International Handbook of Clinical Hypnosis - E-Lib FK UWKS

208 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
Many patients with eating disorders feel helpless, hopeless, and ashamed of
having to seek psychological help. I use the principle of `meeting the patient where
the patient is at,' allowing patients to talk about any subject they wish to discuss,
and letting them choose the priority of their concerns, even if at ®rst it seems only
remotely related to the eating disorder. I listen to metaphors in the patient's
communication, being aware that people communicate simultaneously on two
levels: manifest and latent. For example, an 18-year-old adolescent girl communicates
in the ®rst session her story about the fact that the house she is living in is
crumbling and needs to be renovated and remodelled, and that she is determined to
®nd the resources to accomplish this goal. This patient is talking on a manifest
level about her own house, which in reality may need to be renovated and
remodelled; however, on a latent level, she may be referring to her own body that
needs to be repaired and restored to health. In fact, this girl had lost many teeth due
to repeated self-induced vomiting, and in addition had an electrolyte imbalance,
abnormal liver functions, and esophageal bleeding, requiring immediate medical
and psychiatric care. The clinician's recognition that the patient communicates
about her body in a metaphorical way makes the therapist an ally with the patient's
subconscious mind, and creates an ideal setting for the effective use of hypnosis to
facilitate the desired change.
THERAPEUTIC INTERVENTION WITH HYPNOSIS
When evaluating a new patient, I listen to the patient's communication regarding
dysphoric feelings of helplessness, anxiety, hopelessness, inner tension, insomnia,
fear, restlessness, and so on. I introduce the idea of using hypnosis by
making it relevant to the patient's presenting symptoms, saying to the patient
something like this, `Would you like to learn an exercise of how to reduce your
anxiety and promote a sense of calmness and relaxation?' Patients generally
respond af®rmatively. I then proceed by teaching the patient a self-hypnosis
exercise loaded with suggestions and images of calmness and comfort, asking
the patient to select a place associated in their mind with such feelings. Some
patients select a mountain trail, an inland lake or a state park, many select an
ocean beach.
Most patients respond positively to this exercise which, as mentioned
before, can be tailored to the patient's choice of place. At its completion, the
patients have an experience of success in replacing their feelings of anxiety
and restlessness with new feelings of calmness and comfort. This success
makes the patient into an ally and believer in the healing powers of selfhypnotic
imagery and conveys to them a sense of new hope. To facilitate yet
further the experience of success, suggestions and images for ego-strengthening
are added.