Every smoker is different...
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Case Notes from Smoking Treatments

EVERY SMOKER IS DIFFERENT

Every smoker has a different reason for smoking, so every smoker needs to be treated differently. I can get anyone to give up for a day, a week, a month. The real challenge with Stop Smoking Therapy is not the stopping, that is easy, it's the not starting again. If you can give up for two days, then the physical part is over, everything after that is about your mental associations. Smoking is not about nicotine or addiction, the real reasons that people find it hard to give up is because they associate the smoking with some life supporting resource. Take away the smoking, and they no longer have the resource, so their mind fights desperately to get it back. That is what cravings are, an attempt by a desperate mind to get you to reconnect to that resource. In order to end smoking you need to find out why you need to start again, and fix that.

 

The Weekend Smoker

The Problem Behaviour

Barry only smokes at weekends. He is able to stop every Monday and never thinks about it all week, but on weekends he goes to the bar and then after the third beer feels compelled to join the smokers outside and lights up with them. The next day he feels bad about the smoking, and swears he won't do it again.

He actually does not like smoking itself. But he likes being with the smokers, meeting new people, having something in common with strangers, feels comfortable standing outside with them, and really enjoys it. It is not the smoking he enjoys, it is the company.

The reason he cannot quit smoking

Probing into how he felt about meeting people, he revealed a cluster of relationship problems: he is not comfortable joining new groups, but after he has known them for days or weeks there is no problem; He doesn't like public speaking; He procrastinates; He never feels like one of the crowd; He always feels like an outsider; At school he had two or three close friends, not a bunch of them. All of these things indicate that he has a defensive attitude to people, prefers to keep them at arms length, does not like people to come too close, and never invests himself with others until he knows them very well. He is not unhappy, or antisocial, or seen as strange, just a bit distant. He has always felt this way, so it does not seem unusual to him. Basically he is hypervigilant: afraid of being hurt if he lets people get too close, if he lets himself be vulnerable to others.

 

He is unable to stop smoking because smoking provided the human contact he loves. The alcohol removes the inhibition 'program' that runs in his mind all of the time. This program is very hard to remove because it gives him protection. His unconscious mind knows that and so prevents him from deleting it. He has to be kept safe: that is what the unconscious mind is for, that's what it does. This program keeps him safe from the threat of rejection and criticism, but at the same time stops him from connecting to people. The alcohol has a way of temporarily suspending the program, he can relax his vigilance, and the smoking is way of establishing a shared bond with strangers, so he uses cigarettes as a way of getting to know people. So it is very hard to give up the cigarettes because they are the route to a pleasure he has no other way of getting to. This illustrates well the fact that every behaviour, no matter how bizarre or damaging, actually has a protective function.

 

The Stop Smoking Treatment

Barry was put into a light trance and asked to recall the feeling he got when he had to speak in public. He said he felt choked, could not speak for two or three seconds and felt everybody was watching him. It was like his brain was frozen, he felt like a statue. Then he said it was like he was in a bubble where he felt he couldn't do anything.

The bubble was developed as a metaphor. Exploring the bubble revealed he felt comfortable in it. It was one metre all round him. It was his space. The bubble protected him. It was described as elastic, clear like glass, warm, soft and he didn't like people around it. He tried to avoid people getting too close to the bubble.

He was guided to think about how the bubble could change. He decided it could get bigger, could be as big as the room, could cover the whole world. Further suggestions about what else could happen to the bubble, whether the bubble could divide or shrink or change shape produced nothing.

 

Then he was asked to think about what would happen if other people could be in the bubble. This would be very uncomfortable. This wasn't the right direction either. Then he was asked if the bubble could open. Barry immediately said it could open 'like a hatch' and he could step out. Further guidance encouraged him to explore outside the bubble and he said he could move among people and get close to them and it felt OK. Then he was asked to look at the bubble from the outside. This was an attempt to get it to change but he said it was just sitting there. Symbols that don't change spontaneously usually have a protective function of some sort. The client recognises this and does not want to lose them. The strategy then switches to trying to change the symbol into something else.

 

Barry was asked to think about if it could be transformed to make something useful that would still protect him. He immediately saw it shrinking, and said it was the size of a marble, and he could put it in his pocket. This meant that the bubble was now gone, and nothing was stopping him from getting close to people, and he still felt protected by the marble in his pocket.

 

The final part of the session tested the new mind set. He was taken through a visualisation of being in bar and approaching various people and groups and found he could do this now. He was asked what colour this good feeling was and he replied 'purple'. The purple colour was then used to create further visual anchors for confidence in different situations. He visualised a meeting at work, saw the room filled with purple light, and was led through every step of that situation and felt no anxiety at all.

Smoking was never mentioned in the entire session. Removing the bubble that was keeping him away from forming normal relationships took away the need to use smoking to meet people, as well as improving his professional life. He no longer smokes.

 

The Lonely Smoker

A lot of problem behaviour arises because of operant conditioning. This is related to the classic Pavlovian 'ring a bell and the dog salivates' type of response. It is entirely automatic and unconscious. Something happens and we learn to avoid it and we are quite unaware that the 'trigger = response' thing is happening to us.

Smoking is often an automatic behavioural response. It is not actually an addiction, it is not about the substance. It is about the association between smoking and coping.

The problem

Sadie desperately wants to give up smoking, but when she stops she is anxious, miserable and angry all the time. After one session of hypnosis she stopped for six days but was so agitated she had to keep doing things. She found a forgotten stash of tobacco while cleaning out the garage and immediately rolled a cigarette even though part of her mind was repeating the hypnotic instruction 'your are a non smoker now, you don't smoke'. She logically knew she did not want the cigarette and in fact smoking it made her vomit, but still she had to continue.

The treatment

The driver for this type of behaviour can be very puzzling. But in this case the history of the woman allowed me to work out what was going on. She had an abused childhood, and felt that nobody loved her and felt alone all time. She ran away to LA in her teens and met this guy and started smoking and felt for the first time that somebody cared, she wasn't alone any more. The relationship broke up, but now she had smoking. She had created an association between smoking and not feeling alone. She was completely unaware of the association. And of course when I hypnotised her to give up, she felt alone again. And her mind hated it, and did everything possible to get her smoking again.

 

For every associaton, the mind creates a representation that can be accessed in various ways. Once the right representation has been found, various techniques can undo the association. Sadie initially saw her problem as a red and black pulsating sort of vortex. She was guided to change that until it suddenly transformed, and she saw herself as a four year old, sad and lonely, being ignored by her mother. I used a Gestalt technique called Meeting the Inner Child to allow that little girl to grow up and feel loved. That therapy made a major change in Sadie's view of herself. She no longer feels alone, and she no longer needs to smoke.

 

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