structure of the present client. (If I were a consultant I would never trot out standard recommendations: everything has to be tailored to the overwhelmingly important fact that each company is distinct.) I may use metaphors and images, evoke physical sensations such as nausea; represent true facts graphically: watching two drops of pure nicotine killing a labrador in five minutes makes a vivid picture, as does the fact that tobacco leaves make a good substitute for toilet paper in countries where it is grown; regress the client back to the time of starting to smoke; evoke feelings of love - for members of the family harmed by the smoke; arouse feelings of pride or ambition; use a desire for a clean house which may be linked to the idea that the body is a house for the soul; intensify a desire for a holiday or other good that can be saved for with the £700 or more that is going up in smoke each year and so on. To list all these "techniques" in detail would take up many volumes, even if I were simply to present a single script for the main line, let alone go through all the variations which are involved in modifying such a script to fit a wide range of subjects.

Tying it up

Towards the end I will normally incorporate a suggestion on the following lines.

You will be healthier, wealthier and wiser as a non-smoker. But it will not necessarily make you perfect. No-one is perfect. Anyone can make a slip. Neither of us can be certain that at some time in the future, near or far, perhaps at a party or time of uncommon stress or illness you will not find yourself tempted to smoke another. And it might well be that it would be the best thing to do at the time. All I want you to remember at that time is the thought: "YES, I CAN HAVE THIS IF I CHOOSE, BUT IT WILL COST ME AT LEAST £30!" (My standard fee in 1994)

I will generally talk a bit more about the above, pointing out that most people, if they start again, rapidly return to previous levels of smoking which will cost far more than the £30 another session will cost (£20 if on reduced income).

The purpose of this section is two-fold. The first is that the thought itself is a great deterrent. Few people would ever pay £30 for a cigarette. The second is to motivate a quick return to me, which will make stopping again much easier. There is commonly a feeling of guilt at failing, or a feeling of letting the therapist down, or a feeling that he could have been expected to give life-time cover: these are counteracted by the above.

Furthermore I very much want to know about anything that does go wrong, so that I can perhaps get it better next time. Failures are far more important than successes. Anyone, with any technique, can get some successes but you only improve by minimising the failures, which means making it as easy as possible for them to come back to you if they start again.

SUMMARY

1. Find out as much as possible about the two primary systems of interest, and all other systems, internal and external which are involved. (Study the business and its economic environment in detail.)

2. Decide on a strategy of changing these systems, based on their real nature in the individual, not on some abstract idea. (Plan realistic changes.)

3. Discuss and arrange changes which can be made at the level of conscious will. (See what can be done with the Management.)

4. Induce a trance which is tightly related to the smoking subsystem. (Get to talk to the problematic department.)

5. Implement the planned changes at that level also. (Change working practices there.)

6. Tie it up with suggestions of return if there are problems. (Arrange for further contacts if there are problems.)

* Throughout look for as much feedback as possible. (Ditto.)

Ecologically sound

Finally I would like to highlight my overall philosophy in hypnotherapy, which may throw light on the overall approach I have used above.

We all know of ecological disasters resulting from introducing, perhaps for good reasons, a new species into an ecosystem.

We may all know of instances where a new work practice or rule or law, introduced for a good reason, has had dismal consequences.

We all know how a person's personality may suffer from the undue influence of parental or other ideas which do not suit the person concerned.

HYPNOSIS PROVIDES POWERFUL TOOLS FOR INTRODUCING NEW SYSTEMS OF THOUGHT, FEELING OR BEHAVIOUR INTO THE COMPLEX SYSTEM OF THE HUMAN MIND. IT MUST BE USED WITH THE UTMOST RESPECT FOR THE EXISTING SYSTEM.

I am dismayed by hearing of hypnotists who forcibly slam into a mind powerful suggestions with no regard for their compatibility or otherwise with existing thoughts or patterns. I am as dismayed by the thought of removing a smoking habit by means of a forceful repression as I would be by the thought of dealing with a difficult workforce by simply locking them up in a room. Each may seem to work brilliantly in the short-term, but could have dire long term consequences.

Ideally I am striving to attain a sufficiently complete knowledge of all relevant workings of that system which is the client in front of me AND the even more complex social system of which she or he is a part, so that any changes that I make are in harmony with those systems while also being viable and able to flourish there. (I am striving to attain a sufficiently complete knowledge of all relevant departments of the business I am helping AND the even more complex network of business connections and the economy as a whole, so that any changes I make will harmonise with what is there while also being viable long term.)

That is what I mean by holistic, or ecologically sound, or simply doing a good job.

Reprinted from The Journal of the National Council for Psychotherapists and Hypnotherapy Register, Spring 94.

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A variety of little tips on specific cases

Driving test nerves

THE DRIVING EXAMINATION is a common cause for anxiety, and there are a number of reasons for this. The following technique can be a valuable addition to the normal approaches when the anxiety is connected with an anxiety about examinations generally. The trick is to reframe the process. A typical approach may run as follows.

"Everything in the Highway Code is there to ensure your SAFETY. All the various `rules' are really common sense rules of SAFETY. You take your car to have its MOT as a SAFETY CHECK to check that it is SAFE to drive.

"On Friday (or whatever the date is) you are paying someone to run a SAFETY CHECK on your driving, just as you pay the garage to run a SAFETY CHECK on your car. In both cases there may be something not quite right. In both cases you should be pleased if the fault is found. It is helpful. In either case IT COULD SAVE YOUR LIFE.

"So on Friday you will be driving SAFELY. Not too fast, not too slow. Not to close to the car in front. Always aware of the traffic around you and the road conditions.

"ALL you will be thinking of is driving SAFELY, calmly and easily, while listening to the safety checker's voice."

Of course this approach can be elaborated on, but the central idea is prevent the test as being seen like an EXAM imposed from the outside. In this way most of the nervousness associated with examinations will go also.

The emphasis on the key word SAFETY will also tend to have the side-effect of reducing panic which is, of course, a reaction to the opposite feeling of DANGER.

If your Client has had safety checks done on domestic wiring or a gas cooker or whatever then these can be incorporated into the approach.

Over-eating

THERE ARE TIMES when over-eating is little more than a habit of loading a large amount onto the plate, and then eating it all up. This may go back to childhood.

A technique which I have found to work in such a case is to pay no attention to diets, but simply to focus on the habit of small plates, dishes and spoons.

The small spoon makes the meal last as long as it used to. The small plates can still be as loaded as the larger ones were. But the food intake can be halved quite easily.

The change might be made at a conscious level and/or with hypnotic suggestion.

Fear of Flying

Problem.

This woman has a fear of flying. She has an irrational feeling that the plane is only kept in the air by her own efforts.

& Fear&rarr "I must keep it in the air"&rarr pulling up on seat and pushing down with feet.

Solution.

Get her to train her family and friends to help her to lift the plane! (Recall Erickson's device of "prescribing the symptom".)

How does this work?

1) While she is training them at home they find it hard not to laugh. Laughter leads to reduced tension.

2) On the plane they have to do what she wants, i.e. to lift. Their cooperation d the security of feeling part of a group.

3) Fear activates the usual "fight or flight" mechanisms for which the natural outlet is physical effort. She is making that effort. It leads, once the plane is on level flight, to a nice relaxed physical state, by a natural rebound, enhanced by the laughter and solidarity of the group.

Stopping a pregant woman smoking

Problem.

A pregnant woman wants to stop smoking.

Solution.

Maternal love makes it impossible for a mother to do something which will make her baby distressed: if the baby cries she will stop whatever it was.

Before the baby is born it cannot signal its distress.

But a very large proportion of pregnant women can easily picture their baby's face. (The usual hypnotic techniques may be used to enhance this.) Furthermore, if she then thinks of smiling at the baby it smiles back, but if she imagines smoking, the baby will typically turn down its mouth and cry.

Repetitions of this soon establish the process:

&uarr(Thought of smoking)&rarr &uarr(Picture of crying baby & feeling of distress)&rarr

&darr(Thought of smoking)&rarr &uarr(Picture of smiling baby & feeling of happy love).

Meaning of arrows

After a while this can be simplified to make the thought, "I am a non-smoker" lead to the feeling of happy maternal love, thus continuing to reinforce it.

Dealing with those who expect a miracle change

Problem.

Many clients expect hypnotic techniques to work as fast to "cure" problems as it does to create the effects seen on a stage show.

Solution.

Ask the client the following question, "Which is easier. To put a dent in the panel of a car door, or to beat one out?"

The answer is clearly the former.

It is then possible to say, "In the same way it is relatively easy to implant a suggestion for a new behaviour, but to eradicate an old one permanently will take more careful work and time."

Client locked onto a particular hypnotherapist

Problem

A client had been to a hypnotherapist who successfully stopped him from smoking, but added that no-one else would be able to hypnotise him. The client later started to smoke again, but when after some years he went back to look for the hypnotherapist he discovered that he had died. Is there any way of overcoming the block?

Solution

It may, of course, be the case that the block is more imaginary than real, but the following method can be used to minimise the problem. First, put the client through a standard procedure to relax, focus the attention and so on but without using the word hypnosis. Then say that he will now simply review the orignal experience and allow himself to be hypnotised again by the original hypnotherapist, and receive again the original suggestions! Other suggestions can then be made, ad lib, while calling them "common-sense" observations or something similar.

In this way you recapture the value of the original hypnosis, add to it the power of your own suggestions while he remains in a receptive state, and impress the client by your deft handling of a difficult problem.

Confidence

Problem

A client is suffering from great lack of confidence as a result of criticisms thrown at her by employees in a previous job.

Solution

At a rational level describe the common practice of psychological projection: people blame othersfor their own faults. It is mainly pots who call kettles black; the selfish who accuse other of selfishness; the proud who accuse others of pride and so on.

At a more dramatic level let the client see accusations as labels that have been stuck onto her and ler her enjoy stripping them off and sticking them to whatever part of the anatomy of her accusers that she feels to be most appropriate.

In this way she returns the accusations to where they belong and ceases to feel them personally.

Embarassment at crying

Problem

A client feels embarassed at crying.

Solution

Say that modern science has established that the body has its very own Tension Eradication And Release System. This system, it has been established, has been designed to eliminate from the brain and nervous system all the chemicals that arise at times of stress and leave them feeling calmer and healthier. This Tension Eradication And Release System is called, for convenience, TEARS

Haste and anxiety

Problem

A problem that often arises is the interplay of haste and anxiety. Activation of the anxiety system leads to more frantic activity, but the greater the muscular and mental activity the more mistakes and confusion arise so that worry increases in turn. We want to eliminate this vicious circle.

Solution

With the client in a trance, we may work on the lines of, "You will calm down those troublesome twins Hurry and Worry. Hurry is one of those hyperactive boys, and Worry one of those very nervous girls. And Worry's worries irritate Hurry and make him Hurry more, and Hurry's hurry makes Worry worry. So when Hurry stops, Worry won't worry, and when worry stops Hurry won't hurry, and when both of them stop you will neither be hurried by Hurry or worried by Worry."

(This precise line is best designed for a mother who has good visualisation and children.)

ERICKSON: Therapy is like starting a snowball rolling at the top of a mountain. As it rolls down, it grows larger and larger and becomes an avalanche that fits the shape of the mountain.

Many of these tips appeared in the Journal of the National Council of Psychotherapy and Hypnotherapy Register

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