By Jane Nash
Peter had walked though my door at barely 13 years old. Tall for his age and morbidly obese for his height, he needed to lose fifteen kilos and to change his shape so that he did not display 'man boobs' and not be teased at school in the changing rooms before and after sporting activities.
Because he was under 18 and also because I rarely see children, his mother had come with him. It became quickly apparent that she was displaying Kapassinian Emotional Sexuality (Behaviour traits as measured through the Emotional and Physical Behaviorist theories of George Kappas PhD.) As well as being withdrawn and awkward in her own physical presence, at her first interview she admitted to moving her son's behavior boundaries and consequence boundaries constantly due to guilt or poor time management. As a result it seemed that Peter had learned how to manipulate situations to his own benefit and within the confusion in what was and was not secure, had become a comfort eater.
Knowing that hypnotherapy did not have a trail of vastly successful results after reading Clinical Hypnosis With Children (Ed: Wester, William C, II, & O'Grady , Donald J 1991, Published by Brunner/Mazel Inc), I noted that the suggestions used by Haber, Nitkin & Shenker (1979) were only successful one of the eight subjects in the focus group. In fact, corroborating this small study, Wester suggested that in his own practice, many of his adolescent clients had not managed to reach goal weights or maintain healthy weights.
Before beginning any form of treatment, I interviewed Peter at length about his desires and needs. He was unable to vocalize any positive defined outcomes for himself in week one and so suggestions were made to him about visualizing himself thinner. (Ref: Kohen, Olness, Colwell and Heimel (1984)) In the second week, he said it had been too hard to do and had not enjoyed the week.
The use of a motivation chart was discussed where he could grade himself according to good and bad days – but on the third appointment, he confessed that he didn't feel motivated and indeed felt de-motivated on filling in the chart.
I decided to encourage him to continue to come to session and with the reward of an MP3 track to be developed for Peter's own use in conjunction with his ipod. Each week would have the hypnosis used in session.
Peter had never known consistent boundaries and so instead of focusing on weight loss initially, his suggestions were of stability and boundary setting.
"Each and every time you decide to eat inappropriately, you will be making a definite decision to experience a particular consequence. Each and every time you decide to eat appropriately you will make a definite decision for your body to lose excess and then maintain a healthy body mass. Only you can decide how this will be as only you are in control of what happens to you."
The following session showed a little improvement on Peter's part but the interview session revealed that his mother had found it difficult as she had wanted to eat cakes and chocolate and had bought them to 'share' with her son, feeling 'sorry' for him that he wasn't eating the food he liked.
At no point had I mentioned a diet to either of them. Peter had requested different food to be packed for school lunches but mum had been sabotaging his efforts by insisting he took 'treats'.
I pointed out to her that her efforts were undermining his decision making skills and then used NLP to anchor confidence and motivation to the boy and in turn to the mother so that they could conjure up internal strength as and when they needed it.
As a hypnotic induction I used an eye fascination as he was in and out of trance continuously in the session, followed by a standard progressive relaxation.
Peter's hypnosis session reinforced this idea of generating serotonin using stacked anchors rather than food.
Peter's next few hypnosis sessions were structured using the Milton model form of questioning (NLP) within the hypnosis in separate sections (i.e. week by week) so as not to confuse him. It also had the added benefit for the mother as she was listening to the hypnosis and I wanted of course to effect change in her mind as well so that she could support her son instead of sabotaging his efforts.
There were times when a mixture of questioning styles were used in script work, but the preparations were made as follows:
1) Using Causal modeling:
"As you make some changes, things become easier since you began to come to my sessions. ....As you reach into your lunchbox, controlling your eating becomes much easier since you decided to change......As you enjoy making the right food decisions, things are surprisingly easier since you first thought that you are tired of the way you used to be......"
2) Using Mind Reading "I know that you think that now is the time to make decisions about your own body......You may be wondering about all the ways you can feel in control of your own eating habits......you're curious about how hypnosis works for creating strength and success......you're happy with the feelings connected with making good choices in your eating and exercising"
3) Using Lost Performatives "It's a known fact that the more control you have over your own eating, the happier you feel..... it's well known that decision making belongs to individuals from the moment they are born.......it's not important that you make excellent choices about food for a healthy body and a slimmer you.....it's good to remember that you have all the resources you need to succeed.."
4) Using Cause and Effect "When you feel the urge to eat, you will easily make the decision to eat only when you are hungry...........when you get a feeling in your stomach, it will be easy to tell whether it's hunger or anxiety..... when you feel anxious you will be able to breathe in confidence and quickly re-anchor yourself to the feeling of success......"
5) Using complex equivalents "You are being hypnotized and that means you will be successful in controlling your eating......you have come here today and that means you will be slimmer...........your name is Peter and this stands for strength which you have inside you"
6) Using presuppositions "Do you realize that your unconscious mind has already begun to make the changes it needs to make for you to succeed.........Are you curious about your weight reducing.......how easily can you lose weight........ how easy it is to maintain good habits........are you still interested in being a slimmer you.....did you know that you have already begun to lose weight using up kilojoules just listening and learning now"
7) Using universal quantifiers "every thought you have can help you becoming more and more certain about losing weight and maintaining a healthy body mass.........and now, you can let yourself go all the way to being slimmer.....you will always know the wonderful feeling of having control over the decision to eat when you are hungry"
8) Using modal operators "When you experience this trance you should stop eating between meals and you must know that your subconscious mind is doing everything it can to allow that........ You have to let the subconscious mind do it now..................... Food should be eaten as fuel and not treated as a friend."
9) Using double binds "You may want to stop eating inappropriately now or when you open your eyes..... you may want to feel that control over your eating when I count to 5 or when I count to 20,only you will know what is right for you......you may find yourself forgetting to remember about eating outside of mealtimes when you are doing something more interesting or as soon as I count to 10.."
Peter came for 12 sessions in total, lost 5 kilos in the first month and then consistently 3 kilos each month after that until he reached his target of losing 15 kilos. He never went on a diet, instead, week by week reporting that he just 'wasn't as bothered' as he had previously been about food. He began cycling without any further encouragement and enjoyed an increased level of fitness. His self esteem grew and his bad eating habits declined until he was within his bmi range for his age and height.
Undoubtedly the combination of the NLP format within the trance worked well for Peter due to his age and his acceptance of metaphor. If he had been in his late teens, I would have invoked more meta language. This case study took place at the end of 2008. Peter has grown in height but has maintained a healthy and average weight- fluctuating mildly but never due to an inappropriate relationship with food.
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