HYPNOSIS WITH SUBSTANCE ABUSERS (continued)

Second Session 

When the patient arrived for this double session, he appeared tense, agitated, and distracted. Mr. B said, "I've been bad. I didn't try hard enough. I guess I should get a D, because I only tried the first day. I couldn't separate coffee and cigarettes. I really thought it would be easier than this to change my habits." Together we agreed not to hypnotize him that day and used only a single session to explore his resistance and to question whether this was the right time for him to stop smoking. The behavioral changes were again discussed, and specific suggestions were made. For example, if he drank coffee in his office he could not have a cigarette, but he could have tea with a cigarette. 

Third Session: 

Double Session Mr B arrived early for his appointment and appeared to be elated and in a buoyant mood. "I give myself an A+ this week," he said. He had been able to give up drinking coffee in his office, and he no longer carried cigarettes in his pocket. The patient claimed to be at a 90% motivation level. "I'm a good problem solver at work," he said. "I ought to be able to solve this easily." Given his present motivation, hypnosis was induced four times. The first induction was an eye fixation technique. A purpose of the initial hypnotic induction was to help him learn to become a good hypnotic subject and to give us information about helping him become a good subject. We wanted to see how comfortable he could become, how he responded to hypnotic suggestions, and note his breathing, facial pallor, and peripheral changes in vision. The patient was told to stare at something on the wall, to notice his eyes becoming tired, and to let his eyes close when they became heavy. As his eyes closed, he might feel himself becoming very relaxed. The eye fixation induction took a very long time; he appeared tense, moved slightly in the chair several times, and showed uneven breathing. Eventually, Mr. B closed his eyes, his body quieted, his breathing slowed, and he seemed to be in a mild hypnotic trance. Ego-strengthening and motivational suggestions were given. One suggestion was that he was learning to become a good hypnotic subject in order to achieve his goals, that his problem solving skills were evident, and that he was usually able to succeed at what he tried. We then alerted him by counting to 10. The patient volunteered that during trance his body first felt numb all over and then began to feel heavy. He felt very relaxed. His report of his first induction indicated to us that he had been able to experience a hypnotic trance. He was amazed at how relaxed he had become and was enthusiastic about trying this experience again. 
The material to be used next was gathered from the initial interview and his early history. Mr. B had had fond memories of his childhood. His favorite pastime had been playing ball, and he had been outdoors at every opportunity. In the summer he and his friends would gather at a corner near a field. They would play ball and "kick the can" until their parents would drag them indoors for the night. "I wanted to rush out at every possible chance to be with my friends," he had said. Mr. B felt close to his family and had told how his mother had been famous in their neighborhood for her outstanding cooking. He himself couldn't wait to look in the various pots on the stove when he arrived home from school to see what was being prepared for dinner. 
The second induction used a hand levitation technique. Mr. B closed his eyes and was told to feel sensations of lightness in his right hand. When it was obvious, because of slight movements in his fingers, that he was experiencing some lightness, he was told to imagine a balloon tied to his wrist gently moving and pulling upward. His hand raised about 3 inches and remained cataleptic. He appeared to be in a hypnotic trance, so age regression to his boyhood was suggested. This took him to a time before he was smoking and when cigarettes had no meaning to him. During the initial interview, Mr. B had told us that he used a cigarette to signal himself to stop eating at the end of his meal. When we suggested that he return to a happy time during his childhood, he chose age 9, when he was living in the southwest. Using his own descriptions and words, we suggested he was playing with his friends and then going home to dinner. Once inside, he smelled the aromas of various delicacies that his mother had prepared. However, after gobbling his food his memory of fidgeting in his chair, anxious to rejoin his playmates, was vivid. We suggested that he was hungry and that the food was delicious. He felt happy being with his family. Outside he heard the cries and shouts of other children who had luckily been released from their dinner tables. His concentration was focused on making a speedy getaway himself. He didn't need a cigarette then to signal the end of the meal. He reported how funny it sounded when the idea of ending the meal with a cigarette was mentioned. The patient was extremely impressed with both the hand levitation and the age regression. The hand levitation seemed to give him the proof and assurance that he had been really hypnotized, and the age regression allowed him to recapture pleasant memories, moods, and feelings. 
The third hypnotic trance was to reinforce his reasons for wanting to stop smoking. The reasons were his embarrassment at business meetings, because most people in his company do not smoke; his fear of cigarettes ruling him; his desire to have a strong, healthy body and feel fit enough to resume an exercise program; and his admiration for his father who had given up cigarettes 10 years earlier. We used a coin technique as an induction. The patient extended his hand palm upward, and a coin was placed on the edge of his palm. He was told that with each count the hand would turn a little until the coin fell off, his eyes would close, and he would become completely relaxed, arms resting at his side. The coin fell off at the count of 90. We then reinforced and reflected Mr. B's resolve to stop smoking, reminding him of his discomfort at meetings, his fear that "a little white thing" was stronger than him, the wonderful way it feels to be able to run and not get out of breath, and how successful his father had been in conquering his lifelong cigarette dependence. 
In the fourth and final hypnotic experience for this session, Mr. B was taught autohypnosis. He was asked to choose one of the inductions and hypnotize himself. He chose the hand levitation. When in trance, we did a life progression. This involved activities that he would participate in during the next week as a nonsmoker. Life progression is similar to behavioral rehearsal but includes suggestions for improved sense of smell, taste, and sensory awareness, Specifically, we traced life's events step by step. 
"You waken a nonsmoker. You get up in the morning and brush your teeth. Your mouth feels scrubbed and fresh and clean. You get dressed and sit down to breakfast and enjoy the taste of food. As a nonsmoker, everything has a better taste. The orange juice is tart and delicious, the cereal crisp and crunchy. You get in your car and open the window. The fresh air feels good on your skin and smells good as you drive to work. You arrive at your office and you're a nonsmoker. You sit at your desk and begin to review some reports that you have written, the telephone rings, you answer it, and you do not smoke. When you go to your morning meeting, it feels good not to be smoking. The papers you are holding feel crisp in your hands. You smell your fingers and they have a pleasant smell. You meet some of your associates and go out to lunch as a nonsmoker." 
The life progression was continued to complete the day long activities and ended with: 
"When you go to sleep tonight, all of these suggestions will be reinforced, and when you awaken tomorrow, you will be aware of being a non-smoker."