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In addition to Happy Valentine's day, I've been reviewing all the smoking cessation information
Having confessed publically that I don't do well with smokers, I've been doing tons of research. I realizsed also that I hadn't worked with enough smokers to establish a good outline or sense of purpose or direction. Now I have 5 to work with. It's do or die.
I've gone over all of the wonderful and helpful posts I could find. When I combine them into one document, I'll post it on my blog. I've outlined every damned book and training I've done or read. I'll also post that when it's reasonably legible.
One of my mother's not-so-generous assessments of me was "New broom, sweep clean" which meant I started a lot of things but wasn't so great at follow-through. As a thriving 68-year old, I still hear those words every time I nag myself about something I haven't finished. However, my own conclusion after lo these many years is that it's really ok to start and stop on the journey towards knowledge. Sometimes you just can't get any further at that time. Sometimes it has to sink in enough so that you can then look again and see what's still missing.
In her defense, I guess, it still rankles me enough to motivate me more often than I like to admit.
I have now identified two several places where I think I'm missing the point or where I'm stuck.
Could I ask you guys, even if you shared it before, to answer again? I may have missed it and repetition certainly has its place in learning.
1. I realize that I don't have a good method or outline for prescreening, or, rather, determining how committed a client is (at that moment in time) to becoming non-smoker. Can you guys share the things you say or ask in pretalk or even on a phone interview?
2. Another place I find very awkward is in telling them what to expect or not expect in terms of how long it will take, how hard it will be, etc. I find that so many come in with the idea that they are going to walk out nonsmokers with no urges, cravings, etc. I don't know how to answer them.
3. Since I have seen that some of you guys really do seem to get it in one or two sessions, but I'm not there yet, I wonder if you could suggest a sentence or two to reassure the client that hypnosis for smoking cessation really does work, that some people get it in one session and others need more without setting either negative expectations or setting them up to expect a response that they may not experience, which leaves them feeling like they've failed. I can't seem to get this part.
4. I'm beginning to see that direct suggestion, direct drive, or simple hypnotic repetition is just not enough for most people. I'm beginning to see that the NLP techniques are the best for breaking up cravings, urges, etc. Can you guys share what you use for the cravings that DO come?
5. How do you guys (similar question to number 3 above) set them up for whatever it is they experience? If one session works, super. But it seems foolish to send them out without any idea of what kind of success or obstacles they might expect...again, without setting expectations that may not be realized and at the same time, not discouraging the degree of success they may experience.
6. Since I'm not comfortable yet with expecting it to be a one or two session program, because I'm still figuring it all out, how do you guys address the protocol outline: 1) throw away your cigs or leave them here or 2) what form of cutting down do you suggest? I've read wrapping the cigs up, cutting down in a specific way, changing brands, and all kinds of behavior mod stuff but that would only seem to apply if the one-session program failed. I don't know. This part really has me baffled and I've read so many different ideas.
7. How do you handle it when clients come back and say they've relapsed, to one or two or even back to where they were?
In summary:
1. Pretalk and questions that you ask
2. One session or 5 or 6? How do you decide? Do you just wait to see if they fail or not?
3. Identifying triggers
4. Breaking up cravings (I suppose most of this is NLP)...specifics?
5. How do you handle it when they don't succeed immediately?
Thanks in advance. Sorry if I'm being redundant but I'm gonna this sucker down or turn in my badge.
Susan
Tags: a, becoming, cessation, cigarettes, cravings, for, nonsmoker, pretalk, smoking
Replies to This Discussion
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Permalink Reply by Kelley Woods on -
Hi Susan,
As many of my smoking cessation clients also have email, I send them a "Becoming a Non-Smoker" contract. In this, they list the reasons why they smoke and the reasons why they want to stop smoking. They also post a date when they will become a non-smoker and they then sign the contract. I instruct them to bring this with them to our appointment. So far, every one of my clients have listed the date of our session as the date that they will become a non-smoker! As you can imagine, this makes the job much easier.
I am careful during the pre-talk to address the client as non-smoker, asking questions like: When you were a smoker, did you prefer to use a match...or a lighter?, in order to diffuse any lingering attachments to smoking, putting them in the past tense. I assume that they have already made the decision (although during the session it is formally presented) to become a non-smoker by the time they step into my office.
My confidence and support in their decision influences them. Since I sincerely believe in them stopping smoking to benefit themselves, it is easy for them believe it. I merely embrace the reasons they list in their original contract. I am a mirror of their wishes.
:) Kelley
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Permalink Reply by David Mason on -
You raise some very useful issues.
1. Pretalk and questions that you ask
I do not do any kind of screening. I believe that a professional hypnotist should not be pre-screening clients for smoking. I have read of many hypnotists boasting about how they only take clients when they are ready to stop and refuse to treat anyone else. In my view this is one step away from fraud. If you only deal with people who are committed, determined, and motivated and will definitely stop, what do they need us for? What justification is there for only working with people who are going to give up on their own anyway? And then having the nerve to tell everyone what great hypnotists they are.
I take the view that anyone who expresses a wish to stop should be entitled to full professional help. I have successfully dealt with a smoker who had part of a lung removed and couldn't stop, and people who smoked fifty a day for fifty years and had never been able to stop even for an hour. I regard excessive screening as near cowardice - anyone who is so unsure of their abilities that they can only deal with the most compliant smokers shouldn't be offering their services.
I spend twenty to thirty minutes talking to each smoker to find out why they smoke, how many they smoke, when they smoke, what they get from it, why they think they can't stop.... and I keep going until I am sure I know why they smoke. Then I sort that out.
2. One session or 5 or 6? How do you decide? Do you just wait to see if they fail or not?
I aim for one session only, with a follow up if they relapse. I regard the relapse as a great opportunity to identify what it was that I missed first time round. Why would you need five or six sessions? Your method either works or it doesn't. It either works first time or is not working at all. Spinning out the sessions is immoral in my view.
3. Identifying triggers
I believe that all my clients are intelligent human beings and smoke because they have a very good reason to smoke, and wouldn't be smoking unless there was a compelling reason. In my view people smoke because they have created psychological associations between smoking and some capability they need in their life. Their subconscious mind has formed a link between smoking and being able to do something. If I take away the smoking then they panic about losing that capability. That is what cravings are, the mind's desperate attempt to get the person to take up smoking again so that they can deal with whatever it is that they think they can't do without the presence of a cigarette.
I am working on developing a typology of smokers, but I suspect it will be years in the making. I am intending to do a second PhD on the subject eventually. Oddly enough I find the hardest type of smoker to fix is the one who only smokes two to six a day, but just cannot do without them.
4. Breaking up cravings
During the interview, I do a great deal of searching to find out exactly what it is that they are getting from smoking. I do not believe that tobacco is addictive. I believe that it is smoking that people are addicted to, the whole constellation of actions and beliefs associated with smoking. Deal with the associations and convince the client that they can deal with those specific problems and the cigarettes become irrelevant. When you do that, there are no cravings.
I deal with the issues, once identified, mostly via metaphor therapies of various sorts, Core Transformation, Swish patterns, and then use direct suggestion, personal affirmations, ideomotor convincers and various other techniques, depending on what the client needs, Every client is different so every session is different. There is no one size fits all.
5. How do you handle it when they don't succeed immediately?
I regard it as an opportunity to learn more about the fascinating subject of human behaviour. It isn't about success or failure. It is about my learning more about how to understand the smoker's behavior. Unfortunately I don't have full follow up figures for my smokers, but I am at least as good as other hypnotists in the area, and I get a lot of referrals. My first question when they come out of trance is 'Fancy a cigarette?' and see what their reaction is. It is usually a feeling of wonderment that for the first time in years they really don't feel like having a cigarette. People know instantly whether it has worked or not. The people I do hear back from are usually people who start again after several months. It seems to be always after some major emotional trauma, the old beliefs that they can't get through it without a cigarette resurface. I tell them to expect this might happen, to have the one cigarette, stub it out half way through and come back to see me immediately for another session. I tell them if it happens that they have not failed, what they are doing is digging up an old behaviour, because they don't have anything else to use, and that we can find a way to deal with the issue that doesn't need smoking.
Smoking treatment is not about stopping smoking. 'Why don't you stop?' is the wrong question. The right question is 'why do you start again?'. Fix that and they stop for life.
I am by no means the world expert on this, but I think I am going in the right direction.
Dave Mason
www.hypknowsis.com
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Permalink Reply by Duncan Murray on -
Hi Susan
Smoking cessation is an interesting one - and has a lot to do with the rapport - although I do agree about the screening bit - a 95% success rate because you are making sure of that before you make sure of someone's commitment before they come to see you...hmmmm - well that is at least how one British training body promotes their course....
It is about you being sure of what you are saying and the belief system of the smoker - let's be controversial - nicotine is not a drug, it is just a poison - why doesn't NRT work for 93% of smokers and 6% of smokers stop on willpower alone thus NRT is about 1% effective!! A placebo is 35% effective!!!
A British Hypnotherapist, Chris Holmes wrote a book called 'Nicotine the Drug that Never Was' which is available online as a pdf for not much money at all - if it is not a drug how can they have withdrawal? That is so long as you change their habits and beliefs - their model of reality/truth...
Hope this helps
Duncan
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Permalink Reply by AJ on -
Consider utilizing Dr. Richard Harte's "Goal Image Focusing Technique" in your sessions.
RegalHypnosis.com
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Permalink Reply by Michael Ellner on -
Okay Susan -- Let's dance...
But, first, let me make it clear that I am not interested in getting between you and your mom. However,
"New broom, sweep clean" does not have a damn thing to do with not following through! -- So, you can stop nagging yourself --
The social/political idiom/proverb "New Broom - Sweep Clean" reminds us that when the new regime takes over the old regime is out on their ass --
"New Broom - Sweep Clean" gives you permission to start again! And don't you dare forget it!
=^..^=
1. I don't need no stinking screening --
2. The hypnosis will help increase your urges to be smoke free and decrease any lingering urges to smoke and I will give you a tool that will enable you to move into your Smoke Free Zone on demand...
3. I like working without a net -- Like David, I aim for making it reasonable for my clients to believe that they can stop with one session and work from there...
3A. You seem to be asking for a net -- "Here's a net:
"Hypnosis is effective for smoking cessation - Most of my clients do it in one session and very few need a few additional sessions."
4. See answer 2 above -- Give them a ticket to the Smoke Free Zone (Post hypnotic cue...)
5. If a client relapses - I ask how many sessions do you think you will need to be completely free?" And work from there... Sometimes the difference between a client's success or failure is as simple as meeting the clients expectations.
Michael E.
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Permalink Reply by Graham Old on -
David gives a great response. The question below is one that I use with all of my clients (because I've not yet had one who hadn't tried to quit before. In fact, some succeed for quite some time. I find it useful to remind them of how many times they've managed to quit. It then becomes obvious to them that if they can get their head round why they started again, they've sorted it.
I don't pre-screen and consider it just a ploy to be able to boost one's statistics.
I normally use 1.5 sessions. The first is 95% information gathering and motivation boosting. This is also the point at which I and they discuss how many sessions they would like to quit in.
In the second, I find it essential to test them there and then. I literally use every method I can think of to get them to accept a cigarette. If I can get a little bit of a desire from them, I show them a few craving-busting techniques. This also saves implying that I do that because they'll have cravings later.
David Mason said:The right question is 'why do you start again?'. Fix that and they stop for life.
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Permalink Reply by John Cleesattel on -
I find it humorous to read about those who condemn filtering clients with one breath, and then talk about what they do when their session doesn't work with the next (did someone say fraud?). Someday they will learn that hypnosis doesn't control free will and they will hopefully grow with that realization. We can remove the cravings and withdrawal symptoms completely, but we can't control if they buy more and start the process all over again. Their desire is what makes them non-smokers, and what keeps them non-smokers, and if they don't really want it, they aren't going to get it. Go figure.
John
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Permalink Reply by AJ on
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Eliminating the cause is the only way to prevent the effect from resurfacing. Regression work, however, often takes more than a single session of hypnotherapy. As I indicated elsewhere, band-aid therapy yields short term results.
regalhypnosis.com
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Permalink Reply by John Cleesattel on
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In a way, you are right. I have found that eliminating the triggers to smoke to be very effective. That is what makes them light up without thinking about it, and causes the cravings. I personally haven't found much use for regression in stop smoking interventions, but that's just because its not necessary in the techniques that I use for this. Since I've been doing it this way, along with filtering of clients to pass by those that are there by the agenda of another and don't really want to quit themselves, it seems to be the most effective.
Of the three redo's I've had since doing it this way, the shortest amount of time after the session that a client fell off the wagon was four months. The other two were seven and eight months after. In all cases the clients experienced personal hardships and tried cigarettes again to seek comfort. When they didn't find it, they were back at my office asking if I could help them quit without any withdrawal symptoms again.
I don't say that my methods are the best... they just work well for me.
John
Doc Regal said:Eliminating the cause is the only way to prevent the effect from resurfacing. Regression work, however, often takes more than a single session of hypnotherapy. As I indicated elsewhere, band-aid therapy yields short term results.
regalhypnosis.com
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Permalink Reply by Brett Cameron on -
Hi Susan,
Without giving away too many trade secrets … I would say that 50% of our clients are for stop smoking. And with that we claim to have up to 97% success rate. So here is what we offer:
1. Pre-talk: We offer a 3 session plan. Client pays a set rate for 3 sessions at the first session, and if they choose to only attend one session then that is their free will and choice. I ask them to prepare for change in the week prior to session 1 by wearing their wrist-watch on the ‘other’ wrist or switch jewellery so that the mind sees things differently. (be creative with this one)
2. In the pre-talk I ask them to rate their desire to be a non-smoker out of 10, with 10 being “I really want to be a non-smoker” and 1 being “ahhh … one day maybe”. Anything less than a 7 and I suggest to them that hypnosis will benefit them however success might take a little longer. (ie realistic expectations)
3. 1st session is a lot of Q&A to build an individual profile. By using NLP processes and Hypno the aim of session 1 is to set the subconscious mind up for change. I also let them know that one of three things will be achieved after session 1. Firstly they might find that they have had their last cigarette … congratulations! Secondly they might find a desire to have one more cigarette as though they are farewelling an old friend. And the third outcome might be that they are still smoking however not as many as previously, because at a deeper level they may not be ready yet … and that can be explored at the next session. At the end of the 1st session I will offer my waste paper basket to them to dispose of their cigarettes and lighter as they will no longer have any use for them. (this gets interesting responses)
4. Session 2 is where the real action is: The focus is Parts Therapy, getting all parts in unison, working in concert for team body, ensuring that the smoking part has agreed to take on a more productive role of your choosing.
5. Session 3 is more of the same with more Future Goal work focussing on the gains that they have … never the losses. Always be positive … focus attention on renewed health, enjoying seeing their children and grand children grow up, better finances, improved self esteem, ability to travel to dream locations, better access to public facilities that smokers can’t access, no longer feeling like a social leper etc. All in the positive. Take them towards their goals … not away from the undesired state.
Susan I try to ensure that clients leave feeling elated, relaxed, comfortable; knowing that they have achieved something. Knowing the successes that you have had in other areas, I am sure you are about to become a very successful ‘stop smoking hypnotherapist’
Good luck
Brett Cameron
www.channelled.com.au
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Permalink Reply by Susan French on -
Hi everyone who answered: thank you so much. There are some really, really good specific ideas which I will incorporate. Our beloved John C took pity on me and rescued me by talking the time to walk me through his techniques, which I found extremely logical, well-thought out, and seamless. His technique is very similar to Brett's. He's writing a hypnotherapy book in which he includes his smoking outline. I have found that everything John has put out there is logical, well-founded, makes sense and works, so I'm encouraged. Being able to figure out where I was still "stuck" as Michael calls it (and I agree), helped me a lot in piecing the puzzle together so it flows from one part to another. Those were the questions I posted above.
Maybe I will change my mind as I get better at hypnosis for smoking cessation but I realized that I wasn't setting it up well because I was unsure of some specific ideas. I was still struggling over the setup, which involved my having a clearer idea of the format of the sessions. I think I've totally got that now.
Also, there seems to be a lot of argument about prescreening. Here's my thinking now: the answers are somewhere in the middle, Centrist if you will.
Brett explained it best I think and I agree with his response. Determining the clients level of readiness to become a nonsmoker is not a judgement thing...it's simply a scale to let you and the client know how close to that "transformational experience" they are. That 'transformational experience' is something I've been puzzling over for awhile.
I couldn't figure out how to get myself or anyone else to that "shift" in any kind of reliable or consistent way. The "how to" is beginning to make sense now...whew.
@Michael: you hit it on the nose: I was looking for a "net." That was precisely where I was stuck. In order to move forward comfortably, I needed to have a backup plan. You gave me a good one. Of course, I'm the little girl who never spoke in babytalk. My mother said that she would hear me practice new words in my playpen and then say them perfectly. That sounds like me. I still don't dance because I'm terrified of looking like an idiot. Perhaps that's an outmoded idea. As my friend Frank replied when I used that excuse: "your point being?" and "so what" He was so right. Also, .thanks your support on the "new broom, sweep clean." Mom's been gone for almost 20 years now, so she only exists in my own head...lol.
@Kelley: thanks for your words and for sending me your outline.
One thing I've learned about myself is that 1) I never give up...I keep going back until I've mastered something, 2) I'm not ashamed to admit it when I don't get something, no matter how long it takes until I "get" it.
Thank you everyone for your indulgence and support. From prior threads, I can see that by no means am I the only hypnotherapist who has struggled with smoking cessation. It's a tough one, I think. So I hope others have also been helped as much as I have.
There is some fabulous information on John C's website. Take a look:
http://www.hypnothoughts.com/forum/topics/in-addition-to-happy . Follow that one through the smoking information. It's really great.
Thanks again everyone.
Susan
www.hypno4success.com
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Permalink Reply by Gordon Leith on -
Where is the idea that nicotine is not a drug coming from? Have you ever smoked? The withdrawl was horrible, physical, and only psychologically craving as well. I'd be interested to know where you're coming from. It's not only in the mind. I refer people to their doctor to get help if they want it for the physiological withdrawl, Nicotine Anonymous for the social/spiritual support, and myself for the hypnotherapy support. Let's not exclude other supportive modalities.
Duncan Murray said:Hi Susan
Smoking cessation is an interesting one - and has a lot to do with the rapport - although I do agree about the screening bit - a 95% success rate because you are making sure of that before you make sure of someone's commitment before they come to see you...hmmmm - well that is at least how one British training body promotes their course....
It is about you being sure of what you are saying and the belief system of the smoker - let's be controversial - nicotine is not a drug, it is just a poison - why doesn't NRT work for 93% of smokers and 6% of smokers stop on willpower alone thus NRT is about 1% effective!! A placebo is 35% effective!!!
A British Hypnotherapist, Chris Holmes wrote a book called 'Nicotine the Drug that Never Was' which is available online as a pdf for not much money at all - if it is not a drug how can they have withdrawal? That is so long as you change their habits and beliefs - their model of reality/truth...
Hope this helps
Duncan
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