Q Can you recall the first time CS happened

Black Ops Hypnosis 2

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In many cases, of course, the first time is of great importance as it set the pattern of the process which has been followed with only small variation ever since.

At times the first occurrence has been consciously forgotten, and then a very careful analysis of the current process will often enable one to determine what the original experience is likely to have been. Let us suppose that as a result of questioning it is found that the central symptom in a man is that of a panic attack; that a common factor in triggering off the attack is the sight of a bearded man; and that a common effect of the panic is a gagging reaction and some nausea; and that this has been current since the age of three. Then one possible explanation is that as a child the Client was forced to perform fellatio on a bearded man at that very early age. This provides a hypothesis which can be explored by means of further questions: it is very risky to suppose that the assumption is true without rather more evidence than the above. If four or five other aspects of the problem also fall into place when this hypothesis is adopted then its likelihood is increased.

But it is important to note that the appropriate attitude to take to such an hypothesis is to look for evidence that it may be wrong, rather than confirmatory evidence that it is right. Thus evidence that the man's fantasies and sex life are perfectly normal would cast doubt on the theory, for example. If we were to discover that the man also has the same panic reactions in hospitals, and further questioning revealed that he had been in hospital when he was two with a throat problem, then we have a second hypothesis, which is that the phobia was initiated by a bearded doctor examining his throat too roughly. If, alternatively, we found that the panics could also arise at times when the Client is sitting at a table on a formal occasion, the roots may have to do with his father (we would have to check if he wore a beard at the time) forcing him to eat at an early age.

Hypnotic techniques could then be used to provide further evidence in ways that will be described later. In some cases it is useful to regress the Client to the time of the original experience and to allow it to be relived and the associated feelings to be expressed. Such an expression of emotion is termed abreaction. However, it is worth realising that in many cases symptoms reduce or disappear purely as a result of the understanding which can be achieved by means of the above analysis, which has more of the flavour of Sherlock Holmes than Sigmund Freud.

In dealing with such phenomena it is important to be careful about the language we use. It is easy and common to say that a problem was "caused by" an early trauma. But this sense of cause is not the same as that implied by the use of "d" which is that of a direct or immediate cause. In fact we should analyse such situations in the following way.

Trauma > {Memory trace at a non-conscious level}.

Current stimulus > /{Memory Trace} > /{Associated responses}.

This is not to split hairs. The above analysis can be of central importance since if, using Hypnotic techniques, we alter the memory trace in certain key ways, we can dramatically improve the response to current stimuli. Put more bluntly, people are affected NOT by the past but by what they remember (consciously or subliminally) of the past. We cannot change the past, but we can change memories.

Returning now to the above line of questioning, we have seen that it results in a linked chain of processes, with precursors leading to the symptom which in turn has its resultants. Now consider how this chain could end.

We have the following alternatives. A chain may have open ends lying either inside or outside the person, or the chain may close and form a loop. An example of a chain which starts outside a person is one in which the initial process is that of being shouted at. The process will end outside the person if it leads to hitting or vomiting. It will end inside the person if the last clear resultant is something like a headache or muscle tensions. The chain may start inside a person if, for example, the first clear precursor is a recurrent thought of self-hatred, or some recurrent feeling or physical symptom.

The distinctions above become of value when we come to the next stage in our work, which is changing the situation. It is a commonplace that a ventilated emotion tends to dissipate harmlessly, i.e. an external end to the chain is less of a problem to the individual than an internal end. And the approach to solving a problem will generally be quite different according to whether the primary cause is some quite definite factor in the external environment or some internal process.

The third alternative, which is that the chain may close to form a loop, is of enormous importance. Such loops are very, very common. In colloquial language they are called vicious circles and are often recognised as such by the Client.

Let us look at some simple examples. A man has a slight tendency to blush. But he is embarrassed about blushing. The embarrassment results in more intense blushing. We have a vicious circle, which in a short form can be expressed as:

/{Embarrassment} > /{Blushing} > /{Embarrassment}, or /{Blushing} > /{Embarrassment} > /{Blushing}.

It does not matter which item we start with when we are defining loops: a loop has no beginning and has no end.

Other examples arise in many contexts: sleeplessness can lead to an anxiety (about lack of sleep) which in turn leads to sleeplessness; a sickness at the thought of food can lead to a fear of starving to death which can lead to an increased feeling of sickness; the pain of muscle tension can lead to mental worry which can lead to yet further muscular tension; an asthmatic attack may both be caused by anxiety and provoke anxiety, in which case a vicious circle can exist; acid production in the stomach can both be prompted by stress and (because of its discomfort) cause stress; perhaps simplest of all we have the fact that the feeling of fear can itself be fearful, though a more careful analysis of this will usually show that there are two parts to the system - the emotion of fear and the mental process which says, "This feeling is dangerous".

The general pattern that runs through the above and many other complaints that a Hypnotherapist will see is that of:

/{Fear/anxiety} > /{Symptom} > /{Fear/anxiety}.

Many things can be both a cause and a result of fear, and hence create vicious circles. The consequences of a feeling of fear are many - we have already met them in the "fight or flight" responses. Typically the heart rate increases, breathing becomes faster and shallower, blood is diverted to brain and muscles and away from intestines and skin (though the face is a common exception to this), muscles tense, there may be a tendency to evacuate stomach and bowels, there is sweating, speech tends to be inhibited, the mind races and so on. The exact pattern varies from individual to individual, but if any of these effects is regarded as itself being dangerous or a problem then the above vicious circle becomes established.

A very important part of the diagnostic process is to establish whether or not there is such a vicious circle, which we will later describe as an internal increasing positive feedback loop.

Such vicious circles can exist not just in the individual human being but in other organic systems too. For example, if we find that a problem chain is ending in another person - a spouse, for example - then by changing focus we may consider our primary system to be the couple, which has two clearly defined subsystems - the partners - which we may label A and B. The action of crying by A may lead to violence in B which leads to an increase of crying in A: a vicious circle.

This example is quite important because it reminds us that we should generally not stop our analysis at the boundaries of the individual. Very many problems have to do with the individual's reactions to and actions on others.

One of the beauties of the current systems approach is that we can use precisely the same language and shorthand and diagnostic approach in dealing with processes within the individual, and processes within the family which involve the individual and processes within the society which involve the individual.

We may find for example that the presented problem of a headache is part of the following loop:

/{The boss's anger} > /{resentment in man} > /{headache} > l{job performance} > /{boss's anger}.

In such a case we have a vicious circle where the most potentially useful system to change has little to do with the system where the symptom appears. Instead we should be focusing on the sufferer's methods of dealing with authority and anger from others. If the man can stand up for himself - be more assertive without being aggressive - then the repeated doses of resentment will be avoided and the whole vicious circle will wind down.

Or we might have a typical situation in which the presented symptom is what the sufferer may call paranoia - the feeling that people are thinking in an unpleasant way about him. (This is not the strict clinical definition.) But as a result of that feeling he may start to scowl at people, to skulk into rooms and perhaps to mutter under his breath, as a result of which people will, indeed, start thinking unpleasant thoughts about him: a vicious circle is established.

In such a case the Hypnotherapist might choose to work on the thoughts about other people or the feelings of paranoia or on the behaviour which is maintaining the circle.

The question of how to choose the most appropriate point to start to change a circle will be left until another chapter.

I hope it is clear that the diagnostic procedure outlined above goes a long way to avoid the criticism, "You are only treating symptoms." In fact, the criticism might with more justice be aimed at large areas of contemporary medicine, particularly when it comes to treating the vast range of anxieties, panics, depressions, etc. which are becoming an increasing proportion of the doctor's case-load as the specifically organic illnesses are being controlled more and more. The diagnostic process in Hypnotherapy is detailed and should in principle reveal all factors involved with a presented symptom, and will therefore never be dealing with it in isolation as the doctor all too commonly is.

The above process of establishing the causal chains - the dynamic patterns - involving the presented symptom is clear, though of course the results can be very different in different cases. I would suggest that diagnosis is not complete until the picture that emerges from such an analysis is complete and satisfactory: that it accounts for all the known facts.

But what if this does not happen? What if no chain arises? What if we cannot find any causes? Then, I suggest, we have prima facie evidence that the problem does not lie in our field, but in that of someone else. We are then in a similar situation to the doctor who, having applied all his tests (which are simply a technical form of asking questions), cannot find a cause for the ailment. He is then likely to think of the problem as being psychological. If we can find no clear cause-and-effect chains then we should equally be thinking, "This is physical," and sending the patient back for another opinion. (In the UK people normally take problems first to their General Practitioner and only later to a Hypnotherapist, because the former consultation is free.)

We might also consider referring the Client to another specialist. For example, although in principle we should be able by means of our diagnostic scheme to discover if there is a dietary cause for a problem, it is outside our expertise and so it is unlikely that we will know the precise questions to ask in order to establish the dietary cause. Equally although we should in principle be able to decide if the cause is an allergy, or perhaps some poison in the environment, it will depend on asking the right detailed questions, and the right questions will again be best left to specialists.

I hope that these few remarks will go a little way to explain why it is not necessary for an experienced and intelligent Hypnotherapist also to have a full training in medicine any more than it is necessary for a General Practitioner to have a full training in Psychotherapy. (Though I would strongly recommend that each of these specialists should acquire a basic, sound and relevant familiarity with the other field.) Each has a collection of diagnostic questions designed to establish the causes of a given complaint which is treatable by his or her methods. Each, with practice, learns to recognise when the answers do not add up to something that is capable of being treated by the means to hand. Each then learns to pass the patient on to someone who might have a better chance. Of course each may make mistakes, but I hope that these paragraphs may at the very least moderate the view that a Hypnotherapist commonly attempts to "suggest away" any symptom with no regard for possible physical or psychological causes, and hence makes things worse. This is far from the truth. This is not to say that "help" cannot be misguided: we only have to consider the consequences of Thalidomide or of the indiscriminate use of the Benzodiazepines (Diazepam, Valium, etc.) in the sixties to see that mankind may easily take what appears to be a step to improve things and succeed only in creating greater problems. But it should be clear that the systematic approach to Hypnotherapeutic interventions presented explicitly here leads to a high level of awareness of possible problems and to a minimising of any dangers of an ill-considered intervention.


The first stage of diagnosis is to establish the existing dynamic patterns. Generally this will mean discovering chains of precursors and resultants of the central, presented problem.

One very common and important pattern that can emerge from this analysis is that of a vicious circle (an

Principles of Hypnosis (10) Diagnosis with systems, precursors, resultants and vicious circles increasing positive feedback loop). At times these circles involve larger systems such as family or society.

In considering those chains which do not form circles (open chains) it is useful to note if their ends lie within or outside the individual.

The diagnostic process ensures that the symptom will NOT be seen in isolation.

The failure of the diagnostic procedure to reveal a dynamic cause for the complaint suggests strongly that the Client should be sent to other specialists for their opinion.

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