International Handbook of Clinical Hypnosis - E-Lib FK UWKS

HYPNOTHERAPY IN OBESITY 227
function of obesity in the patient's past and present life situation is of crucial
importance. This may reveal issues we have to deal with in the following phase.
MIDDLE PHASE
Altering Cognitions
A whole series of cognitions may contribute to the maintenance of obesity, such as
the attitude toward eating, poor self-esteem and the way they perceive and experience
their bodies. The Spiegel & Spiegel technique 1978) described earlier,
where suggestions are given that `overeating is harmful and poisons the body', may
help the patient to change their attitude toward overeating. Meanwhile, patients can
once again become conscious of feelings of hunger and satiation, which can be
suggested systematically during the trance Kroger, 1970).
Obese patients very often have strong feelings of inferiority, they feel weak and
powerless against their problem. They may perceive and experience their body as a
great threat and even have feelings of disgust toward their body. During hypnosis,
ego-strengthening suggestions can be made in order to favorably in¯uence the
sense of self-esteem Brown & Fromm, 1987).
Patients can be given the suggestion to look at their body in a mirror and to
evaluate it more positively. Patients with chronic obese problems can be invited
during a guided imagery exercise to imagine themselves in a world where being
overweight is highly valued.
Example
Karen, a 42-year-old unmarried secretary, entered therapy for a dramatic weight
problem. Karen started therapy at 300 pounds and lost only 20 pounds after a year
and a half of intensive psychotherapy. Her weight problem had originated in early
childhood and in the past she had tried all kinds of diet. Each time when starting
eating normally again, she put on weight immediately ... Because of her severe
weight problem, she locked herself up in her apartment and only left her ¯at to go
to work. She had extreme feelings of inferiority. Firstly, self-hypnosis was taught
by means of an audiotape. We discovered that Karen had moderate to good
hypnotic capacities. Since we had learnt from her weight history that losing weight
would be very dif®cult, we decided to introduce hypnosis to alter her negative
feelings and feelings of inferiority about herself. We invited Karen to imagine
herself, during hypnosis, in a world where being overweight was highly valued:
And now that you are feeling more and more relaxed and comfortable, I would like to
invite you to make a trip to a country where most women are overweight and where
being overweight is highly valued ... In this society all women have to be obese ...
To be attractive, you have to be obese. It may be a funny or confusing experience right
now, since everything is so different here ... But listen to all the positive comments