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Deepening the Trance State

Following the induction (Part.2.1) we deepen and intensify the experience of the trance state. This should help the Client when they practice at home, but is not absolutely necessary because good results can come from a relatively light trance in many cases, where the client has assimilated the practitioners suggestions easily (e.g. non-smoking scripts).

Deepening of trance causes fuller dissociation (Yapko) which may help deeper post-hypnotic suggestions become more effective and  longer lasting; e.g. the Ego Strengthening Script, or interventions based on R.E.B.T. or C.B.T. (if the practitioner is qualified) .

The "Stairs (or elevator)" method can be used here (see Part.2.1), where each step down is imagined to be into a deeper state. 

For example ... 

"I wonder if you can imagine yourself standing a the top of the stairs of relaxation, as you take the first step down the stairs of relaxation you can step down into a deeper state of comfort" (Yapko).

Clearly we can avoid the elevator metaphor if the client has a fear of closed spaces.

Chaining and Compounding suggestions are important deepening techniques (See Part.1.3) because they build new responses onto the foundation of the ongoing relaxation response.  Some therapists introduce a physical experience, such as lowering the clients hand, to reinforce a sinking feeling.

A suggestion that the client enjoys a few precious moments of deeper silence and relaxation can be very effective, since the client has relaxed even from the process of "being hypnotised". It is a good idea to arrange to give the client a signal which indicates when it is time to proceed.

It is good practice to give the client  a posthypnotic suggestion that the next time they enter trance they will find it much easier to go deeper.  We can also use this suggestion to re-enter a deeper trance later in the same session.

Type of Induction

The progressive muscle relation technique is a traditional type of induction. This can take quite a long time initially, as each muscle group is tensed and relaxed, but in subsequent sessions a relaxation response comes into play, and the therapist can go through each muscle group more superficially. We build in suggestions for breathing more easily and we can use the breathing as an indication of the depth of relaxation.

As in the visualisation technique we allow time for the suggstions to sink in and be processed by the subconscious mind, but the Client can become bored and distracted if we go too slowly ... we might even find the eyes pop open! In this case we can change tack and use an eye fixation type induction. In the next session we can progress quite quickly through the muscle tension and relaxation and bring in eye fixation earlier.

I prefer to start the process with the eyes and face muscles and then do the body scan downwards so that the mind is relaxed earlier in the sequence.

Another type of induction is the visualisation of a special place or relaxed scene (Part.1.5), where we find a calming place from the clients memories. If there is no memory of such a place we can create one in the present.

The oldest induction method is the eye fixation technique. As the Client stares up at a fixed point the eyes do actually become tired, so we have an immediately verifiable experience to refer back to - the eyes are actually getting heavier and tired and the Client will want to close them. Then you can suggest ...

"You can close your eyes and fall into a comfortable state of relaxation"

The counting method is another popular and useful induction technique. At each count you can suggest that the client experience twice the relaxation ... so that the depth is compounded at every stage. This can be accompanied by a visualisation of going down an elevator, steps or stages and perhaps becoming much more physically heavier and limp at each stage. A variation is to invite the client to count backwards from a hundred until she is too relaxed and to tired to bring any more numbers to mind. You can suggest that as she reaches 95 the numbers will simply seem to disappear.

Elman used a very rapid and direct induction method, which is appropriate for anasthesia and pain relief.

Finally, Milton Erickson used an "As If" method for Clients who were averse to suggestion. He suggests that the client can "close her eyes as if she were going into a deep relaxation". This seems to have practically the same result, but avoids a potential battle of wills.

Suggestibility

A major parameter of Suggestibility in this context, is a measure of our familiarity  with abstract thinking, that is the ability or tendency to experience absorption or concentration on inner experiences such as thought, imagination or fantasy.  This line of research produced the Tellegen Absorption Scale (1974), which was devised to measure "an openness to self altering experience". On this view a concrete and unimaginative individual is unlikely to experience subtle variations of inner states very clearly and will not appreciate abstract ideas as readily, but these abilities can develop with practice (see Part 1.3 Attention and Relaxation).

The suggestibility tests give the opportunity to evaluate the client and determine the most appropriate style of induction to use. Certain types of Clients will respond well to a commanding style but not everyone likes being told what to do! In fact some "Polarity Responders" enjoy doing the opposite. Some of these Clients may also feel that compliance is a sign of weakness of will, and may actually be proud of the fact that they cannot be Hypnotised (see Ericksons "As If" approach, Part.2.1)

Once the Cx is reasonably comfortable about control issues we can begin to discuss suggestibility. Once again the task is to gently extend the Cx's comfort zone by building up familiarity and confidence (preconditioning) in both the therapist and in Hypnotherapy.

The simplest test of suggestibility, which can even be done over the phone, is the "Arms Raising and Falling" test, which it a particularly good way to evaluate the strength of the Cx's imagination. It is a permissive test (as opposed to authoritative), where the Cx is encouraged to imagine a Helium balloon in one outstretched hand and a heavy book in the other. If the arms move gently upwards/downwards in response to the two suggestions you have a positive result. If there is no movement there is resistance which indicates a reluctance to give up control (GoTo Part.1.3.Responsiveness).

If the Cx doesn't respond to the permissive type of test it is worth trying an authoritative type test such as the "Hand Clasp" test. Here the Cx is asked to lock hands in front and imagine they are stuck like glue. The script becomes more authoritative as it proceeds, until the therapist asks the Cx to pull them apart ... if it has worked people will find if quite difficult to separate their hands. There is also a permissive version of this test.

Other tests include:

• Chevreul's Pendulum (tests concentration - permissive type).
• Postural Sway Test (tests trust - authoritative type).

Rapport

Everyone experiences some degree of anxiety when they come to the edge of their comfort zone. The first experience of seeing a Hypnotherapist may sometimes be an additional cause of anxiety in itself.

One way to reduce anxiety is to create good rapport with the Client. Rapport can be achieved quite quickly if we observe and match the clients preferred modalities, i.e. visual, auditory or kinaesthetic. The dominant modality can be found by noticing the kind of words they choose and by the eye movements they make in response to certain questions. When we look down we are usually retrieving sensations ... kinaesthetic information, when we look up we are usually reconstructing a visual image, glances to left or right indicate the use of auditory information.

We can try to include more visual imagery for the visual client, who would respond to the question "Does that look right to you?". We refer to sensations with the Kinaesthetic person, "Does that feel right to you?" The auditory person would respond best to "Does that sound right to you?"

From a therapists viewpoint it is useful to become familiar with the modalities we don't use so often in order to step out of our own habits and stereotypes and improve our dynamics in each area.

We could take up an activity or hobby related to the modaliteis we use less frequently. If our kinaestheic awareness is not so well developed, we might try Sailing, or Diving for example, which would help to develop an increased awareness of the sense of balance or a sensitivty to the wind direction.

This can be useful if we are constructing a guided visualisation, a situation in which an awareness of the Clients primary modality and the use of the preferred words for that modality would enhance the experience.

Practical: Attention and Relaxation

To help anxious or skeptical Cx to develop trust in the induction process we alternate statements that are observable and verifiable, usually a reference to something in the clients immediate environment or awareness, with more abstract suggestions. This is a skillful way of creating links between the clients present experience and what we would like her to experience. (Pacing statments focus on external stimuli, and Leading statements describe internal responses).

As the induction proceeds we can gradually link in more suggestions and more references to abstract internal states.

Links can easilty be made from an existing state to a desired state using the "implied causative", using connecting words such as "as", "while" and "during".

As you watch your breath you begin to feel more comfortable.

We start off the chain with a series of verifiable statements to put the clients mind at ease, and then introduce a single suggestion, as in this example which chains together the main sensory modalities:

As you sink into the chair,

and notice the gentle illumination,

the sound of my voice,

and the warmth of the room ....

... You will begin to feel more comfortable.

In the next sequence we might use three verifiable statements which chain together an awareness of any physical tension (we all have some tension, even at rest) and introduce two suggestions ...

Now, as you become aware of any slight tension in your your body,

any tensions in your neck or shoulders,

or in your arms or in your legs,

You may gradually begin to feel more comfortable,

and relax deeper into the chair

In this way the client gradually begins to rely on the authenticity of our suggestions and begin to flow with the process. The next sequence might only require two verifiable statements and allow three suggestions. Finally we can comfortably make one external reference for each internal reference.

This example method gives the induction a congruent structure which builds up, and corresponds to, the clients confidence in our suggestions. As our observations and suggestions create a credible chain reaction trust and relaxation develop.

YapKo describes this process of building a pattern of responses as a "response set", it is also described as a "Yes set" (Erickson and Rossi), as it builds an agreeable frame of mind, and there is no obvious reason to reject any part of the sequence of references and suggestions.

Ref: Trancework P. 283.

Visualisation and Imagination

Engaging Cx in the visualisation of a special place or an activity they enjoy can help produce deep relaxation, calmness and serenity. Such visualisations are more powerful if the Cx is encouraged to use all their sense modalities. If the Cx enjoyed horse riding she would be encouraged to 'fill-in' such details as the smell of the stables, the sounds made by the horse, especially breathing, the touch of the skin as well as all the sights of the yard.

In this type of visualisation the therapist cannot provide all the details of the content of such a visualisation because these arise from the Cx's memories and imagination. The therapists instructions can only give an outline and structure to the visualisation. If the instructions on content are made as general as possible we will avoid contradicting the Clients ongoing experience or pushing her in what is perceived to be the wrong direction and breaking rapport.

If we suggest the Cx canters along the road whilst the client knows full well that her horse is nervous of cars the flow of pleasant feelings and sensations will be broken, even if only momentarily. This is a further example of how our suggestions are tested and rejected if inappropriate. It would be quite safe to suggest that the Cx is enjoying the sensation of the fresh air in her face, for example, but if we specify the sensation of the warm air in her face, when she actually take the horse for a run on a daily basis, whatever the weather we are creating unnecessary contradictions.

It's also important to get the pace right, if we go too slowly the Client may become bored and distracted. Visualisations require quite some practice and skill to do well!

When the Cx is enjoying a comfortable relaxed state through visualisation we can create an anchor to this state so that it can subsequently be triggered. The simplest way is to ask the Cx to touch and press finger and thumb together whilst being aware of all the sensations, feelings, sights and sounds that are present.

Next time the Cx wishes to bring back this state, pehaps later on at home when learning self hypnosis, or when she experiences an unacceptable level or anxiety or stress, she can simply activat the anchored state with the same signal. Each time such an anchor is used the effect is compounded, and it becomes a very useful part of the Cx Hypnotic Toolkit.

This anchoring technique is using the "Law of Dominant Effect", which is based on the idea that a strong emotion will replace a weaker one. In this case strong emotions are associated with the anchor.