I’ve found that one of the hardest things people find when they begin working as a therapist is how to sort the information they gain from the client. In fact, even before then, how to hear what the client is telling them in a way that leads somewhere useful. It’s so easy to be overwhelmed, or to only hear what you expect to hear. In this blog I thought I’d go through what I keep in my mind as I’m helping a client unravel their problem.
In a way, this is where Cognitive Hypnotherapy really began for me. I needed to model what I did with clients in order to provide a framework for my students to follow as they built up their expertise. Simply giving them one-size-fits-all solutions to each presenting condition simply isn’t something I believe in.
At the heart of my approach is a model of thinking that I’ve found can be applied to whatever presenting issue comes into your therapy room, so on our course students don’t have to be taken individually through the 75 conditions (I made that number up, don’t email me asking for the list) that might present themselves; once they’ve been taught the range of techniques that I’ve found the most effective, and how to create Wordweaving suggestions out of the client’s information, this model of thinking about problems leads them to put together an approach (the most appropriate combination of techniques and suggestion) based on the uniqueness of each client. As you can imagine, this is a world away from the common approach within mainstream hypnotherapy of reading the same script to anyone who uses the same terms to describe their problem. For me, five clients who smoke, or have OCD, or a phobia, are five different stories to unravel, five different minds to learn about.
So it really doesn’t matter what problem walks through the door, my thinking follows the same pattern:
They’ll tell me the label for their problem – “bladder problem”, anxiety attacks”, “phobia”, “cancer”. I don’t put a lot of emphasis on the label – I’m not a diagnostician. What I’m interested in is “what’s the experience they’re having that they give this name to?”
So I think, “What’s this about?” and I start asking questions… I envisage the label for their problem being an attempt to grasp hold of a pattern of information. We call this their problem pattern. To help guide my questions I divided the problem pattern into 4 bits, context, consequence, structure and process.
Context: Is this a mind problem or a body problem? i.e. is this something created by the mind to solve a problem (or a by-product of the mind trying to do so), or is it a bodily malfunction? Questions like, “does this problem happen all the time?” “Are there times when it’s better?”, “times when it’s worse?” “Have you ever been free of it?” “What was happening then?” “When did it come back?” “What was happening around that time?”
What these questions establish is whether the behaviour has a purpose – i.e. does the mind run this problem as a response to a set of circumstances it’s interpreting in a particular way. The reason it does this is historical – it’s making a match between a past problem event and a current event and the present response is either an unconscious attempt to solve the problem, or a by-product of its attempt to solve it. Finding what match the mind is making to provoke this response will take you to the root cause.
If your questions establish a variation in response – i.e. the problem isn’t constantly present, then a context intervention is an option – the root memory is the reason for the response (the problem) in the first place so changing it will be a likely remedy.
In our approach we’d include the following as context intervention options: time line reprocessing, associative regression, gestalt chair. In other models of therapy, whatever might be considered analytical would probably fit the criteria.
If there is no variation in symptoms – i.e. the problem is present without much variation, then it’s more likely to be a body problem and we adopt an approach aimed at utilising the client’s own healing resources. Intervention options are: bonding, fusion, healing paradigm, visualisation etc.
Consequence: This really is part of context, but I made it a separate category to help focus more clearly on it. Our brains are consequence machines – we create simulations of our future based on our interpretation of what is happening to us now (and our interpretation of now is itself based on our interpretations of our past – you can see why I say everything is an illusion). Whenever someone ‘does’ their problem she sees a consequence to it – overwhelmingly a negative one and the sky can be the limit for her misery. Her body will respond to this simulation of her future as if it’s real and probably trigger the flight or fight response to keep her from her future – which will probably exacerbate her anxiety about her problem and we have a negative feedback loop that continues to embed the problem.
Consequence interventions we use include identifying her solution state (life without her problem) and future pace her so she experiences that, and put it in her future. We tend to get the future we expect, so if we embed her solution state into her future her mind will be primed to notice anything that fits this new expectation. We’d also wordweave to prime her with the words she used to describe her solution state. Other visualisations such as the Rocking chair exercise may also be useful.
Structure: How does she experience this problem within herself? This is about submodalities and trance phenomena. Where in her body does she feel the problem? What are the smds of this feeling? Does she get an image (i.e. her future pace of herself doing her problem) what are the smds of that? What trance phenomena create this – sensory distortion? age progression? Others?
Structure interventions include: swish pattern, dropthrough, spinning (taught on the Masterprac), EFT, headache cure, metaphor.
Smd interventions for context issues include fast phobia cure – also known as rewind – (the first event connected to herproblem) and visual squash.
Process: What are the steps she goes through when running her bladder problem? What triggers it, what feeling does she have etc. Understanding her process – the Matrix model – gives us clues about where we might aim a pattern interrupt like an anchor, or where a structure intervention might work best (like the emotion or what makes it stop).
Hopefully you can see that you could substitute the word ‘problem’ for just about any presenting issue – showing what I meant about Cognitive Hypnotherapy as a way of thinking about the way people construct their issues, and a way of organising the structure of our therapy to help people individually.
Having gained this information you can then choose which intervention from which of the 4 bits seems the best choice (usually a combination of several, such as visual squash and an anchor, or tlr and EFT) and deliver it.
When they come back for the next session we evaluate the effect by asking questions like, “what improvements have you noticed?” From their answer decide if you need to do more of the same as last time, change techniques, or move onto doing less. Wordweaving vol II goes into a lot more detail about this.
I thought I’d write this because it seems the most common challenge my graduates face, and I wanted to put across the safety you’ll gain by working progressively within a structure, rather than just feeling that you’re pulling things out of the air, or beginning with a particular intervention because you always do. If you truly listen to your client they always point the way.
Hope that was helpful.