Advance Acclaim

“How do you acquire a lifetime of learning, research, and experience in the most
effective art and practice of clinical hypnosis without spending a whole lifetime
doing so? In Process-Oriented Hypnosis, Michael Yapko distills and shares the very
essence of his career-long knowledge and wisdom as a world-leading practitioner,
teacher, and writer. His unique contribution with this new volume is in ways to use
hypnosis effectively by articulating the specifics of how to be nonspecific. The
process for learning this and becoming a more masterful clinician yourself is simple:
first, read the book, and second, apply its approaches.”
—George W. Burns, Adjunct Professor of Psychology, author, 101 Stories for
Enhancing Happiness and Well-being

“Michael Yapko has explored an element that has become identified as a core
Ericksonian approach—the tailoring that follows listening carefully to the words,
the phrases, and the expressions of the client, then subsequently adapting the
direction of therapy specifically to the needs, wants, and desires of what is revealed
and expressed by the subject. Yapko has taken that basic concept and turned the
whole picture upside down and inside out. And in so doing, he may have arrived at
the most Ericksonian of all approaches—that of looking at the forest and working
within the context of the bigger picture.”
—Roxanna Erickson Klein, Ph.D., coauthor, Hope and Resiliency: Understanding
the Psychotherapeutic Strategies of Milton H. Erickson, MD

“Process-Oriented Hypnosis offers a fresh and approachable vocabulary for many

of the process-oriented concepts and techniques that have often been overlooked and
all but lost in the teaching and training of modern psychotherapy. Process-Oriented
Hypnosis reanimates then creatively expands upon these multi-dimensional
approaches with the kind of clear emphasis on practicality that is typical of Yapko’s
writings. This book is long overdue and is a must-read for all therapists, whether
they use hypnosis as a context for treatment or not.”
—Stephen R. Lankton, LCSW, DAHB, FASCH, Editor-in-Chief, American
Journal of Clinical Hypnosis

“Once again Michael Yapko is proving himself to be a leader in the field of

therapeutic hypnosis in Process-Oriented Hypnosis: Focusing on the Forest, Not the
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Trees. This how-to book integrates practicing psychotherapy with salient and
positive principles including ambiguity, expectancy, discrimination, impulses,
compartmentalizing, acceptance, responsibility, action, integrity, and foresight—the
major principles of modern therapeutic hypnosis. These are, indeed, the trees that
make up the forest of effective treatments. Bravo, Michael!”
—Ernest L. Rossi, Ph.D. and Kathryn L. Rossi, Ph.D., codirectors, PsychoSocial
Genomics Research Institute and The Milton H. Erickson Institute of California
Central Coast

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 A Norton Professional Book

Process-Oriented Hypnosis

Focusing on the Forest, Not the Trees

Michael D. Yapko

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 To Diane with love
44 years later, your smile is still
my very favorite thing to see

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Contents

List of Tables
Acknowledgments
Foreword by Jeffrey K. Zeig
Introduction

Part I: The Foundation of Process-Oriented Hypnosis

Chapter 1: That Problem Sounds Familiar: Repetitions in Therapy
Chapter 2: The Distraction of Content and the Salience of Process in Treatment
Chapter 3: The Process of Hypnosis: Paying Attention with Intention
Chapter 4: Targeting Symptomatic Sequences with Kind and Gentle Interruptions

Part II: The Methods of Process-Oriented Hypnosis

Chapter 5: Recognizing and Tolerating Ambiguity
Chapter 6: Building Expectancy
Chapter 7: Making Better Discriminations
Chapter 8: Developing Impulse Control
Chapter 9: Facilitating Compartmentalization
Chapter 10: Encouraging Acceptance
Chapter 11: Defining Responsibility
Chapter 12: Catalyzing Meaningful Action
Chapter 13: Instilling Integrity
Chapter 14: Evolving Foresight

References
Index

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List of Tables

Table 1.1 Forms of Rigidity

Table 3.1 Possible Shifts in Subjective Experience During Hypnosis

Table 3.2 The Generic Session Structure of Hypnosis Sessions

Table 4.1 Varieties of Therapeutic Dissociation

Table 4.2 A Generic Structure for Hypnotically Accessing and Contextualizing

Resources

Table 5.1 Generic Session Structure for Recognizing and Tolerating Ambiguity

Table 6.1 Generic Session Structure for Building Expectancy

Table 7.1 Generic Session Structure for Making Better Discriminations

Table 8.1 Generic Session Structure for Developing Impulse Control

Table 9.1 Generic Session Structure for Facilitating Compartmentalization

Table 10.1 Generic Session Structure for Encouraging Acceptance

Table 11.1 Generic Session Structure for Defining Responsibility

Table 12.1 Generic Session Structure for Catalyzing Meaningful Actions

Table 13.1 Generic Session Structure for Instilling Integrity

Table 14.1 Generic Session Structure for Evolving Foresight

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Foreword

In 1984, I was honored to write the foreword to the first edition of Michael Yapko’s book
Trancework: An Introduction to the Practice of Clinical Hypnosis, which has continued to be the
definitive textbook for the practice of clinical hypnosis and is now in its fifth edition. In that
foreword, I noted that he provided the necessary building blocks to learn and understand the
evocative vocabulary and grammar of hypnotherapy. Now, more than 35 years later, I am
honored to write a foreword to Process-Oriented Hypnosis, which builds on the exemplary
contributions this talented therapist and theorist has made in the decades subsequent to
Trancework.
As one of the world’s leading experts in the practice of hypnosis, in this book, Michael extols
the value of hypnosis in psychotherapy. Even more, he provides a template for improving
psychotherapy, regardless of one’s preferred theory and form of practice. Hypnotic processes are
inherently woven into every form of psychotherapy, whether or not the practitioner realizes it,
and the intentional use of hypnotherapy, even without formal induction, can be immensely
beneficial.
We become clinicians because we want to help clients live more adaptively. But there is no
right way to provide therapy. As Michael explains, there are many entry points for effective
psychotherapy and just as many departure points, because finite patterns and concomitant
behaviors underlie human suffering. While pathology has common roots no matter what the
presenting problem, the good news is, there are no limits when it comes to human adaptation.
In this edition, Michael outlines general themes that underlie most client problems, including
intolerance of ambiguity, lack of control over impulses, and relinquishing personal
responsibility. Careful study of these themes and Michael’s innovative approach to overcoming
them will help clinicians be more effective, regardless of the specifics of the presenting problem.
When it comes to what makes psychotherapy work, Michael and I share many beliefs and
orientations, including an emphasis on the utilization of the client’s adaptive processes, instead
of analyzing client weaknesses. We both maintain that evocative experiences trump
psychodynamic understandings, and that the power of communication—as especially evidenced
through hypnotic processes—is remarkable. We see trance as a way of awakening people to
dormant resources, and not as a method of programming a person to do this or that. Neither
Michael nor I are keen on using hypnotic scripts. We believe that therapy is an art, the same way
that adaptive living is an art, and should therefore involve creativity, spontaneity, and tailoring to
individual needs. And because living happens in the present and is directed to the future, we
should be goal oriented in clinical practice.
Michael Yapko is as much an advocate for hypnosis today as he was nearly four decades ago.
And his dedication to his art is apparent in both his work as a therapist and his contributions as
an author. Join him on his continuing journey in making powerful hypnotic processes part of
therapeutic practice. This book will help you become a more effective and creative clinician. It is
user friendly, easy to read, and replete with practical suggestions for bettering clinical practice.
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 Jeffrey K. Zeig
Phoenix, May 2020
erickson-foundation.org

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Introduction

It is not the strongest of the species that survives, nor the most intelligent that survives.
It is the one that is most adaptable to change.
—Charles Darwin

When I decided to actively pursue a career in psychology as a young college student, my

academic coursework and clinical training required my participation in different forms of the
therapy experience. The thinking at the time by those in charge was that through your own
therapy experiences, group and individual, you could reduce the risk of your personal issues
contaminating your work and also better understand what your clients would experience by
being in therapy.
I knew about my own issues well before those experiences, though. I knew I was way too
perfectionistic, intolerant of mistakes I made, and often pretty harsh in what I would say to
myself. As my involvement in the therapy field gradually deepened, I became increasingly
concerned that perhaps I wasn’t meant to be a therapist when my own issues were so unyielding.
Filled with self-doubts and negative judgments about myself, more than once I thought I’d better
choose a different profession. How lucky for me that I didn’t because of a single interaction!
One day I was talking candidly with one of my mentors, and I disclosed my self-doubts to
him. I told him I had this voice inside my head that was forever criticizing me, telling me awful
things about myself and how I’d never succeed, and on and on. He listened to me as I told him
how bad it made me feel to have this persistent and draining inner voice. Then he hit me with a
life-changing thunderbolt when all he said was, “Well, why do you listen to it?”
Why do I listen to it? Wow! Everything that I’d learned to that point declared that whatever
went through my mind had some significance to be analyzed and worked through. The very idea
of not listening to it was astonishingly alien to all I had been taught and therefore would likely
never have occurred to me in a million years. Suddenly, there was no need to analyze why I had
those issues or what in my background gave rise to them. I now had a genius of a man, for whom
I had enormous respect, telling me in so many words that my inner voice could say anything it
wanted, but I didn’t have to listen to it. For me, this was a huge, shocking, and liberating
realization. With that one penetrating question, asked so simply and casually, my whole focus
changed from what was wrong with me to discovering what else I could focus on that would
better serve me and the clients I hoped to eventually help.
The lesson went even deeper than that, though. I had been so focused on the small stuff, each
moment’s self-criticism, that I was missing the bigger picture of who I was and what I might be
capable of. I realized in that powerful moment that my focus had been terribly misdirected. I had
been so wrapped up in trying to change the content of what my inner voice told me and how I
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reacted to it that I had entirely missed the process of self-talk involved and what I could do to
change myself at that higher level.
This insight has paid off in a lifetime of personal and professional dividends. I could and did
study the microdynamics of therapy in general and hypnosis in particular, and have written many
previous books detailing them. But as valuable as the microview has been, the macroview, that
is, the bigger picture, has always been at least as valuable. In my book Depression Is Contagious,
I said it directly: We don’t need a better microscope for understanding and treating depression.
Instead, we need a better macroscope, one that can see the bigger picture of what is happening
socially and technologically in today’s world that has led to the sharp rise in depression such that
it is now the world’s number one cause of human suffering and disability, according to the
World Health Organization (WHO). The problem isn’t in people’s brains; more often it’s in their
circumstances. The COVID-19 global pandemic has helped make that point even clearer.
Process-Oriented Hypnosis is an invitation to experienced hypnosis practitioners to develop
their hypnotic interventions according to the bigger picture. It speaks to common themes in
therapy, considers how people develop their problems rather than striving to explain why, and
encourages the use of hypnosis to help people shift their frames of reference in more helpful
directions, just as I was encouraged to do when told I could have a different response to my
harsh inner voice.
This book adds to the many perspectives of hypnosis already in existence. It is not an
introductory training manual for beginning hypnosis students new to the field. To address that
need, I have written the richly detailed and widely used hypnosis textbook, Trancework: An
Introduction to the Practice of Clinical Hypnosis (5th ed.). By making sharp distinctions
between being process and content oriented in structuring one’s hypnosis sessions in Process-
Oriented Hypnosis, I hope to bring another level of sound practice to the field.

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Part I
The Foundation of Process-Oriented
Hypnosis

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Chapter 1

That Problem Sounds Familiar: Repetitions

in Therapy
Each man is an island unto himself. But though a sea of difference may divide us, an
entire world of commonality lies beneath.
—James Rozoff

The Paradox of Individuality

“You’re unique . . . just like everyone else.” This statement represents one of the many
paradoxes inherent in the practice of psychotherapy. On one hand, it acknowledges the
uniqueness of each person that is clearly evident in their physical being, personality, history, and
circumstances. On the other hand, it highlights a challenging conundrum: if everyone is special,
then is anyone special?
The field of mental health has been wrestling with this paradox throughout its history. The
diagnostic classification systems we have developed have encouraged us to respond more to
people’s labels than to the people themselves, thereby diminishing each person’s uniqueness. If
you were to assemble a room full of therapists together and ask them if they believe each person
is unique as an individual, you will get a unanimous answer: “Of course!” But if you then ask
them about how they deliver their treatments, many might tell you about their “10-week program
where in week 1 we do this, week 2 we do this, week 3 . . .” and so forth. Each unique client
goes through the same cookie-cutter program, and at the level of actual clinical practice the
message can be reduced to this: “Here’s a size 9 therapy shoe, now go ahead and fit your foot to
it.”
Similarly, when a psychiatric medication is prescribed as the sole form of treatment (i.e.,
without concurrent psychotherapy) according to the diagnosis and types of symptoms the patient
has, the individual patient is reduced to a neurochemical anomaly to be corrected. The client’s
uniqueness is again overshadowed by the common denominators of the presumably biological
problems they share with similar others.
This is an important issue that sets the stage for what this book is about. While it is ideal to
deliver treatments that are as unique as the clients receiving them, it is often a practical necessity
to develop standardized programs and therapies that can recognize and treat disorders as
efficiently as possible across large numbers of individuals needing help. Delving into irrelevant
aspects of what makes someone unique can delay or even prevent delivering timely and effective
treatment, yet we still strive to prioritize honoring the individual, as well we should. Thus, we
psychotherapists all wrestle with this practical dilemma: How can we acknowledge the
uniqueness of each person without having to act as if we’ve never heard their story before or
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haven’t had to intervene in other cases that were structurally identical?

How Unique Are People’s Problems Really?

Each person who comes to therapy naturally thinks that their problems are unique. Anyone who
has been doing therapy for any significant length of time will likely have noticed that while each
person is unique as an individual, the problems that individuals present are not all that unique. In
reality, the problems that people present to therapists are often remarkably redundant: Here’s yet
another person suffering with an airplane phobia; here’s yet another couple suffering in a
distressed marriage; here’s yet another person feeling unhappy with their job, and so on. When
was the last time you heard a client’s story that was new to you?
This is absolutely not meant to make light of anyone’s problems, because such problems,
suffered by each individual person, can be devastating to them and those around them. They
deserve our attention, empathy, and sincere desire to help reduce their suffering, which is why
we became therapists in the first place. Rather, the point is that people’s problems are repetitive.
Occasionally you might hear of some problem that is unlike anything else you’ve heard before,
perhaps even shockingly so, but far more often your new client is telling you a personal story
you’ve heard many times before. The names and faces change, but the stories you hear are quite
familiar. Human experiences may be diverse in nature, but they also have a great deal of overlap.
Wherever there are families, there are family issues; wherever there are marriages, there are
marital issues; wherever there are human bodies, there are health issues, and so on.
Someone’s problem may, in fact, have some unique characteristics, some extra little twist to
their tale, but these are far more likely to exist on the level of details (content) that are only
indirectly related to resolving the presenting problem. Thus, when therapists are able to avoid
getting distracted by aspects of the problem that aren’t particularly salient to overcoming it, they
can better focus on the aspects that are vital to the problem’s formation and resolution. This point
is one of the primary ways that therapists differ, though, for what one therapist considers central
to someone’s problem is viewed as only peripheral by another.

Micro- and Macroviews of Human Experience

What level of consideration, then, is most helpful to the work we do? In recent years, the level of
consideration has moved to the microlevel as therapists increasingly focus on abstract and
incomplete neuroscience to explain people’s problems and their interventions. With precious
little evidence to support their claims, many therapists now promise to stimulate neurogenesis
and rewire brains. These approaches seem to hold promise and should be explored and
developed further. But, with this book, I’m going in a different direction. Instead of engaging in
what I call bioreductionism as a treatment model, focusing on the relationship between neurons,
I’m encouraging a macroview and focusing on the commonalities of human experience as they
underlie people’s problems. It’s important to say at the outset that this is not an either-or choice
of where therapists need to align themselves. Rather, it’s a both-and opportunity to recognize that
a broader macroview offers at least as many advantages as a microview.
What this book is about, then, is how our therapy clients come to form the problems they
present to us with the hope that we can do something that will be of help to them. The focus
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throughout will be on striving to understand the process, that is, the sequential steps someone
follows that culminate in the development of a symptom or problem. The main point is this:
When people follow sequences, identifiable steps that lead down a symptom-producing path of
experience, anyone following the same steps will end up in the same psychological place. It no
longer matters how many degrees they might have, or where they went to school, or what they
like to do on their days off. For as long as they continue to do what they do (cognitively,
behaviorally, emotionally, interpersonally, etc.) in the same way, the unfortunate outcome can be
quite predictable. The problem is in their process.

Consider an Airplane Phobia as an Example of the Point

Consider a client who presents the problem of an airplane phobia to a therapist. It’s a common
problem and can be quite costly on many levels (e.g., the missed family events, the self-
criticisms for being weak, and the sense of living in too small a personal world self-limited by
fears). A therapist might listen attentively and empathetically to the client describe the content of
episodes of terror suffered during actual past flights, or sad feelings of regret for important
events they missed because they just couldn’t bring themselves to get on an airplane.
A content-oriented approach, one that focuses primarily on the details of the client’s narrative,
might strive to teach the client any of a number of seemingly relevant techniques (such as
mindful breathing, deliberate distraction, systematic desensitization, providing factual
information such as flying being statistically safer than driving, etc.) intended to, hopefully,
counter the anxiety. A content-oriented hypnosis practitioner might perform an induction and
then offer empowering suggestions amounting to not much more than a pep talk (“You can do
it!”). Or the practitioner might offer simple suggestions of how to “get deeply absorbed in a good
book or movie and before you know it the flight will be over . . . You’ll be amazed at how
comfortable you were and then you can look forward to more comfortable flights.”
But a process-oriented approach will have a substantially different focus: How does the client
generate unmanageably high levels of anxiety even just thinking about flying? Even though the
names and faces of clients who present an airplane phobia differ markedly, the process by which
they generate that phobia is amazingly similar.
As someone who flies regularly, I am aware on virtually every flight how different fearful
flyers’ experience is from my own. I settle into my seat and instantly relax as I think, “For the
next 17 hours, no one can call me!” Then I look across the aisle and see someone obviously
anxious as they white-knuckle the armrest and practically hyperventilate. In the early days of my
career, I’d get up and go ask them what they were doing “in there” (i.e., inside themselves). How
did they generate so much anxiety, in sharp contrast to my experience of relaxed flying?
Here’s the short answer: Male or female, young or old, high-powered career professional or
low-key surfer dude, each followed the same process. They each imagined in vivid detail being
held prisoner in their seat as the plane took off, then would clearly imagine the wings falling off,
the plane going down in flames in torturously slow motion while they screamed uncontrollably,
and then all that was left to see were their body parts strewn all over the ground. It’s no surprise
that anyone engaging in that kind of horrific imagery would be terrified of flying.
Why would somebody sitting on a plane think about plane crashes? Because you have to as
soon as the cabin crew begins their safety demonstration. The more salient question for this

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book, though, is why all the flyers who are directly warned about cabin depressurization, putting
on oxygen masks, following the floor lights to the nearest exit if the cabin goes dark or fills with
smoke, and how to “use your seat cushion as a flotation device in the event of a water landing”
aren’t anxious. How do they process the multiple dangers described in the safety briefing at the
start of every flight in such a way as to still be comfortable flying? What specific skills, cognitive
or otherwise, make the threat of a possible fatal air crash not seem to be a threat at all?
Thus, the content of the problem is an airplane phobia with all the associated details (such as
the person’s feelings, history of the problem, previous attempts at resolution, etc.), but the
process of the problem relates to how someone assesses risk and how someone is unable to
distinguish well between real and imminent threats and merely possible imagined ones. A
process-oriented hypnosis session would focus on building these specific skills rather than only
focusing on the content of a fear of flying in airplanes or worse, talking about the client’s
presumed control issues or the symbolism of what the airplane represents in your unconscious.
Clinically, it is well known that someone with a phobia is likely to have multiple phobias, not
just one. Altering the process of how someone assesses risk and utilizes their own resources
more effectively holds the potential to solve many more problems than just one phobia. We want
to be able to improve the way people respond to their feelings of fear when those feelings arise in
any context.

Why Hypnosis?

One of the primary reasons why hypnosis as a treatment tool is so effective is because more
often than not, people’s problems are ultimately problems of focus. They may focus only on
what is wrong and thereby miss what’s right. They may focus on the unchangeable past and miss
opportunities to create a different and better future for themselves. They may focus on the big
picture and miss the salient details (or vice versa) of what actually matters. They may focus on
their feelings when they would be better off thinking rationally (or vice versa). Much more will
be said about hypnosis and its applications in later chapters, of course, but it’s an important point
to establish early on that hypnosis is a valuable tool for helping people to shift focal points.
Hypnosis, in general, is particularly effective in engaging someone’s attention and gently moving
it in a more useful direction, one that is consistent with the goals of treatment. That attribute of
hypnosis becomes especially important when addressing the repetitive nature of people’s
problems that arise from their tendency to focus on images, ideas, feelings, perceptions, and so
on, that cause them distress. What any good hypnosis practitioner does, like good therapists in
general as well, is to say, in essence, “Here. You’ve been focusing on that and it has caused you
significant discomfort. Now, to feel better, you can begin to focus on this instead.” And so, the
hypnotic induction begins . . .

The Problems That Sound Familiar

All people face challenges in life that can easily become the source of emotional distress. No one
escapes the adversities that can range from relatively small bumps in the road of life to the huge
earthquakes that can rock your world. We all face illness, death, failure, rejection, humiliation,
prejudice, too many forms of unfairness to count, and so many other reliable sources of
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emotional and physical pain that can come at us from the outside world. But it’s also true that
much of the distress people experience isn’t externally generated. Instead it’s generated by
internal forces, whether it’s sloppy thinking that gives rise to damaging misperceptions (such as
a crippling perfectionism or an endless rage over unfulfilled and unrealistic expectations) or bad
behavior that leads to self-loathing or worse (such as alcohol abuse or reckless sexual acting out).
Each individual has personal reasons for and ways of suffering, but the paths of human
suffering that people follow are well worn and plainly visible. What follows, then, in this section
is an identification of some (not all) of the most common, repetitive problems that people present
to therapists in the hopes of getting meaningful help. More important is the brief discussion of
each one in terms of what someone, anyone, would have to learn in order to resolve that issue.
The role of process-oriented hypnosis in helping people acquire those skills can then become
clearer.

Rigidity

Not long before he passed away in 1980, Milton Erickson was asked this question by one of his
students: What do you believe is the basis for most people’s problems? Erickson’s one-word
answer: rigidity. That answer is brilliant in its simplicity and has been a constant source of
inspiration for all those therapists (like me) who strive to promote greater flexibility in those
contexts that clients find challenging.
What does rigidity mean exactly? It means someone has a response—a behavior, a cognition,
an emotion—that doesn’t vary even when the context does. In other words, the person doesn’t
adapt to changing circumstances to their own detriment. The ability to adapt is one of the keys to
mental health. When circumstances change but someone persists in a pattern that may have
worked before but can’t any longer, the result is all too predictably negative. There are many
different forms of rigidity a client may display, as delineated in Table 1.1.
It was one of Erickson’s primary goals in therapy to create situations, whether through
hypnosis or prescribed life experiences (such as task assignments or behavioral experiments),
that would make it nearly impossible for his patients to continue doing whatever they were
(rigidly) doing. So many of Erickson’s case examples, and the case examples of Ericksonian
practitioners such as Jeffrey Zeig and strategic therapy practitioners such as Jay Haley, are
stories of wonderfully creative interventions that promote flexibility as the obvious counter to
rigidity.
The use of hypnosis can itself be a model of flexibility. When you do hypnosis, you are
saying, in essence, “We can relate to each other in a variety of ways and on a number of different
levels. You can discover things about yourself that you didn’t know, and your view of yourself
can change as a result. You can learn new skills and new ways of seeing and doing things that
can result in you feeling better about yourself.” These messages are embedded in any hypnosis
session, whether content or process oriented, and they hold great therapeutic possibilities.

TABLE 1.1. FORMS OF RIGIDITY

Cognitive rigidity (tenaciously held beliefs despite contrary evidence and reflexive thoughts containing
obvious cognitive distortions)
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 Behavioral rigidity (persisting in behavior despite it being ineffective)
Emotional rigidity (awareness and decisions made only according to feelings)
Perceptual rigidity (reflexive patterns for interpreting the meaning of events)
Identity rigidity (a self-definition that precludes the possibility of change)
Relational rigidity (a fixed and ineffective style of relating to others)
Contextual rigidity (an automatic response to a type of situation)

Virtually all of the process-oriented hypnosis sessions provided in this book address rigidity in
one way or another. Each aims to counter at least one form of rigidity and usually more than one.
Carefully reading the session transcripts will make this readily apparent to you.

Trauma (at Any Age, but Especially in Childhood)

Trauma can take many different forms, of course, and can range from what many therapists call
the “small t” traumas (e.g., not being picked for the sports team or being passed over for a
promotion) to the “Big T” traumas (e.g., childhood sexual abuse or combat-related injuries). As
mentioned above, no one escapes suffering the adversities of life, but exposure to trauma is
especially hurtful. No one goes looking for it—it finds you. It can easily overwhelm people and
lead to a wide variety of enduring emotional, behavioral, and physical difficulties. These are
typically amplified when the trauma occurs at an early age, before there is any substantial means
of protecting oneself or processing its significance insightfully.
The field of trauma therapy has grown exponentially in recent years. The variety of
approaches that are advocated by the experts in that field range from physically to
psychologically based, and each has great potential value in reducing the sequelae of trauma and
deserve careful study.
The number of skills that one must develop if one is to overcome a history of trauma makes
recovery a formidable therapeutic endeavor. Dealing with guilt, shame, rage, fear, and avoidance
provides plenty of serious issues to address sensitively in therapy. But no matter what therapeutic
approach one might choose to employ, there is one especially important skill that anyone with a
history of trauma will have to develop. That skill is compartmentalization, the subject of Chapter
9. From a process-oriented perspective, what keeps trauma going in someone’s life is when the
past continues to bleed into the present, contaminating now with what happened then. That
means reacting to current people, situations, feelings, and perceptions from the past trauma’s
frame of mind. It is a safe prediction that until the client can fully separate past from present and
respond on the basis of now, not then, trauma symptoms will persist.
Different therapies facilitate compartmentalization in different ways, but they all do it in one
way or another out of necessity. Compartmentalization means separating different elements of
subjective experience from one another. This is the textbook definition of dissociation, and
dissociation is the foundation of hypnotic responsiveness. You can do hypnosis without doing
relaxation processes, but you can’t do hypnosis without facilitating some degree of dissociation.
Thus, hypnosis for helping resolve the distress of trauma should be a part of every clinician’s
repertoire, in my opinion.
Hypnosis in general has shown a remarkable capacity for both quelling and instilling
automatic or nonconscious responses in people, empowering them in the process. Hypnosis to
stimulate new automatic responses and to alter what “the body remembers” are realistic
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outcomes to expect from process-oriented hypnosis sessions that encourage these possibilities.
Enhancing the acquisition of self-regulation or self-management tools is what hypnosis does
best.

Anxiety

At the time of this writing, the COVID-19 global pandemic is the near-constant focus of virtually
everyone. The numbers of infected people and deaths worldwide are staggering and are still on
the rise. No wonder that the number of antianxiety drug prescriptions in the U.S. has increased so
greatly during this time! People are asking anxiety-provoking questions of their government
leaders and medical specialists: When will this pandemic end? Will there be a vaccine? When
will we be able to go back to work and resume a normal life? These are all reasonable questions,
and it is understandable why people are asking them. They want answers. But none are
forthcoming because the onset and course of the virus are ambiguous, at least for now.
People are also asking anxiety-provoking questions of themselves: How am I to cope with the
pandemic’s effects on me and my life? How will I survive financially? What will happen to my
job? How do I explain what’s going on to my young children? What am I supposed to do while
being stuck at home all the time?
People generally prefer certainty to uncertainty and predictability to chaos. On a national level,
well before the pandemic hit, you could already see the distressed response of Americans to
today’s turbulent political and social climate when surveyed about their level of emotional upset.
The American Psychological Association’s 2019 Stress in America survey of Americans,
published on November 5, 2019, and posted on the APA website, starkly revealed that the
majority of Americans feel anxious, depressed, and fearful about life in America today,
particularly in regard to mass shootings, health care, and the next presidential election.
Therapists all over the country had reported the large uptick in their clients’ stress levels
before the pandemic because of the uncertainty about our collective future. There’s nothing like
big existential but currently unanswerable questions to make the future seem ominous: Will
democracy survive in America? Will we be able to save the planet before climate change and
overpopulation doom us all? This isn’t just an American phenomenon by any means. Although
the APA has identified and quantified stress in America, as I travel around the world conducting
clinical trainings, the stress is quite apparent virtually everywhere I go. I’m sure my international
colleagues share the same observation.
Beyond the anxiety associated with these huge issues, anxiety at the individual level is
statistically the most common reason for people seeking therapy, which was especially amplified
by the COVID-19 global pandemic. Many factors contribute to anxiety, as is true of any
condition, but none are more significant than how the individual responds to ambiguity. People
are anxiously wondering what will happen, how they’ll cope, and what they should do.
Ambiguity means there is no single clear meaning of an event, no clear cause-and-effect
relationship, no clear path to follow or decision to make, no certainty to be had. Whatever is
going on in the client’s world (the content), they are cornered by their need to have clarity in a
circumstance where there simply is none to be had. Without that clarity, even small risks can
seem huge, and paralyzing self-doubt can take over.
Someone who is going to learn to manage anxiety will need to acquire specific skills,

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including the ability to first recognize the ambiguities evident in a specific context in order to
begin to define what is known and knowable and what is unknown and unknowable. More
simply, do people know when they’re asking unanswerable questions? Too often, they don’t, so
they get angry at authorities who they think should have the answers even though they can’t, or
they become ruminators who analyze endlessly while looking for an answer they believe they’ll
find if they just keep looking or thinking about it.
Searching for the answer to unanswerable questions (such as whether there is life after death
or why the tornado hit your home but spared your neighbor’s) is a colossal waste of time and
energy and drives up symptoms of both anxiety and depression. Furthermore, we need skills in
assessing risks realistically, or else we could convince ourselves that if we go outside, we might
get hit by a meteor. We can make almost anything seem life-threatening if we imagine how that
would happen in enough detail. As the psychologist and anxiety expert David Barlow said
(personal communication, December 11, 2009), so much of what anxiety is about is
overestimating risks and underestimating resources.
Hypnosis as a means of helping people recognize and develop their resources is critically
important in the treatment of anxious individuals. We want people to know what their resources
are so that they don’t underestimate them or miss opportunities to use them in self-empowering
ways. Recognizing ambiguity is the first step toward eventually better tolerating ambiguity, a
vitally important life skill we want to help develop that has not only treatment value but also
prevention value.
Therapists routinely proclaim clients have innate resources that they’re not connected to or
using. This is true. Why aren’t they using them? Because the resources are dissociated, meaning
there is no internal or external trigger to access them. This is what hypnosis does exceptionally
well: It connects (associates) people to their resources and helps them use the resources
effectively. Empowering anxious people to bring even objectively scary circumstances from
unpleasant and unmanageable into the realm of unpleasant but manageable is a big deal. This is
considered in greater detail in Chapter 5.

Helplessness

One of the most important perceptions people can hold that will exert a strong influence on their
quality-of-life decisions is about their power (or lack thereof) to change either themselves or
their circumstances. Usually, when people come into therapy, they’re not feeling powerful. They
usually feel stymied by unknown forces in their self-help efforts, helpless to know what to do.
Helplessness is powerlessness. People who are powerful have choices, while people who are
powerless have few or none. But power is about perception. People routinely overestimate how
much power they have (“I’m going to make you care about this”) as well as underestimate it (“I
can’t do anything about how I feel”). It is a goal of therapy in general to help people make more
realistic appraisals of how much power they have in a given circumstance. More often than not,
this takes the form of helping someone who feels helpless to discover that they have more ability
to influence what happens than they realize.
The ability to discrimate meaningfully between what is and what isn’t controllable is vitally
important to someone who reflexively retreats into helplessness whenever they encounter a
formidable challenge of one sort or another. Taking responsibility for oneself, being action

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oriented rather than passive, and better discriminating what is and isn’t controllable are all skills
that can be helpfully integrated into process-oriented hypnosis sessions, as you will see in later
chapters on these subjects.

Hopelessness and Apathy

The perception that nothing can be done because any effort to change or improve things will
simply be wasted is the essence of feeling hopeless. The resistance that therapists routinely
analyze and confront in the course of therapy is often driven by the client’s perception that
there’s really no sense in trying. This is especially prominent in the experience of depression. It
is fair to say that the mantra of depression is, “Why bother?” The corollary questions, then, are,
“Why bother to go for therapy? Why bother to read my therapist’s recommended books? Why
bother to do my therapist’s recommended homework assignments when I already know I’m a
hopeless case?”
Hopelessness and apathy are thus entwined and together highlight how critically important it
is to address this terribly impaired view of the future and what’s possible. Knowing how much
people’s expectations—their orientation to the future—shape their experience and treatment
response, it becomes a major goal to help build positive expectancy. The hypnotic phenomenon
of age progression can be utilized for just that purpose. This is the subject of Chapter 6, but other
chapters also enhance the recognition that building positive expectations in a variety of ways is
essential to good therapy.

Coping Skills

Smoking, drinking, drugging, overeating, sleeping too much, sleeping too little, spending money
you don’t have, watching too much porn, self-mutilation . . . whew! There are clearly lots of
ways someone can make their difficulties even worse simply because of how badly they’re
coping with them in self-destructive ways. Primitive attempts to cope with stressors, whatever
they might be, can lead people into the realm of addiction when what was meant to be a quick
and easy way of avoiding a problem instead became the problem. Similarly, a poor coping skill
doesn’t have to lead to addiction; it just has to divert the person from the path of managing
themselves and their problems skillfully and lead to self-loathing instead.
The skills necessary to cope with stressors well, whether external stressors (such as job
pressures) or internal (such as exercising compulsively to have a perfect body), can be well-
defined and facilitated hypnotically. These include (1) the ability to compartmentalize
experience, effectively creating a safe emotional distance from the stressor(s) in order to reduce
its emotional impact; (2) building the expectancy that you can grow and outgrow the need for
what was intended to be helpful but instead became damaging; (3) building the impulse control
to think beyond the moment and make a better choice about what to do, thereby encouraging
foresight as well; and (4) building a sense of integrity about your actions, setting and adhering to
a standard of behavior you can feel good about. All of these goals of a process-oriented hypnosis
are addressed in detail in later chapters.

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 Relationship Skills

Our relationships help define us: We’re someone’s kid, sibling, spouse, partner, parent, boss,
employee, and more. How many roles we each occupy at a given time! How well do we manage
those roles?
Therapists routinely have the experience of listening to someone describe the terrible abuses
they suffered at the hands of their parents. These are the stories of parents who were emotionally
sterile and unavailable, the parents who were manipulative and self-serving in using the weapons
of guilt or withdrawal of affection to get their way, parents who were cruel in the beatings they
gave for truly minor infractions, and on and on. Every therapist listening to such stories has
wondered silently, “Why did this person’s parents have children when they were so woefully
inadequate to the task of parenting?” That’s a good question, and too often the answer is simply
“because they thought they were supposed to” or, worse, “because they forgot to go to the
drugstore.”
Every relationship has requirements for maintaining its health. Clear definitions of what the
relationship is about are the starting point, but the real keys lie in how people define the rules, the
guidelines, for how to interact. This is easier said than done. Everyone needs approval, for
example. How much approval seeking is okay, and when does it become excessive? (“Am I
okay? Am I okay? Do you think I’m okay? What about now? Do you still think I’m okay?”)
How much conflict avoidance prevents unnecessary petty arguments, and how much does it
prevent important discussions of serious issues where a difference of opinion might
uncomfortably arise?
The skills that go into building healthy, positive relationships are on the decline, unfortunately.
Too many people are far more into their smartphones than smart people, and self-absorption has
made relationships of only secondary or even tertiary importance to them. The cost of these
interpersonal deficiencies shows up in troubling ways: The rise in acts of violence against
minorities in recent years shows a clear lack of empathy and respectful acceptance of others’
differences, two of the key relationship skills to bring into your valued ongoing relationships.
Taking responsibility for yourself and owning up to and apologizing for hurtful mistakes you’ve
made is another. Knowing how to define and maintain your own personal boundaries and accept
the boundaries others establish for themselves is a vital way of modeling integrity. Acting with
integrity by doing what you say you’re going to do in order to build trust in others is yet another
key skill to develop.
Another consideration is this: What happens when your role changes through the loss of a
relationship? For example, when you’ve been a caretaker for an elderly parent who passes away,
who are you now? The sense of loss and the grief such an event fuels can be understandably
devastating. But, consistent with the above, it requires a rewriting of one’s self-definition. For
the person who says, “I’ll never get over this . . . I’m no one without that person in my life,” the
grief can be intense and indefinite. Hypnosis to encourage a shift in identity, an acceptance of the
loss, and an expectancy that there will be a gradual rebuilding can be profoundly helpful in such
instances. That same process of redefining yourself at developmental transition points in your
life defines flexibility in yet another important way.
Most of the time when you do hypnosis sessions, you’re encouraging people to focus
internally almost exclusively. Once you enter the social or interpersonal arena, though, many of
your suggestions will be encouraging a greater external awareness, especially of who you bring

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into your life and why while also growing clearer about your level and quality of impact on other
people. You’ll notice this other-oriented quality of suggestion in many of the later chapters’
session transcripts.

Final Points

It has always seemed tinged with cruelty to me when a desperate client in distress asks a
therapist for direction (“What do you think I should do?”) and the therapist replies, “Well, what
do you think you should do?” The quaint philosophy of careful neutrality that guided such
evasive responses has gradually eroded, and most therapists now describe themselves as eclectic
and active in structuring treatment. That’s good progress for the field, in my opinion.
What it tells me is that being active in catalyzing progress in therapy has become the norm.
The desire to do that as quickly and efficiently as one reasonably can makes sense to me. I
attribute that perspective to the influence of my friend and mentor, Jay Haley, who used to say,
“The problem with people in therapy is that they’re in therapy. Therapy isn’t a normal context
for living; the goal should be to get people out of therapy and fully into their lives as soon as
possible.” I think Jay was right about that.
This is what set the stage for me wanting to develop ways of getting to the heart of the client’s
issues more quickly and efficiently without getting bogged down or diverted by unnecessary
details (the content of the problem). Focusing on the process and identifying which skills are
needed to help clients accomplish what they came to therapy to accomplish makes this possible.

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Chapter 2

The Distraction of Content and the Salience

of Process in Treatment
You can’t do big things if you’re distracted by small things.
—Anonymous

Shifting From a Content to a Process Focus

One of the key issues that I address in this book concerns how to provide effective interventions
without making unnecessary and potentially hazardous interpretations. Some therapies have
already managed to do this. The solution-oriented approaches have been valuable in this regard,
demonstrating the effectiveness of approaches that bypass the pitfalls of interpreting meanings
and focusing instead on encouraging behavior and shaping the context in which it appears. The
strategic therapies of Haley and Erickson further provide a welcome foundation of pragmatism
that steers clear of making interpretations in order to intervene effectively. Through approaches
such as these, the focus is on changing how the client does the symptom rather than interpreting
its deeper meaning. Consider the following case example.

Bill came to therapy asking for help with his anxiety problem. It seemed ever
present in his awareness, but it spiked in certain situations, almost always social
ones where he felt certain he was being judged negatively by others. As a result,
Bill was overly self-conscious, fearful of rejection, and socially awkward as he
struggled to say and do the right things around people.

Now, what is salient to Bill’s problem and what is merely distracting content? Think of all the
different therapeutic paths we could go down just from this short description: Should we explore
his need for approval and what in his attachment history amplified that need so greatly? What
about treating his neurologically wired-in fear response? Or his grief from all the relationships
he’s lost and the resulting self-blame and low self-esteem he suffers? Should we focus on his
anger at people for not giving him the acceptance he wants? Should we analyze his unconscious
fear of intimacy as the basis for doing things to drive others away? Should we tell him he’s just
an introvert and that he should accept that in himself? What about teaching him to recognize and
correct his cognitive distortions about himself and others in social situations? What about . . . ?
There are therapists who would agree with any one of these interpretations and then proceed to
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build the therapy around it. I would disagree, as you might predict. None of those viewpoints
speaks directly to the process of how Bill generates his social anxiety.

I asked Bill a few questions about his perceptions of himself and what his ideas
were about his discomfort around people. I was especially interested in his reply to
my question about how he knew what others were thinking. While he was
formulating his answer, Bill was startled when I challenged him directly to read my
mind in that very moment. Of course, he couldn’t, and he was confused by my
demand. But he sensed that I was making a point he needed to grasp.

Listening to stories of Bill’s social failures wasn’t necessary. Listening to stories about how
his parents treated him when he was growing up was an unnecessary distraction. Listening to
him vent his frustration and anger at how judgmental people can be is another unnecessary
distraction. Listening to him describe his sadness at how isolated he feels even in a crowded
room is yet another irrelevancy. Asking him why other people’s approval is so important to him
while advising him to approve of himself is irrelevant. Everyone wants approval, including you.
It’s not pathological and worthy of analysis. The salient questions are, how far will you go to get
approval and what will you do with it when you get it?
So, what is salient to Bill’s case? Bill goes through a series of steps, a sequence, when he
interacts with others. When he first initiates an interaction or responds to an initiation from
someone, he then focuses internally as he asks himself whether he’s being interesting or worthy
of someone’s attention. Next, he rapidly concludes he isn’t and that the other person is judging
him negatively. Now he feels rejected, so he naturally acts rejected (brittle and sarcastic) and,
finally, ends the interaction on a self-critical and anxious low. Why he does this, what his history
is of doing this, and what it might mean may be of interest to some therapists but are unnecessary
distractions to helping Bill. My intervention was straightforward and involved the use of a
process-oriented hypnosis session.

After startling Bill with my playful yet serious demand that he read my thoughts in
that moment, I paused for a long time, long enough to let him wonder what that was
all about. Then I invited Bill to close his eyes and just listen attentively to what I had
to say. My voice became softer, slower, more soothing, hypnotic. Bill remembers
me talking about how people learn to walk and talk and how he thought about his
own experience of learning to do such basic things. There’s nothing threatening or
challenging about having learned some pretty basic things in life, so Bill gradually
became more focused and relaxed as he listened. Then he heard me say
something about how people are born with the capacity to imagine and how it’s our
ability to imagine that leads to amazing creations in technology and art and so
many other areas. I said people can use their imaginations in many different ways,
from thinking about beautiful but imaginary places to thinking about imaginary
explanations for why the world is as it is. He remembers me saying something to

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 the effect that old myths about gods of the sea and the moon and the sun used to
be considered true stories that explained why things are as they are and that
people reacted to them in that way. At first, Bill wondered why he was listening to
my stories about mythological gods and people’s ancient beliefs, but he found them
compelling, and they held his attention. Then I began talking about the myths that
each person lives by, those things we were either told or told ourselves a long time
ago that we believed . . . but now have a chance to revise and modernize. Bill
heard me say something about the misconceptions people form about other people,
making snap judgments about them with no more information than their own hastily
formed superficial conclusions . . . people who think they can read or somehow
know other people’s thoughts . . . living out the myth of being all-knowing. Now he
can realize that no one can do that, not even him with his extensive experience in
pretending he can read minds. I focused him on how important it is to just carefully
notice people and to cultivate a rich and enjoyable sense of curiosity about them . .
. and how easy it would be to turn his attention from the inside to the outside . . . to
engage with people comfortably when he has the chance to demonstrate his
interest in them through the questions he asks so he can learn what’s on their
minds instead of only imagining what’s on their minds. . . . Bill reported later that it
was as if all of a sudden during this session he felt this huge burden lifted from him.
Suddenly people seemed so easy to understand: Observe them, ask questions,
and make it easy for them to answer—and then listen to the answer! Learn
something about what matters to them, discover whether it’s easy or hard for them
to share themselves, see if they have a sense of humor. Bill remembers thinking, “I
can do that!” The next thing Bill knew, I was talking about how he could open his
eyes and bring back a new knowledge he could use to be surprisingly comfortable
around other people.

To this day, Bill credits that single hypnosis session with turning his life around. In that one
session, his focus shifted dramatically from his imaginations about what people were thinking
(and then actually believing himself) to actually engaging with people in order to find out. I saw
Bill for a few additional sessions to improve his social skills (such as how to know what and
when to self-disclose, how to begin and end conversations, how to recognize interpersonal
boundaries, and so forth). Empowered with new confidence and a better feel for people now that
he’s no longer so internally focused and engaging in mind reading, he’s a different man—a much
happier, calmer man. Hypnosis was an experiential vehicle for teaching perspectives and skills in
ways that were gentle, supportive, and easy to integrate.

Asking How to Get to What Matters

As you can appreciate, it is easy to get lost in the content, that is, the details of the elaborate
stories our clients tell us. They provide us with powerful narratives that share the hurts they
suffer that elicit our empathy, the traumas they endured that elicit our sympathy and compassion,
the triumphs that move and inspire us, and all the other details that make their stories so
compelling. The content is valuable, but only to the extent that it provides the therapist with
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some insights about the process.
How much content does a therapist need to listen to before understanding the process well
enough to know where to intervene? How do you know when you have enough problem content
and a strong enough therapeutic alliance with the client to move into the intervention phase with
a well-defined therapeutic goal?
Presumably, you have likely developed a style and method for interviewing your therapy
clients. In this section, I encourage a relatively simple modification to your interviews by adding
one or two more questions designed to elicit greater clarity about how—not why—the client
develops and maintains symptoms. Specifically, the goal of asking pointed “how” questions is to
develop an understanding of the steps in the symptomatic sequence in order to be able to
introduce effective interruptions to its unfolding. Consider my how question to Bill in the case
above: “How do you know what other people are thinking?”
Asking how someone knows something they profess to know or how they made (or will make)
an important decision tells you what they focus on and therefore what they miss or exclude from
the process that generates unwanted results. For example, when Bill focuses on his feelings, how
he knows other people are judging him negatively is only because that’s what his feelings tell
him. I used hypnosis to shift him from being so internally oriented to being more externally
oriented by encouraging him to focus much more on the other person in the interaction and on
what he could learn about them through careful observation and asking inviting questions instead
of mind reading. Bill’s case example is simple, yet this structure of helping people with social
anxiety applies to countless people.
When a client has made a choice (including the typically unintentional choice not to choose)
in some vulnerable area and suffered some unexpected consequence that causes distress, it
reveals a flaw in the decision-making process. Clients don’t know where the flaw in the process
was, just as Bill didn’t. He reacted reflexively, and typically had no idea there was some decision
to be made about where to focus his attention or how to know when he was engaging in mind
reading.
Thus, when the clinician asks the how questions, such as “How do you decide which thoughts
or feelings to keep to yourself and which ones to express?” or “How do you know whether to
accept this limitation or strive to transcend it?,” the most common response is confusion and the
reluctant admission, “I don’t know.” As therapists, we want to know what that flaw is so we can
teach a more effective decision-making strategy and thereby help the client avoid duplicating the
same mistake in similar future episodes. Thus, treatment also provides opportunities for
prevention (for a detailed description of the merits of “how” questions in clinical interviewing,
see Yapko [2016]).
A wonderful book called The Knowledge Illusion: Why We Never Think Alone, by Steven
Sloman and Philip Fernbach (2017), isn’t a therapy book per se but has enormous relevance for
therapists. It makes the same point about the merits of how questions from a different perspective
on helping people come to realize that they don’t know as much as they think they do. Sloman
and Fernbach wrote:

The human mind is both genius and pathetic, brilliant and idiotic. People are capable of the
most remarkable feats . . . and yet we are equally capable of the most remarkable
demonstrations of hubris and foolhardiness . . .
People often lack skills that seem basic, like evaluating how risky an action is, and it’s

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 not clear they can ever be learned . . . Perhaps most important, individual knowledge is
remarkably shallow, only scratching the surface of the true complexity of the world, and yet
we often don’t realize how little we understand. The result is we are often overconfident,
sure we are right about things we know little about . . .
Our point is not that people are ignorant. It’s that people are more ignorant than they
think they are. We all suffer, to a greater or lesser extent, from an illusion of understanding .
..
We can’t possibly understand everything, and the sane among us don’t even try. We rely
on abstract knowledge, vague and unanalyzed. (2017, pp. 3, 4–5, 8, 10)

The great American humorist Mark Twain once said, “It ain’t what you don’t know that gets
you into trouble. It’s what you know for sure that just ain’t so.” He was only half correct.

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Chapter 3

The Process of Hypnosis: Paying Attention

with Intention
Out of hypnotic training comes skill in observing people and the complex ways they
communicate, skill in motivating people to follow directives, and skill in using one’s
own words, intonations, and body movements to influence other people. Also out of
hypnosis come a conception of people as changeable, an appreciation of the
malleability of space and time, and specific ideas about how to direct another person
to become more autonomous.
—Jay Haley, Uncommon Therapy

There are two distinct, but closely related, sides to the type of interventions I’m advocating in
this book: the strategic and the hypnotic. In the first two chapters, I focused on the strategic side
of the equation first by highlighting the repetitive nature of people’s problems while encouraging
you to think of the skills someone would need to have to resolve them, and second by drawing a
sharp distinction between content and process in interviewing in order to more clearly define the
targets of treatment.
In this chapter, then, I want to turn our attention to the hypnotic side of therapeutic
intervention. First, I want to address the foundational question, “Why hypnosis?” Most clinicians
have not had training in hypnosis, which I find most unfortunate for reasons I’ll specify shortly.
Worse, there is a common bias against learning hypnosis, which, if you’ve never seen it or had
clinical training, is typically only thought of as a sleazy form of entertainment. Anyone who
practices hypnosis can tell you about how much time they spend having to debunk myths and
correct people’s misconceptions (for a detailed consideration of the typical misconceptions and
how to respond to them effectively, see Yapko [2019]). Thus, the clinical merits of hypnosis
seem like a good place to begin this chapter’s focus on evolving skills with process-oriented
hypnosis.

Why Learn and Practice Hypnosis?

The merits of hypnosis have been well articulated in the clinical and research literature. It is well
beyond the scope of this book to review the large body of empirical studies affirming its added
value for a wide variety of treatments, but I can summarize some of the key points about what
makes hypnosis valuable here.

Evidence-Based Applications of Hypnosis

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Hypnosis is at least as much about art as it is science. I’d say the same about psychotherapy. But
hypnotic processes clearly have enough structure to define and measure their impact on
therapeutic outcomes. Toward that end, the objective evidence supporting the use of hypnosis
across a wide variety of medical and psychological conditions makes for a compelling case for
including hypnosis in a client’s treatment plan (see Elkins [2017] and Yapko [2019] for in-depth
reviews of this literature).

The Inevitability of Utilizing Suggestion in Any Treatment, Not Just Hypnosis

The study of hypnosis provides an in-depth consideration of the power of communication, both
verbal (especially) and nonverbal. As health care providers in whatever capacity we conduct our
work, we are offering ideas, perspectives, and directives to our clients that range from subtle
suggestions (e.g., “This will help you feel better quite soon”) to high-pressured commands (e.g.,
“You must do this practice every day or you won’t get better”). “Focus on your breathing” is a
suggestion. “Sit comfortably” is a suggestion. “Listen to and really focus on what I say” is a
suggestion. “Meditation will help you” is a suggestion. “Go to the drugstore and fill this
prescription” is a suggestion. Therefore, it’s important to be knowledgeable about the many
different forms that suggestions can take and how to choose from among them what is most
likely to be acceptable to the client. No matter how well-structured or clever a suggestion might
be, if the client doesn’t accept it, then it really doesn’t matter.

Hypnosis Highlights the Subjective Nature of Experience

In offering suggestions to someone, you can use content or process suggestions. Content
suggestions provide specific details (e.g., “You can visualize being in a beautiful garden
surrounded by bright and fragrant red roses in full bloom”). Process suggestions carefully avoid
the use of details (e.g., “You can think of a special place”). One insightful way of characterizing
the differences in style is evident in the language Milton H. Erickson Foundation director and
hypnosis expert Dr. Jeffrey Zeig (2014, 2019) uses: It’s the difference between imposing on
someone what to do (or think or visualize) versus eliciting the person’s own experience from
within. Obviously, a process-oriented hypnosis is built upon the notion of eliciting hypnotic
responses rather than imposing on the client to comply. The style in which suggestions are
delivered will be almost entirely permissive in nature, suggesting possibilities but demanding
nothing. A careful reading of the session transcripts included in this volume will affirm this
point.
It is a basic truth: meaning is in people, not the words you use. This is the basis for a process-
oriented hypnosis: People can only use their subjective experience (i.e., their experiences, views,
style of processing information, etc.) to make sense of the things you say during a session. The
idiosyncratic nature of people’s interpretations of your words assures you that people will form
conclusions you didn’t intend and react in ways you didn’t expect. Most of the time these
disconnects aren’t all that problematic . . . but they can be. Part of good training teaches how to
handle such delicate instances sensitively and skillfully.
The other key point about subjectivity is that people can have very meaningful experiences in
hypnosis that are neither rational nor measurable in any objective way. The client who enjoys
“floating peacefully through space and time” isn’t really doing that from the clinician’s
perspective, of course. But for the client who has that subjective experience, it can be profoundly
meaningful and integrated as a helpful self-regulating resource to access during times of stress.

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Hypnosis Highlights the Malleability of Experience
People in hypnosis process information differently, and they are able to access abilities they
otherwise don’t know how to access. During hypnosis, people can experience marked shifts in
subjective experience, as detailed in Table 3.1.
The shifts that can take place in any and all of these facets of the client’s experience highlight
the point that is so essential to any therapy, regardless of the modality one employs: Your
experience can change. Given the power of rigidity to keep clients stuck in some distressing
pattern, described in Chapter 1, the value of the flexibility that hypnosis encourages cannot be
overstated. Even something as simple as deliberately doing a breathing exercise that significantly
reduces one’s level of anxiety can be transformative. What seemed unchangeable did, in fact,
change, and in light of that experience you will have to redefine yourself as more empowered
than you previously realized. This is why even single-session interventions can have a deep and
lasting impact. It’s also why the pervasive myth of hypnosis diminishing people’s sense of
control rather than enhancing it is so very unfortunate.

TABLE 3.1. POSSIBLE SHIFTS IN SUBJECTIVE EXPERIENCE DURING

HYPNOSIS

Physiology (breathing slows, muscles relax, etc.)

Sensory perception (temperature, weight, distance, etc.)
Cognition (thoughts clearer, slower, detached, etc.)
Affect (happier, sadder, more curious, etc.)
Behavior (self-help, new behavior, proactive, etc.)
Temporal orientation (past, present, future focus)
Self-definition (more resourceful, self-aware, self-controlled, etc.)
Relational definition (more attuned, empathetic, compassionate, generous,
etc.)

Paying Attention with Intention: What’s the Goal?

What does hypnosis actually do? It amplifies and/or deamplifies specific elements of experience.
It generates associations (i.e., connections to) and dissociations (i.e., detachments from)
regarding whatever might be suggested. In each of the session transcripts, you’ll see how
suggestion is used to associate people to some new awareness or resource and/or dissociate them
from some established link that is problematic for them (e.g., this place leads to that memory).
Association and dissociation are two sides of the same hypnosis coin. As soon as you suggest
associating to this, you’re also suggesting dissociating from that. Hypnosis is built upon the
experience of dissociation, and it is arguably the therapist’s greatest ally in treatment. If you
consider the role of detachment in virtually every therapy, you can appreciate this point. For
example, in cognitive-behavioral therapy (CBT) we often encourage people to adopt the
perspective that you are not your thoughts (“Just because you think it doesn’t make it true”). In
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acceptance and commitment therapy (ACT) we might encourage people to externalize their
thoughts (“Picture your distressing thoughts written on a sign carried by a marcher in a parade
and watch it just go by harmlessly”). In emotion-focused therapy (EFT) we might ask the client
to identify the intentions of the feelings beneath their behavior, and so on across many different
therapeutic approaches.
Thus, how you think about hypnosis (and people, and therapy, and life, and . . . ) will naturally
determine how you apply hypnosis. The first lesson anyone studying hypnosis is likely to learn is
this: What you focus on, you amplify in your awareness. The salient clinical question is, What do
we want the client to focus on, and why? Given the hundreds of therapies out there, this is clearly
a primary distinguishing characteristic between therapists.
Regardless of your orientation though, the use of hypnosis is predicated on defining a goal of
one sort or another. Hypnosis is an unapologetically goal-oriented approach; it truly is attention
with intention. How you establish the goals of treatment is your own subjective process, and the
encouragement I provide throughout this book is to better distinguish distracting content from
salient process and then build the hypnosis session accordingly.

Building Process-Oriented Hypnosis Sessions

Whenever you choose to do a hypnosis session with someone, there’s a reason why. You have
(or should have) a goal in mind, a point you want to make experientially, or an experience of
some kind you’re hoping to facilitate. Whatever your intent might be, there’s an innate structure
to hypnosis sessions that provides a means for achieving that goal.
Calling it an innate structure means that whenever you design and deliver a session, it will
have all or most of the components listed in Table 3.2.

TABLE 3.2. THE GENERIC STRUCTURE OF HYPNOSIS SESSIONS

Orient the client to hypnosis

Induction procedure
Build a response set
Introduce therapeutic theme no. 1
Introduce metaphors on the theme, generally moving from less to more direct
Optional check-in point: interaction regarding derived meanings
Introduce therapeutic theme(s), no. 2 (3, etc.)
Introduce additional metaphors per theme
Optional check-in points: interaction regarding derived meanings
Posthypnotic suggestions for integration (contextualize relevant learnings)
Closure
Permissive disengagement

The generic structure in Table 3.2 provides a skeleton framework for your session, a
foundation on which to build the specifics of your approach. Your decisions as to (1) how to
define the session’s goals; (2) what content you will include, such as which induction to employ
and in what suggestion style (i.e., direct or indirect, authoritarian or permissive, etc.); and (3)
what problem theme to address with which kinds of suggestions will produce the wide variations

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in one client’s treatment compared to another. So even though you may be treating five different
people for anxiety, let’s say, what you actually say to each one will vary dramatically depending
on their individual needs and patterns of self-organization according to your assessment (e.g.,
cognitive style, problem-solving style, perceptual style, etc.).
The generic structure components are probably self-explanatory to you as an experienced
hypnosis practitioner (if not, see Yapko [2019]). However, there might be a few exceptions I
want to make clear.

Response Sets
When I use the phrase “build a response set,” I’m acknowledging that most people can’t produce
hypnotic phenomena such as analgesia or regression instantly on demand. Most people need time
to build their hypnotic responsiveness over the course of a session. Thus, paying attention to the
deliberate building of response sets is simply a way of increasing the likelihood of catalyzing a
positive response to the hypnotic experience. Here’s one way to do that: Before asking your
client for a specific response, such as analgesia, you allude in a general way to such responses
that naturally arise in the course of daily living (e.g., “There are times when someone can be so
absorbed in their gardening they don’t even notice that they’ve cut themselves”). The response
set moves the client in the direction of generating the desired hypnotic response but not yet
suggesting a specific response.

Therapeutic Themes
When I use the phrase “therapeutic theme,” I’m referring to the distilled therapeutic message
you’re attempting to get across or the frame of mind you’re trying to help the client build. What
do you want to say to this person that is meant to be helpful? What is the client’s misperception
or self-limiting belief you want to help them detach from? What empowering resource(s) do you
want to associate the client to? By a “distilled message,” I mean the essence of your therapeutic
advice; in 25 words or less, what do you want to say to this person? I can crystallize the
therapeutic messages of each of the 10 chapters of process-oriented hypnosis sessions in this
book as follows:

Learn to recognize and tolerate ambiguity (Chapter 5)

The future is filled with possibilities (Chapter 6)
You can learn to make better choices (Chapter 7)
It’s important to anticipate consequences before you act (Chapter 8)
This part of your experience can be separate from that part (Chapter 9)
You can be more accepting of how things are instead of fighting against them (Chapter 10)
You are responsible for the choices you make but not the choices others make (Chapter 11)
What you do is often more important than what you think or feel (Chapter 12)
You can develop a code to live by that you feel good about (Chapter 13)
You can learn to think preventively (Chapter 14)

When you are clear about what the helpful message is you want to convey, then you have
established the topic of your therapeutic theme. You can decide whether to use more direct
suggestions or more indirect suggestions, as in the use of metaphor, perhaps. The next decision
in this regard is how many themes you want to address in a single session. Each of the sessions
I’ve provided have multiple themes embedded within them, and they show a clear progression of

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ideas as they move toward a resolution. You could quite literally take just one theme, though,
and build an entire session around it. The best way to decide how many themes to address in a
single process-oriented hypnosis session is to assess your client’s attentional style and level of
stimulus need. Some people have long attention spans; others have shorter ones. Some people
need a lot of stimulation to hold their attention (i.e., more themes), while others are perfectly
content to have one idea presented to them and that’s enough for today.

Checking in With the Client During the Hypnosis Session

When I use the phrases, “check in; interaction regarding derived meanings,” I’m highlighting
how important it is to find out what the client is getting from or understanding from your session.
As you’ve learned, meaning is not in the words you use; rather, meaning is in the person who
relates to your words in inevitably idiosyncratic ways. Thus, you can give someone a direct
suggestion to go take a walk outside when they feel themselves getting stressed, and all the
person hears is a dismissive “Take a hike!” Or you can tell someone a great story about another
client with a similar problem, and all they hear is that you talk about your clients in your
examples. Then the client gets wrapped up in anxiously wondering whether you’ll be using them
as an example, and thus never hears whatever the point of your story is.
Talking at clients and hoping they absorb some intended message is an older-style practice of
hypnosis, missing the importance of making the session interactional. Some practitioners are
afraid that if they check in, they will be disruptive. This is an unnecessary concern; while there
may be a momentary lightening of the hypnosis, it is counterbalanced by the value of the
feedback you get that allows you proceed even more intensively than before. After all, you’re not
a mind reader, no matter how skilled you might be. If you want to know what’s going on with
your client, how they’re interpreting your suggestions or what they’re experiencing, there’s one
surefire way to find out—ask! But ask neutrally, that is, without presuppositions about their
experience, as in, “Can you describe what you’re experiencing?” or “Can you describe what you
are aware of?” Questions such as, “What are you feeling now?” or “What thoughts have come to
mind?” are leading questions because they orient the client to assessing then reporting on their
feelings or cognitions. It is generally best to stay neutral and allow the client to describe their
experience without any prompting. Only by checking in with the client during the session can
you have any sense as to whether they are deriving anything useful from your session and
thereby have the chance to make midstream corrections to your approach if necessary.

Individualized Versus Scripted Approaches

As the final section of this chapter, I want to address the elephant in the room. Those who know
my previous works know that I strongly advocate tailoring the hypnosis session to the client’s
individual needs. In fact, here’s what I wrote on the subject in my hypnosis textbook,
Trancework:

Many books and clinical trainings on hypnosis advocate the verbatim use of prepared
scripts that have been written for all types of general problems, such as overweight,
smoking, phobias, and so on. This suggests that the script is the therapy: reading these
words to the hypnotized client will be what effects the cure. The use of scripts promotes the
misconception that hypnosis in clinical practice can be standardized and that each client can
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 receive identical treatment as long as they have the same presenting complaint. Reading the
same script to all smokers as if they are the same simply because they all share a bad habit
is an obvious gross oversimplification. When such an approach fails, typically the client
gets blamed, rather than the scripted approach.
The use of scripts robs hypnosis of its real potency, the strength derived from the
recognition and use of each individual’s unique experiences and needs. Spontaneity and
flexibility are essential for best results in doing hypnosis. Even when a therapeutic strategy
is worked out beforehand, as good treatment planning may require, a skilled clinician will
still incorporate the spontaneous responses of the client into the procedure. (Yapko, 2019, p.
40)

I further wrote, “Using impersonal scripts suggests the power is in the incantation rather than
in the quality of the relationship between clinician and client” (p. 49). Clearly, my view is that
using verbatim scripts is not as desirable as constructing and delivering more individualized
sessions.
So why am I providing 10 full-session transcripts in this volume? While I advocate for a more
individualized approach to eliciting hypnosis, I am also aware that when learning a new skill set,
in this case doing hypnosis sessions with minimal content, it helps to have models that illustrate
those skills. I do not provide these session transcripts so that you will read them verbatim to your
clients. Rather, I provide them as a generic structure upon which you can elaborate. I think the
artist Picasso got it right when he said, “Learn the rules like a pro so you can break them like an
artist.”
Stephen R. Lankton, a highly experienced and perceptive clinician and the editor in chief of
the American Journal of Clinical Hypnosis, took on the issue of using scripts in an editorial in a
recent issue of the journal:

Being an expert in a martial art requires that one follow heuristics and not follow scripts. Human behavior changes quickly,
and the clinician’s appropriate responses must also adapt and change quickly. Yet, the key word in that sentence is “expert.”
No one begins as an expert.. . . . Students learning piano practice chords and scales, ballet students learn fundamental classic
postures, yoga teachers learn well defined asanas and scripted dialogue, and future math geniuses begin by learning the rules
of algebra, trig, matrix geometry, and calculus. In other words, beginning students in any field of art or science are tasked to
follow well defined rules, programs, and scripts. Experts aren’t meant to robotically act or recite these basic forms (other
than in an educational setting), they are meant to elaborate, individualize, and build upon them. (2020, p. 173)

The session transcripts provided in later chapters can best be viewed in this light: You are
encouraged to use and further develop your expertise and go beyond the words and ideas I’ve
shared. But my hope is that these will inspire you and help you to break the rules like an artist.

Final Point

In this chapter, I have identified many of the nuts and bolts of clinical intervention involving a
process-oriented hypnosis. It bears repeating that no book, no person, no scientific study can tell
you exactly what to say or when and how to say it best to a particular client. Ultimately, the only
person that can give you the salient feedback about what works is your client. And what works
for one individual may be quite different from what works for another. It can be a great help to
know that using your words to stimulate the client’s inner associations, that is, to build new

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subjective understandings and linkages, is what makes for successful sessions. That’s true for
therapy in general and equally true for process-oriented hypnosis as well.

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Chapter 4

Targeting Symptomatic Sequences with

Kind and Gentle Interruptions
Human resources are like natural resources; they’re often buried deep. You have to go
looking for them; they’re not just lying around on the surface. You have to create the
circumstances where they show themselves.
—Sir Kenneth Robinson

Setting the Stage for Process-Oriented Hypnosis Sessions

Is the goal of therapy to reduce pathology or to expand wellness? There is a substantial

difference between focusing on what’s wrong with someone and focusing on what’s right with
someone. Whatever problems the client might have, they are more than their problems. They are
more than their history, more than their feelings, and more than their biology. The primary
challenge in doing therapy well is this: How do we help our clients expand their focus beyond
their symptoms and encourage them to use more of their resources in life-enhancing ways?
Anyone who practices clinical hypnosis does so with the firmly entrenched and therapeutically
invaluable belief that people have many more abilities than they consciously realize. Hypnosis
engenders an entirely optimistic appraisal of people in practitioners because of the things that
happen in sessions that are often nothing short of amazing. I can’t count how many times I’ve
either watched or conducted a demonstration where the client is doing something that seems so
improbable (such as controlling blood flow to a particular body part or suddenly and
dramatically breaking free from some lifelong burdensome perception) that all I can think to
myself is, “No way!” Except, there is a way, and they’re showing it to me right then and there.
Hypnosis creates a focused, energized, high-powered context for people to explore, discover,
and use more of their innate abilities. Hypnosis isn’t the therapy, and hypnosis itself cures
nothing. Rather, hypnosis is the vehicle for connecting (associating) people to the abilities and
realizations that ultimately serve to help them. More to the point, it isn’t the experience of
hypnosis itself or the spoken words that are therapeutic. Rather, it’s what happens during
hypnosis in terms of developing new and helpful associations that has the potential to be
therapeutic.
All of the session transcripts in the remaining chapters have therapeutic potential through
offering suggestions that revolve around these practical questions:

1. How can we, the client and I, cocreate a safe and growth-oriented context that promotes
experiential learning?
2. How can we identify which underdeveloped or latent resources may be accessible in a given
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 individual’s experience of hypnosis?
3. How can we structure the development of new therapeutic resources previously unknown
and undeveloped in the client?
4. How can we bring these new or previously inaccessible resources forth at the times and
places they will best serve the client’s needs?

These four questions offer a sound framework for organizing your interventions and give
greater substance to one of the simplest ways to describe the process of therapy: pattern
interruption and pattern building. After all, any intervention will strive in some way to help the
client stop or do less of some problematic response while encouraging the client to start or do
more of some more effective and life-enhancing response.
What this chapter is about, then, is introducing these pattern interruptions and new patterns to
build in ways that are kind and gentle. The reasons why kind and gentle matter are likely to be
self-evident, but all build on the recognition that people learn best and grow in the healthiest of
ways when the environment supports them in doing so. I especially like the way Milton Erickson
used to describe good therapists. To paraphrase, he said, “A good therapist is the weather . . .
someone who provides a good climate for change.”
Toward that end, in this chapter I address five such kind and gentle approaches routinely
embedded in process-oriented hypnosis sessions: (1) dissociation, association, and automaticity;
(2) accessing and contextualizing resources; (3) reframing; (4) therapeutic metaphors; and (5)
seeding assignments. It is important to point out that in the same way the power of a suggestion
isn’t in the words but is in the person’s response to those words, the power of these techniques is
in the person’s response, not the technique itself. Thus, the issue of responsiveness to hypnosis is
of obvious importance.

Addressing Hypnotic Responsiveness

The mere fact that the client is focused or absorbed in the experience of hypnosis does not mean
they will necessarily respond to or integrate anything the clinician has to say. The clinician
provides opportunities for the client to absorb something meaningful by employing carefully
worded suggestions that have the potential to be helpful. The new understandings, the new
associations or links the client forms while attending to the clinician’s suggestions, represent the
potential benefits of treatment during hypnosis. No matter how deeply hypnotized someone
might be, if the suggestions aren’t relevant and meaningful to the client, they will have little or
no therapeutic effect.
There aren’t very many things about hypnosis that all experts agree upon, but this is one of
those few points of agreement: People vary widely in their ability to respond meaningfully to
hypnosis. Why that is and what it means about individual differences is the subject of serious
scientific debate, with reasonable hypotheses asserted by a wide array of experts that may
challenge and even contradict each other. Even the terminology associated with this issue is open
for discussion. Are we talking about hypnotizability? Suggestibility? Hypnotic susceptibility?
Hypnotic responsiveness? Hypnotic talent? Capacity for absorption? Attentional style? All of
these terms are used by different experts who share the goal of wanting to define, describe,
explain, and measure the differences between individuals’ responses to hypnosis. The topic is
inherently fascinating but also has implications beyond the practice of hypnosis. Why are some
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therapy clients so responsive and others less so? Is this a fixed trait or is it malleable?
It has become quite clear that, despite the great many attempts in the last 100 years to measure
and predict hypnotic responsiveness with scores of well-conceived so-called hypnotizability
tests, no one can predict with any certainty whether or how someone will respond to your
hypnotic methods. If you want to find out how someone will respond to hypnosis, then do
hypnosis.
For me personally, I think the most practical position to take regarding the differences across
individuals in the context of psychotherapy is one of therapeutic curiosity. As I begin a session,
very often my first words, even preceding the induction itself, are, “I don’t know.” I might say,
“I don’t know what the most comfortable position is that will allow you to sit most comfortably.
. . . I don’t know at just what moment you’ll find that you want to let your eyes close. . . . I don’t
know just what you’ll discover during the course of this session that can be meaningful and
helpful to you. . . .”
You’ll notice the presuppositions and indirect suggestions in these “I don’t know”
suggestions, but I’m also making a statement that is undeniably true: I really don’t know. And
it’s a statement that reflects my curiosity about you and what you’ll do, when you’ll do it, and
how you’ll do it. How valuable is it to the therapeutic alliance to have your client feel you are
genuinely curious about them and that you have faith that they can respond well and grow from
the experience? Many clients will describe how they feel held by the therapist in the experience,
meaning valued, supported, and treated as capable in ways they couldn’t see in themselves until
then. So, as you move from the interview to the induction of hypnosis phase, you can be curious
about the client’s hypnotic abilities and how you might help him or her connect to those abilities.
This is a way to positively reinforce the development and use of whatever natural hypnotic
talents the client might have to whatever degree they have them.

Dissociation, Association, and Automaticity in Process-Oriented

Hypnosis

Dissociation has too often been considered by clinicians only in terms of psychopathology,
where it has been applied by individuals in ways that are terribly disruptive to their lives.
However, as is generally true of all hypnotic phenomena, what is harmful in one context can be
helpful in another. When therapeutic dissociations are encouraged in hypnosis, they amplify
some element of experience and thereby simultaneously also deamplify another element of
experience. If I suggest that you look over here and amplify that in your awareness, at the same
time I’m diverting you away from looking over there and deamplifying that in your awareness.
Dissociation is defined as the breaking down of global experiences into their component parts.
As I briefly mentioned earlier, dissociation involves a separation of subjective elements of
experience from one another. When there is some association, or link, between two or more
elements of experience that are detrimental (e.g., the sound of a siren instantly takes you back to
when you had a terrible accident), gently interrupting that connection is a worthy therapeutic
goal.

TABLE 4.1. VARIETIES OF THERAPEUTIC DISSOCIATION

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 Cognitive elements (as in separating thoughts from feelings)
Physical elements (as in separating the painful limb from the rest of the body)
Behavioral elements (as in separating someone’s behavior from its underlying intentions)
Temporal elements (as in separating the painful past from the hopeful future)
Relational elements (as in separating someone’s minor flaws from their overall worth as a person)
Emotional elements (as in separating feelings from choice of action)
Self-definition elements (as in separating one’s income level from one’s sense of worth)

Table 4.1 offers examples of dissociation on different dimensions of experience that highlight
their potential therapeutic value. Consider how each form of dissociation could be of benefit in
helping someone overcome a related issue.
As soon as you begin an induction and encourage clients to detach from their usual experience
of themselves (e.g., “You can detach from the external environment now as you turn your focus
inwardly”), you’re suggesting dissociation. As soon as you start to talk to people about different
parts of their experience (e.g., “Part of you feels optimistic about progressing and another part of
you is curious about just how that will happen”), you are suggesting dissociation. Each of the
dissociation types listed in Table 4.1 has the potential to be useful in helping the client
subjectively move away from what is hurting or limiting them and moving toward (i.e.,
associating to) some other quality of experience that can help them. Careful analysis of the
session transcripts provided throughout the remaining chapters will provide many examples of
dissociative and associative suggestions. You’ll likely notice how gently these suggestions are
offered throughout.
What makes dissociations in hypnosis so integral to the therapeutic process? Dissociation
allows for the automaticity of hypnotic responses, meaning the involuntary or nonvolitional
nature of people generating hypnotic phenomena. It is nothing short of extraordinary, for
example, to offer clients suggestions for complex experiences such as age regression or sensory
alterations and have them spontaneously produce such experiences without any sense of
conscious or intentional effort. Automaticity leads the client to subjectively report, “It just
happened.” Neuroscientists have taken on the challenge of explaining how that impressive
response “just happened.” So far, a definitive answer has been most elusive.
Related to the automaticity of suggested responses arising during the course of a session is the
automaticity of responses following the hypnosis session. As you might recall from Chapter 3’s
delineation of the sequential components of a generic hypnosis session, posthypnotic suggestions
are an integral part of the process. You’ll see them included in every one of the session
transcripts and for good reason: posthypnotic suggestions encourage a carry-over from the
session into the rest of the person’s life. It’s the primary vehicle for gently but deliberately
extending the gains made during the session into those situations where the client would most
benefit from them. And it helps generate the therapeutic progress clients report following
hypnosis sessions when they say, “It just happened.”

Accessing and Contextualizing Resources

The process of hypnotically accessing and contextualizing resources brings to life the belief that
people have more strengths and resources than they realize. This is particularly valuable when
clients are preoccupied with their symptoms and feeling powerless, the antithesis of feeling
resourceful. It is truly a positive psychology in action.
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 The essence of the strategy is to listen to clients do what they naturally do, which is tell you
their story, their personal history. As you listen to them describe significant events and
relationships, you can easily find examples of strengths they’ve used in the past that they never
really thought of as strengths (e.g., they liked playing sports or doing crafts as a kid but never
thought about what that says in terms of their competitive spirit or creativity). So you hear their
story and identify resources from their experience that they evidently used well, which may be
the very same resources that would be helpful to counter the problem situation. This is the phase
of accessing resources. When you identify and actually name those resources and extend them
into the problem situation as a better way of managing it, this is the phase of contextualizing
resources.
Age regression is used to recall or revivify some meaningful episode from the past; resources
are identified and named, such as courage, creativity, or perseverance; and then age progression
is utilized to gently integrate those resources into some trouble spot in such a way that the
resources would lead to new helpful perspectives, reactions, and behaviors. Table 4.2 provides a
more detailed but generic structure for this empowering process.

TABLE 4.2. A GENERIC STRUCTURE FOR HYPNOTICALLY ACCESSING AND

CONTEXTUALIZING RESOURCES

Induction procedure
Build response set regarding memory (orient to general experience)
Age regression to a specific memory
Ideomotor signal (such as a raised finger) indicating memory retrieved
Suggestions to facilitate verbalization
Verbal interaction regarding memory
Identify specific resources in past context as you listen to the memory description
Consolidate resources (name the resources that were evident in the memory)
Orient to the future and extend those resources into desired contexts
Posthypnotic suggestions for integration
Closure and disengagement

When people associate to (reconnect with) their own resources, inarguably present in their
history from the examples they unwittingly shared with you through their personal narratives, it
is often a moving and transformative experience for them. It is an exceptionally kind way to
orient people to the realization that they are stronger than they think and not as helpless as they
may have come to believe. This is the empowerment that process-oriented hypnosis can provide.

Reframing

The meaning of an event or a communication is determined in part by the context in which it

appears. Its meaning is also determined in part by the meaning someone assigned to it. When
there is a mismatch between what actually happened and how someone interpreted it, the result
can be most unfortunate. In fact, this is the basis for the various cognitive approaches to therapy,
most notably CBT. In these approaches, it is a constant theme of therapy to tell clients in no
uncertain terms that their thoughts about the events and people in their lives are partially or

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entirely incorrect, that is, the product of so-called cognitive distortions.
What necessitates helping people shift their interpretations and subsequent reactions (i.e.,
emotions, behavior) is encapsulated in a single word: ambiguity. This is the topic of Chapter 5,
the first intervention chapter, because the phenomenon of ambiguity is at the core of life
experiences, both good and bad. Ambiguity means there is no innate meaning, no single
interpretation that fully or even adequately explains some issue or occurrence. When dealing
with something concrete and definable (e.g., “This is a chair”), ambiguity isn’t much of an issue.
But when the issue or occurrence is abstract and can be interpreted in many different ways (e.g.,
“How do you conceptualize spirituality?”), the ambiguity will inevitably lead to differences of
opinion—different perceptual frames—in what it means. Sometimes the opinions one forms can
be quite self-damaging, and these become the targets of therapeutic intervention. They are the
hurtful or self-limiting viewpoints about self, others, life, the universe, everything that become
the basis for reframing in hypnosis. When the same action or event can be interpreted in a
number of plausible ways, helping the client let go of an interpretation that hurts in order to
accept one that helps is the process of reframing. You can clearly see the role of dissociation and
association in this approach.
With the turn of a phrase, especially during hypnosis, liabilities can be turned into assets,
traumatic events can be converted into learning experiences, weaknesses can be turned into
strengths, and so forth. Reframing can be accomplished with a single remark, or can involve a
lengthier, more experientially absorbing hypnotic experience. Any approach that encourages the
client to have a different perspective on the problem involves a reframe. As soon as you say,
“You can look at it this way . . . ,” you’re attempting a reframe.
An underlying assumption in doing reframing as an intervention strategy is that every thought,
feeling, or behavior has some positive value somewhere, but not everywhere. More often than
not, clients’ problems arise when they reflexively use only their feelings or past experiences to
guide them and miss the cues from the environment that would have told them, “Not now. Not
here.” This is a primary means of teaching discrimination strategies to the client, the subject of
Chapter 7.
People typically have good intentions (e.g., always being generous to others), but then employ
a strategy that works against them (e.g., being painfully taken advantage of by manipulative or
abusive others). By taking an experience that the client views negatively (e.g., “I guess I’m just
an easy mark”) and commenting on how and why that same experience might actually be an
asset to him or her somewhere else (e.g., “Your generous nature will be appreciated, not abused,
by the people who feel grateful rather than entitled”), one can change the client’s attitude about
that experience. It’s then no longer a problem of being too generous; rather, it’s reframed as a
problem of being too generous with the wrong people. The problem can be solved by learning to
distinguish who is and who isn’t deserving of this generosity. Reframing is particularly helpful
when suggestions for new and better alternatives are gently offered for replacing whatever
perspective the client held that wasn’t working very well. The reframe says, in essence, “It isn’t
that you’re pathological; it’s the way you’re going about it that’s ineffective in that context.” It
sets the stage for the hypnosis sessions that suggest, “You can do something different when what
you’re doing isn’t working.”
Finding a way to turn a minus into a plus, or vice versa, if appropriate, is a basic part of
clinical work. It’s an exceptionally kind way of helping people get past frustration and self-
condemnation as they come to learn how to read situational cues better and that their perceptions
can be more malleable.
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 Therapeutic Metaphors

In this section, the focus is on stories delivered during hypnosis as a vehicle of therapy. These
stories, known as therapeutic metaphors in the domain of hypnosis, can be told for a variety of
reasons that all serve to help move the client forward in the direction of a goal. The stories have
direction and purpose.
The use of therapeutic metaphor is a core component of most modern hypnotic processes, a
lasting tribute to the influence of Milton Erickson on the field of hypnosis. His use of folksy
teaching tales with his patients was a great innovation at a time when other hypnosis
practitioners were uniformly direct and authoritarian in their methods. Erickson viewed stories as
a kinder and gentler way of making a point than the more common approach in his era of
adopting the demeanor of an authority who will straightforwardly tell you what to do and who is
not to be questioned. Erickson’s observation is a pretty simple one: Most people don’t like to be
told what to do even when it’s clearly in their best interest. So, the ability to tell stories that in
some ways parallel the client’s experience such that they can learn from the story is an easily
integrated pattern interrupter and pattern builder in process-oriented hypnosis.
It isn’t quality that necessarily defines a good story for therapy. Any story that has a message
worth telling, no matter where it comes from, has potential therapeutic value. It can be a piece of
gossip or a funny or sad story on the nightly news. But a story only has value as a teaching tool
to the extent that someone is able and willing to engage with it. Otherwise, the story passes
through our awareness with no substantive connection, and so the message is lost. This is why
the context—the weather—the therapist creates is crucial in determining whether a story goes
over well or just crashes and burns (metaphorically speaking).
Hypnosis lends itself to creating a context of meaning. Hypnosis can give a story an aura of
gravitas that may not be present in just a casual telling of that same story outside of hypnosis.
Hypnosis encourages focus, and the premise for the hypnotic interaction is that the clinician has
something to say that’s worth focusing on and absorbing. The implicit message is, “I’m telling
you this story for a reason.” This is what activates the therapeutic value of stories through a
process called the search for relevance. The client accepts the premise that there’s a reason why
you’re taking the time during the hypnosis session to tell a story. The client accepts the premise
that there is a personal relevance that needs to be acknowledged at some level. This is one of the
many paradoxes in hypnosis: “I’m going to tell you a story that isn’t about you. But it really is
about you, which is why I’m telling it.” The search for how the story might be relevant and
helpful begins.
Generally speaking, the most common use of metaphor in the context of psychotherapy is to
suggest potential solutions for resolving the client’s problems. It’s as if you are saying, “Here’s
the dilemma the person in the story faces that, not coincidentally, parallels the dilemma you face,
and here is how they resolved it . . . so maybe you could do something similar.”
There is a great deal to be said about constructing and delivering therapeutic metaphors well
(see Burns, 2001, 2007; Yapko, 2019, for in-depth considerations of this topic). Suffice it to say
here that good stories aren’t personally threatening to the client and can engage them in
considering new perspectives and possibilities. They are not only gentle and indirect; they are
also process oriented, as you will see in the session transcripts that follow.

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 Seeding Assignments

Realistically, when so much of therapy involves education and specific skill building, there
needs to be some vehicle for helping clients acquire the education and skills they need and then
actually use them in their everyday lives. Homework assignments are a primary vehicle for
promoting the acquisition and integration of new perspectives and skills beyond the therapy
room. They are intended to encourage new behaviors, the development of specific new skills that
have been undeveloped or underdeveloped, test out the accuracy of one’s perceptions, and
amplify particular thoughts, feelings, and behaviors that the clinician judges important to the
therapy. Homework assignments operate on the level of actual direct experience, a more
powerful level than the merely intellectual. Homework helps people integrate new learnings on
multiple levels. And by doing homework, the client has to expend effort, increasing the
likelihood that they will place a greater value on the therapy.
A large body of research evidence makes it clear that clients have a faster rate and better
quality of result when therapies include the use of structured homework. There are many
different types of homework assignments such as role-plays, symptom prescriptions, ambiguous
function tasks, skill-building tasks, and externalization strategies, to name just a few. The
challenges to the clinician are about knowing what to assign and when, taking care to make sure
the assignment is safe, relevant, acceptable, and instructive for the client. But when clients aren’t
inclined to be proactive in their own behalf, even waiting passively for you to fix them, getting
the client to carry out homework assignments can be difficult.
Negative expectations that inspire a “Why bother?” attitude can easily preclude a willingness
to do the assignment, so building a positive expectancy is important (see Chapter 6). Strategic
therapist and family therapy pioneer Jay Haley called this process of introducing the homework
assignment during the hypnosis session “seeding” (1973, p. 34). By orienting the client to the
necessity of doing things differently in order to get better outcomes and using illustrative
metaphors to that effect, the clinician can plant the seed that frames action as desirable and likely
to produce positive results. This is a powerful means for motivating client action (see Chapter
12). The clinician can think in these terms: Where can I send the client and what can I ask them
to do that will help them acquire the perspective and skills to help catalyze therapeutic progress?
The literature of strategic, action-oriented therapies contains a treasure trove of creative and
helpful homework assignments. These can be useful in helping clinicians generate relevant
homework assignments that can teach specific skills (such as coping, problem solving, and social
skills) to clients needing help developing such skills. During hypnosis the client is oriented to the
aims of the skill and the benefits of acquiring it, perhaps even doing an age progression to a time
of actively carrying out the assignment, what might be called an experiential rehearsal.
Posthypnotic suggestions for doing the assignment and being curious about what will be
experienced or discovered are invaluable. Then, after the hypnosis session ends, the clinician can
assign the real-life skill-building task.

Closure

I clearly hold a professional and personal value that leads me to emphasize the process-oriented
strategies I’ve presented here as kind and gentle. I am a firm believer that people, all people, can
do better than they’re doing, can aspire to more. Human potential, to me, isn’t just an empty
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phrase, it’s a call to action. When so many people are struggling in their lives for any of a
number of reasons, including the aftereffects of a global pandemic, economic recession, political
instability, social division, and so many other debilitating events that affect us all directly and
indirectly, the need for mental health professionals of all types has never been greater. The need
for kind and gentle methods that can inspire and heal has also never been greater.

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Part II
The Methods of Process-Oriented Hypnosis
A Note About Generic Session Structures
In each of the following 10 chapters, I provide session transcripts that are richly detailed yet must still be
considered generic. They are meant to illustrate how a process-oriented hypnosis session might be structured
and delivered while addressing a particular issue, but I do not intend for them to be read to the client verbatim.
Instead you can consider ways you might adapt the session to the needs of individual clients. Not only will the
content of your verbalizations vary according to the unique attributes of each individual client, but the steps
themselves may vary according to what needs more or less amplification in the client’s experience. As always,
it is a matter of clinical judgment what a particular client is likely to respond to best. The more feedback from
the client a clinician uses in formulating an approach, the more likely the interaction can be tailored
appropriately.

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Chapter 5

Recognizing and Tolerating Ambiguity

Don’t ask the meaning of life. Life is asking the meaning of you.
—Viktor Frankl

The Case of Lisa

Only 13 years old, Lisa is already wise beyond her years. A smart, sensitive girl, Lisa has been brought to
therapy by her father, who is quite concerned about the high level of anxiety she is experiencing. Lisa has
“always been a bit of a worrier,” Dad reports, but lately her level of worry has been reaching new heights. He’s
not sure why but speculates that maybe she is suffering some aftereffects of her mom and dad having divorced
three years earlier. Though difficult for her at first, he thought she adjusted reasonably well to the back-and-
forth of their shared custody.
Interviewing Lisa, she was open and engaging, seemingly quite happy to have the chance to talk to someone
about what was bothering her lately. She came right out with it when she said, “I’m stuck at home now because
of the coronavirus lockdown. My school is closed. I can’t see my friends in person, and all I can think of is how
the virus is going to kill everybody I love.” She got teary-eyed for a moment, but just a moment, and then asked
directly, “What if everyone I love dies? What if I get the virus and I’m the one who gives it to my mom and dad,
and they die? What if I don’t know I have the virus and I give it to people, and they die? What if . . . ?” With each
“what if?” question, Lisa became increasingly agitated and finally had what amounted to a mild panic attack.
There was no mistaking how anxious and afraid she was.
Is this about her cognitive distortion of catastrophizing? Is this about a crippling fear of death, either her own
or that of her parents? Or a further loss of the unfulfilled need for secure attachments? Is she an adolescent
dealing with identity issues of dependence and independence? Is this a delayed grief reaction to her parents’
divorce? Or a fear of an imminent loss of control? Or what?
How Lisa generates her anxiety was demonstrated clearly right in front of me. Long before the COVID-19
pandemic, she was already a “worrier,” as described by her dad and as she affirmed. Previously, though, her
worries were more mundane: “What if I fail the math test? What if my new teacher doesn’t like me? What if the
other kids on the soccer team don’t think I’m good enough?”
Now that her worries have risen to a life-or-death set of questions related to the coronavirus, Lisa’s anxiety
level has risen right along with them. The content of Lisa’s anxiety relates to the virus and who might die and
how she might be the unwitting cause of their death. The process of how Lisa generates her anxiety is
straightforward: She asks unanswerable questions about all the uncertainties associated with the pandemic and
then fills in the knowledge gaps with her greatest fears, making them seem both real and imminent. No wonder
she’s overwhelmed emotionally. And this has been her pattern all along, whether wondering if she’ll pass the
math test, will be liked by her new teacher, or whether her teammates will think of her favorably.
Lisa’s questions are not pathological. Her concerns are legitimate. But she has already developed a
ruminative coping style, facing the ambiguities of life by endlessly asking herself scary questions that she has
no ability to answer definitively. Because she is unable to answer these “what if?” questions definitively, the
questions hang in the air as imminent threats to her well-being and the well-being of those she loves. It
overwhelms her emotionally by seeming to be both horrible and entirely unmanageable.
Rumination as a coping style is the target of the process-oriented hypnosis session. What she ruminates
about, the issue du jour, will routinely change across circumstances, but the pattern of asking “what if?”
questions and then spinning those same questions around and around will persist without treatment. Learning
to recognize and tolerate ambiguity, developing clarity about what can and can’t be answered, requires a shift
of focus: instead of imagining things being horrible and unmanageable, the focus turns to identifying what
resources you have to cope with the uncertainty and eventual outcomes. By amplifying awareness for her
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 resources, Lisa can learn to answer the “what if?” questions with some variation of, “If that happens, it would be
bad . . . but I’ll manage it.” It’s a big and healthy leap to go from “I can’t handle it” to “I hope I don’t ever have to
handle it, but if I need to I will.” That level of self-awareness and self-trust as an effective problem solver is the
aim of using process-oriented hypnosis to help anxious and ruminative clients learn to recognize and tolerate
ambiguity.

The Role of Ambiguity in Quality of Life

The field of psychological testing has developed many tests over the decades, including that
class known as projective tests, which includes sentence completion tests, the enigmatic pictures
of the Thematic Apperception Test, the Draw-a-Person Test, and, perhaps most famous of them
all, the inkblots of the Rorschach Test. The Rorschach Test presents the test subject with a series
of inkblots on cards and asks the person to describe what they see in the inkblot. The inkblots
don’t have any innate meaning but invite projections from the test subject. Where else but from
within the client’s own mind through the mechanism of projection can these interpretations of
and reactions to the inkblots come from? The Rorschach is a pretty old test, but it still offers us
this valuable insight: In the face of uncertainty about an ambiguous stimulus in the form of an
inkblot, people will reflexively form interpretations about the inkblot’s meaning. But the pattern
of making meaning—the process of projection—goes well beyond mere inkblots. It shapes much
of one’s life experience, including the symptomatic experiences that distress people and may
even bring them into therapy.
Consider your response to this question: What is the most ambiguous stimulus every human
being faces? When I ask this question of groups of people, usually therapists, they might offer
answers such as, “what happens after we die,” or even just “other people.” These are good
answers and bring into sharp focus how different people’s projections can be about the meaning
of life experiences.
Ernest Hilgard, one of the great founding fathers of experimental hypnosis, once described
hypnosis to me as “believed-in imagination” (personal communication, August 14, 1988). That is
an astute framing on his part, capturing both the essence and spirit of hypnosis. To go a step
further than just the hypnotic interaction, though, one could also say that everyone’s view of life
is similarly a product of “believed-in imagination.”
That’s why my own answer to that question is life: Life is the most ambiguous stimulus we all
face. One could even say life is an experiential Rorschach blot! Life doesn’t have an innate
meaning. We give it meaning through the choices we make. Out of all the things you could have
done with your life, why did you make the choices you made that have brought you to where you
currently are in your life? All of the choices we make—what job to take or what profession to
pursue, whether to be single or married, whether to work out regularly or just eat more pizza on
the couch—these are all choices we make in the face of the uncertainty in the question, what do I
want my life to be about? Some people’s response to the Rorschach of life is never to even ask
that question.
From the ambiguous stimulus of life, one person forms a belief that life is wondrous and
joyful, while another forms the belief that life is a miserable burden to endure. These represent
two radically different believed-in imaginations that have specific and measurable mental health
consequences for each individual. We give it meaning through the choices we make and then we
live with the consequences that follow, for better or worse.
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 From this vantage point, it is easy to see how ambiguity may well be the most powerful and
pervasive risk factor of all known risk factors for a wide variety of mental health issues.
Ambiguity in this context refers to the lack of clear meaning associated with one’s various life
experiences. Events occur; we observe them occurring; but what we most often don’t know with
any degree of certainty is what, if anything, they mean. The great majority of events in life do
not have a clear and inherent meaning, leaving each of us the task of having to establish for
ourselves, through the mechanism of projection, our own subjective interpretation of what the
meaning or significance is of the event. The quality of the meanings we form with our
projections provides them with their emotional valence, the degree of comfort or distress they
generate and the decisions that they lead us to make.
Beyond real events that may be ambiguous, imagined events may also invite our projections:
We have a job interview next week, for example, and we imagine the interviewer forming a
negative impression that precludes our getting the job, thereby raising our anxiety level about the
interview. Or we imagine being on an airplane that crashes and thereby generate a sense of panic
about the prospect of flying. Daily life experience presents us with endless opportunities to
project meanings that can generate depression, anxiety, low self-esteem, destructive
relationships, and much, much more.

Coping with Ambiguity . . . Badly

In Chapter 2, I highlighted the point that people tend to know much less than they think they do.
That observation becomes especially evident when people form firm, unyielding opinions about
things they can’t possibly be certain about because certainty doesn’t exist there. How can you be
certain as to what God’s plan is for the Middle East? Or why reincarnation isn’t possible? Or
what Abraham Lincoln would have done if he’d lived? Much more personally, how can you
know with certainty that you’re capable of being perfect and that you must be self-hating until
you are? How can you know for certain that you won’t get a job you’re actually well qualified
for, so there’s no need to apply for it?
Why can’t people willingly and with self-awareness sidestep the vulnerability of their own
beliefs? Consider as an example the so-called cognitive distortion of jumping to conclusions, the
error of reaching a conclusion despite the lack of any supportive evidence. Why jump to
conclusions if not merely to have a conclusion? But the salient question is, why have so strong a
need for a conclusion? What is it about ambiguity that is so uncomfortable and compelling in the
force it generates to reach a conclusion, even at the risk of reaching an incorrect one or, worse,
one that actually causes emotional harm? From this vantage point, you can appreciate why the
ability to recognize when a question is unanswerable in an objective sense (e.g., is there a God?)
and then to accept “I don’t know” as a legitimate answer instead of just making up something
that you choose to believe is exceptionally sophisticated.
For the person who is deeply uncomfortable with ambiguity, it poses another risk: the negative
coping style called rumination. Rumination means spinning around the same thoughts over and
over without getting anywhere. It’s endless analysis at the expense of taking sensible action.
Rumination is based on the subjective perception that if you analyze the ambiguity long enough,
clarity will emerge. Thus, people who ruminate think that they are taking action, but that is only
illusory and most often simply perpetuates asking even more questions that can’t be answered
(e.g., “What if I always feel this way?”).
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 Rumination is very strongly correlated with increased symptoms of anxiety and depression.
The topic of taking action and how action is a necessary counter to passivity is explored in depth
in Chapter 12.

Typical Problems Derived From a Lack of Tolerance for Ambiguity

The types of problems that people might present for treatment that reflect an inability to
recognize and tolerate ambiguity can seem quite diverse, and may include such problematic
patterns as:

Jumping to conclusions without evidence just to have a conclusion

Rigid thought patterns of feeling certain about things you can’t possibly be certain about
Inability to admit not knowing something
Feeling anxious or nervous about what might happen that will be overwhelming
Feeling unable to cope with some stressor
Spinning around the same thoughts without reaching a meaningful conclusion
Expecting and even demanding that things be as they were, resisting the need to adapt
Excessive reassurance seeking from others
Overreliance on others’ opinions about what to do
Overanalyzing actions and conversations for their true meaning

These patterns represent the kinds of problems clients might present that all reflect a lack of
tolerance for ambiguity. The content of what they want help with is what they will naturally
describe to the therapist, but it is up to the therapist to recognize the client’s inability to
recognize and tolerate ambiguity as the process needing intervention.

Defining the Salient Therapeutic Targets

For as long as an individual is unable to tolerate uncertainty, they will be motivated to continue
forming meanings about life experience with little or no insight into the interpretive process, and
thus suffer the mood and other consequences (e.g., anxiety) when these meanings are negatively
distorted yet accepted as true. Thus, one of the most basic goals in treating therapy clients in
general, and anxious and depressed clients in particular, is to teach them how to recognize and
tolerate ambiguity. This goal even precedes identifying specific cognitive distortions or irrational
beliefs in the client. Before teaching someone to avoid jumping to conclusions (or personalizing,
thinking dichotomously, or forming any other cognitive distortion), that person would have to
become more comfortable with having no conclusions, that is, reduce their drive to have a
definite answer. By addressing the issue of ambiguity in therapy and making it a primary target
of a specific process-oriented hypnotic intervention, the larger goals of therapy, such as teaching
rational thinking skills, as in cognitive therapy, can be well facilitated.

TABLE 5.1. GENERIC SESSION STRUCTURE FOR RECOGNIZING AND

TOLERATING AMBIGUITY
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 Induction

Response set: Uncertainty

Theme 1: The value of knowing and not knowing
Theme 2: Accepting not knowing
Theme 3: What you focus on, you amplify
Theme 4: Recognizing and interrupting the process of projection

Posthypnotic suggestions for integration

Closure and disengagement

The primary therapeutic goals of a process-oriented approach, therefore, are to (1) learn how
to quickly recognize ambiguity in situations; (2) be on guard against one’s own tendency to
interpret such events in some patterned and hurtful way that may not be objectively true; and (3)
develop a tolerance for ambiguity that permits comfort with not knowing. Not knowing what’s
right or what’s true in a given context can be either empowering or victimizing, depending on
one’s perspective. Not knowing can be an empowering spur to finding out. Table 5.1 provides a
generic structure for using hypnosis to encourage a client’s developing greater comfort with
uncertainty.

SESSION TRANSCRIPT

Induction
You can begin by taking in a few deep relaxing breaths. . . . Orient yourself now to internal experience for a while. . . .
Right here, right now, what I most want to encourage is you having an experience that’s worthy of your time . . .
worthy of your attention . . . an experience that allows you to discover something of value about yourself, about life,
about something that’s meaningful. . . .

Building a Response Set Regarding Uncertainty

Of course, here at the beginning, there’s really no way for you to know just what I’m going to be suggesting, just what
possibilities I’m going to encourage. . . . And can anyone looking at you . . . really know . . . the depth of your
experience? . . . It’s so limited . . . to think in terms of measurements or even brain scans. . . . Someone monitoring
your brain . . . as you grow more relaxed . . . might correctly point out . . . how one part of your brain becomes more
active . . . or another part becomes less active . . . yet have no knowledge at all . . . of what you’re actually
experiencing inside. . . . And in that respect, . . . it’s what’s so wonderful . . . about being connected to your own
experience . . . the privilege of being the only person anywhere . . . who knows what it feels like for you . . . to breathe
comfortably . . . to feel your body . . . growing more relaxed . . . and there is something special about that . . . of all the
things that define you . . . as an individual . . . physically separate and distinct from others . . . and unique in your
history. . . . But as always . . . what we see is a product of the lens we look through . . . the framework of our values
and biases we use quite unconsciously . . . to see ourselves . . . or to see the world around us . . . whether it’s the
lens of biology . . .for explaining ourselves . . . or the lens of humanities. . . . What lens do you use at a given moment
. . . and with what realization as a result? . . . And your usual ways of viewing and experiencing yourself . . . afford you
the chance to develop many understandings and insights about yourself . . . and about life. . . . But you know and I
know . . . there are things about ourselves . . . we don’t know. Things we do know, we don’t really understand. . . .
That little bit of mystery . . . that little bit of uncertainty . . . is something each of us builds a relationship with. . . . It’s a
curious thing . . . how you come to know . . . what you don’t know . . . times you discover that what you thought you
knew turned out to be incorrect . . . and likewise . . . how you come to know . . . and come to terms with knowing . . .
that there are some things you’ll never know. . . . Now, it’s a curious thing to me that we spend so much of our lives
striving to know . . . desperately at times striving to know . . . and for some people, it turns into a mission . . . to try and
know the unknowable . . . the people who want to know whether you can weigh a human soul . . . or the people who
want to know whether you can measure . . . how much you love your family. . . .

Theme: The Value of Knowing and Not Knowing

Wanting to know is a powerful driving force . . . that helps us better understand the world around us . . . and the
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people in it, too . . . including ourselves. . . . But as you may discover, there’s also a value in not knowing. . . . There
are lots of examples that I can give you where it’s a great advantage to realize you don’t know . . . and an even
greater advantage to know that you’re not going to know. . . . As comfortable as I would want you to feel right now
with knowing where this session is going . . . it might well begin to occur to you what a great skill it is to be equally
comfortable not knowing. . . . After all, you don’t know which ideas I’m going to introduce to you will be the ones that
help transform aspects of how you live. . . . You don’t know which ideas I’m going to offer you will prove to be
enlightening. . . . What a pleasure not to know . . . and to have a sense of curiosity and willingness to discover. . . .
When you get so comfortable not knowing, it allows you a universe of possibilities . . . to explore new viewpoints . . .
to seek out new explanations for things you think you already understand. . . . There may be something that you can
think of now that you know you don’t currently know the answer to . . . perhaps a question that you can openly
acknowledge to yourself that you don’t know the answer to . . . and you may not ever know the answer to . . .
questions that may be by their very nature unanswerable . . . that you can be really glad, really glad . . . that you can
achieve a measure of acceptance . . . that no answer will be forthcoming. . . .

Theme: Accepting Not Knowing

But whether you realize it yet or not . . . I’m really addressing a deeper issue . . . a much deeper issue. . . . It’s an
issue of how you handle uncertainty. . . . Now you know and I know uncertainty is inevitable in many areas of life. . . .
Isn’t it interesting the range of reactions that people have, the people who strive to avoid uncertainty because it
scares them when they fill uncertainty with fear . . . while other people embrace uncertainty . . . absorbed in the
curiosity of wondering what will happen without any dread that comes from anticipating the worst. . . . Uncertainty is
an invitation for greater structure . . . the structured information gathering you can do to answer a question if it’s an
answerable question . . . or the structured acceptance of what can’t be answered, at least not right now. . . . Consider
one of your most basic questions in life, a question that has nagged at you for years . . . and now you get to ask
yourself, “Is this an answerable question? Is there any amount of research that could answer that question?” What a
relief when you discover there are questions that can’t be answered. . . . There are no data to explain to someone
why life isn’t always fair. . . . There are no studies to explain why someone was injured or killed in a freak accident. . .
. There is no good explanation for why an innocent child is harmed by abusive parents. . . .

Theme: Recognizing and Interrupting the Process of Projection

Yet people make up explanations in such situations. . . . Too many people are happy to have explanations for things
that can’t be explained with actual facts just so they can have an explanation, even if it’s wrong. . . . Consider a
simple example. . . . I’m sure you’ve had the experience of calling someone . . . getting their voice mail . . . and
leaving a message. . . . And when the person doesn’t call back in a time frame you think reasonable . . . you might
naturally wonder what it means . . . whether the person is simply busy . . . or whether their voice mail is working
properly . . . or whether the person is avoiding you for some reason . . . or any of many other possible reasons. . . .
And how can you know what the real reason is? . . . But it’s human nature to speculate about what things that happen
mean . . . and the real skill is knowing when you’re merely speculating . . . and when you have real evidence to
support your interpretation. . . . After all . . . you don’t want to react to something on the basis of an incorrect
interpretation . . . and all the speculations about why that person didn’t call back are normal . . . and reflect our desire
to make sense out of things that don’t seem to make much sense. . . . And whether you want to understand
something like why someone doesn’t call back . . . or something much more complex, like how to build a successful
career or build a happy marriage . . . it’s one of human beings’ greatest strengths that we strive to understand and
make sense of the things that go on around us. . . . And the fact that you can generate so many different explanations
for why someone doesn’t call back . . . gives you an opportunity to realize you don’t know why they didn’t call back. . .
. You can make lots of guesses . . . but you really don’t know for sure . . . and when you don’t know how to explain
something . . . it’s perfectly all right just to say you don’t know. . . . After all, no one really expects you to know why
someone else doesn’t return a phone call. . . . It’s a gift of honesty and clear thinking when you can say “I don’t know”
instead of making up an answer that might well be wrong . . . and even hurtful to you. . . . Before you reach a
conclusion . . . any conclusion, you can learn to ask yourself, “How do I know?” And if your answer is, “I just feel it’s
so” or “I just think so” . . . then you can know that you’re forming a conclusion with no apparent real information. . . .
That doesn’t mean you are wrong, necessarily, but it increases the chances of being wrong. . . .

Posthypnotic Suggestions for Integration

And each time throughout the day you encounter this situation where the meaning isn’t clear to you . . . or, better yet,
when you can even anticipate such an ambiguous event before it happens . . . you can recognize there are many
different ways to interpret that event . . . and many different ways to think about events that have yet to occur . . . and
you can instantly remind yourself you don’t know what it means, at least not yet . . . and so your skill level grows in
being able to recognize the uncertainty in many life situations . . . and grows in being able to comfortably accept that
sometimes you don’t know and may not ever know why or what it means . . . and grows in your trust in yourself to
handle the uncertainties of life with a sense of calm confidence and clarity about what you do and don’t know before
you react. . . .

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Closure and Disengagement
Now, out of all the things that I’ve talked about . . . far be it from me to predict what will be enduring in your
awareness. . . . But you can certainly decide that for yourself as you start to bring this experience to a comfortable
close. . . . Take whatever time you want or need to process your thoughts and feelings . . . in order to absorb the
deeper implications. . . . And then when you’ve had enough time and feel like you’re ready to . . . you can start the
process of gradually reorienting yourself at a rate that’s comfortable and easy. . . . Take your time, and when you’re
ready, you can let your eyes open, feeling fully alert and feeling refreshed.

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Chapter 6

Building Expectancy
People don’t come to therapy to change the past. They come to therapy to change the
future.
—Milton H. Erickson

The Case of Carmen

Carmen’s life hasn’t been easy. Raised on a cattle ranch, she was one of four kids, all of whom were expected
to work hard to help out before and after school. Her childhood had some happy times, to be sure, but not
enough of them to satisfy her wish that her childhood had been more carefree. When she finished high school,
she did what the small-town girls where she lived usually did: she got married and had two kids of her own. By
age 54, she was long single following an amicable divorce over 10 years earlier, and her kids were grown and
gone. For the first time she felt like her life was truly her own.
Carmen had always had the dream of going to college and developing a profession for herself. She doubted
her ability to do so, though, especially in what she considered to be her “advanced years.” Her kids encouraged
her to go for it, apply to a college, maybe a junior or community college, and get the ball rolling. Carmen firmly
said, “Maybe,” and never got as far as applying. Finally, her oldest son, without her knowledge, filled out an
application in her name, and no one was more shocked than Carmen was when she received a letter of
acceptance to the local community college, where she could begin pursuing an education and develop her
goals. Carmen’s first reaction when she found out what her son had done was to become furious with him. That
passed rather quickly, though, as the conversation now turned to how she could possibly make this work. What
did she know about taking college classes? What could she do at her age to study and learn and remember,
especially when almost all the other students were less than half her age? Her kids were wonderfully
persuasive, to their credit, and they helped her get registered and develop a class schedule. Before she knew
it, she was sitting anxiously in the front row of a lecture hall, pen and notebook at the ready.
Carmen was shocked to discover that she could be attentive and actually learn. She didn’t think she had it in
her. And as for all the young people surrounding her, she dismissed them as no real competition after all
because she was one of the few that actually wanted to be there.
Jumping ahead some years, Carmen found a passion for counseling. She applied to a graduate school
program she was sure she’d never be accepted into . . . but she was. Now at age 59, she had a master’s
degree in counseling, she had ambition, and she had total paralysis related to actually going to work using her
degree.
Seeking therapy to get unstuck seemed sensible to a counseling program graduate, so she did. Disclosing
her history of seeming to always freeze up when she had the chance to move forward in some area of her life,
she wondered why she suffered with this difficulty. The content of her problem was delaying or avoiding taking
a step forward in her own behalf, whether in getting out of a bad marriage (her husband pushed through the
divorce), going to college, going to graduate school, or taking a job.
Was this about poor self-esteem? An unconscious fear of success (or failure)? An unconscious need for self-
sabotage or punishment? A crippling perfectionism? Or what?
The process of Carmen’s problem was that whenever she dared to establish a goal, she reflexively formed
the expectation that the goal was unreachable because of her presumed personal shortcomings. She expected
to fail and, based on that perspective, why bother to try?
Her current situation, the one that brought her to therapy, was wanting to get a job in her chosen field. But
she stopped herself from applying for a job by asking these questions: Who’s going to hire me at my age?
Who’s going to want a 59-year-old intern with no experience? Why did I get a degree anyway? What was I

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 thinking?
Carmen needed some help to get clear that she’s not the one who decides whether she’s worth hiring. She’s
not the one who decides whether they’re willing to take on a 59-year-old intern. She’s not the one who decides
for anyone what they’re willing to do. The use of hypnosis to build the expectation that there are people out
there for whom age isn’t the primary consideration generated a marked shift in her viewpoint. Hypnosis was
used to help build the realistic expectation that effort would be rewarded, just as it had been in previous cases
when she (or someone on her behalf) took action and succeeded despite expectations of failure. Facilitating a
sense of optimism that her future was filled with possibilities directly countered her negative expectations. A
session utilizing hypnosis to build expectancy was all it took. Less than a month later, Carmen called to say she
was thrilled she had found a great job where she’d be learning a lot. She summarized the lesson well that had
been told during the hypnosis session: “The best way to predict the future is to create it.”

The Role of Expectancy in Quality of Life

The effects of our expectations on our experience can be profound. The power of expectation has
been demonstrated in numerous places and called by many names, and virtually all models of
psychotherapy emphasize the value of positive expectations in enhancing treatment results.
Probably the most widely used term is “self-fulfilling prophecy,” describing how our behavior is
unconsciously aligned with our expectations, whether good or bad, increasing the likelihood of
their eventual fulfillment. Addressing the issue of expectations—both yours and the client’s—
makes good clinical sense and helps build the therapeutic alliance.
Depressed clients in particular, people who suffer hopelessness and despair and thus have lots
of negative expectations, show us how vitally important positive expectations are for eventual
recovery. The clinical challenge to therapists is the necessity of building hopefulness out of
hopelessness. Hypnosis is an ideal mechanism for helping to accomplish this goal for a variety of
reasons I will address in this chapter. I have previously described some hypnotic strategies
serving this purpose in a number of publications (Yapko, 1992, 2001, 2010a, 2010b), and in this
chapter I provide another one that is entirely process oriented. Helping clients cocreate a
compelling vision of what’s possible in their lives is one of the most important things that can
happen in therapy.

The Effects of Hopelessness on the Therapeutic Process

Hopelessness is a cornerstone of depression but is by no means exclusive to depression. People

can feel hopeless about anything going on in their lives and/or anything that’s going on in the
world at a given time. When someone presents for therapy and conveys their sense of
hopelessness, the first things a clinician might assess are how pervasive and personal the sense of
hopelessness is for the client.
Pervasiveness speaks to how generalized the client’s sense of hopelessness is: Do they feel
that everything in their life is hopeless, or just the specific problem domain for which they seek
help from you? The more pervasive the person’s sense of hopelessness, the wider the target area
for treatment, making it necessary to address the issue of how to help the client go from an
overgeneralized and unrealistic perspective to a specific problem or class of problems to address.
Feeling hopeless about everything is simply too broad a perspective to hold, and the cost of
doing so in terms of suffering a crippling despair is a terrible consequence.

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 The personalization of hopelessness addresses the issue of whether the client sees the problem
as beyond anyone’s ability to solve, or whether the inability to solve the problem is a reflection
of their own incompetence or lack of personal resources. It makes a substantial difference in the
clinical picture whether someone is able to recognize that a circumstance is beyond their own or
anyone else’s ability to resolve versus thinking it’s a reflection of their own shortcomings. The
latter is a much more painful perspective to hold and is more likely to be the case in therapy
clients.
Unlike the past, which has already happened and can be reviewed, albeit with our imperfect
memory, and the present, which we can tune into and be mindfully aware of as it unfolds from
moment to moment, the future hasn’t happened yet. Therefore, it doesn’t have the ready
availability and concreteness of the past and present orientations. The future is abstract and
ambiguous. As first described in Chapter 5, it is another experiential Rorschach inkblot of sorts,
an ambiguous stimulus that invites our projections to give it shape and substance. The quality of
those projections can shape our treatments and our clients’ clinical response to those treatments
and, even more significantly, one’s entire quality of life.
Hopelessness is obviously a statement of negative expectancy for the future. In the therapy
context, it is a powerful factor that quite literally influences every phase of treatment response.
That’s why it is imperative that every therapist, regardless of theoretical orientation and style of
practice, recognize and respond proactively to the need to build a positive expectancy, the core
message of this chapter. To be specific about how expectancy affects the process of therapy, let’s
consider each component of treatment.
The first stage is the client making contact to request help. It is well known that the majority
of people who need mental health treatment don’t receive it. There are a number of reasons why
people don’t seek out the help they need: Some are afraid of the stigma of being “mentally ill” (a
phrase I personally detest); some don’t have any insight as to the nature of their own problems
and believe “that’s just the way I am” or “that’s just the way life goes”; and others—perhaps
most—feel hopeless that anyone can say or do anything that would make any difference. It’s a
straightforward question: Why would I seek help from someone if I don’t believe help is
possible?
That perspective can easily be compounded by the belief that treatment will involve endless
sessions spent talking about your childhood or being told to take drugs you don’t want to take for
your “illness.” Expectations clearly play a huge role in deciding whether to seek help.
Furthermore, expectations shape the concern related to seeking treatment, namely staying in
treatment. How many clients drop out of treatment after just one or two sessions because their
sense of hopelessness was never sufficiently challenged by the therapist? How a therapist
conducts the first therapy session or two can make a great difference in whether or not the client
continues in treatment. The process of building expectancy described later in this chapter speaks
to this critically important issue.
The next consideration is how hopelessness affects the rate of treatment. If someone goes
ahead and seeks treatment despite their misgivings, how can they possibly progress quickly if
they believe progress isn’t possible? The negative expectation that change is unlikely creates a
barrier that can partially or wholly block good therapeutic input, leading the client away from
success and thereby confirming their negative expectations—the self-injurious self-fulfilling
prophecy.
The issue of treatment cooperation is directly affected by the client’s expectations as well.

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Most therapists encourage clients to make use of reading materials, typically self-help books
(i.e., bibliotherapy) and/or structured homework assignments intended to facilitate the
acquisition of ideas and skills taught in therapy. It is a constant cause of frustration to therapists
how often the client does not do the suggested readings or assignments. To the hopeless client,
though, the prevailing perspective is, “What’s the point of doing the reading or homework
assignment when nothing is going to come of it?” Expectations help determine whether the client
will cooperate with the treatment plan.
Expectations influence not only the rate of recovery, but also the degree of recovery. In the
clinical literature, researchers can consider therapies successful if a client moves just a couple of
points on some symptom measurement scale. For the client who continues to have symptoms,
despite their being fewer or less severe than before, will the therapy be considered a success?
Perhaps, but the expectation that the problem will never go away serves as a predictor of whether
the treatment’s success will be partial or complete.
Finally, the client’s hopeless expectations that “this problem will never go away” or “even if
the problem goes away for a while it’ll just come back again” help predict the client’s
vulnerability to relapses. No treatment can be considered complete without addressing the issue
of relapse prevention, and clearly expectations about the permanence of a symptom in one’s life
or the sense that “it’s gone forever” will be a major determinant of what the future brings.
When expectations play such a pivotal role in the therapy process, it seems imperative that
every therapist become adept at creating a context early on in therapy to help the client develop
positive expectations for treatment. The process-oriented hypnosis session contained in this
chapter is an experiential means for helping to serve this purpose.

Realistic and Unrealistic Hopelessness

Hopelessness may be realistic or unrealistic depending on the circumstances. What we discover

so often in the therapy context is people who reflexively assume there is nothing they can do to
change their circumstances and so retreat into hopeless passivity. How well someone can
distinguish realistic from unrealistic hope is a critically important skill to have in order to make
sound and effective decisions.
Hope may be a good thing, but it can also be hurtful, again depending on the circumstances.
Hope that you can make your life better is usually very helpful as a foundation for actually doing
so. But hope can be destructive—after all, every person who gambled away a desperately needed
paycheck was hopeful. Every person who stays in an abusive relationship is hopeful their partner
will change.
Since expectations are the filter through which we make evaluations, the quality of those
expectations—how realistic or unrealistic they are—makes a difference. When clients have
unrealistic expectations for therapy, for example, how likely are they to be disappointed when
they discover their therapy experience didn’t live up to their expectations? This is how we judge
almost everything, even our closest relationships. As relationship experts will tell you in no
uncertain terms, marital satisfaction is highest when your partner does what you think they
should do. But what happens when someone holds an unrealistic expectation, but clearly doesn’t
realize it? I have a favorite cartoon that shows a clearly unhappy woman telling her obviously
perplexed partner, “If you really loved me, you’d win the lottery!”

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 From the start of treatment, then, helping establish realistic expectations for the therapy
experience is imperative. The hypnosis session provided in this chapter speaks to the need for the
client to evaluate (with the therapist’s help, of course) whether their expectations are realistic,
not just for therapy but for whatever issues they face. A lot of frustration and disappointment can
be prevented in this way, yet another good reason to make addressing expectancy a formal stage
of early treatment.

Typical Problems Derived From Negative Expectancy

The types of problems that people might present for treatment that reflect negative expectancy
may include such patterns as:

Depressed mood
Being reactive rather than proactive in managing life situations
Giving up on oneself (resignation)
Apathy toward oneself and/or life in general
Rigidly believing that effort is pointless
Predetermining that they will never succeed (failure is inevitable)
Suicidal ideation and/or behavior
Refusing to consider or try potentially helpful alternatives
Believing their problem is genetic and unalterable in any way
Being frequently disappointed that people or situations don’t live up to their expectations,
leading to social withdrawal and isolation
Nocebo responses to medication or therapy

What specifically the person feels hopeless about is the content, but the target of building
expectancy is the process of how the person comes to believe and maintain the belief that their
problems cannot be overcome.

Defining the Salient Therapeutic Targets

When negative expectations contaminate life experience, it becomes clear that addressing the
issue of expectancy will be important. Telling someone steeped in negative expectancy to “try
and look at the bright side” may be well intended but is an exceptionally weak piece of advice.
It’s the equivalent of telling a depressed person to cheer up. It’s a worthy goal but telling
someone what to do doesn’t enable them to do it. Experience is a much more powerful teacher,
and the experiential learning of a process-oriented hypnosis session can be invaluable in this
regard.
The therapeutic targets, then, include (1) helping the client look ahead, not behind, disrupting
the pattern of using the past to predict the future. A principal cause of negative expectations
comes from past failures (e.g., “I’ll never be happy because I never have been”; “I’ll never have
a good relationship because I’ve never had one”; and the twisted logic of negative expectancy
when saying, “I won’t be happy until my parents treat me better when I was a kid!”). Other
targets include (2) separating past failures from future possibilities; (3) redefining the future as

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having opportunities not yet known but inevitable; (4) scaling global hopelessness down to an
individualized plan of action; (5) distancing someone from their expectations long enough to
help them distinguish between realistic and unrealistic expectations across all life experiences;
and (6) motivating a willingness to take action with the message that sensible effort can pay off.
Any and all of these messages can be contained in a session on building expectancy, amplifying
which ones are most essential at the time. Table 6.1 offers a generic strategy for helping the
client build positive expectancy.

TABLE 6.1. GENERIC SESSION STRUCTURE FOR BUILDING EXPECTANCY

Induction

Response set: Expectancy

Theme 1: Expectations shape experience
Theme 2: Your expectations can mislead you
Theme 3: What you focus on, you amplify
Theme 4: Developing realistic goals to pull yourself forward
Theme 5: You have personal resources you can use in new ways
Theme 6: Looking and moving forward
Theme 7: Planting seeds for the future
Theme 8: Looking ahead to positive possibilities

Posthypnotic suggestions for integration

Closure and disengagement

Session Transcript

Induction
You can find yourself a comfortable place to sit, a place that is free of unnecessary distractions . . . and then you can
arrange yourself in a position that is comfortable for you. . . . The important thing right now is to make sure that your
body has good support . . . because you can realistically expect that as your body gets really relaxed, it naturally
tends to feel heavier . . . and it helps to relax when you can be physically comfortable effortlessly. . . .
Once you have settled into a comfortable position that you can easily sit in for a while . . . you can let your eyes
close. . . . That way you can start to build an internal focus . . . a focus within yourself . . . so that you can find inside
yourself . . . those parts of you . . . that most need to experience comfort . . . relaxation . . . the experience of being
soothed . . . and also inspired . . . as you build a greater degree of focus over the next few minutes . . . on the helpful
ideas introduced here. . . .

Building a Response Set Regarding Expectancy

And especially on the important realizations they can bring to you. . . . In that way you can fully expect . . . to absorb
new possibilities . . . new things you can do that can be helpful to you . . . new skills that you can develop and use in
many different life situations . . . on your own behalf . . . new perceptions that can give rise to a stronger sense of your
emotional growth. . . . Out of all the things that there are to focus on at this moment . . . you can begin this process of
evolving a meaningful vision of your future by first turning your attention to . . . the feelings of sitting comfortably. . . .
It’s an easy thing to do to notice how each breath that you take in . . . can allow you to grow more comfortable . . .
more relaxed within yourself. . . . And as your comfort deepens . . . you can appreciate that you have some time right
now . . . of absolute freedom . . . the freedom to just be. . . . Nothing you have to think about. . . . Nothing you have to
analyze. . . . How comforting to be able to have some quiet time to yourself . . . to enjoy the freedom of not having
your thoughts spinning around in different directions. . . . It means that little by little . . . your thoughts can begin to get
more focused. . . . Your mind can grow more comfortable . . . just as your body can get more comfortable. . . . And
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little by little, the experience develops . . . more completely and more fully . . . of being deeply relaxed . . . wonderfully
comfortable . . . and it’s an interesting thing to observe in yourself . . . where your attention goes when it doesn’t have
to go anywhere. . . . It’s one of the most pleasing things about the experience of hypnosis. . . . There is a certain
quality of freedom embedded within each hypnosis session . . . the freedom to let your mind wander if you’d like . . .
the freedom to either entertain—or dismiss—any particular thoughts or sensations as you choose. . . . And that’s part
of what you learn about yourself . . . your individual way of experiencing these sessions . . . whether you find it easy
to focus . . . whether you’re able to build a meaningful experience of absorption simply because you choose to. . . .
And you can probably appreciate how different the experiences of hypnosis are for different people . . . and even how
different it is for you from one time to the next. . . .

Theme: Expectations Shape Experience

And so much of what you experience is directly related to what you expect to experience . . . and that’s true across so
many life experiences. . . . You expect to not enjoy a new restaurant your friends want to try, and you don’t . . . or you
expect not to like someone new at your job, and you don’t. . . . How easily things can live down to your expectations .
. . especially when they’re tainted by an arbitrary and undeserved negativity . . . undeserved because you haven’t
experienced it yet. . . . And, likewise, how easily things can live up to your expectations . . . when reflecting a sense of
optimism and a well-practiced ability to notice what’s right. . . . So as you enjoy this hypnosis session . . . it can be
helpful to be aware of your expectations for yourself, whatever they might be . . . as you anticipate how well you’ll be
able to focus now . . . and how easily you’ll be able to absorb new ideas. . . . And it’s that anticipation I’m going to
speak about . . . encouraging you to consider the question of how your expectations come about in the first place . . .
for whatever you have yet to actually experience . . . and the question that follows . . . as to how you know whether
your expectations are accurate and useful . . . or whether they contaminate your experiences . . . by reaching
unfounded conclusions well ahead of the actual experiences yet to unfold. . . . It’s a valuable skill to be open to new
experiences . . . to approach them with what has been called a beginner’s mind . . . a mind without prejudice or
expectation. . . .

Theme: Your Expectations Can Mislead You

As you well know, the world is filled with diverse cultures . . . people leading very different lives from your own. . . .
There are peoples and places so different and unfamiliar across the earth that can remind you that there are lots of
different ways of going through life successfully, happily. . . . And some of those cultures are extremely different and
others only mildly different. . . . It’s a really powerful experience to spend time in other places . . . where your ideas
and your expectations of how things should be and how people should live are quite different from how these people
actually do live. . . . And yet you discover that even though their lives aren’t as you expected . . . they’re still living well
and enjoying life in their own way. . . . They still love family and music and celebrations and good food, whatever they
think of as good food, even if you don’t happen to think so. . . . And this experience highlights how our expectations
can sometimes be quite irrelevant to what actually happens. . . . And there are experiences that you’ve had in your
own life that turned out to be so different from what you expected. . . . It can be a simple example, such as when you
felt obligated to go to a social gathering that you were really not in the mood to go to, perhaps even dreading having
to go . . . but you went and much to your surprise you ended up having a great time, even though you didn’t expect to.
. . . You had some enjoyable conversations with interesting people . . . and the food was good . . . and the music was
good . . . and you ended up genuinely enjoying yourself. . . . Other simple examples, such as never trying a food that
just didn’t seem appealing to you, especially when you were a child . . . and then eventually you tried it and came to
love it. . . . Or another example of going to meet a person you weren’t expecting to like, and perhaps didn’t like when
you first met, who eventually became special to you . . . a person you really came to like or even love despite your
original negative expectations. . . . And if you think about it, your life is sprinkled with those kinds of experiences . . .
where something turns out to be quite different than what you were expecting and even much better than you
expected . . . and it’s good to allow for that possibility. . . .

Theme: What You Focus On, You Amplify

And as always, what you focus on shapes so much of your experience. . . . So the first principle in learning to move
forward in your life is what you focus on, you amplify. . . . And what an extraordinary thing it is to be able to focus your
attention on what’s useful . . . and life-enhancing. . . . So often people don’t think to do that . . . so they focus on
what’s wrong instead of what’s right . . . or they focus on things in the unchangeable past instead of a wide-open
future filled with the chance to make positive choices. . . . Now there are many different things that I can talk about
that are important in helping you learn to feel good . . . but right now it can be quite valuable to think about . . . the
mind . . . your mind. . . . After all, that’s what we’re dealing with . . . your thoughts . . . your feelings . . . your way of
looking at things. . . . And you already know how enormously complex the mind is. . . . There isn’t anyone who
understands all of it. . . . The fact that your mind is so complicated . . . is precisely why . . . you can have unexpected
reactions . . . confusion about your feelings at times . . . mixed feelings about things or people . . . why you can have
conflicting motivations about things you want to be able to do but then don’t . . . how you can consciously feel hopeful
about your future being compelling and meaningful . . . and at the same time . . . be concerned that your hopes may
not be realized. . . . Having these mixed feelings and reactions is so very, very normal . . . which can be a relief to
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know. . . .

Theme: Developing Realistic Goals to Pull Yourself Forward

And you know there are different levels of awareness we all have . . . things that we’re aware of on the surface level .
. . and deeper things that can be hidden even from ourselves. . . . And some of the most powerful experiences that
you are capable of having . . . take place at levels much deeper than just what you’re aware of . . . much deeper. . . .
And whether you call that deeper part of yourself . . . the unconscious mind . . . or the subconscious mind . . . or your
deep self . . . doesn’t really matter. . . . It’s just very important for you to know . . . that there is a deeper part of you
that can learn . . . and can absorb . . . new understandings. . . . And it’s that deeper part of yourself . . . that you can
gradually come to know more about and better understand. . . . I know . . . and you know, too, of course . . . that you
want things . . . to be better in your life. . . . You want to feel better . . . and not just feel better but actually be better . .
. in deeper and more enduring ways. . . . And feeling and being better can indeed happen . . . when you begin to do
things . . . differently . . . when you go beyond the old and the familiar ways of thinking and behaving that haven’t
served you as well as you might have hoped. . . . So, you’re beginning to learn . . . about your mind . . . especially its
ability to focus and get absorbed in new possibilities . . . and you’re starting to learn about the relationship . . .
between the things that you think now. . . . and feel now . . . and do now . . . and what happens later . . . the eventual
results of the choices that you make. . . . And what would you like to experience differently? . . . You can start to
become clearer about what you want for yourself. . . . You can gradually develop a wonderful and detailed image of
what your life could look like . . . and how it could feel good and satisfying to you . . . (10 second pause). Now I don’t
know if you could create that kind of wonderful vision right now . . . this moment. . . . But whether you could or couldn’t
yet . . . you can understand how important it is to have things to strive for in your life . . . the kinds of things that pull
you forward in your life and give you a strong sense of purpose. . . . And even if you’re not sure right now what those
things might be . . . that kind of powerful personal vision can begin to evolve for you over time . . . as you begin to
learn more about what matters to you . . . and what you are capable of . . . that you don’t even realize just yet . . .
because you already know that there’s nothing more powerful than a person with a vision. . . . Now, what is vision? . .
. It’s a future possibility . . . a possibility that is so motivating and compelling . . . that it leads you to start doing positive
things now . . . that gradually make your vision possible . . . eventually . . . steps you begin to define and follow that
lead you in a meaningful direction . . . that provide you with a level of satisfaction and at the same time keep you
wanting more for yourself . . . a complex mix of feelings, of feeling good about where things are going and at the
same time wondering what more there may be to discover and experience. . . .

Theme: You Have Personal Resources You Can Use in New Ways
You can use your own experience to better grasp the point. . . . After all, there are important things in your life . . . that
you have accomplished. . . . If you have a job or a profession . . . you didn’t get it by accident. . . . You developed
skills and applied for it and created the possibility of actually getting it. . . . If you have a high school diploma or a
college degree . . . you didn’t get it by . . . sending in two dollars and a cereal box top. . . . No, you got it by
consistently going to class . . . consistently taking and passing tests . . . consistently writing papers and turning them
in . . . and were there times that you didn’t want to go to class? . . . Of course there were times that you didn’t want to
go to class . . . but you focused on the greater goal of graduating and went anyway. . . . And by fulfilling that most
important task, what you discovered is that . . . your feelings of a lack of interest in going . . . may come and go . . .
but the diploma stays. . . . The college degree stays . . . It’s a very valuable realization . . . that the goal of eventually
graduating from school . . . kept you going . . . even when you really didn’t feel like it . . . or when the job was tough at
times, you stayed with it and somehow made it work. . . . That’s the power of vision . . . the ability to see beyond the
discomfort of the moment . . . by making the goal the clear priority. . . . When the goal matters more than temporary
discomforts like fear or doubt . . . that’s when people surprise themselves in the best of ways by accomplishing what
seemed unlikely. . . . The wisdom of Nelson Mandela is worth sharing here . . . for he said, “It always seems
impossible . . . until it’s done!” . . .

Theme: Looking and Moving Forward

And his extraordinary life and achievements, despite suffering in terrible conditions, shows us all the power of that
observation. . . . There are ordinary people who become extraordinary when they take action by setting a goal . . . a
realistic goal . . . and strive to achieve it. . . . You can take that valuable principle . . . and you can apply it in such a
way . . . that whatever it is that may have been hurting or limiting you in the past . . . you can turn your attention and
actions away from. . . . After all, you can’t really move forward by looking backward . . . any more than you can drive a
car forward while only looking in the rearview mirror. . . . And you can now begin to develop a new vision for yourself .
. . a reason to learn some new skills . . . change some of the things that you say and do that would help move you
forward . . . slowly and gradually . . . doing more things for tomorrow’s successes than getting lost in whatever
discomfort you might have had today. . . .

Theme: Planting Seeds for the Future

You know, it’s a very common metaphor among therapists to talk about the unconscious mind . . . as fertile soil . . .
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and to tell people that through therapy you can plant seeds . . . that will grow into something healthy and beautiful. . . .
It’s a useful metaphor, and it’s also literally true. . . . And you’re planting new seeds right now . . . through this session.
. . . Now, fewer and fewer people live on farms these days. . . . Most people don’t take the time to grow things that will
flower or produce fruits or vegetables. . . . That’s because most people live in cities. . . . And there are many good
things about city life . . . but there is also something lost by living in a city . . . because in the city the lifestyle
emphasis people tend to acquire is on things happening “right now.” . . . That’s very different than the perceptions you
develop when you grow up on a farm . . . when every day . . . your approach to life requires you . . . to think in longer-
term ways. . . . You can easily learn to think in terms of planting seeds . . . preparing yourself . . . for the changes
about to come . . . in your life. . . . There are so many powerful and great things . . . that can happen in your life . . .
and the challenge is defining what’s worthy of your efforts . . . and defining the steps to follow to reach your goals . . .
and discovering what you know as well as what you know that isn’t really so . . . that you can leave behind as you
move forward. . . .

Theme: Looking Ahead to Positive Possibilities

And when you realize that . . . at a very deep level . . . as you’re starting to . . . then you can nurture your feelings of . .
. optimism . . . that things can change. . . . Things can improve. . . . You can and undoubtedly will learn things that you
didn’t know before. . . . You can practice developing new skills . . . that you didn’t have before. . . . And so . . . I can
safely predict . . . that there are important experiences . . . that you’re going to have in your life . . . that will be
wonderfully valuable. . . . And they will really teach you something about what it means to shift your focus to
observing what’s right . . . and to notice more of the things around you that are worth noticing . . . the beauty of a
sunset . . . the joyful playfulness of people’s pets . . . the polite smile or kind word of a stranger. . . . There are lots of
experiences ahead of you . . . good things to look forward to that haven’t happened yet. . . . There will be places that
you will go . . . that you haven’t been to yet . . . places that will be powerful in one way or another . . . places that will
generate happy feelings . . . places where you’ll feel good. . . . And I can safely predict . . . that you will meet people .
. . that will influence you in important and wonderful ways . . . that you haven’t met yet . . . people you will find
inspiring that bring out some of the best in you . . . people that will care about you . . . people that will become friends
. . . people that will become teachers . . . people that you haven’t even met yet . . . that will contribute . . . to the higher
quality of your life. . . . There will be favorite movies of yours that haven’t even been made yet . . . and there will be
new songs you will love that haven’t even been written yet . . . and the future—your future—is filled with possibilities
worth exploring and discovering. . . .

Posthypnotic Suggestions for Integration

Now whoever it was that said there are no guarantees in life . . . there are only opportunities . . . clearly had the right
idea. . . . Opportunity speaks to the future . . . and the future hasn’t happened yet . . . but the future is coming . . . and
how you shape it to your liking begins with the choices you make today. . . . You can begin to make better choices
now . . . that will bring you more of the things that you want for yourself in the future. . . . And then that rich, vivid,
detailed image . . . your vision of your future . . . can be what pulls you forward in your life. . . . You can expect . . . to
find yourself . . . starting to do some things differently . . . and I think you’ll be happily surprised to discover . . . that
you are starting to do some things differently . . . in ways that are more in line with your evolving vision. . . . And it is
the power of the future . . . to draw you in . . . in ways that can feel great . . . that can guide your daily choices . . .
choosing carefully what to say and do . . . for the results you want tomorrow . . . the next tomorrow, and all of your
tomorrows. . . . And so you can nurture these seeds of optimism that you’re planting today. . . . You can let them
grow. . . . Let them grow. . . . Now you can take whatever time you want to or need to . . . to absorb these important
ideas and possibilities . . . and to integrate at a deep level . . . the strength of these messages about possibilities. . . .
and the future . . . and growth . . . and change. . . .

Closure and Disengagement

When you’ve had enough time to enjoy this experience of comfort . . . then that’s when you can bring this experience
to a comfortable close. . . . So, when you’re ready to bring yourself out of hypnosis. . . . you can start to reorient
yourself at a rate that is gradual and comfortable . . . slowly alerting yourself. . . . And when you’re ready . . . you can
reorient yourself completely . . . and allow your eyes to open and fully alert yourself . . . bringing back with you the
best feelings . . . of feeling relaxed and comfortable . . . and wonderfully optimistic . . . as you remind yourself . . . in
the nicest of ways . . . that the future hasn’t happened yet . . . but you can make it deeply fulfilling . . . one day at a
time . . . one decision at a time. . . .

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Chapter 7

Making Better Discriminations

In the sky there is no distinction of east and west; people create distinctions out of their
own minds and then believe them to be true.
—The Buddha

The Case of Peter

Peter looked as tired as he said he felt. Only 36, Peter acknowledged that he was feeling a lot older than his
chronological age. He said he was working way too many hours, especially during these days of uncertainty
and doubt in the minds of so many. Huge and consequential issues concerned every citizen of the United
States, as surveys about the national mood revealed. Health care, gun control, deep and sometimes violent
political divides, and more ratcheted up people’s anxiety and depression. As a psychologist in clinical practice,
Peter was in the front row seeing it all up close.
Peter came to therapy for help in addressing his high level of stress and fatigue. He felt sure he was doing
good work, but just too much of it, and he was sure he couldn’t sustain that level of intensity without some
predictably bad consequences. People were hurting, and he wanted to help, but he knew—intellectually,
anyway—that the demand exceeded his supply.
Before I had a chance to ask, Peter spontaneously provided some personal history. He described how even
as a boy he was “psychologically aware.” He described himself as a “responsible” and “empathetic” child, traits
he has always valued in himself that also served to steer him into his career as a psychologist. Asked to say
just a little about his family when growing up, Peter described his parents as “die-hard liberals” who were “social
activists.” They heavily emphasized the value of being of service to others, the importance of seeing things from
other people’s perspective, and the value of giving of one’s time and energy to others. He had two siblings, a
brother and a sister, and he said, “It’s no surprise that we are all professionals in service-oriented professions.”
He said quite sincerely, “I admire my parents for what they modeled and expected of us,” and I believed him.
I asked Peter what he did for fun. He joked, “What’s that?” Then he said, “Playtime has never really been my
thing. I guess I’m always so aware that there’s more to be done that that’s where my time and energy goes.
Don’t get me wrong, though. I like being productive, and I like that sense I’m doing something meaningful
instead of just watching TV or going on yet another first date. But wasting time on my leisure just seems so
needlessly self-indulgent.”
Given Peter’s personal values for being productive and giving of himself, even to the point where it
sometimes hurts, Peter seemed to have a blind spot that is not uncommon among health care professionals.
Clinicians routinely report that they haven’t taken vacations in a very long time, that they work long and
sometimes inconvenient hours to accommodate their clients’ needs, and that they probably give more than they
really should.
So, what about Peter? Does he have poor personal boundaries that need firming up? Is he emotionally
needy for his clients’ approval and even admiration? Is he unconsciously trying to repair some unresolved
attachment issues? Is his self-esteem entirely defined by his professional status, and the more he works the
better he sees himself? Or what?
Peter’s dilemma is understandable, of course. It’s not pathological to want to be of service to others. On the
contrary, it is wonderfully compassionate and typically motivated by a genuine desire to reduce human
suffering. But when you have grown up with the clear message that your worth comes from what you do for
others, most or all of your life experience is then geared toward that value system. What goes undeveloped or
underdeveloped, then, is the other side of the equation: There is also value in what you do for yourself.
The content of Peter’s problem is stress from working too much. With one how question, the process of how

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 he chooses what he is going to do became glaringly apparent. The question was formulated by his statement,
“Wasting time on my leisure just seems so needlessly self-indulgent.” The how question posed to Peter was
this: “How do you determine whether doing something for yourself is selfish or taking care of yourself?”
Peter paused, tried to process the question’s meaning, then asked me to repeat the question. When I did, he
had this clear look of confusion on his face before he slowly admitted, “I guess I don’t. Anytime I do something
for myself, it feels selfish. It doesn’t feel good even though it’s supposed to, so I guess that’s why I don’t do
things for myself very often.”
Hypnosis was used to help Peter start to make a sharp distinction—a meaningful discrimination—between
what is selfish and what is simply taking care of self. He had never made this distinction before and now could
begin to develop the salient skills for doing so: establishing a work schedule that allowed for free time, learning
how to limit the number of sessions he did in a day or a week to prevent burnout, getting practice in saying no
more easily when it would serve him well to do so, initiating leisure activities with friends and so forth, all the
while feeling good about getting ever clearer that taking care of self is not equated with selfishness. It can be, of
course, but isn’t necessarily. There is a difference!
Peter was a quick learner. The discrimination strategy addressed in hypnosis really stuck with him powerfully.
Based on that experience, he immediately implemented some changes in his use of time and energy, which he
later shared with me. He was doing fun things and not giving a second thought to the idea that he was being
too self-indulgent. He said he felt better than he had in a very long time.

The Role of Discrimination in Quality of Life

Cognitive psychology, the study of how people think, has given rise to new understandings about
how people gather and use information. This includes how people decide, usually at a level
outside of awareness, what is salient to pay attention to in a given environment and, likewise,
what is essentially irrelevant. When people get sidetracked into irrelevancy, paying too much
attention to what doesn’t really matter and too little attention to what does, their misplaced focus
naturally leads them away from making optimal decisions. Furthermore, when someone’s
perspective is so global or overgeneral that they simply don’t know how or what to decide in a
situation requiring a decision, they are far more likely to make poor decisions on the unfortunate
basis of hurt feelings, old history, misconceptions, or blind faith.
It is a fundamental truth in living that the quality of your decisions shapes the quality of your
life. The importance of having meaningful strategies for making effective decisions on a
situation-by-situation basis cannot be overstated. Simply reacting on the basis of the feeling of
the moment is too often the path to later regret: How could I have done that? What the heck was
I thinking? How can I live with these awful consequences?
Cognitive psychologists and cognitive neuroscientists use the term “discrimination” to
describe the process of making distinctions between different situations that give rise to one’s
reactions. For example, your reaction will be entirely different if you believe someone stepped
on your foot by accident than if you believe they did so deliberately. Your ability to discriminate
an intentional act of harm from a moment of unintentional carelessness fully shapes your
reaction of either anger or tolerance.
When someone faces some challenging situation and has a choice about whether and how to
respond, do they realize that a choice is even available? Reflexive responding—the predominant
tendency of people to just react to some circumstance with neither insight nor foresight—clearly
says no. If and when a person recognizes an opportunity to make a meaningful choice, does that
person have the ability to choose wisely? Only if there is a well-defined and effective template
for making good choices, one that considers more factors than just an impulse, or the familiarity
or emotional comfort of a reaction. Using hypnosis as a vehicle for helping people go beyond
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reflexive responding is an exceptionally good use of hypnosis.
In this chapter, then, I consider one of the patterns of thought involved in how people make
important life choices, the ones that shape their responses to life circumstances, especially those
choices that carry the potential to really make a critical difference in their emotional well-being
and quality of life. The emphasis is on how one decides to do this, not that, in especially
vulnerable situations, that is, those that hold great potential for causing psychological distress. In
developing a process-oriented hypnosis session, the goal is to help our clients develop what are
called discrimination criteria, the key factors that help one determine which path to take to
respond effectively to some particular situation.

Global Cognition and Symptomatic Experience

The pattern of thought I’m referring to is called global cognition, also known in more everyday
terms as overgeneral thinking. Some individuals are quite detailed and linear in their thinking,
while others are more general. The salient metaphor for global thinking is “can’t see the trees for
the forest,” that is, seeing the big picture only at the expense of the associated details. How does
global thinking give rise to many of the most common problems people suffer, and what does
this imply for effective treatments? Global thinking has been shown to impair problem solving
and exacerbate the tendency of depressed individuals to selectively show greater recall for
negative memories when depressed. A similar link between overgeneral thinking, memory, and
post-traumatic stress disorder (PTSD) and depression has been established as well (Callahan,
Maxwell, & Janis, 2019; Hallford, Austin, Raes, & Takano, 2018).
The implications of global thinking and the lack of discrimination skills for understanding
how people develop problems are profound. When people are unable to determine whether it’s
this or that, focusing on one criterion to the exclusion of other available information, they run the
risk of responding to someone or some situation in an inappropriate or ineffective way. The
resulting discomfort is what brings people into treatment. Here are three examples to illustrate
the point:

Depressed people commonly feel helpless to improve their lives. They globally assume they
have no control over situations, and so do nothing proactively to improve them. They focus
on their feelings of helplessness and thereby miss the controllable opportunities to make
things better. Such a person needs a discrimination strategy to help them determine when
they have control and can make a positive difference with sensible action steps and when
they are, indeed, helpless and have no control over circumstances, and no amount of effort
will make a difference.
Anxious people commonly worry about what might go wrong that will hurt them. They
globally assume they will be overwhelmed and dread the prospect of facing whatever they
fear. They focus on and amplify challenges as being beyond their abilities to manage and
pay little or no attention to their personal resources for coping. Such a person needs a
discrimination strategy to help them determine when something is indeed a serious problem
and when something is only an inconvenience.
People with relationship problems are often hurt by the actions of their partner and feel
angry and disappointed. They globally focus on what they want from the person that they’re
not getting and not on what this person is objectively capable of providing. Such a person
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 needs a discrimination strategy for knowing whether their expectations for the person are
realistic or unrealistic.

Typical Problems Derived From Global Cognition and a Lack of

Discrimination Skills

The types of problems that people might present for treatment that reflect global thinking and the
associated lack of ability to make meaningful discriminations are quite diverse and cross into
many different areas of life. If you consider the number of decisions that you need to make in the
course of a single day—big and small—you can easily see why having good discrimination
criteria readily available to guide you is so important. Here are some of the common presenting
problems that reflect global thinking (at the very least in the problem context but perhaps nearly
everywhere else as well) and a lack of effective discrimination criteria:

Overgeneral problem presentation (e.g., “I just want to be happy”)

Emotional overreactions
Inability to identify one’s feelings (lack of emotional differentiation)
Poor personal boundaries
Indecisiveness
Poor problem-solving skills
Avoidant coping style
Inability to think critically or in detail about issues
Overgeneralizations about oneself (“I’m too anxious to ever learn to relax”), other people
(i.e., stereotyping), or situations (e.g., “I’m not safe at the grocery store because I had a
panic attack there once”)
Global and rigid self-definition based on one’s diagnosis (e.g., “I’m a phobic”)
Holding beliefs or philosophies that have no exceptions (e.g., “Everything happens for a
reason”)
Inability to compartmentalize experience
Inability to think linearly or sequentially (e.g., fails to see cause-and-effect relationships)
Little or no insight

These patterns represent the pervasive and serious effects of a global cognitive style and the
resulting inability to make important distinctions. What the client presents for therapy as the
problem reflects the content-related results of their issue (e.g., “I feel guilty all the time” or “I’m
a depressive”). The goals of the process-oriented therapist are to identify the exact role of global
thinking in the problem content and then to teach the client how to go from overgeneral to
specific in resolving the problem. The process-oriented hypnosis session provides a means for
teaching the salient skills to achieve these goals. Such sessions also encourage better
discriminations beyond the current concerns, and thus have a preventive component as well as a
treatment component.
It’s important to point out that global thinking isn’t globally (i.e., always and everywhere) a
problem. Like any pattern, its value is ultimately determined by the context in which it appears.
Some things are enhanced by a global perspective (“Isn’t the sunset beautiful?”), while for others
a global perspective is clearly problematic (“How can my checking account be overdrawn? I still
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have some checks left!”).

Defining the Salient Therapeutic Targets

In terms of problems, people are inevitably global regarding the things they don’t know about or
understand. The task of the clinician becomes one of providing a structured means not only to
identify the overgeneral thinking of the client, but also to identify and teach specific strategies to
effectively counter it and thereby limit its detrimental effects. Most typically, therapists do this
when they define treatment goals in specific and concrete terms and then encourage the client to
take active steps toward achieving them, an intervention process termed behavioral activation.
Catalyzing meaningful action is the topic of Chapter 12.
On an individual level, the client who suffers some distress and perhaps even pursues therapy
to help alleviate this suffering has little insight into the specific rigidity that fuels the distress.
Here’s how it works: If I adopt the global view that “quitters never win” and therefore believe
that “one should never, ever give up,” then I will continue to “try, try again” without ever
considering—much less exploring—the possibility that my effort may be wasted because no
amount of effort—not just by me but by anyone—can make a difference in a particular
circumstance.
In life, there are many, perhaps too many, situations we face where we simply can’t make a
meaningful difference. But if you believe that one should never give up, you will continue to try
—and fail in such instances. The costs of failure may be ruminative self-doubt, despair,
depression, and high levels of interpersonal conflict with those who say “Give up already,”
thereby causing possibly irreversible damage to the relationship. The rigid and global philosophy
of never giving up precludes identifying the exceptions to the rule, that is, when giving up is
actually the wisest thing to do. The key discrimination question then becomes, “How do you
know when to persist in pursuit of some goal and when to stop trying?” A related discrimination
question is, “When you established the goal in the first place, how did you determine whether it
was a realistic goal?”
People get lost in their global philosophies (e.g., “always follow your heart”) as they strive to
live by them, making decisions and pursuing courses of action based upon them. What typically
drives people into therapy, then, is when the person directly and painfully experiences the
restrictions associated with that belief or perspective. Global thinking unintentionally prevents a
critical examination of the belief that would highlight its applicability in some circumstances but
not others. Global thinking leads the person to believe the philosophy is entirely (i.e., globally)
sound. If and when it fails, it is not typically regarded as a situational failure of the philosophy or
belief. Rather, global cognition usually leads the person to view the shortcoming as their own,
what surely must be a personality defect, character weakness, or psychologically motivated
reason to fail. It just doesn’t and wouldn’t occur to most people that the problem is caused by a
rigid adherence to a belief or philosophy that is counterproductive to the realities of the specific
circumstances they’re in.
People aren’t aware of their blind spots—they don’t know what they don’t know, nor do they
know if what they do know is erroneous. All they know is that what they’ve been doing isn’t
working, their problems or symptoms are seemingly out of control, and they don’t know what to
do. They may well realize that their efforts are counterproductive yet persist because they feel
they have to do something.
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 When a client has made a choice (including the typically unintentional choice not to choose)
in some vulnerable area and suffered some unexpected consequence that causes distress, it
reveals a flaw in the decision-making process. The client doesn’t know where the flaw in the
process was. They reacted reflexively and typically had no idea there was some discrimination to
be made. Thus, when the clinician asks these key discrimination questions, “How did you decide
that was the best decision to make?” and “When making a choice, how do you decide whether it
should be A or B?” the most common response is confusion and the reluctant admission, “I don’t
know.”

Discriminations Representing Repetitive Issues to Address in Therapy

The discriminations listed below are some of the most common issues underlying common client
presentations. They are repetitive themes of therapy. You can probably imagine pretty easily
what the range of presenting complaints might be for each of these.

How do you know whether this situation is in your control? (People not controlling things
they could or, conversely, trying to control things they can’t)
How do you know whether you are responsible for this situation? (People feeling guilty
when they shouldn’t or, conversely, not feeling guilty when they should)
How do you know when you can follow your heart? (People following their feelings when
they shouldn’t or, conversely, not listening to their feelings when they should)
How do you know whether this a sensible risk? (People exaggerating slight risks or,
conversely, minimizing significant risks)
How do you know whether you should hold on? (People holding on when they’d do better
to let go or, conversely, letting go when they’d do better to hold on)
How do you know what to self-disclose? (People revealing too much to the wrong audience
or, conversely, not revealing or sharing enough with the right audience)
How do you know whether your expectations are realistic? (People getting attached to a
specific outcome of how things should be or, conversely, having no idea of what they might
want from a situation)
How do you know when something is personal? (People who take things personally that
aren’t or, conversely, people who don’t take things personally that are, indeed, personal)

The process-oriented hypnosis session, then speaks to the specific discrimination issue
underlying the presenting problem. The clinician has to be able to provide specific discrimination
criteria (e.g., “Before you accept someone’s blame and feel guilty as a result, here’s how you can
know whether it’s truly your responsibility or you’re just being blamed for someone else’s
mistake”) that the client can integrate and use to solve the current dilemma as well as manage
future episodes. Table 7.1 provides a generic structure for helping clients evolve the skills for
making better discriminations.

TABLE 7.1. GENERIC SESSION STRUCTURE FOR MAKING BETTER

DISCRIMINATIONS

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 Induction

Response set: Discriminations

Theme 1: New experiences create new opportunities
Theme 2: We learn what to value as we grow up
Theme 3: Socialization can blur important distinctions
Theme 4: Developing the ability to make better discriminations

Posthypnotic suggestions for integration

Closure and disengagement

SESSION TRANSCRIPT

Induction
You can begin this focusing session by taking in a few deep, relaxing breaths . . . and orient yourself now to internal
experience for a while. . . . Certainly you’re becoming experienced enough . . . and self-aware enough . . . to know
more and more about what’s comfortable for you . . . how much time you need or want . . . to build the higher qualities
of a meaningful focus for yourself. . . . Using your deeper knowledge can make it easy for you to be comfortable . . .
easy for you to get more deeply absorbed inside with each passing moment . . . as you discover that the outside
environment becomes less important for the moment . . . and so gradually recedes into the background. . . . It can be
quite interesting to notice how your level of attention grows in intensity as time goes on . . . and what you focus on
begins to change. . . .

Response Set Regarding Discriminations

And out of all the things there are to notice . . . at a given moment . . . such as the routine sounds of the environment .
. . or the sensations of comfort increasing within you . . . or the sound of my voice . . . there are things that are
relevant . . . and there are things that are irrelevant . . . to creating a meaningful experience of comfort for yourself
right now . . . many different things which naturally pass through your awareness. . . . And that in itself is a rather
curious statement . . . deciding what’s relevant and what’s not . . . what’s worth focusing your attention on . . . and
what isn’t . . . and how very calming it is . . . to just let things that really don’t matter right now sail on by . . . passing
effortlessly through your awareness. . . . And it can be an easy thing to allow . . . because there’s no particular
pressure . . . no mandate . . . about what you’re supposed to do. . . . You can just comfortably recognize what’s
routine in your thoughts . . . or experience . . . that is so routine . . . that it’s just not worth paying attention to right
now. . . . Those can drift into your awareness . . . and then drift right out again . . . as your attention turns to new ideas
and possibilities . . . that encourage a deeper understanding . . . of what’s worth paying attention to . . . especially
when you’re needing to make a good choice . . . of where to place your focus . . . and where to invest your energy
and resources . . . as you recognize opportunities to make important distinctions with insight . . . and foresight . . . just
as you did moments ago . . . when you chose to be comfortable and turn your attention inward . . . and create a
wonderfully comfortable space . . . and get absorbed in a different way of experiencing yourself. . . .

Theme: New Experiences Create New Opportunities

And when people are exposed only to the familiar . . . such as the same picture on the wall in your home that you no
longer notice because you pass by it every day for years . . . or the routine sounds of the environment you work in
you that you’ve stopped noticing simply because they’re always there in the background. . . . People tune out the
familiar. . . . You know as well as I do that what tends to capture people’s attention is what’s new or what’s different . .
. the unexpected things that happen in the space of a moment . . . perhaps the things someone says or does that
catch you off guard . . . quite often in the form of a happy surprise . . . such as the unexpected phone call from
someone you’ve been thinking about but haven’t talked to in a long time . . . or the surprise compliment or kind
gesture someone gives you for no particular reason that you really appreciate . . . or the things someone says that
you never really thought about before that inspire you in the best of ways. . . . And the invitation being offered to you
here and now . . . is to allow yourself the luxury . . . of being able to notice things within yourself . . . that you don’t
usually pay much attention to . . . such as where your mind goes when it doesn’t have to go anywhere in particular . . .
or which parts of you drift off most easily and offer you a wonderful sense of detachment from the usual. . . . And
that’s what provides a window into your inner experience . . . allowing new understandings to emerge . . . and just
how different an experience this can be . . . giving rise to different ideas, different understandings. . . .

Theme: We Learn What to Value as We Grow Up

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And that’s what gives you a chance now to consider the value of new ideas . . . and new understandings . . . when
you come to realize . . . that some of the things that we learned while growing up . . . and things we then come to
think we understand about ourselves and the world around us . . . sometimes turn out to not be very helpful to us . . .
things you were taught through direct messages or even just by watching and listening to influential others . . . who
had a perspective that once may have seemed right without question or seemed to at least have made some sense. .
. . Well, nobody, I mean nobody, escapes the power, the influence of socialization . . . that process of learning how to
become a person that we all go through. . . . You grew up around people . . . parents, teachers, relatives, friends . . .
and they each shared their values through the things they said and did . . . what they emphasized and what they de-
emphasized in the way they acted and the things they said. . . . And you started learning very early in your life . . .
what was deemed important . . . what was valuable to pursue. . . . Socialization is a very powerful force. . . . Consider
how much it shapes our perceptions of what we think we know or how we think we should act. . . . And then at some
point in your development . . . as you grow more experienced and more aware . . . you might come to recognize that
things you thought were true weren’t . . . and ways that you thought you should act, you shouldn’t . . . because
situations change . . . and new responses are needed. . . . And you start to become aware of your ability to choose
which beliefs to hold onto as still relevant . . . and which ones to discard as no longer relevant . . . if they ever really
were relevant at all. . . . You take charge of yourself as you evaluate which things to reaffirm as still important and
which things to dismiss because they just don’t work for you anymore. . . .

Theme: Socialization Can Blur Important Distinctions

And when you learn from significant others . . . what’s important to them that they believe should be important to you,
too . . . you learn a style of responding to life experiences. . . . For example, if you have parents who are
perfectionistic . . . who are quick to point out and criticize even small, meaningless mistakes or less than perfect
grades in school . . . but rarely, if ever, compliment what you’ve done well . . . then you learn to focus your attention
on what’s wrong in almost every life situation . . . and rarely, if ever, on what’s right. . . . You’ll be quick to notice your
inevitable flaws simply . . . because you’re human . . . but not acknowledge your strengths. . . . Such people don’t
learn to distinguish between an unrealistic perfectionism and a realistic sense of what’s plenty good enough. . . . Or if
you grow up learning to always put others’ needs and wishes ahead of your own . . . taught that your worth only
comes from what you do for others . . . then you might learn to be generous and sensitive . . . but you don’t learn how
to do caring things for yourself . . . because it seems self-indulgent and even selfish. . . . Such people don’t learn to
distinguish between selfishness and taking care of self. . . . And there are things you learned growing up . . . ways
you were taught to be and values you were taught to live by . . . that were so deeply ingrained in you . . . that you
hadn’t really realized their significance before. . . . Perhaps you knew about them . . . but there’s an important
distinction between knowing something and realizing something. . . .

Theme: Developing the Ability to Make Better Discriminations

And we all encounter pieces of wisdom handed to us in the form of old sayings . . . such as “you’re never too old to
learn something new” . . . but what can be confusing at times is the piece of wisdom that contradicts that wisdom . . .
when someone says . . . “But you can’t teach an old dog new tricks” . . . or the common advice some people give
when they tell you to “follow your heart” . . . and the opposite advice of others who say, “Don’t follow your feelings
because they can too easily deceive you.” . . . And how do you decide which piece of conflicting advice to follow at a
given time? . . . The ability to recognize that there are at least two sides to consider . . . is one of the most important
new understandings that you can develop. . . . And as you learn more and more about how to decide when it’s best
right now to do this but not that . . . each time you need to make an important choice insightfully . . . it can lead you to
make better and better decisions as you move through your life . . . decisions you can feel good about . . . that start
with making important distinctions between options that can generate good consequences. . . . And there are so
many of these important distinctions to make each day . . . such as determining what is and isn’t in your control in
some situation . . . or what is and isn’t your responsibility in some area of your life . . . or when to listen to your
feelings and when to override them . . . when to open up to someone and when to keep a sensible distance . . . all the
while growing in yourself a richer and deeper understanding that socialization may lead you to see only one side of
something. . . . And your newly emerging awareness allows you to see the choice embedded in each situation . . . so
that you can better choose between this possible response and that one. . . .

Posthypnotic Suggestions for Integration

It’s the experiences that you have each day that present a choice to you . . . to do what’s familiar because you’ve
always done it that way . . . or to recognize an opportunity to do something different. . . . By recognizing that you’re
making a distinction that you hadn’t considered before . . . that leads to a different and more effective response . . .
you simply hadn’t made before . . . a new process is emerging within you . . . that makes it so much more reflexive to
choose wisely with foresight and insight. . . . And when you emerge from this valuable experience . . . and you can
see the choices available in different environments . . . you can enjoy discovering that it is so empowering for you to
evolve the confidence in your own judgment to make the necessary distinctions that lead to more satisfying and
enriching outcomes . . . a future of making good choices based on making the distinction between possibilities using
the best information you can have at the time . . . in order to choose what will work best . . . produce the best possible
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result . . . in a particular situation. . . .

Closure and Disengagement

And you have some decisions to make right now as we bring this session to a close . . . about what you really want to
hold on to from this experience . . . and what distinctions you realize now you most need to learn to make . . . and
even at just what moment you’ve had enough time to process these ideas and possibilities and are ready to end this
session. . . . But first, take whatever time you want or need to process your thoughts, feelings, reactions to fully
absorb the useful things that have occurred to you. . . . And when you’ve had enough time to process . . . and you’re
ready to bring this experience to a comfortable close . . . you can start to do so by slowly reattaching to your body . . .
and to the environment as your awareness of your surroundings grows. . . . You can feel increasingly alert and
energized now . . . and when you’re ready, you can let your eyes open and reorient completely. . . .

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Chapter 8

Developing Impulse Control

Men are rather reasoning than reasonable animals, for the most part governed by the
impulse of passion.
—Alexander Hamilton

The Case of Charlotte

Seventeen-year-old Charlotte was somewhat of an enigma, no more so to anyone else than to herself. She was
in her senior year of high school, getting excellent grades, and was socially connected to a nice network of
friends. She was awaiting a reply to her university application and felt confident she’d be accepted and move on
to a new and exciting phase of life as a university undergraduate. She sounded like she was on top of the
world, so I waited for her to get to why she was in my office asking for help. I didn’t have to wait long. Suddenly,
her exuberant demeanor was gone, her tone became hushed, her eye contact went away, and she was clearly
trying to figure out how to say what she wanted to say. Finally, instead of telling me, she showed me. When she
rolled up her sleeves to expose her forearms, both had easily visible scars.
Charlotte watched me closely for my reaction. I think she was relieved to see I didn’t have much of one. I’ve
seen the residuals of self-harm too many times before to be shocked by it, sometimes in people much older and
sometimes much younger than Charlotte. I waited for her to initiate the conversation, and she returned the favor
by waiting for me to do the same. Finally, I just asked her directly: “What’s that about?” She paused, trying to
come up with a sensible reply, and finally just said, “I don’t know. I don’t know why I do that. I just do. It’s as if
something builds up inside of me and I just feel this weird urge to cut myself and when I do the urge goes away,
at least for a while. I think it might just be my way of handling stress.”
Charlotte engaged in self-harming behavior. What’s that about? Was it an act of self-hate? Was it thinly
disguised suicidal behavior? Was it a passive cry for attention or help? Was it anger turned inward that was
really meant for her parents? Was it a faddish behavior in today’s young people to wear as some kind of badge
of honor, and she just wanted to fit in with that crowd? Was it the residual of unresolved trauma? Or what?
I asked Charlotte a few pointed questions about her internal experience: “How do you know when you’re
stressed? How far ahead of time do you know the feeling is building and you’re going to cut yourself? How do
you decide where to cut yourself and how deeply to cut? How do you view the cuts and scars after you’ve made
them? How do you explain the cuts and scars to your friends? To your parents? To your doctor? Are you
connected to others who do this same kind of cutting?”
It was as if Charlotte, bright as she was, had never thought of these things before. Her answer to each
question was some variation of “I don’t know” or “I’m not sure.” How could such a smart young woman be so
oblivious to what’s going on inside? Her lack of what is termed “emotional differentiation” means her feelings
were so global, so jumbled up together, that she couldn’t even begin to untangle them in order to develop
realistic self-regulation strategies.
The content of Charlotte’s problem is whatever is currently stressing her, whatever is going on in the moment
that gives rise to the impulsive desire to cut herself. The process is her poor coping style in which she faces
some stressor, real or imagined, and jumps to the self-harm behavior to manage it. She shows no pause to
develop either insight or foresight regarding whatever’s going on or how she’s feeling and how best to manage
it. She simply feels and responds to the impulse to cut herself.
Using hypnosis to encourage impulse control, it was important to first depathologize her behavior by
asserting that people do what they know how to do to cope, even when sometimes it works against them. But
people can develop new understandings and new skills that go along with different levels of personal growth.
Charlotte was led to realize that she was groomed to focus outside herself, especially on getting great grades

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 and participating in purposeful activities outside of school to embellish her value to prospective universities. In
so doing, she was detached from (dissociating) developing a strong and clear internal awareness. Using a
sports metaphor, she was all defense and no offense, a point she understood easily. The task now was to
eventually be able to answer questions requiring insight, such as being able to identify, name, and report on her
feelings as a big step toward learning to manage them skillfully. If you can’t identify it, how can you manage it?
The suggestion was embedded throughout the hypnosis session that she was learning the topography of her
inner world, the things that she would know about herself that she’d never realized before. This would evolve as
her response began to change quite dramatically to what she previously thought of simply as a “buildup” of an
unspecified nature. Now, she was told, “When you start to become aware of a buildup of any kind inside, it’s a
buildup to greater self-awareness, a buildup to greater personal insight, a buildup to the foresight to know that
you can do more to help yourself than harm yourself.” The suggestion that “the impulse to harm can give rise to
the stronger impulse to pause . . . and be self-aware and choose a helpful response you can be proud of”
helped establish a new and positive association for Charlotte.
The process of self-discovery and a developing a renewed self-definition can certainly be relatively quick, but
not instantaneous. Charlotte had six sessions spread out over several months. It was easy to utilize the natural
transition she was about to go through, with moving on from high school to college and all that she would be
leaving behind, including outdated behaviors, and all that she’d be growing into, such as more mature and safe
relationships, including her relationship with herself. The cutting behavior stopped almost right away, but her
recognition of the sometimes-confusing elements of her inner world took her some time to develop. She was
given values clarification exercises to help her define her priorities and ways to act that would be consistent
with them as well as additional hypnosis sessions to reinforce that thoughts and feelings can come and go, but
she can think ahead far enough to know when a particular thought or feeling is going to take her someplace she
really doesn’t want to go. Charlotte learned that she’s much more than her impulses. Seeing her after her first
semester away at college, she was absolutely radiant. She hadn’t cut herself again and was proud of how she
had handled some pretty delicate situations with, in her words, “insight and foresight.”

The Role of Impulse Control in Quality of Life

Two common phrases people use to describe the consequences of their actions are, “I don’t know
what made me jump in and do that, but I’m so glad I did!” and its opposite sentiment when
people lament, “I don’t know what made me jump in and do that, but it was a huge mistake I
deeply regret.” Both these statements reflect actions taken in the spur of the moment, deeds done
impulsively without the benefit of either insight or foresight. Clearly, there are times when the
consequences turn out to be favorable, but at other times the consequences can be painful and the
source of regrets that endure for a lifetime. When impulsive actions hold so much potential for
harm to oneself and others, the need for a means to manage one’s impulsivity skillfully becomes
obvious. This chapter focuses on the role process-oriented hypnosis can play in facilitating this
skill.

Temporal Orientation Shapes Life Experience

Each person forms a relationship to the dimension of time, called a temporal orientation. How
that relationship is defined and prioritized, whether consciously or nonconsciously, plays a huge
role in the way people go about living their lives. Consider, for example, what defines one
person as ambitious while striving to climb the career ladder with a clear vision of what their
goals are, while someone else apparently lacks ambition altogether and is perfectly content to
live in their parents’ basement and play video games all day. They have two very different
relationships to the construct of time, one ambitiously future oriented, the other passively tied to
this moment’s entertainment. If you think about different people’s lifestyles and how the element

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of time features within them, it is generally not difficult to see who is living in a way that more
heavily favors one sphere of time over another.
What the orientation in time leads someone to specifically do (or not do) represents the
content of their experience. How their temporal orientation influences their choices or reactions
represents the process. It is a powerful realization with significant clinical implications that every
problem we treat inevitably has an element of time embedded within it. Consider the following
examples.
Depression is largely a past-oriented phenomenon that prominently features a hashing and
rehashing of nearly every hurt, rejection, humiliation, and failure that an individual has suffered.
If the depressed person thinks about the future at all, it typically involves extending the troubled
past into the future (as discussed in greater detail in Chapter 6), literally saying such things as,
“I’ll never be happy. Why? Because I never have been. I’ll never have a good relationship. Why?
Because I’ve never had one.” And the ultimate past-oriented conundrum: “I won’t be happy until
my parents treat me better when I was a child!” You can probably predict the effect of bringing a
past-oriented problem like depression to a past-oriented therapist. A useful clinical guideline
suggests that when the structure of the attempted solution matches the structure of the client’s
problem, it’s generally a formula for stagnation. From a process-oriented point of view, helping
the client interrupt the pattern of using the negative past as a reference point to predict the future
and build the pattern of establishing new goals and defining and taking the steps necessary to
reach them is vital.
Anxiety disorders are future oriented, typically featuring a focus on what could go wrong,
even catastrophizing and predicting that things will go wrong with devastating consequences that
are terribly frightening. Thinking the future holds imminent disaster is what drives phobias,
leading people to believe that their safety is threatened. Psychologist David Barlow from Boston
University, a major figure in the anxiety field who has spent his life researching anxiety’s many
causes and treatments, framed anxiety in a simple and compelling way I also shared earlier.
Paraphrasing, he said, “Anxiety arises from people overestimating risks and underestimating
their own resources.” It is an orientation to the future that predicts harm that one is helpless to
stop and inadequate to manage. From a process-oriented perspective, helping people learn to
discriminate real threats from imagined ones (i.e., enhanced risk assessment) and connect them
to their personal resources for an increased sense that the challenges they face can be managed is
at the core of good treatment.
Impulse disorders, by definition, are present-oriented phenomena, represented by the motto to
live by, “I want this now!” To present-oriented individuals, the past and the chance to learn from
it are long gone from awareness, and the future seems both unknowable and unimportant in this
moment of reflexive responding. All that matters is the desire of the moment, whether it’s for a
drink, a drug, a comfort food, a desire to hit someone who’s making them angry, a sexual
conquest, a chance to win some money at the card table, a chance to blame someone else for
their bad choices, and on and on. The number of ways impulsivity can lead someone down a
destructive path are seemingly infinite. What someone does impulsively is the content of their
problem, but how someone responds to an impulse is the process. The development of impulse
control is a highly desirable self-regulation skill across countless life situations, and process-
oriented hypnosis can facilitate the teaching of that skill.

How Now Attains Ascendance

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When the culture encourages a do-it-now philosophy along with other structurally similar
messages (e.g., “Don’t hold back your feelings,” “Feel free to say or do whatever you want,”
“Just do it,” and “Who cares what others think?”), there is no reason to develop restraint, the
essential ingredient of impulse control. In America, and other places too, we have seen a
loosening of the social restraints that encouraged people to be more civil with each other. The
result has been an escalation in hate crimes and open disdain for anyone perceived as different
and therefore less than. Tolerance encourages restraint, a clear emphasis on accepting differences
between people based on simple respect.
On an individual level, the lack of a mechanism of restraint leads people to speak without
forethought and say things they soon come to regret. They do things on a whim, with no
forethought at all about the possible consequences that brings them, and most often the others
around them as well, a great deal of hurt. Now is what matters, consequences be damned.
What about the effects of teaching a philosophy of now to such now-oriented people? When
therapists are the ones to say, “The past is gone, and the future hasn’t happened yet, so all there
is is this moment,” are they really doing their clients a favor? Some of the most destructive
things that humans do are clearly in the name of right now. But it’s also true that some of the
most valuable experiences human beings can have arise directly from being present in the
moment.

Typical Problems Derived From a Lack of Impulse Control

The types of problems that people might present for treatment that reflect an inability to exercise
impulse control can seem quite diverse, and may include such problematic patterns as these:

A lack of foresight or inability to predict likely consequences

A poor grasp of linear thinking and cause-and-effect relationships
A reckless attitude that eschews the need for any self-restraint
A history of negative experiences from which they learned little or nothing
A history of making bad decisions in the heat of the moment that they later regret
A lack of coherent strategy for addressing important issues with no better plan than to just
wing it
A general inability to consider or even care about their effect on others
Avoidance as a coping strategy (prioritizing immediate comfort over problem solving)
An ability to justify bad behavior with poor excuses

Defining the Salient Therapeutic Targets

If a present orientation can be both helpful and harmful, depending on the context, it raises
another discrimination question we must be good at answering for our clients: How do you know
when to be present in the moment and when you’re much better off thinking beyond the
moment? The general answer lies in the ability to recognize the consequences of either position
in some situation. That highlights what might seem to be a paradox: being future-oriented
enough to know whether you can be present-oriented right now.
There are therapists who advocate the point of view that the future can’t be predicted. I flatly
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reject that statement because it’s both global and fundamentally incorrect. I accept that aspects of
the future can’t be predicted, but many things can be predicted. I can predict that if you abuse
your kids, they will have some pretty serious emotional problems to contend with as a result. I
can predict that if you smoke two packs of cigarettes a day, you’re going to suffer some negative
health consequences. I can predict that if you think you can just say anything you want to
anybody you wish, you’re going to face plenty of rejection.
We may not be able to predict everything, but that doesn’t mean we can’t predict anything. It
isn’t all or none, and requires of us another type of discrimination: What things can be predicted
on a clear-cut cause-and-effect basis, and which things are so multifactorial and context specific
that an accurate prediction is unlikely? An ability to make accurate predictions, an obviously
future-oriented skill, should be one of the skills we routinely teach in the course of therapy. It is
the foundation for teaching impulse control.
To teach impulse control in therapy, one would have to first recognize the merits of thoughtful
restraint. Appreciating the pause needed to determine what might be an effective response in
some circumstance provides time enough to be deliberate in deciding whether to respond and
how to respond. Why is it better to accept the speeding ticket than to strike the cop you’re
furious with for writing it? Even the impulsive, raging client knows better than to make matters
worse by striking a law enforcement officer. In the client who impulsively lashes out, but this
time manages not to, where does that unexpected restraint come from, and how can we extend it
through process-oriented hypnosis into other contexts?
Impulse control requires a key skill that can be taught in therapy, especially when utilizing
hypnosis. That skill is called dissociation. Dissociation features an ability to step outside of the
immediacy of your experience, whether it’s your physical experience, as in pain relief, or your
cognitive experience, as in thought-distancing strategies. Dissociation allows people to step out
of the moment long enough to consider other people’s feelings or the likely consequences of
some contemplated action. Hypnosis is by its very nature a dissociative experience, as is
mindfulness and other similarly structured focusing experiences. Dissociation has a much
broader clinical relevance than what many clinicians learn if they only study dissociative
disorders, particularly when it’s structured to help people go beyond the moment.
An interesting example of the ability to separate—dissociate—from an immediate desire in
order to go beyond the moment is the psychologist Walter Mischel’s famous research from the
1960s on what is commonly called the marshmallow test. In his experiments with young children
ages 4 and 5, it became very clear how strong a role future orientation plays in delaying
immediate gratification for a greater future reward. The children were given a marshmallow as a
treat and then were told the experimenter would be leaving the room for a few minutes. The child
could eat the marshmallow right away if they liked, but if they waited for the experimenter to
return “in just a little while,” they would be given the reward of a second marshmallow. Some
kids popped that marshmallow into their mouth as soon as he left the room, and others sat
looking longingly at the marshmallow and somehow managed not to eat it, thereby earning the
extra one. Mischel (2014) followed the kids who participated in the experiment over the course
of their lives. Four decades later, he wrote about the long-term higher-level successes of those
children who were best able to delay gratification in his book, The Marshmallow Test: Why Self-
Control Is the Engine of Success.
The primary target of the process-oriented hypnosis session, then, is to facilitate the client
developing the necessary resources to pause before acting or reacting. During that pause, the
client can consider what might be the most effective or desirable response in that particular
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circumstance. Shifting the client’s focus from the immediate to the possible consequences
imparts a strategy for making decisions with greater insight and foresight. The use of hypnosis
and its innate capacity for encouraging automaticity in responding can be a particularly helpful
means for making it more reflexive for the client to pause and reflect before acting or reacting.
The result of being more deliberate represents a second target of treatment: It empowers
people to act with greater integrity and attain greater success. This can serve to significantly
improve their self-esteem, feeling better about what they do and how they do it. A third target,
then, becomes apparent, namely the ability to prevent regret. What a lighter load to move
through life with when you’re not burdened with regrets!
Learning to control your impulses is clearly a pathway to greater success on many levels. As
you’ll see, process-oriented hypnosis can go a long way in helping people develop that skill set.
Table 8.1 suggests a means for helping clients develop greater impulse control.

TABLE 8.1. GENERIC SESSION STRUCTURE FOR DEVELOPING IMPULSE

CONTROL

Induction

Response set: Impulse control

Theme 1: Much of our experience is reflexive, driven without awareness
Theme 2: Amplifying the space in between perception and reaction
Theme 3: Impulsivity is overcome by anticipating consequences
Theme 4: You can become more future oriented

Posthypnotic suggestions for integration

Closure and disengagement

SESSION TRANSCRIPT

Induction
You can begin by taking in a few deep, relaxing breaths . . . and the very act of slowly breathing in and out . . . is such
an easy and rhythmic natural experience. . . . It literally sustains life . . . and encourages a wonderful sense of calm
within you . . . a deepening level of relaxation that becomes more pronounced with each breath you take. . . . And
when you take the time to sit quietly and focus the way that you are now . . . it’s really comforting to just let your eyes
close and turn your attention inward . . . so you can notice some of the many different aspects of your own internal
experience. . . . And of course, that includes your physical experience . . . the experience of breathing comfortably in,
effortlessly out. . . .

Building a Response Set Regarding Impulse Control

And when it’s so basic to your very life . . . there’s something quite comforting about knowing how automatic a
process breathing is for us. . . . It’s one of the many great marvels about the human body. . . . Especially when you
consider how many things are taking place within us at a given moment . . . how many bodily functions are going on
automatically that we tend to not even notice, much less think about . . . such as the blinking of your eyes as they
refresh themselves from moment to moment . . . the circulation of blood and distribution of nutrients from the foods
you eat . . . the coordinated movement of muscles that help balance you and move you . . . and the rhythmic act of
breathing that continues every moment of your life. . . . And thankfully there’s no reason for you to have to think about
breathing. . . . You can appreciate that the impulse to breathe is necessary and wonderful. . . . You don’t have to think
about it. . . . Your body just responds to the impulse to breathe . . . that automatic signal from deep within to inhale
and the automatic signal to exhale. . . . And like the drive to breathe . . . there are so many other drives built into our

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very makeup . . . drives from deep within us . . . such as the drive to seek out new or stimulating experiences when
we’re feeling bored . . . or the drive to seek out experiences that soothe us when we’re feeling stressed. . . .

Theme: Much of Our Experience Is Reflexive, Driven Without Awareness

And it’s the automatic nature of experiences . . . those things we do on impulse . . . that I’m drawing your attention to
right now. . . . And even as you listen, you might notice the drive within you to get absorbed in new ideas . . . that can
become reflexive . . . and come to appreciate the ways they can help you in moving through life each day with greater
deliberateness. . . . So much of what we experience is driven without any awareness. . . . There isn’t any personal
sense of us doing it . . . things that we just do that we feel compelled to do . . . something from within us that leads us
to react instantly and thoughtlessly . . . to feel and behave in sometimes puzzling and even illogical ways. . . . It’s easy
to see in ourselves when we just consider simple examples . . . such as going to the grocery store to do your
shopping. . . . You don’t necessarily realize why you choose this brand over that brand of a product. . . . You just
reach for it and place it in your cart. . . . But when we look at the marketing research about the brands that people buy
. . . it’s probably no surprise to anybody that we are much more likely to buy the brand that we’ve heard of than the
brand that we haven’t . . . the brand we have some familiarity with, either through past experience or through
advertising we’ve seen. . . . And when you consider how many billions of dollars get spent on advertising . . . we can
ask, does all that advertising really work? And the answer is clearly yes. . . . It builds in us a sense of familiarity that
shapes the way we spend our money without our even realizing it. . . . Other research shows how shoppers can be
influenced to make impulse buys just by the way items are placed in the grocery store . . . which ones are on lower
shelves and which ones are on higher shelves . . . which items are on the end caps of aisles and which ones are
placed on central display. . . . And there’s a reason why the candy is placed at the checkout counter . . . to create an
impulse to buy candy as a small reward at the end. . . . And when you ask people why they chose that product over
the other one, most of the time they say, “I really don’t know. . . .” And another easy example of how much of what we
experience is driven without much awareness . . . is how often people react to someone that reminds them of
someone else they know as if they’re that person. . . . So they may take an instant liking to someone that reminds
them of someone they like . . . or they may take an instant dislike to someone that reminds them of someone they
really don’t like. . . . And it’s not a conscious or deliberate process of saying to yourself, “I’m going to like this person
because of the way they remind me of someone else I like.” . . . It just happens automatically as an impulse to react. .
..

Theme: Amplifying the Space Between Perception and Reaction

And when you’re sitting quietly, focusing the way you are right now . . . you have an opportunity to discover
something really important . . . and it can be a really profound discovery when you start to recognize . . . that there is
a space that exists in between a thought or a feeling and a reaction. . . . It’s the space, that all-important moment,
where someone becomes aware and feels an impulsive drive to say or do something . . . that sometimes may not be
the best thing to say or do. . . . But now you discover that there’s that important moment . . . that can seem longer and
longer as you become more skilled in using that moment. . . . You can develop a sense for that moment where you
can pause long enough to choose first whether to react to something. . . . And, if so, then how to react . . . even in,
and especially in, difficult situations . . . that require something more thoughtful. . . . What an extraordinary capacity
you are born with to take that space in between a thought or a feeling and a reaction . . . and to use it skillfully . . . to
first choose wisely whether to say or do something . . . and then, if so, what to say or do that will serve you best in
that situation. . . . I can tell you about an experience that a friend of mine had not long ago. . . . He had just gotten a
new sporty little car . . . a beautiful car that could really reach high speeds effortlessly . . . and he was driving along
happily, not really paying attention to how fast he was going on the freeway. . . . And the next thing he knew there
was a siren blaring . . . and when he looked in the rearview mirror, he saw a police car behind him with lights flashing
. . . and his heart sank as he knew he had to pull over. . . . He went through a quick series of feelings of being angry,
then scared, and then angry again. . . . But he pulled over, and though he felt barely in control of his emotions . . . he
prepared himself to face up to whatever would happen next. . . . The police officer came up to his window and made
the usual request to see his driver’s license and car registration. . . . The officer was very polite but also very clear
that my friend deserved and was going to get a speeding ticket. . . . Well, nobody wants a speeding ticket, and
everybody tries to talk the officer out of it . . . which is what my friend tried to do. . . . “Gee, Officer, it’s a new car. . . .
And I didn’t really know how fast I was going. . . . And gee, Officer, I was in a hurry and I just wasn’t paying attention
and I’m sorry and gee, Officer . . .” and all the other excuses he used to try and change the officer’s mind. . . . And
when the excuses didn’t work, my friend got angrier and angrier, and he really wanted to argue with the officer. . . . He
really wanted to argue because he was so mad . . . and somehow, as much as he wanted to argue, he soon grew
quiet and accepted responsibility for his mistake of driving too fast. . . . And when he was given the ticket, he took it
politely, and the episode was over. . . . And when I saw him later that day, he was still angry about the whole thing. . .
. He thought he deserved a break. . . . And when he was describing to me how he wanted to yell at this officer and
how he wanted to shove the ticket right back in his face, but didn’t . . . I asked him, “As angry as you were, why didn’t
you vent? Why didn’t you yell at him? Why didn’t you get angry? . . . And he thought about it for a moment . . . as if
he’d never really considered this question before . . . before he simply said, “Because it would have just made things
a lot worse.” . . . Take a moment now and consider that answer. . . . “It would have just made things a lot worse.” . . .
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Theme: Impulsivity Is Overcome by Anticipating Consequences
He was no longer responding to his feelings in the moment, was he? . . . Instead, much to his credit, he was thinking
ahead in that angry moment about the possible consequences of following his impulse to lash out . . . acting on his
impulse to vent his anger. . . . And that automatic jump into an awareness of consequences was what allowed him to
contain his angry impulse and set it aside for a much better outcome. . . . Well, that’s a really interesting shift in
awareness from the immediate to the eventual. . . . And if you think about the people that you know who are effective
. . . they follow that same model. . . . They use their capacity for thinking ahead and containing the impulse of the
moment. . . . You might find it quite interesting and helpful to know that there’s a very famous set of psychological
experiments conducted by a psychologist named Walter Mischel. . . . They are well-known experiments that have
come to be known as the marshmallow experiments. . . . And when he first did these experiments decades ago, he
was working with young children ages 4 and 5. . . . And it was unbeknownst to them, of course, at that young age,
that this was an experiment in studying delayed gratification . . . the ability to resist an impulse for some greater gain. .
. . So he sat them down at a table and talked with them a little bit . . . and then he presented them with a
marshmallow, a favorite snack of kids in those days and still a favorite for some kids. . . . Then he told them, “I’m
going to give you one marshmallow right now that you can eat right now if you’d like . . . but I’m going to leave the
room for a few minutes, and if you haven’t eaten that marshmallow while I’m gone, I’ll come back and give you a
second marshmallow, and then you can have two instead of one.” . . . Well, there were some children who gobbled
up that marshmallow without even thinking, as soon as he left the room . . . and there were other kids who sat and
looked at the marshmallow and smacked their lips but managed to wait until he came back. . . . You could tell they
clearly wanted it right now, but they demonstrated even at that young age . . . the extraordinary ability to set aside the
impulse to eat the marshmallow now . . . in order to have two by waiting just a little while. . . . Now, that’s interesting
that some kids could do that . . . but what was even more interesting was how Walter Mischel followed these kids all
the way into adulthood to see how their lives would turn out . . . and then he wrote a book about it that came out not
long ago . . . and what he discovered, to no one’s surprise, is that the kids who could delay gratification . . . who could
think beyond the impulse of the moment . . . were more likely to build careers instead of just having jobs. . . .
Consequently, they were likely to make more money and live a more comfortable lifestyle. . . . They were more likely
to be physically healthy and didn’t smoke or drink or overeat . . . and that ability to think beyond the moment governs
so much of the quality of life. . . . The people who are willing to go to school, trade school, college, whatever, and
endure the hours, weeks, and months and years of class time . . . and endure all the demands and stresses of school
such as writing papers and exams . . . they give up some comfort now because they want something greater later in
terms of a higher quality of life. . . . Likewise, consider the people who carefully guard their health . . . who have the
impulse to eat favorite junk foods or drink lots of alcohol . . . but in that space, that important moment in between the
impulse and the reaction . . . is the thought, the deeply held belief, that their longer-term health matters more . . .
much more . . . than the impulse to put junk into their body . . . and there’s a lot to learn from these experiences and
how people handle them with finesse. . . .

Theme: You Can Become More Future Oriented

And for you now to be aware of that wonderful moment, that space in between the impulse and the reaction . . . draws
your attention to how you can become more oriented to the future . . . more oriented to the consequences, the
eventual consequences of the decision you make in that moment . . . than you are to the immediate feeling or
impulse. . . . You see, you can have a flash of anger, but you can let it pass in order to handle the situation more
calmly . . . and gently. . . . It means you can have a flash of fear and you can quickly set it aside . . . because there’s
something important to be done . . . something more important than just being afraid and lashing out in fear. . . . And
it’s all about making these sorts of forward-looking choices about the best eventual consequences that you get to
make in that special moment . . . in that sizeable space in between your initial impulse and what you then actually say
or do. . . . And as you get better and better at using that space wisely . . . that’s what allows you to gradually develop
a genuine sense of pride in yourself and how you react under pressure . . . embodying the phrase “grace under
pressure.” . . . The pride that develops in you when you can think beyond the impulse and when you can routinely find
that space in the moment where you can jump ahead in your awareness . . . and handle your feelings and reactions
in ways that you respect in yourself. . . . And by making choices beyond the moment, you have the ability to not just
feel better, but to actually be better. . . . And it might occur to you that there’s still another benefit to using that special
space in between impulse and reaction. . . . It’s the ability to prevent regret because you didn’t say careless words
and because you didn’t overreact emotionally. . . . Instead you were careful . . . and you were thinking beyond the
moment. . . . And doesn’t it feel wonderful when you can handle a situation well and actually like what you did there
because you let your cooler head prevail? . . . The ability to prevent regret is a huge and valuable gift to yourself. . . .

Posthypnotic Suggestions for Integration

You know as well as I do . . . that everyone has impulses . . . including self-destructive or simply foolish ones. . . .
Everyone, in one way or another, wants the marshmallow now. . . . Some people want the drink now. . . . Others want
the drug now. . . . Others want the sex now. . . . Others want the freedom to do whatever they want now . . . even if it
hurts others or themselves. . . . But what it’s really about to live well . . . is to go beyond the impulse . . . go beyond
being driven by emotions and unconscious forces that you don’t even understand or don’t even recognize until much
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later, if ever. . . . And so right now, you’re learning something really important . . . that you can absorb deeply and use
well for the rest of your life . . . that you have the space and the time to make better choices . . . choices that help
create the kind of future you’ll be happy to live in. . . . And you can use that space and time more automatically . . . in
ways that you’ll find satisfying . . . letting your cooler head prevail. . . .

Closure and Disengagement

It’s nice to have had the time to explore within yourself and discover abilities you didn’t necessarily know you have. . .
. And it’s these new awarenesses that you can bring back with you when I invite you to reorient yourself in just a little
while. . . . But first, it’s a good use of time to bring this session to a comfortable close . . . an unhurried time to enjoy
the sense of comfort you’ve developed and bring it with you when you reorient. . . . And when you’re ready to bring
this session to a close . . . you can begin the process of slowly moving your body as you bring yourself back to your
usual state of alertness . . . reorienting fully now and opening your eyes . . . alert and comfortable. . . .

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Chapter 9

Facilitating Compartmentalization
In fact, we are each a confederation of rather independent modules orchestrated to
work together. . . . There is not one centralized system working to produce the grand
magic of conscious experience.
—Michael Gazzaniga, The Consciousness Instinct

The Case of Bradley

Bradley, age 32, is the father of two young boys, ages 5 and 7. He has come to therapy with the report of being
a “self-described wimp as a dad.” Bradley describes his marriage to Jeanette of almost 10 years as a happy
one. He says there is “nothing deeply wrong” that brings him to therapy right now, but he is aware that if he
doesn’t get a good handle on one of his troublesome issues, his family might suffer as a result. He’d like to
prevent that from happening.
Asked what it means to be a “self-described wimp,” Bradley began by first making sure I knew that he wasn’t
“always a wimp everywhere.” He said he was just a wimp with his sons, an observation that Jeanette had made
many times that he brushed off as nothing to take very seriously. He thought he was just being a good dad.
I inquired, “What changed that brought you here?” Bradley again assured me that he wasn’t really a wimp but
said that he had handled an interaction with one of his sons quite poorly. Jeanette expressed a great deal of
disappointment, and it just added to his own poor appraisal of his behavior.
He got to the story that illustrated the problem and led him to see me: His younger son, Timmy, had found a
lighter somewhere, who knows where, since neither he nor Jeanette smoke. Timmy was playing with the
lighter, and no one was in the room to see it happen, but he set fire to the couch, and it quickly began to fill the
room with smoke. The smoke detector went off just as Timmy was screaming for his mom and dad, and
pandemonium broke loose. Fortunately, Bradley had a fire extinguisher nearby and was able to get to it quickly
and extinguish the flames. Everyone was okay, which was the primary consideration, of course. But in the
immediate aftermath, when Bradley should have had lots to say both verbally and nonverbally, he went AWOL.
He didn’t say anything, didn’t do anything, just froze as his mind spun with the question, “What am I supposed
to do here?”
Jeanette, on the other hand, went into high gear. She grabbed the lighter, with her face all about a controlled
fury, before she erupted into shouting at Timmy about what he’d done and the tragedy that could have
happened and the damage that did happen, and so on, and so on. Bradley watched the eruption and said
nothing. Timmy was appropriately upset and crying. His brother was conspicuously missing in another part of
the house. Jeanette was red faced with anger, and Bradley was all but invisible. It was in that moment, a greatly
amplified moment related to other similar AWOL moments, that Bradley wondered about his fitness to be a
parent to his boys. Jeanette was sorry to have to admit to him that she wondered the same thing.
Bradley enjoyed the fun of being a dad. He liked the roughhousing, tossing around a ball together, teaching
the right way to field a ground ball. But when it was time to provide some discipline, Bradley just couldn’t seem
to get the job done. He said, “It makes me feel like I’m abusing them if I yell at them or punish them. They’re
really good boys, so I rationalize their occasional bad behavior as ‘Oh well, boys will be boys.’ ”
So, what’s Bradley’s issue with providing parental discipline? Is he simply conflict avoidant? Was his
relationship with his own father marred by harsh punishments, and he’s overcompensating as a result? Is he
fearful his boys will withdraw their love from him if he disciplines them and then won’t want to be with him
anymore? Does he fear honesty and the intimacy that goes with it? Is he afraid he’ll scar them for life and be a
failure as a dad? Does he have an unconscious ambivalence about being a dad that leads him to withdraw from
the tougher parts of the job? Or what?
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 The content of Bradley’s problem is his difficulty with providing necessary discipline to his boys. The process
of his problem is his internal orientation, his using his feelings to inform his actions or lack thereof. It doesn’t feel
good to him to discipline them, so he doesn’t.
If you were to get a thousand parents in a room and ask them the question, “How many of you enjoy
disciplining your child?,” it’s a pretty safe bet no one will raise their hand. Hugs and kisses are wonderful; yelling
and punishing not so much. But parents do it because it needs to be done. If you want to raise a personally and
socially responsible child, meaning they have clear boundaries that define right and wrong, acceptable and
unacceptable, then discipline provides those boundaries.
The use of hypnosis to facilitate compartmentalization skills becomes essential in cases such as these, that
is, people who don’t do what makes them uncomfortable even though it needs to be done.
Compartmentalization skills mean breaking a global experience down into its components. In Bradley’s case,
there are his child’s intentions, the behavior arising from those intentions, the message the child is sending
through his behavior, the impact on other people and the environment, the message that is sent back if you do
or don’t react, the absorption or dismissal of that message regulating learning from feedback, the applicability of
that lesson in other contexts that will arise, and how that confirms or contradicts previous messages. There’s a
lot going on in an interaction. And yet another component is Bradley’s feeling state in response to his son’s
behavior.
Of all the things Bradley could be focused on, though, it’s his focus on his feelings of distaste for discipline
that governs his response. He doesn’t want to, doesn’t like to, and so he doesn’t. Hypnosis to facilitate
compartmentalization was used with Bradley to make one vital point: There are things more important than your
feelings. One of those is helping your sons develop a moral code, a greater sense of right and wrong, and the
desire to consistently do what’s right. The suggestions that dominate compartmentalization sessions revolve
around the message that “there are many different voices speaking at one time: the voices of reason, passion,
fear, optimism, others’ judgments, . . .and so on. And you get to choose—you get to choose—which voice to
listen to that will serve best in a given situation.”
The problem isn’t that Bradley has a voice inside his head that says, in essence, “Look the other way.” The
problem is that he listens to it. The hypnosis session with Bradley gave voice to these different parts of his
experience and the different parts of the interaction and made it really clear to him that he was going to need to
consistently respond to the voice that would serve to improve his sons’ character rather than responding to the
voice that made it easier for him to ignore and thereby indirectly sanction bad behavior.
In the span of just a few sessions, Bradley developed full clarity about what it would mean to set aside
(compartmentalize) the voices of fear or convenience and focus on and respond from the voice encouraging
good character in his sons instead. From that vantage point, it became instantly clear to him what needed to be
said and when. His worst fears about being a disciplinarian never materialized. In his own self-satisfied words,
he said, “My wimpy days are over.”

The Role of Compartmentalization in Quality of Life

Every person plays multiple roles in life. One can be someone’s child, parent, grandparent,
spouse, employer, employee, friend, and so on, living through each day juggling the different,
sometimes conflicting, demands that accompany each role. Some roles are chosen; some we are
born into. Some endure a lifetime; others are transient. Some are very clearly defined with
unambiguous expectations of what that role requires; others are so fuzzy that we stumble through
them trying to do our best.
When someone must manage many different roles in relationship to other people and
institutions, it helps considerably to know which role(s) one is in at a given moment and what
behavior best serves the demands of the situation. Similarly, when each person is made of many
different parts on many different levels of experience, how we learn to recognize, develop, and
value our different parts is a strong indicator of having a refined self-awareness. How we then
come to understand the necessity of knowing which part(s) of ourselves to express and,
conversely, which to suppress, in a given circumstance is a powerful force in shaping our quality
of life. Having the insight and foresight to know, for example, that “now isn’t the time to kick

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him when he’s down” means suppressing anger at some hurtful or self-destructive decision that
person made and focusing on expressing compassion instead.
This sophisticated skill is made possible only when someone has the ability to
compartmentalize experience. Compartmentalization, discussed briefly in Chapter 4 and
elaborated here, is the ability to break a global experience, such as an interaction in which one is
feeling emotionally upset or threatened in some way, into its component parts. Instead of
responding to the entirety of some experience, whether internal states or external circumstances,
since they are two sides of the same coin, compartmentalization skills empower you to determine
which part of yourself to respond to and which part of yourself to respond from.
Consider these two common examples: (1) Therapists routinely tell their anxious clients, “Feel
the fear but do it anyway.” Unless a client has the ability to compartmentalize and set the fear
aside sufficiently well to keep their focus on taking effective action, their unrestrained fear can
easily paralyze them into inaction. (2) Consider how often the biggest regrets people have result
from their “moment of weakness” when they gave in to the part of themselves that enabled them
to cross a line that shouldn’t have been crossed. Whether the part that proved destructive was
anger, lust, greed, need for approval, selfishness, or some other part, focusing on it, rather than
away from it, and thereby giving it greater power had unfortunate consequences.
The ability to compartmentalize allows for a skillful divide-and-conquer strategy, an ability to
deliberately detach from one element of experience in favor of connecting to another element
that will be more beneficial. It stands in direct contrast to entire therapy approaches built on the
self-limiting one-dimensional notion, for example, that you should always focus on the
cognitions or on the emotions of the client simply because that is your preferred treatment
approach. It is a simple truth that each part of a person is valuable someplace, sometime, but not
every place all the time.

Compartmentalization and Dissociation in Hypnosis

Compartmentalization is the everyday term for dissociation that practitioners of clinical hypnosis
use in their professional nomenclature. From the earliest days of hypnosis as a therapeutic tool in
the late 19th century, advanced by the famed neurologists of that era, including Pierre Janet,
Jean-Martin Charcot, and Hippolyte Bernheim, the process of dissociation was a primary focus
of inquiry. The use of hypnosis revealed remarkable displays of compartmentalization, or
splitting off, of core elements of mental experience including memory, perception, sensory and
motor functions, and even personal identity. Normal individuals, while dissociated during the
experience of hypnosis, could isolate and amplify elements of experience, increasing or
decreasing their magnitude of influence in response to suggestion. Dissociation is now the basis
of modern inquiry for this reason.
One of the more influential models of hypnosis that refined Janet’s pioneering work is called
the neodissociation model. It was primarily developed and advocated by experimental
psychologist Ernest Hilgard, who, along with research psychologist André Weitzenhoffer,
founded and ran the famed Stanford Laboratory of Hypnosis Research. Their lab was the center
of the hypnosis universe for decades, producing some of the highest-quality research into
hypnotic phenomena. Hilgard’s research into what he perceived as hierarchically organized
networks of functionally specialized and reciprocally connected neural processes set the stage for
today’s cognitive neuroscience. Through the use of technologically sophisticated brain-scanning
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devices (fMRI, PET, SPECT, etc.), serious neuroscientists are now addressing basic but utterly
fascinating questions raised by hypnosis such as, What goes on in the brains of people capable of
experiencing suggested anesthesia sufficient to tolerate surgery without a chemical anesthetic?
The ability to detach from painful sensory cues and maintain comfort is a remarkable display of
dissociation in hypnosis. It highlights Hilgard’s insight when he concluded that “the concept of a
totally unified consciousness is an attractive one but does not hold up under examination” (1994,
p. 38). Researching how the mind influences the brain makes for endless fascination.
In the early days of hypnosis, however, dissociation was viewed only through the lens of
pathology. Unfortunately, it is still true today that most clinicians’ training includes
consideration only of the pathological forms of dissociation, such as dissociative identity
disorder (DID), depersonalization, psychogenic amnesia, fugue states, and the like. There is a
sharp distinction to be made, though, between pathological and nonpathological dissociative
experiences. Psychiatrist Richard Chefetz summarized this point well when he wrote the
following:

Dissociation is not just a marker for life experience gone poorly. Dissociative process is something we use every day as we
unconsciously sort salience in the flow of consciously and unconsciously perceived mental input. Associative process alerts
our awareness that something is worth noticing. Dissociation tells us we need not pay any attention. The healthy result of
this sorting is a coherent mind. (2015, p. 1)

Dissociation and association inevitably coexist across all experiences because, as we pay
attention to (i.e., associate to) this, we no longer pay attention to (dissociate from) that. The
general function of any hypnosis session then, process oriented or otherwise, is to use the
dissociated experience of hypnosis to help the client detach from whatever needs to be detached
from (e.g., a hurtful memory, a physical pain, a cognitive distortion, a destructive impulse) and
attach to some other element of experience that will be helpful.

The Role of Detachment (Dissociation, Compartmentalization) Across

All Therapies

It can be especially enlightening to recognize the essential and therapeutic role dissociation plays
in all forms of treatment, whether the practitioner realizes it or not. Consider the 10 different
therapies below and how a primary message of that model reflects a need for dissociation from
what isn’t helpful in order to suggest a new reassociation that can be.

Cognitive-behavioral therapy (CBT): “You are not your thoughts” highlights the standard
practice in CBT of helping you detach from cognitive distortions you hold and then reattach
to a more objective, rational perspective.
Emotion-focused therapy (EFT): “Focus on the feeling beneath that behavior” is the
standard practice of EFT, encouraging you to separate from the surface emotion in order to
become aware of and associate to the underlying emotion.
Ego state therapy: “Which part of you tells you that?” is a standard question that encourages
identifying a part that can be detached from the whole and given its own identity and
purpose to address in treatment.
Psychodynamic: “Your unconscious need has motivated you to do that” suggests detaching
from the need-driven dynamic and associating to new insights to guide future responses.
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 Gestalt: Suggestions such as “It seems your hand is trying to tell you something” encourage
the client to detach from the lack of personal awareness and associate to messages from
within that can guide reactions with greater self-understanding.
Mindfulness: “You can focus on forgiveness” is a typical suggestion to detach from anger
or the desire for revenge and instead focus on and associate to a higher-level response of
compassion and forgiveness.
Acceptance and commitment therapy (ACT): A suggestion that “you can focus on
acceptance” encourages the client to detach from their unrealistic expectations and
subsequent disappointment and associate instead to the perceptions that life isn’t fair and
acceptance will serve you better than fighting against that which you cannot change.
Dialectical behavior therapy (DBT): “You can watch the impulsive message go by as if on a
sign carried by a parade marcher” is a typical suggestion for detaching from your thoughts,
especially the ones that drive hurtful emotional responses, and instead associate to the
imagery of thoughts being outside of you in the comfortable distance.
Ericksonian hypnosis: “Your unconscious is smarter than you are” is an indirect suggestion
to detach from a reliance only on your conscious mind and instead associate to or recognize
that you have other, hidden resources that can surface from your unconscious when needed.
Strategic therapy: “When you carry out the task, you’ll discover something important” is a
standard line that helps detach the client from the passivity fueled by negative expectancy
and associates the client to the belief that effort will be rewarded with a new and valuable
understanding.

Each approach differs in the content of what it strives to dissociate in the client’s experience as
well as what it strives to associate them to that would be helpful to them. But the process of
dissociation and association is clearly evident in each approach.

Dissociation Is Evident Even in Routine Hypnotic Suggestions

Beyond the role that dissociation plays in psychotherapy in general, you can see its role in many
of the most basic suggestions commonly used in the clinical applications of hypnosis. Consider
the following examples:

“Focus on your breathing” suggests separating one’s attention on breathing from other
ongoing elements of experience that can recede into the background.
“Focus on your experience as it unfolds right now” suggests separating one’s attention from
the past or future.
“Your unconscious can listen even while your conscious mind drifts off” suggests
separating conscious from unconscious processes.
“You can be willing to experiment with new experiences” suggests separating yourself from
an attitude of certainty.

Suggestion in treatment is, of course, inevitable. In the practice of hypnosis, suggestion is

especially well-recognized, and as soon as we say, “Here . . . focus on this,” we’re encouraging
not focusing on that.

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 Typical Problems Derived From Either Over- or
Undercompartmentalization

The types of problems that people might present for treatment that reflect compartmentalization
issues can seem quite diverse. In part that’s because the compartmentalization can take either of
two primary forms: experience that is undercompartmentalized or experience that is
overcompartmentalized. Undercompartmentalization is reflected in global or overgeneralized
responses where it is clear the person can’t separate out the different components of their
experience. Global cognitive style, almost by definition, precludes effective
compartmentalization. Some examples of undercompartmentalization patterns would include the
following:

The inability to separate the past from either the present or the future (as in PTSD and
depression)
Emotional overreactions (as in rage or panic or too much “feeling your pain”)
A lack of emotional differentiation (as is typical in self-harm)
Taking things personally that aren’t personal
A lack of critical thinking, impairing the ability to separate facts from feelings
A lack of personal boundaries or recognition of others’ boundaries

Overcompartmentalization means the boundaries that separate one experience from another
are overly rigid, thereby preventing an effective crossover of learning from one experience to
another. Someone who overcompartmentalizes generally fails to recognize how experiences are
similar or related, and responds to them unrealistically as a result (e.g., behaving badly but
thinking you’re still a good person and it shouldn’t affect how others see you). Some examples
of overcompartmentalization patterns would include the following:

An inability to detect gradations or degrees of experience (as in not recognizing rising stress
levels until they reach a critical point)
An inability to consider or learn from past experiences
Emotional underreactions and lack of empathy (as in, “That’s your problem . . . tough
luck!”)
An ability to rationalize or justify bad behavior
A global perfectionism (as though anything less than perfect is terrible)
Rigid personal boundaries or rigid expectations of how others should behave

Defining the Salient Therapeutic Targets

When formulating a treatment plan, the clinician is likely to be contemplating an answer to these
two questions: What do I want to help the client dissociate from? And what do I want the client
to associate to?
Every experience has a variety of components. The essence of people’s problems is that they
associate to parts of their experience that work against them. This makes it easy to appreciate
how people’s problems are largely problems of focus: The person focuses on the unchangeable
past instead of the possibilities that can exist in the future, or focuses on what’s wrong and never
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seems to notice what’s right, or focuses on their feelings when they would be better off thinking
rationally (or vice versa), or focuses on others when they’d do well to focus on themselves (or
vice versa).
This is one of the primary reasons why hypnosis is such a valuable treatment tool. What
hypnosis does so very well is grab people’s attention, wherever it is directed, and redirect it to
some element of experience that will serve them better. The primary goal of
compartmentalization is to shift focus toward (i.e., “give voice” to) a specific element of
experience previously either underrepresented or ignored altogether. To shift someone’s focus
from what’s wrong to what’s right, for example, can have lasting impact on the person’s outlook,
as techniques like the empirically validated gratitude journal (writing down at least three positive
things, however big or small, that happen each day and doing so for at least 6 months) show us.
Hypnosis can increase the magnitude of the perceptual shift to noticing what’s right as well as
the emotional impact of doing so. The dissociation from the old and the association to the new—
the compartmentalization of past perspective away from the new—reflects good therapy.
A second reason why hypnosis is so valuable also relates directly to compartmentalization and
has to do with the client’s resources. Therapists routinely talk optimistically about their clients’
innate personal resources and the role of therapy in helping people connect to and develop them.
That raises a fundamental question: If people have resources, then why don’t they use them? The
answer should be apparent: Because the resources are dissociated—meaning there is no link, or
trigger, to associate to them in some desired context (i.e., overcompartmentalized). Clinically,
the goal is to connect people to their resources and place them in context. Hypnosis is especially
well suited for that task, since people in hypnosis can readily access personal resources that they
didn’t know they had. You can imagine what it’s like for someone in pain, for example, to
discover their ability to generate hypnotic anesthesia during a hypnosis session. Once again,
dissociation and association must be viewed as the core elements of effective psychotherapy.
Thus, the goal in a process-oriented hypnosis session is to help the client dissociate from
whatever they are currently associated to that is working against them. What they’re associated
to (e.g., their specific feelings about some person or situation) is the content of their problem or
issue. How you dissociate them from that element of experience and reassociate them to some
better, more adaptive element of experience is the process. As long as it’s clear what you want to
bring into the foreground of the client’s awareness (e.g., effective action) and what you want to
help recede into the background (e.g., exaggerated fear), this process-oriented hypnosis session
can be most valuable. Table 9.1 offers a generic structure for helping clients evolve
compartmentalization skills.

TABLE 9.1. GENERIC SESSION STRUCTURE FOR FACILITATING

COMPARTMENTALIZATION

Induction

Response set: Specific components of global experience

Theme 1: Every experience is composed of multiple components
Theme 2: What you focus on—or away from—shapes your reactions
Theme 3: Prioritizing helps compartmentalize what’s unhelpful
Theme 4: Compartmentalizing your feelings when difficult choices need to be made

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 Posthypnotic suggestions for integration
Closure and disengagement

SESSION TRANSCRIPT

Induction
You can begin by taking in a few deep, relaxing breaths . . . and as the experience of focusing your attention
becomes increasingly familiar to you . . . you can more easily and more readily . . . begin to build a deep sense of
growing quieter inside . . . your thoughts slowing down . . . your inner voice gradually quieting to a gentle whisper. . . .
Each breath . . . can relax you.. a little more deeply. . . . It’s easy to enjoy the simple rhythm . . . the symmetry of
breathing . . . each breath in . . . taking in a deeper level of comfort . . . and each breath out . . . letting out . . . what
you really don’t need. . . . And so each time you inhale . . . it can allow your body . . . to grow more comfortable. . . .
Each breath out . . . provides a soothing release . . . allowing you the comfort . . . of knowing that this time is for you. .
. . This experience is for you . . . and that you’ve created this time . . . to just . . . provide some space . . . space to
relax . . . some room to learn . . . and grow . . . perhaps from things you hear me say . . . but more importantly . . .
from things you come to realize. . . . And when you have a calming experience like this one . . . there’s a moment-by-
moment . . . flow . . . to your thoughts . . . a moment-by-moment . . . flow to the session . . . and at the same time . . .
there’s a purposefulness to the session . . . that goes well beyond being just a relaxation session. . . . Although it
certainly is wonderfully relaxing . . . it’s more . . .much, much more. . . .

Building a Response Set Regarding Specific Components of Global Experiences

Because when you have an experience like this one . . . there are so many different aspects to it . . . just like any
experience that has some complexity in its makeup. . . . There are different facets to the experience. . . . So in this
experience right now . . . one facet is your internal dialogue, the things you say to yourself as different thoughts pass
gently through your awareness . . . the ongoing conversation in your mind that is simply the process of thinking . . .
and perhaps even going from thinking to realizing. . . . There’s also the facet of the external dialogue . . .my voice . . .
my words . . . reassuring you . . . encouraging you . . . providing you with possibilities for feeling better . . . and being
better. . . . There’s also the facet of the external environment . . . such as the everyday sounds of the routine aspects
of life that go on around you . . . whether it’s the sound of the wind in the trees . . . or birds singing . . . or the distant
sounds of traffic . . . or the sound of a dog barking or the sounds of kids playing . . . or even just the sounds of the
stillness of the environment. . . . But all of that is outside of you . . . such routine background sounds that they’re
hardly worth noticing . . . and simply pass through your awareness as you grow even more absorbed inside . . . and at
the same time you begin to recognize these facets of experience as you grow more focused. . . . There’s also the
facet of your internal environment . . . the quality of feelings . . . that you experience as your body relaxes . . . the
sensory awareness of what it’s like to have your breathing slow down . . . the pleasurable feelings of your muscles
relaxing as you become more still. . . .

Theme: Every Experience Is Made of Multiple Components

And as your thoughts continue to slow down . . . and you experience the comfortable flow . . . of just being with
yourself in a way that’s . . .easy . . . and relaxed . . . you can come to an important realization . . .that whatever
experience you happen to be in . . . there are many different components . . . many different components that
combine to make up the full experience. . . . When you do something as routine as watch a movie . . . you’re not just
watching a movie. . . . You’re processing experience on many other levels as well . . . even if you don’t realize it . . .
because there are many different components to a movie. . . . Certainly there are the visual images that flash across
the screen . . . the things you watch . . . but those images . . . are a trigger . . . a catalyst . . . for your emotional
reactions . . . the way you react to the things you’re watching. . . . So when you watch a really funny comedy . . .
there’s obviously a quality of humor that leads you to smile and laugh without effort . . . the silliness or perhaps the
wittiness or maybe the absurdity . . . whatever that quality is that makes something seem funny to you . . . and it isn’t
just images that trigger feelings. . . . There’s the carefully chosen music in the soundtrack . . . and also the sound
effects . . . that make it abundantly clear . . . that it’s a comedy. It’s meant to be funny and taken lightly . . . or that it’s
meant to be taken seriously when you’re watching a drama. . . . And the movie’s characters inspire reactions through
the way they endear themselves to you or anger or alienate you. . . . So there are the feelings in the moment . . . but
movies can also be a catalyst for memories . . . as you remember . . . things from your own experience that might
relate to what you’re watching. . . . And if you’re watching with someone else, there’s a relationship component to the
experience. . . . The movie keeps you connected to one another by sharing the experience . . . the social side of
watching a movie together. . . . So there’s images, sounds, feelings . . . reactions, memories. . . . It’s much, much
more than just watching a movie. . . . And what I’m drawing your attention to in a very deliberate way . . . is that even
just watching a movie . . . like countless other everyday experiences . . . has many different components to it. . . . And

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sometimes people seem to forget . . . or just never really thought about it . . . that when there are so many different
components making up everyday experience . . . we choose . . . we can choose . . . which component to pay closer
attention to. . . .

Theme: What You Focus on—or Away From—Shapes Your Reactions

How you view the different experiences you go through each day . . . which facets of a circumstance you pay
attention to . . . shapes how you react to them . . . how connected you feel or how disconnected you feel from some
aspects of the situation. . . . Well, it’s not only about what happens in your life. . . . It’s not just an event that occurs
that you only see one side of. . . . By now you have already come to know . . . that each experience has many
different components . . . many different aspects to consider. . . . On one level, there’s what objectively happens . . .
but on another, far more important level . . . there’s your interpretation of what happens . . . the meaning that you give
. . . to different experiences . . . the part of the experience that you focus on and thereby amplify. . . . When people
face some situation that requires a response . . . you can easily see how what they focus on shapes what they
experience and how they respond. . . . It’s interesting to observe how some people focus on . . . trying to figure out
what the most effective response might be to what’s happening . . . while someone else gets wrapped up in how it
makes them feel. . . . Someone else immediately starts to focus on what to do next . . . and someone else focuses on
. . . the uncertainty and feelings of inadequacy when the solution isn’t immediately obvious. . . . And so it becomes
very important . . . very important . . . to remind yourself . . . at any given moment . . . that you can actually choose
which aspect of an experience to focus on . . . what the best response is . . . which is a different focus than how it
makes you feel. . . . What the most skillful way of handling something is . . . which is different than how it makes you
react. . . .

Theme: Prioritizing Helps Compartmentalize What’s Unhelpful

And the more that you begin to focus yourself on regularly asking yourself the question . . . “What’s the best response
here?” . . . focusing yourself on what is going to . . .effectively empower you . . . to say or do something to yourself or
others . . . that rivets your attention . . . to a response you can feel good about. . . . Even if it isn’t comfortable,
necessarily, but is still an effective response. . . . And then you discover how you can set aside feelings of upset or
fear . . . how they recede into the background as you focus on what’s best or most helpful right now . . . aware of your
feelings, of course . . . but comfortably distancing yourself from them as you handle well what needs to be handled . .
. instead of simply reacting as if you have no choice but to be upset or anxious. . . . You have a choice to focus inside
or outside . . . on feelings or taking meaningful action . . . and much more often than you ever realized before . . . the
more that you focus outside . . . with the goal being doing or saying what works best . . . in answering some person or
handling some situation effectively . . . the more you can appreciate your own skills in recognizing what to shine your
spotlight on in some situation and what to let recede into the darker background. . . . And if you think about the people
who are effective people and high-powered people . . . you watch them do exactly that. . . . Watch a skilled politician
in a debate or press conference. . . . Watch the CEOs of companies . . . who hold meetings in front of voters or
stockholders . . . and someone in the audience will ask a pointed question . . . a critical or even rude question . . . and
the person with finesse deftly sidesteps the criticism and rudeness. . . . That’s not the part of the question they
respond to. . . . Instead the part that they respond to is the opportunity to provide information . . . the opportunity to
provide perspective. . . . And so they sidestep the criticism . . . even though you can be quite sure . . . that on the
inside . . . the criticism or rudeness irritates them. . . . They have feelings . . . but they let them quickly recede into the
background as they shine their internal spotlight on the opportunity to calmly explain and to nondefensively clarify . . .
because that’s what is more important in responding in that public arena. . . . And I can give you a thousand
examples of that same kind of effective responding . . . such as a really good parent . . . whose child has just done
something wrong that angers them . . . or frustrates them because they were just so careless. . . . And even though
they have that initial surge of anger and want to . . . punish this child . . . they recognize that this is an important
opportunity . . . to teach . . . and to teach in a way that’s loving and patient. . . . Now not everyone has ideal parents
like that. . . . Maybe you did or maybe you didn’t. . . . But the point I’m making . . . is that you can have . . . a flash of
anger . . . a flash of fear . . . a flash of doubt . . . a flash of cynicism . . . a flash of pessimism . . . but what can take
hold of you almost instantly is . . . the realization that that’s not the part of you . . . that you want to respond from. . . .
You’d rather respond from a different part of you . . . perhaps by recognizing that you can also have a flash of
understanding . . . a flash of tolerance . . . a flash of compassion . . . a flash of kindness. . . . And so you can set aside
the anger or the fear or the frustration . . . and focus yourself intently . . . on providing an effective response . . . of
saying what needs to be said . . . what explains and clarifies what needs to be explained and clarified . . . what needs
to be taught and demonstrated. . . . And when you grow more comfortable . . . with breaking situations down into their
components . . . so that you’re perfectly clear . . . that, yes, there’s an emotional reaction . . . yes, there’s concern . . .
or anger or even fear . . . but what’s more important. . . . what you keep your focus on . . . is that there’s quite often
something more important . . . than getting caught up in your feelings. . . .

Theme: Compartmentalizing Your Feelings When Difficult Choices Need to Be Made

Often there’s a difficult task at hand . . . a situation to be managed that will have implications or consequences that
will endure beyond the moment, that matter more than the feelings of the moment. . . . And if you think about every
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movie you’ve ever seen where there was a hero . . . a hero that stayed focused on . . . the dangerous and even life-
threatening mission they couldn’t turn away from . . . the hero was clearly afraid. . . . You could see it in their face. . . .
Anyone could see it. . . . The hero may even have said it out loud . . . “I can’t do this” . . . when going through those
agonizing moments of self-doubt. . . . But it was their perseverance, their tenacity in focusing on the challenge. . . .
Their fear or self-doubts . . . receded into the background when they shone their spotlight on the path they knew they
had to follow. . . . Now you know that courage isn’t about not feeling fear. . . . Courage is about staying focused on the
goal . . . and it’s a powerful realization when you come to know that the only time you can show courage is when
you’re afraid. . . .

Posthypnotic Suggestions for Integration

Every day, then, you have many opportunities to recognize the different components of your interactions with others .
. . and the situations you face. . . . And as you can discover to your great satisfaction . . . you can find it getting easier
and easier to stay focused on the mission. . . . And I say the mission . . . but that might make it sound much too
important when all you’re really trying to do is . . . teach a colleague or a friend . . . or a child . . . or a relative . . . how
you want to be treated . . . or what you want them to know about something . . . or what needs to be done. . . . But it
can really be helpful to you to know that all through each day . . . you have an opportunity . . . to notice in the world
around you . . . what’s effective . . . what works . . . how people achieve things. . . . They were motivated to achieve . .
. even as they were scared to achieve them. . . . And as you come to more deeply understand and appreciate . . . that
anxiety, concern, fear, anger, worry . . . is only one part of you . . . and a part of you that’s growing smaller and
smaller day by day . . . as you make more satisfying choices about which part of you you’ll respond to and respond
from . . . as you grow stronger and more focused . . . more oriented toward recognizing what your best and most
effective response can be . . . and so being able to appreciate now that every experience has many different
components . . . what you’re learning is a way of dividing and conquering . . . reducing concerns . . . as you focus on
and amplify . . . in your awareness . . . what you want. . . . I think you’ll enjoy discovering . . . how much calmer . . .
and more focused you are. . . . And you can remember . . . this wonderful saying I learned a long time ago . . . that
obstacles are what you see, when you take your eyes off the goal. . . . And so you can be calm . . . and focused . . .
and aware of the opportunities . . . to handle situations with skill . . . and purpose . . . keeping your eyes on the goal . .
. and letting the obstacles recede into the background. . . .

Closure and Disengagement

You can take some time now to quietly absorb . . . these deep messages . . . and remind yourself many times
throughout the day to focus on . . .which components of any experience . . . will best serve . . . your needs . . . in ways
that will strengthen . . . and build your confidence. . . . And then when you’ve had enough time for now . . . to process
all these different ideas and possibilities . . . you can begin to bring this session to a comfortable close . . . at a rate
that’s gradual and easy. . . . And in a little while . . . when you’re ready . . . you can reorient yourself completely . . .
bringing back with you that sense of knowing . . . knowing. . . . And when you’re ready, you can reorient yourself
completely . . . fully alert . . . fully refreshed. . . .

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Chapter 10

Encouraging Acceptance
Now that I’ve given up all hope, I feel much better!
—Popular bumper sticker

The Case of Kathryn

Kathryn knew something was wrong when she found the lump in her breast. She had found lumps occasionally
before, but they always turned out to be benign cysts. This time, though, it felt different, and an icy feeling of
dread came over her immediately. The hoarse throat and persistent cough she’d had for weeks now suddenly
seemed ominous. She had assumed it was a low-grade cold and that her fatigue was also part of fighting it off.
Finding the lump, she told herself not to jump to any conclusions. Perhaps it could just be a differently shaped
cyst or one of a different texture, but still just a benign annoyance like the others. Despite telling herself not to
jump to any conclusions, she found herself jumping anyway. Her anxiety level rose sharply as she called her
doctor to get evaluated as soon as possible. Amazingly, she was able to get in the next day because of
someone else’s cancellation. She hoped this might be a sign of impending good fortune but didn’t really believe
she’d be so lucky this time.
By the time she and her husband, Kevin, arrived at the doctor’s office, Kathryn was barely holding it together
emotionally. She was afraid, and no amount of reassurance from Kevin could reduce her anxiety. When she
was called in to see her doctor, she was examined thoroughly. The doctor ordered a biopsy taken, and when it
eventually came back as malignant, her doctor ordered a breast MRI to determine how far the cancer had
spread. She was referred to an oncologist for treatment. Kathryn was in shock at the use of the “c” word, the
very diagnosis she had spent too many years fearing was inevitable given her history and her family history.
Inevitable had now come to pass. Now what? She could see the fear in Kevin’s eyes even though the words
that came out of his mouth were meant to be reassuring: “We’ll deal with it, honey. We’ll deal with it.”
She was given the news by her oncologist that she would need to have a total mastectomy of the one breast
where the lump was found, but it was also recommended that she have a preventive (prophylactic) mastectomy
of the other breast to reduce the risk of additional cancer. She went instantly numb. What was she feeling now?
Her brain was racing at top speed, too many thoughts shooting back and forth to even know what she was
thinking, much less feeling. Kevin held her hand tightly, actually too tightly, and she had to loosen his grip.
When she looked at him, he had tears in his eyes but a forced smile as he said, “We’ll deal with it, honey. We
will, and you’ll be okay.” Her oncologist watched this interaction she’d seen a thousand times before but was
still touched by their connection. She was glad Kathryn had a loving husband’s support.
When Kathryn came for therapy, she had already had the double mastectomy. She’d had it only a short while
before and was having great difficulty coping with what had happened to her. She felt the body she’d lived in for
the past 52 years was now unrecognizable to her. Beyond that, it was also unacceptable to her. She had
always overreacted, it seemed, to every little sign of her body aging, but that was small stuff by comparison.
Following the double mastectomy, she felt she lost so much of herself and that she could never look at herself
in a mirror again without feeling revulsion. She had always felt good about her body, and took pride in her
appearance, felt attractive to Kevin, and together enjoyed a rewarding sex life. Now? She was sure all that was
gone.
As Kathryn described her despair and her inability to move on, she also expressed anger at well-intentioned
people who said, “Focus on the positive. You’re alive. All you lost was some tissue, and doing so saved you.
You should feel lucky!” She understood they were trying to be supportive, but it wasn’t their body that had been
“mutilated,” as she thought of her own.
Kathryn’s feelings are understandable. She had been through a lot, and it had forever changed her in some
painfully obvious ways. Why couldn’t she accept what happened more readily? Is it because she defined her
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 self-worth by her body’s appearance? Is her sexuality determined by her breasts? Is it a symbolic loss of
herself, and she no longer knows who she is and fears finding out? Is she jumping to the scary conclusion that
her husband will be turned off to her, and she’ll lose his love? Is she so dichotomous in her thinking that if she’s
not perfect, she’s worthless? Or what?
The content of Kathryn’s problem is the loss of her breasts and her associated feelings of grief. The process,
though, is about adjusting to the reality of circumstances beyond your control. Consider how many more times
she could feel betrayed by her body in her lifetime: another wrinkle on her face, another varicose vein on her
leg, another brown spot dots her hands, her hair becomes thinner and grayer, and so on and so on.
The reality is, if you’re lucky enough to live a long time . . . you get old. And the older you get, the more
physical challenges you’ll face, from cosmetic to structural, from wrinkles to arthritis and worse.
Hypnosis is particularly helpful when logic is doomed to fail. Kathryn already knew at some level that she was
lucky to be alive, and she knew she was lucky to have caring and skilled doctors as well as a loving, supportive
husband. She could acknowledge “how good Kevin has been through all this.” But as much as Kathryn might
know intellectually about these things, she was still asking, “Why me?” and still wanted to fight back even
though the surgery was already done.
Hypnosis to gently encourage acceptance of a harsh reality can allow the reality to seem much less harsh.
Such sessions need to go slowly and move only gradually from less to more direct. I did hypnosis with Kathryn
several times before ever speaking directly about her loss and the process of reconstruction she’d be
undergoing. The early sessions spoke about human nature in a general way, speaking of the unrealistic and
idealistic wishes people have for a world population living in peace, the ways that most people strive to live
better lives, how people everywhere love their families, and how creative and artistic people can be in the way
they see the world.
Kathryn could easily relax and focus in these sessions, but more than that, she was starting to expand her
views beyond herself, an interruption to the self-absorption she naturally had during all she’d been through.
Examples of people adjusting to less than ideal circumstances, whether noisy neighbors or an economic
downturn or their aging bodies, held her interest, and at times she even smiled at the absurd conditions people
have to deal with, things they can’t really do anything about. She was getting calmer, less self-rejecting, and
getting much better at believing Kevin when he told her he loved her, not just her breasts. There came a
moment during one hypnosis session where she really grabbed onto that realization with both hands, and a
transformation in her view followed soon after. She understood at a much deeper level that she’s more than her
body, much more. Over the span of a month, her attitude went from revulsion to excitement about her eventual
reconstruction. Curiously, she said, “It’ll be nice to look more normal, but unexpectedly, I’m not feeling all that
urgent about it.”

The Role of Acceptance in Quality of Life

Who doesn’t wish for some things in their life to be different? Who wouldn’t love to have a
magic wand to change the things they think are terribly unfair, heal themselves or the people
they love from sickness, or obtain something deeply desired, whether it be material wealth,
power, fame, special knowledge, world peace, or spiritual enlightenment? How much focus or
mental energy people give to their wish that something will change can have a profound impact
on their general outlook on life, encompassing their relationships, level of life satisfaction,
productivity, physical and mental health, and even their political views.
Discontent with the status quo is a double-edged sword. In its favor, a desire to change
something deemed unsatisfactory provides the motivation that might well give rise to taking
action that results in an improvement. Necessity might well become the mother of invention.
Innovation almost inevitably begins with a question: How can we do this better? That’s true in
the world of technological innovations, where we want the product to be faster, cheaper, more
efficient, more something. It’s equally true in the social realm when we strive for better: fighting
against prejudice, striving for better care and more humane treatment of members of our society,
generally working to create pathways of improved quality of life for people. Inspiration to want
more than what we have was captured perfectly in this popular quote from Robert Kennedy:
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“Some men see things as they are and ask why. I dream of things that never were and ask why
not.”
The other side of discontent, though, is when, instead of inspiring us, it leads to bitterness and
suffering. If you want to find someone’s dissatisfaction with some aspect of themselves or with
life itself, you won’t have to look very hard in most cases. When people don’t have as much
money as they think they should, or don’t get the lucky breaks that undeserving others seem to
get instead of them, or don’t get to do something they feel they should be able to do, whether
others like it or not, or aren’t treated the way they think they deserve to be treated, it’s easy to
understand where the frustration comes from and how it can lead to anger, disillusionment, and
even go as far as lashing out against the perceived injustice. The extraordinary political divide
we see in America today came about from a desire to break a government-as-usual system that
was the basis for too many people’s discontent.
The key question that we as clinicians need to address, then, is this one: When faced with a
problem, any problem, how shall we decide whether to strive to accept the reality of those
circumstances or strive to change them in some meaningful way instead? This is not an easy
question to answer but is a constant factor that literally defines the direction therapy will take. It
is quite different to employ approaches that strive to help someone accept some distressing
circumstance than to employ approaches that encourage a transformation of oneself, of the
circumstance itself, or a combination of the two.

Fighting Against Reality: Acceptance as a Starting Point . . . or an End

Point

I’d like to share a story here that is special to me for a number of reasons. It’s a story I first
shared in my book Mindfulness and Hypnosis (Yapko, 2011). It says a great deal about
acceptance and the quality of one’s outlook.

I was in Africa a few years ago and had the occasion to visit a small village in Zimbabwe.
The people were economically terribly poor but spiritually rich, generous in sharing their
way of life with my small group of visitors. Only a year before, the village had been lent a
hand when an international relief organization dug a well for them. For the first time ever,
they could go to the well at their leisure and pump clean water to drink. It was a daily ritual
for the village women to take their containers, walk the long mile to the well in the heat and
dust, pump vigorously to get the water into the container, then carry the heavy container
back to the village balanced on their heads. I imagined a sudden rise in neck problems
among the village women but saw no evidence of this.
I was amazed at the amount of hard work a woman had to go through to get a bucket of
water back to her home. In talking with one young village woman about this, I asked with
an expression of both awe and respect in my voice, “How can you walk a mile each way to
get water?” It was really meant as a rhetorical question indirectly expressing admiration for
her enduring the associated difficulties, but she looked at me with a gentle smile and replied
simply, “Because that’s where the water is.”

This young African woman had no anger in her, no hint of sarcasm in her voice in her reply to

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me. She modeled equanimity—she was peaceful, compassionate and accepting, both of me as a
visitor and of her life conditions as well. (Can you imagine how easily she could have worked
herself into anger and bitterness by resenting having to walk so far to do the prescribed chore of
fetching water?) When I think of what a powerful example of acceptance looks like in real-world
terms, I invariably think of this young African woman. (She, of course, has no idea that I think of
her often and in this special way.)
What acceptance means in the broadest sense is an ability to accept the reality of something,
whether it be an external situation that affects you personally, or a personal situation that is
challenging at least, excruciating at most. Fighting against reality, those factors that objectively
regulate the distressing circumstance, can be seen as a desperate flailing away with no possible
path of resolution, resulting in further desperation. Or it can be a methodical and sensible plan of
attack that yields tangible positive results. In either case, acceptance is a critically important
starting point. If you accept that there’s nothing that can be done to change whatever is
distressing, then the wisdom of the bumper sticker quote at the top of this chapter becomes
apparent. If you accept that the reality is what it is, but your awareness of that reality leads you to
develop a motivation and means of changing it, the benefit is obvious. This is the basis for a
process-oriented hypnosis session that strives to encourage acceptance as a starting point and,
perhaps, an end point as well.

Typical Problems Derived From a Lack of Acceptance

The types of problems that people might present for treatment that reflect a lack of acceptance
can seem quite diverse, and may include such problematic patterns as these:

A chronic and deep-seated anger over the fact that life isn’t fair
An inability to distinguish well what is and is not controllable in some, perhaps many,
circumstances
An oft-expressed wish that things would be “the way they used to be”
An ability to justify or rationalize bad behavior with the retort, “Why should I be the one to
have to change?”
Criticism of and disregard for viewpoints other than one’s own
Criticism and rejection of others who are different (prejudices such as racism, etc.)
Exerting pressure on others with the destructive message, “You should be more like me”
Exerting pressure on themselves to be things they can’t be (e.g., perfectionism)
Rejection of inevitable parts of themselves (e.g., anger, fear)
Inability to acknowledge, much less own, mistakes
Inability to agree to disagree agreeably
Inability to distinguish accepting from agreeing with

Defining the Salient Therapeutic Targets

Australian psychologist George Burns quoted the Dalai Lama, addressing the power of
acceptance in this way: “If you have a problem that you can change, you don’t have a problem.
And if you have a problem that you can’t change, you don’t have a problem” (Burns, 2010, p.
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310). The Dalai Lama has a very good point. What complicates the issue, though, is the
considerable skill that goes into making an accurate determination as to whether a problem can
or can’t be changed.
Remember the children’s book The Little Engine That Could by Watty Piper (the pseudonym
of author Arnold Munk)? It’s a beloved classic tale of a little train engine that, despite its small
size, perseveres up a mountain in order to deliver its cargo of wonderful things to children on the
other side. As it struggles to make the climb, it repeats the mantra, “I think I can, I think I can, I
think I can.” It’s a story of perseverance in the face of adversity that culminates in a happy
ending.
The cartoonist Gary Larson drew a cartoon that is a sad but funny follow-up to the little
engine: He is now a down-and-out beggar on a street corner holding a sign that reads, “I thought
I could, I thought I could, I thought I could.” This cartoon speaks to the issue that naturally arises
in therapy: What if either the clinician or the client thinks they can but really can’t? Or,
conversely, what if they think they can’t but really can?
Thus, one of the most important—arguably the most important—discrimination someone has
to make is about controllability, that is, how much control someone has in a given context. Given
how much of depression originates in misperceptions of hopelessness and helplessness and how
often the anxious person tries to avoid seemingly threatening realities, the perception of
controllability is obviously vital to these and many other disorders.
An insightful clinician would have to examine their beliefs about the issue of controllability
and how they influence their style of clinical practice. Specifically, how do you determine what
is and is not controllable in a given situation? How do you determine when a client is limited in
some way, and those limits should be accepted and respected, versus when the client should, in
your judgment, instead strive to transcend them? (This topic and some guidelines for making
such vitally important discriminations are discussed in detail in my book The Discriminating
Therapist [Yapko, 2016].)
Beyond controllability, another repetitive theme of therapy related to acceptance is a pattern of
self-rejection. It’s evident when people identify parts of themselves that they are constantly
fighting with. They report such things as, “I hate myself for never standing up for myself,” or “I
hate myself for not being able to get over what that person did to me.” People can be terribly
harsh with themselves, judging themselves mercilessly in the most negative ways imaginable.
It’s one thing to say, “I really blew that one,” a specific criticism, but quite another to say, “I’m a
total loser,” a global condemnation. When people see in themselves things they don’t like and
then globally condemn themselves, it’s a valuable opportunity to remind people that they are
much more than that part of themselves they hate so much.
When people ask you to use hypnosis to “Help me get rid of that part of me. . . . Help me get
rid of my sweet tooth” or “Help me get rid of my neediness,” it’s an important opportunity to
help people absorb the deeper message that you don’t get rid of parts of yourself. Rather, you
learn to first accept them as inevitable and then redefine your relationship to them. When you
provide the reframing in hypnosis that even the parts of themselves they hate have a potentially
positive role to play in their lives (e.g., anger that is skillfully used to address an injustice), they
can reach an acceptance of that part and move to the next stage of how and when to integrate it
so that it functions usefully rather than destructively. For as long as it is viewed as a part of them
that they devalue, the lack of acceptance of its inevitable presence ensures that part will remain
dissociated and destructive.

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 A primary message among the many messages in this process-oriented hypnosis session, then,
is that each part of you has value when you employ that part in the appropriate context. The
problem isn’t the part of you that you labeled as bad. The problem is when you give
indiscriminate expression to that part in a way and in a context that doesn’t support that
expression. It requires flexibility, then, to develop another part that would be more effective in
that context. This chapter’s process-oriented hypnosis session helps facilitate that process.
Acceptance is one of the core foundational elements of mindfulness-based approaches. Instead
of trying to change, improve, modify, or fix things, which is viewed as a certain path to
unhappiness, cultivating an attitude of acceptance can provide a means of detaching from
focusing on problems. Acceptance is a means of getting off the seemingly never-ending treadmill
of striving for self-improvement and getting on a path of greater compassion, tolerance, and
patience toward the self and others. Buddhist teacher Tara Brach (2004) uses the term “radical
acceptance” in her book by that name to emphasize the fuller benefits to be obtained when a
global compassion is the vehicle of relationships with self and others.
The inherent paradox regarding acceptance, which I first articulated in my book Mindfulness
and Hypnosis (Yapko, 2011), may be evident in how promoting acceptance—essentially a
message of “Don’t change!”—becomes the catalyst for change. On one level, the therapist says,
“Don’t try and change anything; instead accept the inevitable.” On another level, the therapist
says, “By not trying to change things, you will change.” Paradoxes can’t be resolved logically.
They are experienced. One of the many advantages of using hypnosis in treatment is that the
message doesn’t have to be logical: people in hypnosis can absorb messages and have
meaningful experiences even with entirely illogical suggestions, a phenomenon known as “trance
logic” (Yapko, 2019).
More than half a century ago, the late psychiatrist Milton Erickson wrote, “The purpose and
procedures of psychotherapy should involve the acceptance of what the patient represents and
presents. These should be utilized to give the patient impetus and momentum so as to make his
present and future be absorbing, constructive and satisfying” (1954b, pp. 127–128). Erickson is
unambiguous in his stated perspective: Acceptance is the desirable foundation for defining the
therapeutic relationship and precedes the ability to utilize elements of the client’s experience in a
goal-oriented fashion.
Although both mindfulness and hypnosis emphasize the importance of accepting reality for
what it is, hypnosis generally pays more attention to acceptance as a precursor to making
deliberate and meaningful change. Both mindfulness and hypnosis are clear that acceptance has
to precede change, but in hypnosis a well-defined therapeutic target lies one step beyond
acceptance. In hypnosis, there is an implicit or explicit suggestion to do something. The client is
encouraged to make specific cognitive, behavioral, perceptual, sensory, and/or relational shifts in
the direction of a goal. In contrast to mindfulness, which is often described as paying attention
without intention, hypnosis may best be described as paying attention with intention. In the
world of psychotherapy, this is especially appropriate, since therapy is itself necessarily—and
appropriately—a goal-oriented process.
The primary therapeutic goals of a process-oriented approach, therefore, are to (1) help the
client distinguish between what is controllable and what is not; (2) reframe the value of parts the
client has rejected as bad as having merit when expressed insightfully in appropriate contexts; (3)
help the client detach from distressing realities in order to reduce emotional reactivity and greater
acceptance; and (4) help the client attain a greater level of compassion for and tolerance of
differences in relationship to others. Table 10.1 can be a helpful strategy for encouraging
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acceptance in clients of circumstances that can’t be changed.

TABLE 10.1. GENERIC SESSION STRUCTURE FOR ENCOURAGING

ACCEPTANCE

Induction

Response set: Acceptance

Theme 1: Some challenges in life are inevitable
Theme 2: There’s no sense in fighting against the inevitable
Theme 3: It helps to know what’s inevitable before fighting against it
Theme 4: Making judgments is not only desirable, but necessary
Theme 5: Shifting your focus to notice what’s right
Theme 6: Accepting and utilizing your different parts skillfully

Posthypnotic suggestions for integration

Closure and disengagement

SESSION TRANSCRIPT

Induction
You can begin by taking in a few deep, relaxing breaths . . . and orient yourself now to what can gradually and
comfortably . . . become a familiar and welcome experience . . . of simply allowing yourself the luxury of taking a few
minutes to focus yourself . . . and to clear yourself. . . . You know as well as I do . . . how the pace of life seems to just
keep getting faster and faster for many of us. . . . So much to do, so many responsibilities. . . . That’s why it can be
especially nice every once in a while . . . to take a few minutes to just breathe . . . and to just be . . . a human being
instead of a human doing . . . to get really comfortable in your thoughts . . . in your body . . . and even in your very
soul. . . . In this session . . . you can just enjoy the inner sense of calm that slowly evolves . . . when you make a point
of focusing on something meaningful. . . . Of course, each time you experience these focusing sessions . . . whether
we’re doing a session together in person . . . or you’re spending time focusing when you’re on your own . . . it’s a little
bit different from one time to the next. . . . Sometimes your thoughts will drift in one direction . . . while other times
your thoughts will naturally drift in other directions. . . .

Building a Response Set Regarding Acceptance

And yet each time you focus . . . no matter what direction your thoughts may take . . . there is an underlying sense . . .
a really deep awareness . . . for the value of being with yourself in a calm, gentle, and deeply beneficial way . . . an
easy acceptance of your growing depth of appreciation . . . for your abilities and deeper self-awareness . . . an easy
acceptance for the natural tendency of your mind to wander at times . . . and an easy acceptance that there’s a lot to
get absorbed in right now . . . especially the things you discover that can really make a difference in how you feel
about things that take place in your life . . . and how you make judgments about yourself and your life experience . . .
and how some of those judgments naturally change over time . . . as you develop a greater clarity about your own
capabilities. . . .

Theme: Some Challenges in Life Are Inevitable

And how you make judgments as you move through life . . . will powerfully shape your reactions to the challenges you
face . . . and the actions you take as a result . . . and it’s easy to understand why. . . . After all, life goes on, people
change, situations change, things happen. . . . Even just the process of getting older makes this point. . . . The
challenges you faced when you were a child having to learn the most basic things . . . such as how to walk and run . .
. how to read and write . . . how to attend school . . . and year by year life became more complex. . . . Adolescence
came along and your body changed. . . . You didn’t choose it, but it happened. . . . And as you grew into young
adulthood, you started to face the pressures of people expecting you to take on more adult responsibilities. . . . You
didn’t choose it, but it happened. . . . And all the life changes that unfolded over time . . . from working jobs to

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developing friendships . . . things that might seem to have just happened . . . from dealing with births and deaths
among relatives or acquaintances . . . and the ups and downs of the economy . . . and the need to do laundry and go
to the grocery store . . . all just keeping up with the inevitable responsibilities and everyday challenges that are simply
part of life . . . things you don’t necessarily choose, but have come to accept as inevitable . . . an easy acceptance
that comes from knowing what life requires of us . . . whether we chose it or not. . . .

Theme: There’s No Sense in Fighting Against the Inevitable

Sometimes, though, people don’t choose their battles very well. . . . They fight against things they’d do much better to
simply accept. . . . For example, I have a friend who has a young daughter. . . . She’s only 8 years old . . . and she’s
been getting some of her questions answered lately about where babies come from. . . . She had asked her parents
for the sex talk . . . and they’re attempting to answer her sensitively and without more detail than she seems ready to
handle . . . especially because they know she’s not one who usually cares much for change. . . . She much prefers
the familiarity of experience over the novelty of experience. . . . And when they talked about reaching puberty and the
changes her body would go through . . . and especially what menstruation was all about . . . she threw a tantrum . . .
yelling at them because she didn’t want to go through puberty. . . . She didn’t want her body to change . . . and she
was really disturbed about this and announced quite matter-of-factly that she refused to go through puberty. . . . She
declared it simply was not something she would tolerate and advised her parents not to expect it in her case. . . . And
I wonder what you would have told her . . . how you would have responded to her wanting to fight the inevitable
changes that are biologically programmed into human DNA. . . . And I wonder how you would explain when it is
sensible to fight against something you can’t accept and want to change . . . and when it is sensible to simply accept
the inevitable with insight and grace . . . and how valuable it can be now to recognize that some battles just aren’t
worth fighting. . . . And it gives you a chance to determine which of your own fights can give way to a calm
acceptance. . . .

Theme: It Helps to Know What’s Inevitable Before Fighting Against It

Before fighting against something . . . and wasting valuable time and energy . . . it really helps to know something
about what, if anything, you can do to make a difference in that situation. . . . Sometimes people fight without realizing
they’re in a fight they can’t win . . . like fighting against aging . . . or fighting against ever dying . . . or fighting against
the need to sleep or eat. . . . These aren’t noble fights. . . . They’re foolish ones. . . . But other fights are indeed noble .
. . fighting against your self-limiting fears or doubts . . . fighting against others who underestimate you by succeeding
in ways they didn’t think possible . . . fighting against injustices you see unfolding before your very eyes by modeling
fairness and integrity. . . . And you’re discovering now how important it is to make clear and sound judgments about
what is in your control and what isn’t in your control . . . what you can strive to change in yourself or others and what
you simply cannot . . . and can come to accept for what it is . . . even if you don’t particularly like it. . . . And even
within yourself . . . you face the same need to make a clear-headed judgment . . . as to whether to strive to change
some aspect of yourself . . . or whether to accept it with grace as just a part of who you are. . . . It may not be your
idea of perfect . . . but it may be embraced as simply inevitable . . . like your height . . . or your shoe size . . . or your
love of a particular type of music. . . .

Theme: Making Judgments Is Not Only Desirable, but Necessary

Now, making judgments about people, about situations, and even about yourself . . . is so natural. . . . It’s how we
decide on a desirable course of action . . . deciding what to do based on how we see and evaluate things . . . and
consider what it takes to develop good judgment . . . the ability to see things realistically and make good decisions
accordingly . . . making good decisions about who is worth bringing into your life . . . good decisions about managing
your money . . . all kinds of decisions in life that need to be made . . . and that includes the ability to see yourself
realistically . . . knowing yourself and your strengths and what you’re capable of doing well. . . . It’s all too easy for
many of us to become self-critical at times . . . getting down on ourselves when we don’t live up to some expectation
or standard that we’ve set for ourselves . . . instead of being accepting of what it means to be inevitably human . . .
and come up short sometimes. . . . It’s all too easy to be doubtful about ourselves at times. . . . And for as long as you
care what others think . . . an important aspect of being socially responsible . . . and for as long as you want to
perform well . . . an important aspect of taking pride in what you do . . . you’ll naturally make judgments about yourself
. . . too many of which may be unfairly harsh at times. . . . And it’s worth asking how you know when a criticism is
justified and when it is simply pointless. . . .

Theme: Shifting Your Focus to Notice What’s Right

But such negative judgments aren’t constructive . . . simply because they don’t teach anything positive that highlights
what can be done better. . . . They’re just harsh and uncomfortable . . . punishing someone for doing wrong doesn’t
teach them how to do what’s right. . . . And when you begin to move away from those judgments . . . and begin to shift
your focus from what’s wrong to what’s right . . . you’ll begin to notice things in yourself and others that would have
escaped your attention previously. . . . What a relief when you take the time . . . to remind yourself that no one
experience and no one part of you defines you . . . and how that realization can lead to a greater self-awareness and
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self-acceptance than you ever thought possible. . . . What a pleasure it can be when you take the time . . . the way
you can right now . . . to remind yourself about the richness of your experience . . . the interesting people that you’ve
met along the way . . . the special places that you’ve been . . . the valuable things that you’ve experienced. . . . These
are the personal riches. . . . They’re the ever-present reminders of some of the extraordinary opportunities that come
our way in life. . . . One of the things that I most like about this kind of focusing experience . . . is that it can be such a
kind and gentle way of reminding people of their strengths. . . . It can be such a generous way of helping people find
and acknowledge their hidden talents, talents you perhaps didn’t even know you had . . . talents that you’re
rediscovering . . . that you’d forgotten about. . . . It can be such a supportive and realistic way of reaffirming to you
that you don’t have to be perfect in order to be really good. . . . I like that. . . . I like the positive recognition that comes
from acknowledging people’s strengths and resources. . . . Too often people overlook their own strengths or the
strengths of others . . . or take them for granted. . . . So I’m encouraging you to enjoy these wonderful capacities of
yours . . . and to notice much more of what people you encounter have to show as valuable . . . that you can
appreciate . . . a much deeper acceptance of the inevitable differences that exist between people . . . that have a
greater value than you might ever have realized before . . . making it so much easier to acknowledge what’s right with
them . . . and what’s right with you. . . .

Theme: Accepting and Using Your Different Parts Skillfully

It’s just a nice way of reinforcing for you what I hope you already know . . . that you have a lot of really great
resources inside of you to explore, and to develop further . . . and to enjoy. . . . It’s one of the curiosities about
perception . . . how something that you hear might seem irrelevant to you at first . . . and then, inexplicably, it
gradually starts to grow in relevance. . . . Or how something can seem distant to you in your awareness . . . and then
it gradually moves closer until it fills your awareness with something that is pleasing . . . inspiring . . . or perhaps
surprising . . . but certainly useful. . . . It’s one of the many values of just being comfortable and present in a focusing
experience such as this. . . . It’s also what makes it easy to appreciate . . . and it is easy to appreciate . . . how each
aspect of your experience has a positive value someplace, sometime. . . . It’s more obvious when it relates to the
things that you really enjoy. . . . But the point is . . . that every experience is valuable someplace, but no experience is
valuable everywhere, or all the time. . . . A simple example: You might love a particular food . . . but you wouldn’t want
to eat the same thing every day, no matter how much you love it. . . . You can enjoy a particular place to go on a
vacation or holiday, but sometimes you want to go somewhere different and do something different. . . . You want to
see and experience other things, too. . . . So, no matter how much you love that particular place, you can still prefer to
be someplace else today . . . and what you learn along the way is that very important principle . . . that the value of
things, the value of experiences, the value of parts of yourself . . . that value depends on circumstances. . . . Consider
how great it is to be able and willing to challenge people or even to challenge yourself at times . . . and how wonderful
it is at other times to choose harmony . . . to choose tolerance . . . and the wisdom is knowing when to do what. . . .
Likewise, the value of being able to reach acceptance of the current conditions at times . . . and likewise knowing how
important it is to go beyond acceptance in order to create changes. . . . Now, you can easily start to form the
impression that I’m talking about the potential value of each experience . . . and you’d be right to do so. . . . I really
don’t know if you’ve started to take these ideas to the next level yet . . . whether you’ve started to appreciate that each
part of you is valuable someplace, sometime. . . . That even includes the parts of you that in the past you might not
have liked very much . . . or understood very well. . . . But you can now sense something changing about that
viewpoint . . . as you start to become aware that even the parts of you that you haven’t liked so much still have a
positive value at times. . . . They have a positive potential if those parts of you are used well and in the right
circumstances. . . . And isn’t that the artistry of living well and living skillfully? . . . Learning to use the different aspects
of yourself purposefully . . . in order to create positive possibilities. . . . So often in my clinical experience, I’ve talked
with people who tell me how bad, how unacceptable a part of them is in their view of themselves. . . . So they’ll say
things to me such as, “Help me get rid of my anger,” or “Help me get rid of my competitive nature,” or “Help me get rid
of my need for approval.” . . . It usually takes people a little while to really grasp the deeper meaning of my reply . . .
when I tell them that you don’t get rid of these things. . . . They are a part of you. . . . You don’t get rid of parts of
yourself. . . . No, instead you learn how to use them effectively, selectively, and wisely to your own best advantage . .
. and to the advantage of the people you care about. . . . You can be deliberate in choosing . . . when and how you
express these parts of yourself . . . but it’s important when you realize that these parts all have a positive value
someplace . . . just not in the places, perhaps, or in the way . . . that you’ve been using them . . . when they seem to
just pop up in some context where they really aren’t at all useful. . . . It requires a different perspective . . . to learn
how to accommodate all your parts . . . instead of striving to eliminate the ones you just haven’t known how to
manage skillfully. . . . When you come to that inevitable realization . . . that each part of you is valuable someplace,
but not every place . . . what a wonderful discovery to find out that you can actually develop an appreciation for what
previously seemed only worthy of your self-criticism or self-rejection. . . . When you process these ideas on so many
different levels, it’s a really good reason—a really good reason—to start to develop that deeper trust for yourself. . . .
And isn’t that what’s evolving at this very moment? The deeper trust in yourself that you can think about experiences
that are empowering and transformative. . . . It isn’t about controlling the world, or controlling the people around you . .
. simply because you can’t. . . . Rather, it’s about trusting yourself to reach inside yourself and find the part of you that
can best help you manage some circumstance and go ahead and use that part skillfully . . . and with a genuine sense
of self-acceptance . . . as well as compassion for others. . . .
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Posthypnotic Suggestions for Integration
Now, I’ve talked about many different possibilities of things you might consider. . . . I’ve provided a good reminder to
you that you don’t have to live perfectly . . . as if you could, even if you wanted to. . . . After all, fighting to be perfect
just isn’t a fight you can win for as long as you live in a human body and have a human mind . . . but you do have lots
of opportunities to live well . . . to absorb that message certainly translates into a shift about the kinds of things that
you can say to yourself . . . and the way in which you say these things to yourself . . . a much kinder, gentler voice in
your thoughts . . . and the things that are positive you can see and accept in yourself . . . the things that are valuable .
. . and the things that you begin to notice in other people and in the world around you that are worth acknowledging
and accepting. . . . You can enjoy noticing those expansive shifts in your perceptions . . . particularly when you realize
that you’re the one responsible for them . . . they are yours. . . . Well, you probably know by now that you can be as
attentive to the possibilities presented here as you wish. . . . After all, it’s your experience to create and enjoy. . . . You
get to decide what you can absorb and maintain in your life from this and each experience . . . because it’s worth
holding on to even after I invite you to reorient in just a moment. . . . Some people hold on to the physical and
emotional comfort. . . . Some people hold on to the feeling of really appreciating the richness of their own experience.
. . . Some people hold on to the realization that some life challenges are inevitable, and some life conditions are just
not worth fighting against . . . allowing you to hold tightly to the idea that you can be so much more self-aware and
self-accepting. . . . I certainly hope that the good feelings you have can be easily memorized and accessed again and
again at your leisure. . . .

Closure and Disengagement

When you’ve had enough time to process this experience and consider and absorb the deeper messages, then you
can start to bring this experience to a comfortable close. . . . Take whatever time you want to . . . to have that sense of
completion for right now. . . . And then when you feel like you’re ready to . . . you can start the process of reorienting
yourself at a rate that’s gradual and easy . . . so that in a little while you can reorient yourself completely and let your
eyes open . . . feeling alert, fully alert, deeply refreshed, fully reoriented, and feeling just great!

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Chapter 11

Defining Responsibility
The price of greatness is responsibility.
—Sir Winston Churchill

The Case of Kyle

Kyle’s moodiness posed an ongoing challenge to his wife and kids. His 9-year marriage to Karen was generally
good but was at times exhausting to her because of Kyle’s unpredictable fluctuations in mood and outlook. He
could be warm and upbeat one minute, then distant and irritable the next. He was that way when she met him,
which she accepted as “that’s just Kyle,” but lately it seemed to her that Kyle was spending more time in what
she called “the down zone” than ever before. Worse, his irritability was often unleashed on their kids. Melissa,
age 8, and Martin, age 5, were both so sensitive to their dad’s responses to them that they would often grow
silent and obviously distressed when Kyle would yell at them for truly petty reasons. Karen secretly wondered if
it was a mistake to have kids when Kyle was so easily stressed by them but knew it was a pointless question
given the fact that they already had them.
Kyle came to therapy alone at Karen’s insistence, which he diplomatically called a “strong recommendation”
that he decided to accept. He didn’t really see exactly what she was concerned about that made seeing me
such a priority now. He thought he was “pretty much okay.” But after that less-than-insightful self-assessment,
Kyle went on to disclose that he had always been an introvert and moody and figured “that’s just the way I am.”
When asked about his moods and their impact on his behavior, Kyle admitted that sometimes he wasn’t as
“nice” as he “should” be to Karen and the kids. When I asked what that meant exactly, he said he would get into
these “states” where everything annoyed him. At such times he just wanted to be left alone for a while, and if
anyone intruded on his need for space, he’d react with anger.
I asked Kyle if he gave people any kind of warning that he needed space, and he looked at me with genuine
surprise. Then he turned it into a joke: “Warning! Warning! Dangerous moody man!” He dropped that demeanor
quickly and turned serious again as he described a recent episode that gave rise to Karen’s “strong
recommendation.” Melissa had come to him with a request for her own smartphone, and when she wouldn’t
take no for an answer, he blew up at her and said some awful things about what a “spoiled little bitch” she’d
become. Melissa was momentarily shocked by his intensity and words, and then began crying uncontrollably.
Kyle knew this was bad, but he didn’t know how bad until he saw the look on Karen’s face. It was a look that
said, “What the hell is wrong with you? What are you that you could say that to Melissa?” Kyle’s nonverbal
response was to withdraw and go find some space to be alone.
In the next session, I spoke to Karen, first alone and then together with Kyle. She had a lot to say, of course,
about what was going on with Kyle. In the following session, I spoke to Melissa alone, then Martin alone to draw
out their feelings and observations about life at home; giving kids a voice is such a necessary way of
empowering them, especially during times of family distress. The picture of home life was quite clear: Kyle’s
erratic moods and behavior kept everyone on edge. Hearing Melissa as the older of the two kids describe
interactions with her dad that could only be described as nasty was truly disheartening and made it clear what
the first target needed to be. Martin echoed what Melissa said in much less sophisticated language.
What about Kyle? Is he just an angry man who needs to “get his anger out”? Is he depressed and needs to
be medicated? Is he carrying the residuals of childhood trauma? Is he just a chronically dissatisfied man who
finds fault everywhere he looks? Is it about poor self-esteem and feeling undeserving of what he has? Or what?
The content of Kyle’s problem is his moodiness and the need to better manage his moods. The process is
how Kyle’s internal absorption keeps him focused on himself and his feelings, too often expressing them in an
uncensored form. It precludes him from sensing any responsibility for having to protect the people around him
from his moody irritability and the way he speaks to them when he’s in a bad place within himself. Kyle will
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 need to develop some boundaries that can help him refocus his attention outside himself in order to fulfill his
responsibility to his marriage and family. His responsibility, one of the many he has, is to protect them from his
moods and verbal assaults.
In introducing responsibility to Kyle as an issue to discuss, I said directly, “Kyle, I’m sorry you struggle with
your moods. I am genuinely sorry you suffer these foul moods that distress you so. But, that doesn’t give you
the right to say the awful things you say to Karen, Melissa, Martin, or anybody else. Your mood is going to lift,
but they’ll be hearing the echoes of the nasty things you said for years, maybe even forever.” Kyle blurted out,
“But that’s how I feel! Am I supposed to lie or playact that everything’s okay? If I can’t be me with my family,
then where can else can I?” Kyle had given himself permission to say these things as evidence of his “being
honest” with them. When isn’t honesty the best policy?
Process-oriented hypnosis provides a gentle context for introducing new perspectives and possibilities for
meaningful change. In Kyle’s case, it was easy to talk about the concept of atmosphere, first with distant
examples such as the atmosphere a restaurant strives to create for its diners or the atmosphere a teacher
creates for their students. The atmosphere can differ in lots of ways depending on the desired effect. Then it
was an easy transition to talk about the atmosphere he created in his job as a project manager in a construction
company. Did he encourage his group members to be open with him in expressing their needs or concerns?
Did he encourage them to support or compete with each other? Did he treat them harshly when they made a
mistake? Then moving it to an even more personal level, he could think about the family atmosphere he grew
up in, whether it was emotionally warm or sterile, what was emphasized as important and what was trivialized,
what things his own dad said to him that he still holds on to, whether good or bad, and so on.
Finally, it turned more personal when introducing the recognition to Kyle that each person directly affects the
others in their sphere of influence. Every interaction is going to lead people to feel better or worse about
themselves to one degree or another. What happens when someone denies that power, though, and is
oblivious to the effect they have on others? What happens when they’re so self-absorbed that they hurt people
without even realizing it? Bad moods were reframed into an opportunity to exercise greater self-restraint as the
responsible thing to do in a number of different ways over several hypnosis sessions, and Kyle got the point: He
can’t just do whatever he wants or feels when he has entered into a marriage and created children that he has
a responsibility to care for and love. Kyle became teary as the magnitude of his lack of responsibility for his way
of treating his wife and kids became clear and painful. In that moment, he vowed to do much better.
Kyle took the responsibility to make sure he could correct his kids without attacking them, to forewarn Karen
when he was feeling down and needed some space instead of just disappearing, and took care not to discuss
anything of importance if he couldn’t give it his full attention and keep his cool.
Kyle listened to our hypnosis sessions often and was moved each time to focus on what it means to be
responsible for yourself and what you say and do. Kyle lived up to those responsibilities. And, no surprise, he
found he was liking himself much more now as a consequence. He said, “I’m a lucky man. I’ve got a great wife
and kids, and I don’t ever want to lose them by acting like a jerk. Thanks for helping me see that with 20/20
vision.”

The Role of Responsibility in Quality of Life

Consider the following two scenarios:

John drops a glass, and it shatters on the floor. Mary is quick to offer her assistance and
helps him pick up the pieces of broken glass. Unfortunately, she cuts herself on a sliver of
glass while doing so and bleeds profusely. John feels terrible about Mary getting hurt. How
much responsibility for Mary’s cut does John bear?
Mary has asked John numerous times to fix the broken electrical plug at her desk. He
always says he will, but many weeks and arguments later, he still hasn’t fixed it. Fed up
with waiting, Mary finally tells John he has three days to fix it or she’s going to call in an
electrician to do the job. He dismisses this warning as a frustrated bluff. Five days later
Mary calls an electrician, who promptly fixes it for a charge of $180. John is furious with
her for hiring someone and paying them so much when he was “planning to get around to
it.” He berates her and then stops talking to her altogether. How much responsibility for

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 John’s anger does Mary bear?

Both of these scenarios raise a difficult question: How do we determine the level of personal
responsibility for one’s actions and experience? This issue is vitally important in the context of
psychotherapy. Every client we treat in whatever manner we treat them has to come to a
meaningful conclusion that will help determine whether and how therapy progresses. This is the
question one must answer: Am I in charge of my life, or aren’t I?
For clients who believe they are not responsible for themselves, victims of genetics or
circumstances, why strive to learn anything different? For clients who have agency, the sense
that they are at least partially in control of their lives, then using therapy as a means to lead a
better life makes sense. Beyond the global beliefs of the client, the content of what they believe,
the real challenge in therapy at the process level is to help the client be clear in a given situation
where the responsibility for oneself is to be found.
Philosophers have argued over the question, “Am I responsible for my actions, or aren’t I?”
for centuries. More recently, neuroscientists have entered the debate arena and offered a
completely different view, one that has an especially great relevance for practitioners of
hypnosis.

The Unconscious and Free Will: Do Either Actually Exist?

Modern cognitive neuroscience no longer focuses on the unconscious as though it is an

organized entity; rather, it focuses on the role of unconscious processes governing subjective
experience. A sharp distinction is made between automatic and controlled processing. Automatic
processing isn’t easily explained, as the person isn’t really aware of how they made decisions or
formed responses and features a sense of effortlessness in responding. Controlled processing
features thinking, reasoning, and planning.
What brought neuroscientists into the free-will debate is the recognition of how unconscious
processes can be influenced by priming strategies, that is, the introduction of stimuli (e.g., words,
images, objects) outside of conscious awareness that have a demonstrable effect on perception
and behavior. Famed neuroscientist Michael Gazzaniga, well known for his pioneering work
with so-called split-brain patients, tackled the subject of free will in depth in his book, Who’s in
Charge? Free Will and the Science of the Brain: “Our minds are always being unconsciously
biased by positive and negative priming processes and influenced by category identification
processes. . . .Our very own brain machine runs on its own steam, even though we think we are
in charge. Now that’s a puzzle” (2011, pp. 69, 8).
The issue of what is and isn’t in our control has already come up more than once previously,
and once again becomes extremely salient to the current discussion of responsibility. If free will
is illusory when in actuality we are pushed and pulled by nonconscious processes, then how
responsible are we for our own actions? And, if it isn’t me who’s responsible for what I do, then
who is?

Attributions and Making Sense of Responsibility

One of the core components of human nature is the need people feel to make sense out of their
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experience. As we saw in Chapter 5, the meaning of most of the experiences we have throughout
life is infused with uncertainty. Most experiences, including the experience of hypnosis, are
sufficiently ambiguous to invite our projections about what they might mean. Sometimes the
projections make us feel good (“I can tell from the way they stand next to me that they like me”);
other times the projections make us feel bad (“I can tell from the way they stand next to me that
they don’t like me”). Sometimes the projections empower us (“Stand back—I’ll handle this!”),
and other times they define us as helpless (“There’s nothing I can do about it”). Once again, we
see how the quality of your projections shapes your outlook and responses.
When some event happens, whether good, bad, or neutral, it is the most natural of tendencies
to immediately ask, “Why did this happen?” This question launches the process of making
attributions—explanations—for the perceived causes. Embedded within the attribution is the
perception of where the responsibility is placed for the event and its consequences. Since the
attribution is merely a projection, it may range from reasonably accurate to wildly—and
painfully—inaccurate.
Many people reflexively blame others for their own bad decisions and circumstances, while
others reflexively accept such mislaid blame and thereby suffer unnecessary guilt and poor self-
esteem. How you deal with the issue of responsibility is a powerful factor in shaping your quality
of life experiences and, especially, your relationships with others. In fact, it is one of the key
factors I encourage people to assess when they’re beginning a new relationship with someone:
How does this person deal with issues of personal responsibility? Whatever else might be good
about someone that attracts you, if this person is irresponsible, the relationship is going to suffer
and is not likely to end well.
Perceptions of responsibility exist on a continuum. At one end is the person who readily
assumes responsibility for their actions, including blame when they misstep. At the extreme, they
may not only take responsibility for their own actions but may even take the blame for the
actions of others as well. The heavy burden of an overdeveloped sense of responsibility is just
something they live with and rarely consider because it is simply reflexive to attribute blame to
themselves.
At the other end of the continuum is the person who accepts little or no responsibility for their
own actions. If you confront them about something they did, you get a defensive reaction that
can range from simply making silly excuses and irrational justifications to angry counterattacks,
threats, and even violence.
A primary factor that helps shape a sense of responsibility is the role you’re in at the time of
an important interaction. A sense of agency comes with knowing that when you’re in a particular
role, there are demands that go along with that role. For example, when you’re a parent, there are
clear expectations about what it takes to fulfill that role’s responsibilities well. When you’re a
therapist, there are clear professional guidelines about what you can and can’t do to fulfill that
role successfully. Acting in a way that violates the boundaries of that role is an evasion of
personal responsibility.

The Impact of Taking or Refusing to Take Responsibility

Blaming others for your bad behavior or poor decisions is an obvious evasion of personal
responsibility, reflecting an underdeveloped sense of responsibility. Making excuses for bad

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behavior or exercising poor judgment defines one as untrustworthy. Such evasion may benefit
someone in the short run by helping them delay or, in some cases, even prevent having to suffer
the negative consequences of their actions. That is the short-sighted goal, of course—divert the
blame elsewhere so I don’t have to take it and suffer anything as a result. It speaks volumes
about whether it’s more important to someone to get out of a difficult spot or maintain trust. If
you’re willing to hurt others, perhaps deeply and irreparably, to save your own skin, that is a
shocking display of egocentricity.
Being someone who justifies the unjustifiable guarantees that others will perceive you as
lacking genuineness and personal integrity. How often this destroys marriages and families is
painfully obvious to therapists who work with the hurtful consequences of people who lie, cheat,
lead secret lives, and proclaim that they have a good reason for what they’ve done. There are
many ways to approach the issue of the blamers and the bad behavior self-justifiers, but an
especially clear, insightful, and entertaining book on the subject is Mistakes Were Made (but Not
by Me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts (revised edition)
written by social psychologists Carol Tavris and Elliot Aronson (2015).
Blaming yourself or letting others blame you for things you are not responsible for reflects an
overdeveloped sense of responsibility that can lead to the excessive or inappropriate guilt
described in the clinical diagnostic manuals. It’s worth pointing out the collective wisdom of the
field in saying that guilt can be excessive or inappropriate. Guilt can be paralyzing for a
relatively small transgression that may have even been repaired through apology or some form of
compensation. Proportionality is difficult to gauge, after all—how much guilt is enough and how
much is too much? The inappropriate guilt is an acknowledgment that someone can assume
responsibility for something they’re really not responsible for. Guilt presupposes responsibility,
for you don’t feel guilty about events for which you don’t feel personally responsible. You might
have regrets, wishing things had happened differently, but regret is not the same as guilt.
Deflecting personal responsibility away from the self by blaming others is an obvious way
blame can be helpful to someone. But guilt can also be a formidable weapon when it is used as a
manipulative tool to coerce someone into complying with a selfish demand. “Pack your bags
because you’re going on a guilt trip” is meant to be a humorous way of describing how someone
can attempt to use guilt to coerce you into doing what someone else wishes. Being able to
recognize such manipulative tactics and how to short-circuit them without suffering guilt pangs
is an invaluable skill set to teach your guilt-prone clients.
It should be apparent that these are discrimination issues that come into clear focus when you
ask the client the salient discrimination question: How do you know when something is your
responsibility and when it isn’t? (For further discussion of this issue see Yapko [2016].)
It’s a different issue, of course, when someone feels guilty about having done something that
hurt others. They accept the responsibility for it and now suffer the guilt feelings that are
proportional and appropriate to the circumstance. What can a therapist do to help in such cases?
The goal isn’t to take away the person’s guilt, simply because that isn’t realistic. The person
knows what they’ve done, they know whom it hurt and how much it hurt, and they will forever
have to live with this uncomfortable knowledge.
The more realistic goal in such circumstances is to help the client compartmentalize the guilt.
That means acknowledging it but not globally defining yourself by it. The compartmentalization
strategy provided in Chapter 9 can be adapted for this purpose and used to complement the
process-oriented hypnosis session provided in this chapter.

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 By compartmentalizing guilt, I mean helping the person evolve the perspective that whatever
they may have done, they are more than that. It’s an acknowledgment that someone can go
beyond the destructive label attached to whatever they did and can grow into someone who is
better than that. Labels are a sure-fire way to stabilize perspective and thereby make it harder to
change perspective. It’s one of the principal reasons why I have developed my process-oriented
approach that addresses how people generate their problems rather than following a diagnostic
label-based approach to treatment.
Too often, people take on a diagnostic label and use it as a basis for believing that their
problems are unsolvable. Therapists unwittingly reinforce this when they actually teach the client
to define themselves according to a label of one sort or another. As soon as someone learns to
say, for example, “I’m a trauma survivor,” they have now learned that they can globally define
themselves by their unchangeable past. Their history can’t change. Only their response to their
history can change, and a principal way of helping someone to do that is to encourage them to
discover that they are not their history. They are more than their history. And we as therapists
want them to be responsible for becoming more than their history.

Typical Problems Derived From a Lack of Clarity About Responsibility

The types of problems that people might present for treatment that reflect an inability to define
issues related to personal responsibility can seem quite diverse, and may include such
problematic patterns as these:

Excessive guilt
Inappropriate guilt
Self-justification and a lack of guilt for destructive or hurtful behavior
Blaming others or external circumstances for one’s bad choices
Conflict-avoidant behavior when confronting bad behavior is necessary
Taking on more than your fair share of work at home or on the job
Taking on less than your fair share of work at home or on the job
Making commitments to others or yourself that you don’t honor
Apologizing excessively and inappropriately or, conversely, never apologizing when
appropriate
An inability to distinguish guilt from regret

These issues represent the kinds of problems clients might present that all reflect a lack of
clarity about the issue of responsibility. The content of what they want help with is what they
will naturally describe to the therapist (e.g., what they feel guilty about that the therapist
recognizes as misplaced self-blame). However, it is up to the therapist to recognize the client’s
inability to know how to distinguish accurately what they are and are not responsible for as the
process needing intervention.

Defining the Salient Therapeutic Targets

Therapists can easily muddy the waters of responsibility based on their own subjective views or

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philosophies. There are those who say things such as, “There are no accidents” and “Whatever
happens in your life is your responsibility.” Such global philosophies work against the client ever
learning specifically how to determine when they are and are not personally responsible for
something in their life. It leads to a reflex of self-blame even in circumstances where it should be
obvious that they’re not to blame. If you believe there are no accidents, for example, and you’re
responsible for everything, then something as absurd as believing you must have caused the
driver to rear-end you at the red light because “you had some unconscious need to learn an
important life lesson” might actually make sense to you. Philosophies may sound deep, yet still
be counterproductive at least, ridiculous at most.

TABLE 11.1. GENERIC SESSION STRUCTURE FOR DEFINING

RESPONSIBILITY

Induction

Response set: Agency

Theme 1: The past need not define us in the present
Theme 2: People are more than their one-dimensional labels
Theme 3: People are sometimes contradictory
Theme 4: Taking responsibility for your mistakes and reducing guilt in the process
Theme 5: Recognizing what you’re not to blame for even when the finger is pointed at you
Theme 6: Being clear about where the responsibility really lies
Theme 7: Making better discriminations about personal responsibility

Posthypnotic suggestions for integration

Closure and disengagement

The primary therapeutic goals of a process-oriented approach, therefore, are to (1) help the
client be clear about the roles they are in and the boundaries that define their responsibilities; (2)
help the client to determine whether it was their words or actions that generated the outcome of
concern; (3) help the client shake the negative label associated with a past mistake and begin to
redefine themselves as much more than that label; (4) help the client develop a means of
atonement for past mistakes; and (5) help the client develop a clear recognition of when someone
is blaming them inappropriately and have the boundaries and the words to say to resist accepting
the blame and deal with any anger that arises as a result. Table 11.1 delineates a generic strategy
that can help facilitate reaching these goals.

SESSION TRANSCRIPT

Induction
Now would be a good time to arrange yourself in a position that is comfortable . . . and as you find that physically
comfortable position . . . you can start focusing yourself now . . . on making yourself comfortable . . . on all levels. . . .
Now, I know that here at the beginning . . . your thoughts may be going in many different directions. . . . But when you
close your eyes . . . as you can now . . . and you start to relax your body . . . by breathing . . . slowly . . . and deeply . .
. and by letting your arms and legs . . . just rest there . . . starting to feel heavy and relaxed . . . and getting heavier
still . . . you can get so comfortable . . . that even your mind . . . begins to slow . . . down . . . your thoughts . . . getting
more focused . . . your mind getting clearer. . . . And little by little . . . your feelings . . . are soothed . . . and comforted
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. . . so that in the most . . . wonderful of ways . . . you get to just be . . . for a while. . . . No demands right now . . . no
pressures of anything else that you have to do right now. . . . This is your time to just be at ease . . . growing
comfortably detached . . . from the usual things that take up space in your awareness . . .

Building a Response Set Regarding Agency

And this is, of course, your experience. . . . It’s your body that’s gradually relaxing . . . moment by moment . . . and it’s
your willingness to focus yourself that makes growing comfortable possible now . . . and it’s your decision to spend
time listening to the ideas and possibilities I’ll be presenting to you over the next few minutes. . . . And it will naturally
be up to you to choose what you find meaningful and what’s worth absorbing during this time of being deeply
attentive. . . . And what a wonderful capacity we each have to make choices so many times each day . . . choices
about what to say or do at a given time . . . and to know . . . really know deep inside . . . that the quality of our lives is
largely shaped by the quality of the choices that we make . . . the choices we make for ourselves. . . . And wouldn’t it
be ideal if every decision we ever made led to great success and satisfaction? . . .

Theme: The Past Need Not Define Us in the Present

But, you know and I know that part of growing up is learning from the inevitable mistakes we make . . . things we wish
we had handled better. . . . And it’s a curious thing how different people come to terms with the things they would love
to have a chance to do over again . . . how some detach from it quickly and simply say some variation of, “Oh, well!” .
. .and others replay it over and over again . . . as if there’s anything more to be gained from riding around that cul-de-
sac. . . . And right now you have the time and the space to take a clear step forward in your emotional life. . . . You get
to finally . . . come to terms with . . . and create a wonderful sense of detachment from old, outdated feelings . . . that
have taken up much too much space within you. . . . And it can be quite comforting to gradually come to realize . . .
how many of them are simply no longer relevant . . . certain feelings you had at a time in your life . . . that you now
can come to view as simply a piece of history that has receded into the past. . . . And you can use this time to do
some emotional house cleaning . . . in order to ease outdated feelings from too long ago . . . out of your system . . . a
little at a time. . . . They lose their place in your new and still growing views of yourself. . . . Someone wise once said
that “every step forward . . . means leaving something behind” . . . and you know that’s true from your own
experience. . . . The things you left behind from childhood like a favorite toy . . . or a favorite game . . . that is now only
a distant memory. . . . As you grow clearer and stronger . . . that feelings from the past that are outdated . . . can be
left in the past . . . you can grow clearer and stronger about who you are now . . . and what you’re about . . . and how
you’ve grown over time . . . and who you are becoming. . . . After all, you’re still growing as a person . . . seeking out
new experiences like this one we’re sharing together. . . .

Theme: People Are More Than Their One-Dimensional Labels

You have a very important opportunity right now . . . to reach a new level of understanding . . . about your own sense
of integrity. . . . And by integrity . . . I mean . . . a moral guide that you strive to live by . . . that shapes what you’re
willing to do and say . . . and what you’re not willing to do and say . . . and how you respond to yourself and others
when you behave in a way that goes against that moral guide. . . . And one of the most difficult concepts . . . for
people to grasp . . . is that . . . no one can be defined by a single label. . . . You might be a young person or perhaps
an older one . . . but you’re more than that. . . . You may be someone’s child or someone’s sister or brother . . . but
you’re more than that. . . . You may be a boss or an employee . . . but you’re more than that. . . . No one is one-
dimensional, defined only by a single characteristic. . . .

Theme: People Are Sometimes Contradictory

And so it can become easier for you to understand that someone, anyone, can do something . . . that isn’t very nice . .
. and yet . . . still be a good person. . . . It isn’t so simple . . . that a bad person only does bad things and a good
person only does good things. . . . Sometimes . . . really good people . . . do something that really isn’t very good . . .
just as sometimes . . . a really bad person can do something really nice. . . . An honest person . . . can do something
dishonest . . . and a dishonest person can sometimes tell the truth. . . . Life isn’t quite so simple or easy . . . and it
distorts things to think . . . in overly simplistic and extreme all-or-none terms . . . such that if you do something bad . . .
it makes you a bad person . . . any more than if you do something good, it makes you a good person. . . . It’s just too
simple and one-dimensional to be entirely true. . . . Someone can be a pretty sensitive person . . . and a pretty
perceptive person . . . who may be good at reading other people . . . getting a good sense of who they are . . . what
they’re about. . . . And as sensitive as one generally may be . . . every once in a while . . . even sensitive, perceptive
people can miss the chance to be sensitive and perceptive and mishandle some interaction or decision. . . . They may
say something that wasn’t very well thought out . . . that hurt somebody . . . or they may do something that ended up
hurting someone else’s feelings. . . . Now, it may be a pretty serious breach, but most of the time it may not even be
anything all that big. . . . It might just be a snippy reply or a sarcastic barb . . . that someone said that was insensitive.
. . . But even if it was relatively small . . . it did hurt someone’s feelings and it really wasn’t the intention. . . . It just
came out thoughtlessly. . . .

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Theme: Taking Responsibility for Your Mistakes and Reducing Guilt in the Process
But, since no one is perfect . . . and since nice people can say mean things sometimes . . . the real measure of
someone’s integrity . . . is that as soon as they realize that they did or said something that injured someone else . . .
they’ll accept the reality that they did something hurtful to someone . . . and they’ll apologize for it . . . and strive to
make it right in some meaningful way. . . . They can own up to the fact that it was their action . . . and the right thing to
do is to take personal responsibility for the hurtful consequences. . . . And yes, they may feel bad about what they
said or did. . . . They may feel guilty. . . . But it’s good to remember at those times . . . and you can remember so
clearly at those times . . . that even a sensitive person . . . can occasionally do an insensitive thing . . . and even a
smart person . . . can occasionally do something . . . pretty foolish. . . . And remembering that when you have created
a way to live with integrity . . . that you can go out of your way to right any wrongs you’ve done whenever you can . . .
even a simple but sincere apology can go a long way. . . . And taking steps to act with integrity can quickly ease
feelings of guilt . . . and allow you a comforting recognition that you’re much more than what any mistake you might
have made would suggest. . . .

Theme: Recognizing What You’re Not to Blame for Even When the Finger Is Pointed at You
But you know and I know . . . there’s another side of this responsibility issue to consider. . . . There are lots of people
out there who make bad choices . . . who say things and do things that are hurtful to themselves or others . . . and
somehow manage to convince themselves that it wasn’t really them who made the choice. . . . It was somebody
else’s fault. . . . And it’s important to recognize . . . and recognize quickly in various life situations . . . that you’re not
always responsible for other people’s feelings. . . . You can come to recognize more quickly and efficiently that they’re
responsible for their own feelings and reactions. . . . Sometimes the action you take or the things you say can hurt
someone . . . but not because you were wrong or thoughtless. . . . For example, sometimes you have to tell someone
they behaved badly, and they won’t like hearing that . . . but it doesn’t mean you were wrong to say so. . . . And as
another example, sometimes you have to end a relationship that isn’t going anywhere good, and it hurts the other
person’s feelings . . . but it doesn’t mean you were wrong to end it. . . . As you can see, it’s a challenge sometimes to
distinguish when you are and when you’re not responsible for other people’s reactions. . . . Sometimes someone else
may point the finger of blame at you . . . for something . . . that you’re really not to blame for. . . . They may tell you . .
. for example, that it’s your fault . . . that they had to stay up all night worrying . . . simply because you went out for the
evening . . . or that it’s your fault they were too distracted to remember where they put their car keys. . . . And if you’re
not perceptive enough to recognize . . . that they’re blaming you for something you’re not to blame for . . . then you
could easily take in that blame and feel bad . . . or guilty . . . unfairly, unnecessarily. . . . It’s easier, much easier . . . to
blame others for one’s own bad decisions or bad behavior than it is to take personal responsibility for those bad
decisions or behavior. . . .

Theme: Being Clear About Where the Responsibility Really Lies

It will save you lots of unnecessary guilt if you can quickly determine who is really responsible for what happened in
some situation . . . before accepting blame from somebody else or blaming yourself. . . . And it will define you as a
person with integrity when you accept the responsibility for your own actions. . . . It’s true that some situations are so
emotionally charged that it can take a little while to sort out who’s responsible for what. . . . Here’s an example to
consider. . . . I’ve worked with people who have . . . gotten angry when they were criticized in ways they thought unfair
. . . and behaved in a way . . . that crossed a line that should never have been crossed . . . saying cruel things in
anger that should never have been said. . . . And when they cooled down . . . they were truly sorry. . . . They took
responsibility for it, learned from it, and never did it again. . . . And the relationship not only survived but eventually
even thrived. . . . And, other times . . . I’ve worked with people who crossed a line by saying nasty things in anger and
thoughtlessly blamed the other person. . . . They actually justified their awful behavior when they said, ‘’Well, if that
person hadn’t provoked me, then I wouldn’t have said those things.” . . . And they literally blame the other person for
what they said. . . . Such a person doesn’t take responsibility for their behavior, nor do they feel guilty that they hurt
someone. . . . It’s appalling . . . and destructive and irresponsible . . . and just plain foolish. . . . What a clear sign of
maturity and integrity when you take responsibility for yourself . . . and the things you say and do. . . . But
unfortunately not everyone does . . . and some people will be happy to blame you for their bad choices . . . and will try
to make you feel guilty, as if you made them say or do something that crossed the line of decency. . . .

Theme: Making Better Discriminations About Personal Responsibility

Part of what you’re learning here . . . I hope . . . is that the ability to feel guilty . . . means that you have a conscience .
. . a higher sense of virtue . . . a moral code you strive to live by that you may have violated in some way and felt bad
about. . . . And now you can appreciate more than ever before how that can be a good thing . . . and it can teach us
valuable life lessons. . . . And if you or I hurt someone . . . then feeling guilty is normal . . . appropriate . . . even
desirable . . . but it doesn’t need to be a hurtful feeling that lingers too long. . . . When you can remind yourself that
smart people can sometimes do foolish things . . . and sensitive people can sometimes do insensitive things . . . and
responsible people can sometimes do irresponsible things . . . it’s so much easier to lift the burdens of guilt from your
shoulders . . . so much easier to let it fade into history . . . when you take timely responsibility for your actions and do

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what you can to make amends. . . . And so, you can let old guilt go . . . day by day . . . let it go . . . living your life at a
higher level of integrity now . . . by being more aware of yourself . . . and being more deliberate about the choices that
you make . . . and situation by situation, more quickly recognizing the boundary . . . that defines the limits of your
responsibilities . . . clearer than ever about what’s yours and what isn’t. . . . Clear now that it isn’t your job . . . to keep
that person from making bad choices they defend their right to make. . . . And it isn’t your job . . . to keep that person
from getting angry when you tell them something they’d prefer not to hear. . . . And it isn’t your job . . . to make sure
your spouse’s report for work or your child’s school report is written and turned in on time. . . . You may want to help .
. . but it’s a responsibility that belongs to that person . . . and you really don’t want to contribute to their pretending it
isn’t. . . .

Posthypnotic Suggestions for Integration

And so the clearer you get . . . about the limits of your responsibilities . . . the less often you’ll feel guilty
inappropriately or unrealistically . . . and the less you’ll blame others for your mistakes . . . and the less you’ll be
willing to take the blame for others’ mistakes. . . . And the more quickly and efficiently you can master the skills that
go into knowing where the lines are that define responsibility . . . the more you’ll be able to appreciate yourself . . .
and like yourself . . . for the things that you do . . . and the good ways that you treat people . . . with integrity . . . and
respect . . . and the good ways that you treat yourself . . . with integrity . . . and respect . . . and the ways that you
make it clear how you expect to be treated with respect . . . and how you make it clear that you are unwilling to take
responsibility or blame for other people’s bad choices. . . .

Closure and Disengagement

And notice how good it can feel to you now to go through your day-to-day life . . . without any of the guilt pangs of old.
. . . And doesn’t it feel good . . . even now . . . to let go . . . and feel good . . . and be so much clearer about what it
means to be responsible for oneself? . . . So, enjoy the comfort . . . the relief . . . that you’re feeling now . . . and carry
it with you . . . throughout the rest of your day . . . and throughout every day. . . . Now, you can finally unpack your
bags . . . because you’re not going on a guilt trip! . . . And when you’ve had enough time to . . . fully absorb . . . the
implications . . . and meanings . . . and learnings of this focusing experience . . . then you can start to bring this
session to a satisfying end . . . with a strong, comfortable feeling that’s really nice to experience. . . . And when you’ve
done that . . . you can start the process of bringing yourself out of hypnosis . . . at a slow and gradual rate that is
comfortable for you. . . . Then when you have brought yourself to a fully alert state . . . you can open your eyes . . .
and go about doing the things that you need to . . . to make it a really good day. . . .

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Chapter 12

Catalyzing Meaningful Action

Never confuse motion with action.
—Benjamin Franklin

The Case of Bart

Bart, age 28, had scheduled and canceled two previous meetings before our first meeting finally took place. I
can’t say I was surprised when Bart told me his reason for seeking therapy: “I’m a procrastinator. I don’t mean
to be, but I am. I know there’s something I need to do, and I intend to do it, but something always seems to get
in the way. I guess I must just be lazy or have ADD or something.”
Bart didn’t really need to provide examples of his procrastination for my benefit, but he was on a roll, so I let
him go on. He said, “I’m super aware of everything I need to do. I mean, you should see my apartment. Well,
no, you shouldn’t see my apartment because I’d be embarrassed, but you should see what a mess it is. I can’t
find stuff, I don’t know what I did with stuff, and when I think about actually taking the time to get organized, it
seems like a great idea but then I don’t do anything. It’s just so overwhelming. I wouldn’t even know where to
start. I see what needs to be done. It’s too much for me to handle, so I go to a movie or play video games
instead. It’s kind of the story of my life. I want to do things, or at least I think I want to do things, but then
nothing. I manage to hold onto my job, always just barely squeezing my work in under the deadline. It actually
causes me a lot of stress, but I don’t do anything about it. Can you help me?”
Does Bart have an unconscious fear of success or failure? An unconscious need to suffer? An inadequate
personality disorder? Is he suffering with a masked depression? Is he afraid of commitment? Is he just lazy or
ADD as he suggested? Or what?
Bart has a cognitive style, or a pattern of thinking, called a global cognitive style. Global cognition, also called
overgeneral thinking, generally refers to seeing the big picture at the expense of seeing the associated details.
Metaphorically, as in this book’s subtitle, the person sees the forest, not the trees. Global cognition is
responsible for a number of different emotional and behavioral consequences; anxiety and depression are just
two problems associated with it. Procrastination is another manifestation of a global cognitive style.
The content of Bart’s problem is whatever he’s putting off doing that troubles him right now. The process is
about how he decides what he’s actually going to do. I asked Bart directly, “How do you decide at a given
moment what you’re going to do?” His response was most revealing: “I don’t know.” After a pause he added, “I
guess I just follow my gut. I’m pretty spontaneous.”
Bart’s strategy reflects an internal orientation (i.e., he uses his feelings to decide what to do) but an external
locus of control; my question was “How do you decide?” and his answer was that he doesn’t decide proactively.
He responds reactively. If he’s going to react to his gut feelings as the basis for what he’s going to do, when
exactly he is going to feel like cleaning his apartment when that feeling apparently only comes around once a
century? When is he going to feel like suspending his spontaneity to do something that doesn’t feel particularly
good to do but still needs to be done?
The other part of the process Bart employs in his life concerns his perceptual style. Some people make
things bigger than they really are; others make things smaller than they really are. Bart makes even simple
tasks seem so big in his mind (“I see what needs to be done. It’s too much for me to handle, so I go to a movie
or play video games instead”) that they seem too formidable to approach.
Hypnosis is all about shifting perceptions. The first principle you learn in studying hypnosis is “What you
focus on, you amplify.” What elements of a client’s experience do we want to amplify, and, in the process, what
other elements do we want to deamplify? In Bart’s case, it would be important to amplify three things in
particular: (1) the means for breaking global and overwhelming tasks into smaller, specific, sequential,

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 manageable steps; (2) the merits of being proactive rather than reactive in living his life; and (3) the greater
satisfaction to be enjoyed that comes with fulfilling a task or reaching a goal that outweighs the spontaneity that
gives away valuable time to unworthy activities.
The hypnosis sessions with Bart were quite straightforward, weaving these goals into each of the five
sessions we had. He was offered numerous examples of breaking globals into specifics (e.g., you don’t “take a
shower,” a global term; rather, you “follow a specific series of steps that culminate in you being clean”),
examples of people who waited passively for opportunity to fall into their laps, and examples of times he had
been pushed to get something done by some deadline and how much satisfaction he got from the final product,
no matter how much he didn’t like being pushed to complete it.
Bart was given homework, which was seeded during the hypnosis session. For example, he was given the
assignment to break taking a shower down into its component steps. Predictably, he identified only three global
steps: get wet, lather up, rinse off. When I added in all the details (How do you find a shower? Do you turn the
lights on? Do you take your clothes off? Do you open the shower door or curtain before stepping into the tub or
shower? Do you turn on and test the water temperature before stepping in?), Bart said, “Well, yeah, you do all
those things. I just never thought about it before.” I said, “That’s the point: Anything you want to do has a
sequence to it, and what makes it seem so overwhelming is when you don’t know the sequence.” I gave him
another assignment as well: Put a chair in front of your apartment door facing the door. Then sit there for 15
minutes every two hours while you’re at home. He asked, “What am I supposed to do while I’m sitting there?” I
said, “Wait for opportunity to knock.” He laughed, but actually did the assignment. He later said, “I think that
was a turning point for me. Sitting there, waiting for opportunity to come find me, made me feel really foolish,
but in a good way. I’ve done more in the last two weeks than in the last two years! Now every time I think about
what I need to do, I think to write out the steps, and it doesn’t seem so big anymore, and I think about waiting
for someone else to do it for me, knowing nobody will. I really think I finally got it! Thanks.”

The Role of an Action Orientation in Quality of Life

While it is often difficult to know what’s in someone’s mind or heart, observing what they do
and how they do what they do is particularly revealing. It is a basic tenet of communications
theory that all behavior has message value. What does someone’s behavior tell you? Does it tell
you they are impulsive and reckless, or thoughtful and deliberate? Self-absorbed or sensitive to
others? Goal-directed or random? Consistent and largely predictable or erratic? There is little
room for doubting the wisdom of the maxim, “Action speaks louder than words.” The message
received from what we do usually comes through loud and clear.
Clearly, though, not all action is meaningful, despite being revealing. People routinely engage
in actions that are hurtful to themselves and others. The list of self-destructive behaviors people
can engage in is a long one and well-known to psychotherapists. Some are subtle while others
are painfully obvious to everyone. Similarly, the list of ways one person’s actions can harm
others is also a long one and can range from direct (e.g., violence) to indirect (e.g., polluting the
environment).
Why would someone engage in self-destructive and/or antisocial behavior? The amount of
suffering humans endure from such behavior cannot be calculated but touches all of our lives.
These are human tragedies that are anything but logical and are generally looked at by therapists
as poor attempts to cope with stressors, both real and imagined, and/or the product of genetic
predispositions.
If actions do indeed speak louder than words, and all behavior has message value, the role of
action in determining one’s quality of life is obvious. Engaging in behavior that is positive and
helpful to both oneself and others is our idealistic hope for all people, our wish for world peace
on a planet populated by contented and productive inhabitants. At the far more modest level of
the therapy context, the clinician’s task is to find ways of helping the client do less of this and do

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more of that. Indeed, of the more than 800 distinct forms of psychotherapy said to be available
today, although they vary in degrees of emphasis, all encourage clients in one way or another to
do something different. Every therapist has heard the oft-repeated cliché, “The definition of
insanity is doing the same thing over and over and expecting a different outcome.” Though a
cliché it may be, it is a perspective that guides the therapy process. It clearly defines the goal of
wanting to get the client to follow a different course of action. The challenge, and it’s a
formidable one, is how to encourage the client to take action that may be difficult or scary or
even just simply unfamiliar and uncomfortable.
Hypnosis as an intervention is especially well-suited for encouraging meaningful action.
Hypnosis provides a carefully constructed context in which the client can develop a positive and
motivating association to suggested behaviors. The amplification of the benefits of action (the
qualities of positive expectancy described in Chapter 6) and the acceptance of personal
responsibility for the need to take action (as described in Chapter 11) can be embedded in the
type of hypnosis session described in this chapter. What specific action we want the client to take
is the content of our intervention. The process is helping the client recognize in any context when
purposeful action is required. How should the client know when to seize the moment by doing
something that will lead to some desirable outcome or, conversely, when to take the action of
insightfully taking no action for the same reason? This represents yet another discrimination
issue, a decision-making process that can be integrated into the process-oriented hypnosis
session, as you will see in this chapter’s transcript.

Free Will and Social Influence

As discussed in the previous chapter, the question of free will naturally arises when discussing
the actions people take. Do we choose our behavior, or are we somehow preprogrammed to act
the way we do? How we answer that question for ourselves leads to our self-understandings of
why we do what we do: “I take this action because ‘it’s genetic’ or ‘wired into my brain,’ ” or “I
take this action because I want to . . . and I can.”
The field of social psychology in particular has studied the power of situational influences on
behavior. Can a peaceful person become violent under certain conditions? Or can an honest
person behave dishonestly under the right conditions? The literature of social psychology is
filled with fascinating examples of how changes in circumstances give rise to changes in
behavior. Consider an example for yourself: If I ask you, “Would you be willing to walk totally
naked on a busy downtown street in broad daylight for a distance of half a mile?,” most people
would say, “No way!” Then I change the conditions when I make this offer: “Would you do it
for 5 million dollars tax-free?” In the blink of an eye, what seemed unthinkable a moment ago is
now being given serious thought!
The content of the naked stroll isn’t the point. Rather, the process of a change in circumstances
that gives rise to new behaviors is the point. This is the foundation of strategic therapy
approaches that strive to change the client’s circumstances through some safe and appropriate
means in order to elicit new behaviors that can be helpful. Milton Erickson’s use of hypnosis and
strategic task assignments earned him a reputation as a creative genius, accolades he richly
deserved. Studying his innovative ways of changing the client’s problem context in some way,
requiring an action of adaptation by the client in the process, is highly recommended.

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 Action in Therapy: More Can Be Better

Cognitive-behavioral therapy has become the most widely studied psychotherapeutic treatment
for a variety of disorders and has many outcome studies supporting its therapeutic efficacy
(Padesky & Greenberger, 2020; Greenberger & Padesky, 2016). As a form of psychotherapy,
CBT encourages the depressed client to actively perform a variety of self-awareness and skill-
building exercises, which appear to have at least as much therapeutic impact on the client as the
focus on changing the client’s presumably distorted cognitions. Subsequent research has
affirmed that therapeutic change is likely to be greater in those therapies that employ homework
(e.g., active skill-building exercises) than in those that do not. The term “behavioral activation”
is used to emphasize the importance of getting the client to actually do something rather than
merely passively acquire information or contemplate their feelings and circumstances (Yapko,
2010a).
Behavioral activation strategies as a means of promoting experiential learning, skill building,
and proactive behavior have been developed into a model of psychotherapy called behavioral
activation therapy, known simply as BA. The general goal of BA is to increase the client’s
frequency of positively reinforced behaviors. It targets many of the most common symptom
patterns among therapy clients, including inactivity and, especially, an avoidant coping style.
Clients are taught strategies for carrying out goal-oriented behaviors more successfully.
It does not seem coincidental that of the psychotherapeutic treatments with the highest levels
of empirical support, none of them focus on analyzing the past; none of them focus on abstract
theoretical issues (such as unconscious guilt or existential angst); and all of them emphasize,
directly or indirectly, developing skills and using them to take positive actions of one sort or
another. It is essential that the client is defined as an active participant in the treatment process,
engaged in experiential learning through a variety of mechanisms such as hypnosis (and
structurally related processes such as imagery and mindfulness), structured homework
assignments, and role-playing.
Researchers and clinicians are virtually unanimous in their belief that hypnosis is an active
process, a means of intervention that requires the client to actively attend to, engage with,
integrate, and ultimately apply suggestions offered by the clinician or researcher (Yapko, 2019).
Hypnosis as a vehicle of experiential learning is already well established. (For a comprehensive
review of diverse applications, see Elkins [2017].) Hypnosis as a means of actively encouraging
emotional self-regulation through skill acquisition is also well established.
One of the many strengths of hypnosis is evident in its ability to give some definition to the
problem. That is especially important when the client doesn’t have much in the way of self-
awareness or insights into the specifics of what needs to be done. When a client’s thinking is
overgeneral, then reports such as, “I just want to be happy” are common. As a consequence, the
client may be frozen in knowing they need to do something but are unaware of what that would
be. Process-oriented hypnosis can help teach the client greater skills in emotional differentiation
and the dynamics of breaking global problems into problems that can be resolved with a well-
defined plan.

Rumination Gets in the Way of Meaningful Action

Rumination is a style of coping with life stressors and negative mood states that features a very
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strong internal orientation, a process of engaging in self-focused attention on one’s negative
feelings and perceptions at the expense of taking effective action. More concretely, rumination as
a coping style means that when the going gets tough, the tough get thinking . . . and thinking, and
analyzing, and anticipating, and worrying, and asking themselves the same depressing questions
(e.g., Why is this happening to me? What does this say about my life? What does it predict for
my future?) over and over again that they’re no closer to answering on the 25th go-round than
they were on the first. It’s the basis for what many understandably call an “analysis paralysis.”
Helping to fuel negative expectancy (hopelessness) and helplessness, rumination is a principal
catalyst for passivity—the virtual opposite of behavioral activation—and thus must be
considered a primary target of intervention, hypnotic or otherwise. As Susan Nolen-Hoeksema,
an expert in rumination’s effects on anxiety and depression, stated in an interview, “Even when a
person prone to rumination comes up with a potential solution to a significant problem, the
rumination itself may induce a level of uncertainty and immobilization that makes it hard for
them to move forward” (Law, 2005, p. 38).
Asking oneself probing questions such as the above may seem reasonable or even insightful,
but instead of getting focused on solving a problem, one may get wrapped up in anxious
worrying and depressed feelings, focusing on them, analyzing them, linking them to more and
more problems, and thereby making them ever larger and more complicated. This isn’t how one
will feel better. To the contrary, this is how people get worse by feeling bad about how bad they
feel.
Rumination as a coping style, like other coping styles, develops early in life and becomes a
deeply ingrained, reflexive pattern for responding to the negative situations one encounters. The
research clearly shows that people who ruminate (1) have higher levels of vulnerability to
depression; (2) have more severe depressions; (3) have more chronic depressions and more
relapses; and (4) are more likely to suffer anxiety in combination with their depression (Nolen-
Hoeksema, 2003).
Rumination increases self-doubt, which, in turn, increases one’s level of anxiety and
behavioral paralysis. If you feel you can’t make a decision because you don’t know what to do,
and even if you did know what to do, you fear it would probably be wrong, then you may freeze
into inaction.
As the principle of cognitive dissonance would predict, people who engage in rumination
naturally defend it and rationalize it, typically by saying they’re not ruminating, merely
“analyzing all the possibilities.” Thus there’s a rationale for rumination that actually serves to
keep it going: The people who ruminate tend to believe they’re gaining insight through the
process of rolling an issue around and around in their minds. Realistically, thinking something
through is generally desirable, particularly when it is an exercise in impulse control. But there
comes a point when thinking becomes overthinking, and where the ability to solve a problem
with decisive action becomes impaired rather than enhanced. If one is too global in one’s
thinking to be able to distinguish useful analysis from useless rumination, then all analysis will
mistakenly seem productive, an illusory step in the direction of problem solving. The goal, then,
is to learn to identify where the point is in a given circumstance that distinguishes useful analysis
from useless rumination so that one can decide on and then actually take a course of timely and
effective action.

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 Typical Problems Derived From a Negative Action Orientation

The types of problems that people might present for treatment that reflect an inability to take
meaningful action are quite diverse, and may include such problematic patterns as these:

Rigid perceptions of the unchangeable causes of their behavior

Negative and self-injurious coping behaviors
Taking directionless action just for the sake of taking action
Taking no action for fear of making a mistake
A history of regretting not taking effective actions
Believing taking action will be punished or painful in some way
Believing taking action is futile
A lack of clarity about what action to take
Not having a sense of personal responsibility for taking action
Waiting for more data to analyze to confirm what they already know they need to do
Waiting for ideal conditions (“a sign”) to arise that realistically can’t and won’t before
taking action

These represent the kinds of issues clients might present that all reflect difficulty in being
sensibly proactive. The content of what they want help with is what they will naturally describe
to the therapist, but it is up to the therapist to recognize the client’s inability to recognize when
and how to take meaningful action as the process needing intervention.

Defining the Salient Therapeutic Targets

The primary goal of a process-oriented hypnosis session is to encourage timely and effective
action on the part of the client. Hypnotic suggestions can be structured in such a way as to help
teach clients to recognize their globally stated concerns (e.g., “I just want to feel better”) and
develop them into more well-defined problems that can be resolved through a structured,
concrete plan that encourages taking appropriate action. How the clinician defines and treats the
client’s issues matters a great deal. A profound lesson I learned from my friend and mentor Jay
Haley, a pioneer in family and strategic therapies, is this: Never define problems in unsolvable
terms.
The use of hypnosis to encourage action over rumination involves several factors: (1) The
client must come to recognize that action is necessary (even if, paradoxically, the course of
action is to take no action other than to strive for acceptance of unchangeable circumstances). (2)
The client must come to believe that it is possible to identify a specific course of sensible action
that has a reasonable chance of succeeding. Two specific skills make this possible: delineating a
specific linear strategy to implement, and an ability to make a realistic assessment of the
probability that it will be effective. The individual may need help developing these skills as well.
It is an important precaution to acknowledge that building expectancy without a well-defined
next step may only serve to increase the client’s frustration. (3) The individual must be able to
compartmentalize, that is, set aside fears or doubts and follow the action plan to its completion,
perhaps modifying it as necessary along the way as new information surfaces (as discussed in
Chapter 9).

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 A process-oriented hypnosis session can also impart these messages: (1) there are more ways
to make decisions than just according to one’s feelings; (2) pursuing new learning experiences
can encourage a revision of old restrictive beliefs and attitudes; (3) there is rarely just one right
answer or decision to be made, but rather multiple possible decisions, each with its
consequences; and (4) one must learn to discriminate between useful analysis and useless
rumination. Table 12.1 offers a structured means for promoting behavioral activation.

TABLE 12.1. GENERIC SESSION STRUCTURE FOR CATALYZING

MEANINGFUL ACTIONS

Induction

Response set: Taking helpful action on your own behalf

Theme 1: Your decisions to act are inevitable, and they shape your quality of life
Theme 2: Past actions don’t predict future possibilities
Theme 3: Good action plans necessarily have steps to follow
Theme 4: There’s a danger in thinking too much

Posthypnotic suggestions for integration

Closure and disengagement

SESSION TRANSCRIPT

Induction
You can begin by taking in a few deep, relaxing breaths . . . and begin to focus your attention . . . gradually, of course.
. . . There’s no reason to hurry as you start to grow more comfortable within yourself. . . . You have the time now to
just enjoy the experience . . . of finding and using more of your own internal resources . . . the natural gifts you have
to be able to close your eyes . . . and look inside yourself. . . . And as always, you have an opportunity now to create
an experience for yourself that’s soothing, comforting, and growth oriented . . . in ways you’ll discover gradually over
time. . . .

Build a Response Set Regarding Taking Helpful Action on Your Own Behalf
I can slow my voice down to help you slow down as well . . . so you can start to actively build the qualities of a
gradual absorption. . . . You can actively take the time that you need to build for yourself an internal atmosphere that
makes it easier . . . much easier . . . to consider the possibilities of things you can start to do differently . . . and to
explore the deeper . . . much deeper implications . . . of what it means to have the self-awareness . . . that you can
easily convert into a plan of action . . . for feeling good . . . about what you do. . . . You’ve made the choice to allow
yourself this time. . . . You’ve made the choice of closing your eyes . . . and you’ve made the choice to listen . . . good
choices and good actions that can really make a difference in your life . . . in the best of ways. . . .

Theme: Your Decisions to Act Are Inevitable, and They Shape Your Quality of Life
And every day each of us makes so many decisions ranging from small to large . . . small ones such as what to wear
today . . . or what to have for breakfast . . . or whether to watch this TV program or that one. . . . These aren’t usually
serious decisions that carry a lot of consequences. . . . But at the other end of the spectrum, there are sometimes
huge decisions to be made . . . decisions to take actions that can have a deep and lasting impact . . . such as, “Am I
going to stay in this job or am I going to go?” . . . Or “Do I say something about this person crossing the line here, or
do I say nothing?” . . . And so even as you sit quietly, there are choices you’re actively making at this very moment . .
. even if you don’t realize it . . . about what to take in . . . and what to use as a new frame of reference for meaningful
action. . . . And you can clearly hear me say that the quality of your life . . . is a reflection of the quality of your
decisions . . . the decisions that you actively make when you deliberately choose a course of action . . . even if,
paradoxically, the action is to deliberately take no action. . . . It’s a curious thing to consider how someone decides

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whether to take action or choose to take the action of no action. . . . I remember vividly watching one of my teachers,
who was one of the pioneers of a therapy model called transactional analysis, conduct a clinical demonstration with a
man. . . . She knew that he was an action-oriented person. . . . He described quite clearly how his first reflex in almost
any situation was to want to do something . . . to take some action that was meant to help but sometimes actually
backfired. . . . How much of his socialization led him to adopt the belief in the mantra, “Don’t just stand there, do
something!” . . . and it was a real shock to me when she said quite earnestly to this man . . . the virtually opposite
message: “Don’t just do something, stand there!” . . . I really hadn’t considered before that powerful moment that
there are times when the decision to act means deciding not to act . . . but the ability to choose and the process of
choosing are what I’m encouraging you to focus on now for a little while . . . knowing that even when you choose not
to act . . . it’s an action plan you’ve just created . . . that will have consequences for you to consider. . . .

Theme: Past Actions Don’t Predict Future Possibilities

And so I’m curious . . . and perhaps you are, too . . . about your internal atmosphere . . . the environment you create
inside yourself . . . as you live your life . . . how you challenge yourself to grow . . . and to outgrow . . . what’s no
longer useful to you . . . how you notice . . . and whether you can really appreciate . . . defining what you already do
so well . . . recognizing and acknowledging your strengths as a person . . . and how you resolve what can sometimes
seem to be contradictions . . . between certain things that you used to believe about yourself . . . and about others . . .
and what you’re now coming to believe . . . how many of the older perspectives you hold . . . can still be valued . . .
and reaffirmed for their merits and contributions to your life . . . and how some of the old . . . can be modified . . . and
redefined. . . . You can easily recall actions that you’ve taken in the past . . . things you’ve done that turned out really
well . . . and others that you would have hoped for a different result . . . times when you took action, and it was the
right thing to do . . . other times an opportunity for action that drifted by. . . . And researchers have addressed this very
question about decisions and actions . . . and you might be interested to know that on a purely statistical basis alone .
. . people are generally far more likely to regret the actions they didn’t take than the actions they did. . . . And to
actively open up a future for yourself that will be satisfying to you . . . a future that has so few, if any, regrets. . . .
You’ll need to know the steps for making a sensible decision to take action . . . knowing now more clearly than ever
before that making decisions is inevitable . . . and whatever you do or don’t do is still your plan of action . . . and
learning how to take sensible action steps . . . helps you build trust in your own judgment. . . .

Theme: Good Action Plans Necessarily Have Steps to Follow

It can feel good to know you have choices about what to focus on at any given moment . . . and how your choice
automatically leads you to a next step . . . and a next step after that . . . on the path to some well-defined goal. . . . But
you know and I know . . . that sometimes people aren’t focused on a well-defined goal at all. . . . Instead they simply
focus on how they wish things were . . . as if waiting for some magic to happen . . . that will improve their lives . . .
without them having to learn anything new or do something different. . . . And I have a good example to share with
you of what I mean. . . . I clearly remember working with someone not long ago . . . who asked for my help. . . . He
told me that he was dissatisfied with his life . . . that it just didn’t turn out the way he had hoped it would. . . . And when
I asked him questions about how he ended up in this position of being dissatisfied . . . he said he really didn’t know. . .
. He said that “it just sort of happened.” . . . He couldn’t point to any actions he took that landed him in his current
place in life . . . and he wasn’t aware of any actions he didn’t take. . . . He was just living life from day to day. . . . And
when I asked him what he wanted in seeking help from me . . . he said quite simply that all he wanted was “to be
happy.” . . . And he was afraid that being happy “just wasn’t in the cards for him” . . . and he felt he must be defective
because everyone else seemed happy and he wasn’t . . . which made him feel badly about himself. . . . Now I can
easily understand someone wanting to be happy. . . . It’s what you want and it’s what I want, too. . . . But I wonder
what you might have said to him . . . how you would have responded to his wish to be happy. . . . It was very clear to
me very quickly . . . and might be equally clear to you as well . . . that his way of thinking was so general . . . so
lacking in details that it was difficult for him to recognize his own feelings . . . or the decisions that he made and the
actions they did or didn’t lead him to take. . . . So I gave him an assignment he could do before my next appointment
with him . . . I asked him to find at least three things per day that he did that he felt competent to do . . . things he
could do successfully . . . simple things like taking a shower . . . or getting dressed . . . or going grocery shopping. . . .
And I asked him to pretend he had to teach someone else to do those simple things who had never done them before
. . . and had no idea of where to begin and how to do them. . . . And for this assignment he had to articulate a series
of steps to follow that would guarantee the person would be able to do the task successfully. . . . And it was his job to
identify all the steps involved in, say, taking a shower . . . and bring them to me to discuss. . . . Well, he brought me a
list of only three steps: Get wet, lather up, and rinse off. . . . So I asked him how someone who never did it before was
supposed to know how to find a shower . . . and did they know to undress first and take off their glasses . . .and did
they have a towel to dry off afterward? . . . And how was that person supposed to know how to turn on the water and
get the temperature right? . . . And how was the person supposed to know how to use soap or shampoo? And how
long were they supposed to wash before rinsing? . . . And with each question I asked, he came to the startling
realization that his list of steps would never help anyone successfully take a shower. . . . He wasn’t able to tell me the
steps to follow so that someone, anyone, could successfully take a shower. . . . And then I asked him how someone
would feel if they tried to follow his steps for taking a shower and failed to succeed . . . and he understood someone
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would probably feel bad and even defective. . . . I paused and then I asked him what the steps were to be happy . . .
and he got the point instantly. . . . He realized he didn’t know . . . and in that moment he became wonderfully aware
that he was not defective. . . . He just didn’t know the steps to follow . . . the sensible action to take. . . . And how can
you take the next step when you don’t know what the next step is? . . . Someone wise once said something I think is
worth you remembering . . . “A goal without steps is merely a wish.” . . . And learning to define the steps and actively
take them is how you can move from the wish to be happy to the genuine experience of liking your life and how you’re
living it. . . . And I think you’ll enjoy discovering you can develop a whole new way of thinking . . . that serves you well
. . . a style of thinking that allows you to observe the steps that people take . . . that you may be able to take, too, in
your own way . . . to experience something you really want to experience. . . . You’re learning now that there are
steps to take to build a good career . . . or to have a good relationship . . . things you can do that can work. . . . And
there are things to do that will likely never work. . . . And now you’re learning to take action . . . but action within a
sequence that can likely succeed . . . so that one step at a time . . . you can move forward in ways you feel great
about . . . and are happy with. . . .

Theme: There’s a Danger in Thinking Too Much

And how do you grow into thinking in terms of goals instead of mere wishes? . . . What are the steps . . . that you can
follow . . . when you don’t know what steps to follow? . . .And when something happens . . . and you’re not sure how
to react or what to do . . . it’s so natural to want to contemplate what’s going on . . . to consider what it means . . . or
what could be better . . . or what needs to be solved. . . . It’s understandable that you would want to understand . . .
and even ask why something is the way it is . . . but as you’re discovering . . . there’s an important distinction to be
made between useful analysis . . . and useless rumination. . . . How much analysis is needed before some action is
needed? . . . After all, understanding alone isn’t enough. . . . It must invite action . . . doing something that can help. . .
. And so often the action to take is a simple, straightforward one. . . . For example, instead of wondering if someone is
annoyed with you about something you said or did . . . you can ask. . . . Instead of wondering what to do . . . when
you know you need to do something purposeful . . . you can ask for ideas . . . and you can take actions you’ll feel
good about. . . . And instead of analyzing your past some more . . . you can do something to make tomorrow better. . .
. And consider again the question I asked earlier: How much analysis is needed before some action is needed? And
the more important question: How do you know when it’s useful analysis and when it’s useless rumination? . . . And
here’s my answer: If it doesn’t lead you to take timely and effective action, it’s useless rumination. . . .

Posthypnotic Suggestions for Integration

So your too busy mind can slow down . . . and stop its spinning around of the same old stuff . . . and then it becomes
clearer what to do. . . . You gradually grow clearer about what steps you need to take . . . even if the first steps are
just to find out from trusted others what the steps are you might take. . . . And I’m happy to help you with that. . . . And
gradually you can find yourself reflexively . . . automatically . . . pushing yourself to convert worries to actions . . .
vulnerabilities to strengths . . . worries to sensible actions. . . . You can actively convert concerns to decisions and
helpful solutions . . . with a strong sense that there’s something good to be gained . . . an outcome that’s clearly worth
the effort. . . . And it eventually becomes second nature to you to be a person of decision and a person of action . . .
and the sense of calm within you grows as you become more decisive. . . . The quiet in your mind grows as you take
effective action . . . a calm mind . . . and a calm body . . . and a strong sense of comfort that spreads over you . . . that
you may not be able to easily explain in words. . . . And it’s wonderful that you don’t have to. . . . You can just enjoy it .
. . and then really integrate deeply the recognition that what you do matters at least as much as what you think or feel.
. . . And the deeper meaning of the saying, “Actions speak louder than words” can have a new and profound
significance for you . . . all the while knowing that what you do defines more of who you are than what you think or
feel . . . and doing well to feel well . . . comes so much more easily. . . .

Closure and Disengagement

And as we begin to bring this session to a close . . . it might be more obvious to you than ever that it’s your
experience here . . . your time of having been comfortably absorbed . . . as you consider what it means to go from a
feeling or an idea to taking meaningful action. . . . And even now . . . you get to decide how much time you want to
continue being relaxed and focused on these ideas . . . perhaps even as long as another full minute if you wish . . .
[pause]. And now you can take the action of reorienting yourself at a gradual rate . . . beginning to move as you
become more alert . . . building your momentum for becoming fully alert, fully reoriented . . . opening your eyes . . .
feeling ready to do what needs to be done. . . .

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Chapter 13

Instilling Integrity
Always try to be the person your dog thinks you are.
—Popular bumper sticker

The Case of Jack

Jack started drinking in high school. There were always parties where the beer flowed freely, and if there was a
party going on somewhere, anywhere, you were sure to find Jack there. Everybody drank, it seemed, but not
quite in the way that Jack did. He wasn’t aggressive or obnoxious when he was drunk, but his ability to drink
great quantities was well known by all his peers.
Despite drinking way too much, Jack was able to do the things he needed to do. He passed all his classes
with flying colors, applied to a fairly prestigious university, got in, and formally transitioned from his high school
drinking days to his university drinking days. By now alcohol had become so deeply ingrained in his day-to-day
life that it really didn’t matter what day or time it was, it was time for another drink.
Somehow during his university drinking days Jack found the time to take and pass his classes and graduate
with a degree in political science. He didn’t know yet what he would do with his degree, but he slowly began his
search for what to do in terms of a career.
Jack was fairly oblivious to all the human wreckage he was leaving behind by the time he graduated. He had
never been arrested for a DUI, but he had smashed a car or two when driving while intoxicated and managed to
get away with it. He had made some true enemies of classmates he begged, borrowed, and stole coursework
from. He had made lots of promises he never intended to keep to unsuspecting people he was willing to burn.
He had dated some really nice women but was too drunk too much of the time to treat them as anything better
than convenient sex partners. He routinely told them what he knew were lies just to hook up, that he “really
cared” for them and he’d settle down one day, “But, hey, if you can’t party in college, when will you?” More than
one woman had left him in disgust and rage, but Jack didn’t care. On to the next one. . . .
Jump ahead a few years. Jack found a job working for a political action committee, had a modest but decent
income, was still carefully avoiding any real relationships, and was still drinking as much as ever. Then came
the unfortunate but all-too-predictable turning point: He was driving while slightly intoxicated, just as he had
many times before, but this time he hit and badly injured a pedestrian who was right where he should be, in a
crosswalk. For a split second Jack thought about driving away, and he was unsure then and is still unsure now
as to why he didn’t. But he didn’t. He was arrested, jailed briefly, went through a grueling detox, fined, given a
community service mandate as well as a therapy mandate, and was then left to pick up the pieces of his life.
His victim’s injuries were bad, but he survived. In this regard, Jack was lucky, but for the first time in his life,
Jack was flooded with guilt.
Jack had already joined AA as a part of his court-ordered treatment when he came for therapy. The story he
told about himself smacked of a sociopathic, narcissistic, terrible human being, but the man in front of me was
none of those things. He was pensive, fretful, regretful, racked with guilt and self-doubt, and wide open to
whatever I might say that could be of help to him. He was clear that he had hit the proverbial bottom and now
had to reinvent himself as a much better human than he’d ever been. As he said ruefully, “The party is over.”
So, what’s Jack’s problem? Was he drinking to cover up his true feelings because he doesn’t want to feel
vulnerable? Or because he hates himself, is depressed and suicidal? Does he have a fragile self-esteem that
requires him to be the party-guy center of attention? Does he suffer an antisocial personality disorder and is so
morally bankrupt that he finds using and abusing others satisfying? Does he have buried feelings of resentment
he’s using alcohol to soothe? Does he have an addictive personality, genome, and/or brain such that he was
inevitably going to be an addict of one kind or another? Or what?

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 The content of Jack’s problem is becoming sober and living a life of sobriety. The process Jack now faces is
that of becoming a human being, a mensch, somebody with integrity who’s worth knowing. He had a long way
to go.
Feeling true guilt for the first time he could ever remember gave the therapy some leverage. He didn’t want to
feel that way, and now it was his constant companion. His involvement in AA encouraged him to acknowledge
the wrongs he had committed against the people he hurt through his terrible behavior. He wasn’t sure how to
do that exactly since so many of the people he hurt were in the distant past, their names and faces lost in the
haze of his alcoholism. He and his sponsor, whom he really liked and appreciated, talked about this step of his
recovery a lot.
Hypnosis is a great tool for helping people engage in the process of self-discovery as well as self-definition.
Each of us has to define ourselves on a variety of different levels simply because we play so many different
roles in life: someone’s kid, someone’s parent, someone’s boss or employee, someone’s friend, someone’s
spouse, and so forth. The challenge in life, the road to building integrity, is to define those roles and their
boundaries. This is what it means to develop a “code to live by.”
In Jack’s case, the hypnosis sessions began gradually, introducing the concept of how people become
people: the socialization process that we all go through that teaches us what’s right and wrong, what’s valued
and devalued, what you can and can’t say or do, and so forth. We all go through a value programming process,
the personal values we’re encouraged to develop and live by.
But those are outside forces working on us as we grow up. What about someone in Jack’s position, an adult
who has already lived a significant portion of his life? Is he just who he is, or is he more? Asking rhetorical
questions such as these during hypnosis sessions helps launch people into the direction of self-awareness and
self-definition. More important, it sets up the greater part of Jack’s intervention: developing his own code of
honor. His time in AA meetings helps facilitate this as he listens to others’ stories of life mistakes as well as
sharing his own. He is literally bombarded with stories that can tell him what works in life and what doesn’t, and
what defines integrity for him.
What values does he profess to have as his life foundation? What specifically does he recognize and value in
other people? What gives them worth and dignity, and what must he do to acknowledge their worth and
preserve their dignity, as well as his own?
Jack had about 10 sessions, and the combination of hypnosis sessions and exercises in values clarification,
empathy, problem-solving skills, and more gave Jack a map to follow, a structure to use to make decisions he
could feel good about, knowing he couldn’t feel good about any decision that hurt someone for his gain or
amusement. He was clear that the time he would feel best and have the greatest self-respect, would be when
he set forth his rules for himself and then lived by them, especially when they weren’t particularly convenient
but were still the right thing to do.
I didn’t see Jack again until he came back three years later. He said, “My code of honor required me to come.
I want to acknowledge you for what’s happened in my life. My legal troubles were substantial, and though I’m
still not out of the woods entirely, I’m getting a lot closer. I still work at the same place but have been given
more responsibility, more money, and more respect. I’m not feeling deserving exactly, but I am feeling lucky.
But best of all, I met a woman about a year ago that is the most kind and loving woman I could ever hope to
meet. I am head over heels in love with her, an exciting but scary feeling. We’re getting married at the end of
the year. I wanted to invite you to the wedding personally. Will you come?”

The Role of Integrity in Quality of Life

When I was an undergraduate student at the University of Michigan (Go blue!) a long time ago, I
took a course in philosophy. While much of the course was loftier and more abstract than is my
usual way of thinking, my professor said something once that was crystal clear, immediately
relevant, and powerful enough to stay with me all my life. He said, “Integrity is what you will do
when you know you won’t get caught.” What he said and the way he said it struck me like a
thunderbolt. I was young and was only just starting to develop a deeper quality of thinking, and I
just hadn’t given the subject of personal integrity much thought up to that time. His words that
day launched me in a whole new direction as I began to focus much more of my attention on
how I would define integrity for myself.
I have since heard many variations of my professor’s words (“Integrity is about how you’ll act
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even when no one is watching you”), and all of them strike a visceral chord. How shall we define
ourselves in terms of character strengths and virtues? And as a corollary, how might others
regard us in those qualitative terms?
The times when we tend to be the most self-critical and harsh with ourselves, the times we
suffer blows to our self-esteem, are when we violate some standard of behavior that we’ve set for
ourselves. It may be a relatively small transgression such as blowing our diet today, or it might
be a great transgression such as punching someone out when they enraged us in some way. The
feelings of shame and regret we have when we cross some line that we’ve drawn for ourselves
that is not to be crossed can be incredibly corrosive. It can give rise to a level of self-loathing that
makes self-preservation seem both undeserved and futile. Instead, it can generate the kinds of
self-destructive behaviors (such as alcohol or drug abuse) and/or antisocial behaviors (such as
drunk driving or domestic violence) that reveal for all to see how little regard one has for oneself.

Typical Problems Derived From a Lack of Integrity

The types of problems that people might present for treatment that reflect a lack of integrity can
seem quite diverse, and may include such problematic patterns as these:

Lying to or deceiving others for personal gain at their expense

Engaging in behavior that is harmful to others with little or no regret
Justifying bad behavior with no sense of actual wrongdoing
Having little or no awareness of the situational rules that define appropriate behavior
Knowing what the rules or expectations are and violating them without regard either for
others or for the consequences
Having little or no insight into what one holds as personal values
An inflated self-esteem that is undeserved
A willingness to manipulate others in self-serving ways that are harmful to them

These represent the kinds of problems clients might present that all reflect a lack of integrity.
More often than not, if such people show up for therapy at all, it’s because they were dragged in
by someone they hurt. Sometimes, though, people know they are doing things that lack integrity
and need help developing their character strengths. The content of what they want help with is
what they will naturally describe to the therapist, but it is up to the therapist to recognize the
client’s inability to create and live by a meaningful code of conduct as the process needing
intervention.

Defining the Salient Therapeutic Targets: Positive Psychology and

Focusing on What’s Right

The use of hypnosis in clinical contexts might well be the first application of a positive
psychology, preceding by decades the formation of the current science of positive psychology.
After all, anyone who practices hypnosis begins with the conviction that people have more
resources than they realize. Based on that core belief, the practice of hypnosis strives to connect
or associate people with those resources and then help them use the resources in the context(s)
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where they can serve their needs well.
The orientation to identifying and mobilizing the client’s personal resources is the very core of
a hypnosis practice. It addresses this basic philosophical question about the nature of therapy: Is
the goal of treatment to reduce pathology or expand wellness? The practice of hypnosis, with its
emphasis on empowering people to use more of their innate resources, answers this question
unambiguously.
Positive psychology has become an influential force in the field, valued especially for its
striving to shift the collective focus of the profession from pathology to wellness. By asking
profoundly important questions about how we can bring out the best in people as individuals,
communities, and cultures, positive psychology has broadened our view of people to consider
their strengths and virtues. What do we really know about what defines the best of human
potentials?
As a direct response to the pathology-focused classification systems in the field of mental
health, psychologists Martin Seligman and Christopher Peterson, leading advocates of positive
psychology, undertook extensive cross-cultural research to catalog the best of what humans have
to offer. The result was their seminal contribution, Character Strengths and Virtues: A
Handbook and Classification. In that book, Peterson and Seligman offer an important insight
relevant to this chapter:

Character strengths are the psychological ingredients—processes or mechanisms—that define the virtues. Said another way,
they are distinguishable routes to displaying one or another of the virtues. For example, the virtue of wisdom can be
achieved through such strengths as creativity, curiosity, love of learning, open-mindedness, and what we call perspective—
having a “big picture” on life. (2004, p. 13)

One of the primary goals of a process-oriented hypnosis, then, is to associate people to their
strengths. That means first creating a context where people can identify their strengths. What
about all those people who are so global in their thinking, so lacking in emotional differentiation
and insight, that they really don’t have a clue as to what their strengths are? Encouraging such
people to review situations in their life and then helping them identify and own (i.e., have agency
for) personal resources they displayed in those situations can be a powerful lead-in to the
process-oriented hypnosis session provided in this chapter.
Likewise, what about those people who are feeling so badly about themselves, who are so
filled with self-loathing, who have behaved so badly perhaps or who feel so trapped in their
misery, that the very notion of having a character strength seems virtually impossible to them.
Well, it might be—at this time. But it points the way to a worthy goal and highlights again the
importance of the ideas and methods for building a future orientation, contained in Chapter 6. To
structure an intervention that speaks to what can develop, what new strengths and virtues can
emerge, is what it takes to build hope. In such cases, hope can literally save lives.

Defining Integrity: Having a Code to Live By

One of the most inspiring stories I’ve ever heard is told by astrophysicist and popular speaker
Neil deGrasse Tyson. It’s his telling of his first encounter with famed scientist Carl Sagan, who
was professor of astronomy and space sciences and director of the Laboratory for Planetary
Studies at Cornell University. Sagan was known to virtually all Americans through hosting the
popular science series Cosmos as well as his frequent endearing appearances on late-night
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television programs.
Neil was only 17 years old, self-described as “just a kid from the Bronx,” but was already
deeply immersed in his love of physics and astronomy. He had applied to several universities
with the intention of studying physics as an undergraduate. One of the schools he applied to was
Cornell University. His application was so impressive that it was forwarded directly for review
to Carl Sagan. Almost unbelievably, Carl wrote a letter to Neil inviting him to come up on a
Saturday for a guided visit to the university and his lab. Neil took the lengthy bus ride and there,
ready to greet him, was Carl Sagan! He was taken around while they talked at length about
Neil’s interests and what his future might look like.
When it was time for Neil to catch his bus home, it had started to snow. Carl said the snow
might delay his bus and, if that should happen, he told Neil to call him and he’d come get him
and let him stay the night at his home. Neil was, needless to say, quite floored by this man’s
kindness and generosity to a potential student. In telling this heartwarming story, Neil said, to
paraphrase him, “I already knew what kind of a scientist I wanted to be. From that moment with
Carl I now knew what kind of a man I wanted to be.” Here was a moment, a powerful moment,
that inspired in Neil a lifetime commitment to be available and generous in sharing his
knowledge and support with others. (To hear the full story in his own words, search “Neil
deGrasse Tyson and Carl Sagan” on YouTube.)
This story represents the foundation of the worthy goal of instilling integrity. What
specifically we want to encourage as worthy behavior is the content, and how that behavior
aligns with and reflects the underlying values of the person is the process. It starts with
reinforcing the notion that you are responsible for the choices you make and the behaviors you
engage in, as discussed in Chapter 11.
The next step, then, is to define and develop a personal code of conduct. By a code of conduct,
I mean an organizing set of principles that will define what you can and can’t do and what you
are and are not willing to do. When someone steps into a role, whatever role that might be, there
are rules that define what is ethical, moral, and legal. These rules may be explicit and well
defined or only implicit and perhaps even easily overlooked.
Consider some examples: When someone becomes a cop, there are rules of conduct (no, you
can’t pocket some of the drug money you seized, and no, you can’t plant fake evidence on
someone you don’t like). When someone becomes a psychotherapist, there are rules of conduct
(no, you can’t sleep with your clients, and no, you can’t look the other way while a child is
endangered). When you become a parent, there are rules of conduct (no, you can’t take a nap
while your toddler plays near the swimming pool, and no, you can’t teach your 6-year-old how to
make and enjoy margaritas).
The code of conduct provides a structure for living. It provides a straightforward way of taking
at least a little of the ambiguity out of life while providing clarity and certainty that “this is how I
want to live. These are the standards I want to set for myself.” We want to help our clients,
especially the ones that have behaved badly and know it, to develop a structure that is honest,
realistic, and can provide meaningful guidance when they are faced with the need to act with
integrity.
That structure is derived from a self-awareness of one’s values, what you prioritize and
consider important. A whole science has been built around what is termed values clarification,
and there are literally thousands of books and workbooks that can help someone gain greater
clarity about their values. That clarification paves the way for then honoring those values in your
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own behavior, doing those things that reflect and give action to those values. Just as important, it
helps you recognize the values that others hold that may or may not be quite different than yours.
The ability to recognize other people’s strengths and virtues is a powerful basis for building good
relationships and having realistic expectations for what matters to those folks. Consider how
much anger and disappointment that can prevent.

Self-Esteem and Your Honor Code

Doing things that reflect and give an action voice to your values is how self-esteem builds. Self-
esteem is a statement about how you regard yourself. Self-esteem is also a source of confusion
for therapists who think that building a client’s self-esteem is a goal of treatment. Well, there are
lots of people who have high self-esteem . . . who shouldn’t! They may like themselves but
having high self-esteem doesn’t mean you’re a good person. Every sociopath in prison for brutal
crimes has good self-esteem despite having no legitimate basis for doing so.
Here’s the intersection, then, with positive psychology’s emphasis on building up character
strengths and virtues. So many of the virtues that have been catalogued only surface in the
context of our relationship with others. Honesty, loyalty, compassion, generosity, love, and more
become manifest only or primarily through our interactions with others. And, consistent with my
earlier point that one of the reliable pathways to feeling badly about oneself is to betray a value
or virtue, the need to earn respect for yourself is also tied to the need to earn respect from others.
How far should someone go to earn the respect of others? How does one evaluate one’s level
of integrity or, even more simply, one’s effectiveness in the way one has performed? These
questions highlight one of the ambiguities associated with trying to live a life of integrity. How
well can I live up to my personal code of conduct? How appropriate and realistic are the
standards I’ve set for myself? These soul-searching questions can easily become the basis for
ruminations that give rise to higher levels of self-doubt, anxiety, and depression, as discussed in
Chapter 12. Here again, the value of a process-oriented hypnosis session to help curtail the
ruminations and encourage clarity of purpose cannot be overstated.
It helps to know that one’s character strengths represent potentials to be developed and are not
fixed, unchanging traits. The client can come to know that whatever mistakes they’ve made,
whatever flaws they’ve had revealed, there is room to grow into being someone they themselves
can respect. It’s not about globally raising the client’s self-esteem. Rather, it’s about the client
using their personal code of conduct to say things and do things consistently that allow them the
wonderful opportunity to walk away from some interaction, whether in relationship to
themselves or someone else, saying to themselves, “I like what I did there.” Table 13.1 provides
a vehicle for helping your clients evolve a personal code of honor.

TABLE 13.1. GENERIC SESSION STRUCTURE FOR INSTILLING INTEGRITY

Induction

Response set: Changing self-definitions

Theme 1: You generate your experiences
Theme 2: You can develop a personal code of honor

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 Theme 3: Discover, define, and own your strengths and virtues
Theme 4: Rumination and self-doubt cloud self-awareness
Theme 5: You can recognize and acknowledge strengths in others, too
Theme 6: Integrity means honoring your code of conduct

Posthypnotic suggestions for integration

Closure and disengagement

SESSION TRANSCRIPT

Induction
You can begin by arranging yourself in a comfortable position . . . preparing yourself to focus . . . and relax . . . and
listen. . . . It may help you grow more comfortable more quickly when you let your eyes close. . . . This focusing
experience can be a welcome opportunity for you to spend a little time with yourself in a way that’s relaxed and quiet.
. . . It’s a quality of time that is free of any particular demands . . . meant for you to simply experience yourself in a
comfortable and calm way. . . . Right now you have the room . . . all the room you need inside yourself . . . to be with
yourself in a way that’s easy, gentle, and even generous. . . . And, of course, as you’ve been experiencing different
hypnosis sessions over time . . . by now you have acquired ample experience with allowing yourself the luxury of
relaxing . . . and you’re wonderfully capable of making a deliberate decision to get internally focused . . . to build a
quality of attention that also has some intention. . . . And here at the outset . . . you might not know exactly what the
session’s intentions are just yet . . . but there’s plenty of good reason to believe that you can expect positive qualities
of comfort and meaningful ideas that, as you listen, can feel really good to you . . . knowing full well that you’re able to
choose what’s important to focus upon . . . and consider . . . and make good use of in the future. . . .

Building a Response Set Regarding Changing Self-Definitions

Well, this session and every session . . . provides a forward-looking approach that reminds you in powerful ways that
you’re much more than your history. . . . You’re much more even than who you think you are in this moment. . . . After
all, who you are naturally goes through changes over time . . . things you can recognize that used to matter to you
that just don’t matter much anymore . . . and, likewise, things that never really mattered very much to you that matter
a lot to you now. . . . These changes in your priorities and values sometimes arise seemingly quickly . . . and some of
these changes evolve gradually. . . . It highlights the point that your view of yourself requires frequent updates . . .
considerations of who you were, but much more importantly who you’re becoming. . . . And embedded within this
session is an invitation to begin to use your capacity to look forward in a different way. . . . And whether it’s slightly
different or greatly different . . . you really won’t know until you discover what changes in your experience of yourself
in the coming days and weeks. . . . But one of the things that I want to draw your attention to is how easily you can
allow yourself the experience . . . of getting absorbed . . . and it becomes even easier with each hypnosis session . . .
as you go inside and discover more of your innate resources . . . and update your view of yourself . . . redefining
aspects of yourself in ways that you can feel really good about. . . . And even now as you relax and focus yourself . . .
I’m encouraging you in the most respectful way that I know how . . . to notice the quality of your experience and the
ways it gradually changes as you continue to grow more comfortable. . . . And what exactly you notice as you listen, I
obviously have no way of knowing. . . . It might be the physical sensations of relaxing . . . such as the changes in your
breathing and muscle tone. . . . It might be the gradual immersion in a deeper awareness of the things you say to
yourself through your thoughts . . . as you consider new possibilities. . . . And when you do . . . how easy it can be to
acknowledge and appreciate the greater goals you have of developing new ideas and perspectives that can make
your life better. . . . It can bring into sharp focus the type of internal atmosphere that you generate that is consistent
with wanting to grow as a person and redefine yourself in some important ways . . . the very reason you’re taking the
time to focus on and experience the benefits of learning through this and other sessions you listen to as well. . . .

Theme: You Generate Your Experiences

When you’re able to go inside yourself . . . and focus yourself . . . and engage with new ideas and possibilities as you
are right now . . . it would be easy for you to take that ability for granted . . . as if there’s nothing particularly special
about it. . . . But I hope you can appreciate . . . I expect that you can appreciate . . . that doing what you’re doing right
now . . . is exactly what far too many people don’t know how to do. . . . They have no idea that they can alter their
physiology and deliberately relax just as you are doing. . . . They have no idea they can enhance their mood and feel
better by choosing to get absorbed in ideas that are enlightening and uplifting, just as you are doing. . . . And this is
why taking the time you’re taking now to generate experiences of comfort like this one becomes so valuable. . . . It
says a lot of good things about what you value . . . and you can appreciate the process . . . the how of how you go

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about using what you experience. . . .

Theme: You Can Develop a Personal Code of Honor

Because how you integrate meaningful ideas and perspectives into your life . . . is worth considering . . . how your
internal atmosphere gradually grows calmer . . . how you develop a greater sense of what really matters to you . . .
what your values are and how they guide the choices you make . . . how you evolve a stronger sense of confidence
as your personal code of conduct becomes clearer. . . . Now, what do I mean by a “personal code of conduct”? . . .I
mean the ever-clearer guidelines you’ll define for yourself and then follow . . . the personal code of conduct that leads
you to know you’re living your life with integrity . . . being true to yourself in ways that keep building your own self-
respect. . . . And there are lots of examples of codes of conduct different people live by . . . the code that someone
who joins the military adopts to be an honorable part of a greater whole . . . the code that physicians live by in how
they treat their patients . . . the code that teachers adopt that guides their relationships with their students . . . and on
and on. . . . And you’re defining your own code of conduct in the way you live . . . what you prioritize . . . what you are
willing to say and do, and what you’re simply unwilling to say or do . . . in order to honor your personal code. . . . Now,
that doesn’t mean you will always say and do the things you feel good about. . . . After all, you’re not a robot that can
just be programmed. . . .

Theme: Discover, Define, and Own Your Strengths and Virtues

But you can aspire to enjoy a level of self-respect that comes from knowing what matters to you . . . and how you can
live by that knowledge. . . . And being absorbed in experiences like this one . . . can help people discover important
and even life-changing things about themselves . . . especially when they discover their own character strengths . . .
and their virtues. . . . Now, I can easily talk about the atmosphere that surrounds you in daily life . . . the way the world
and the people in it treat you as you live your life. . . . And sometimes the atmosphere that others create outside of
you is wonderfully positive and supportive . . . and other times, not as much when people are thoughtless or worse. . .
. But in the same way that I can talk about an external atmosphere . . . I can talk about an internal atmosphere, the
atmosphere that you create inside yourself . . . the way you treat yourself . . . the way you talk to yourself through your
thoughts . . . the way you choose what you’re going to do and what values you choose to live by and integrate into
your everyday living . . . and what you choose to show the world about you through the things you say and do . . . that
make clear statements to others about what you have adopted as your personal code of conduct. . . . And having
learned as much as you have learned about how people will evolve as they strive to rise to the standards that they set
for themselves . . . and how people grow into being richer in their internal resources as they explore new possibilities
and have new experiences and develop new insights . . . it all really comes together now to help you form and live a
meaningful life that you can feel good about. . . . And when I start focusing your attention on your character strengths
and virtues . . . it’s important to know what I mean. . . . I’m speaking about those characteristics that represent the
best of human experience . . . the most valuable aspects of what human beings . . . including you . . . are capable of. .
. . Some of the virtues people prize most . . . regardless of where they live . . . or what culture they live in . . . are
loyalty, compassion, honesty, empathy, and self-sacrifice. . . . I can add to that list the capacity to love. . . . These
virtues really do represent the best of what humans can be. . . . And what is especially noteworthy is that all of these
virtues . . . loyalty, compassion, honesty, empathy, self-sacrifice, and love . . . are all virtues that most prominently
surface in our relationships with others. . . . These strengths and virtues are reflected in what we do and say in our
interactions with others. . . . And the quality of the relationships that you build are so powerful in defining you . . .
reflecting clearly what you value . . . what you choose to say to people and what you deliberately choose to withhold .
. . what you focus on and amplify in your awareness of others and what fades into the background as unimportant. . . .
And I wonder, if I had the chance to meet you socially and ask you what you consider to be your character strengths .
. . your virtues . . . I wonder how you would answer that question. . . . I wonder whether you’ve ever given this
important question any serious, in-depth consideration . . . and you might reply with an updated self-awareness . . . or
whether you may have been trained to be so modest that it’s hard to acknowledge your own strengths and virtues. . .
. Training yourself to be so self-aware that you know exactly what your greatest strengths are . . . doesn’t mean being
arrogant or full of yourself. . . . It means knowing your strengths and recognizing that this is the foundation for learning
how to use them sensitively and skillfully . . . in a way that shows personal integrity. . . . And when you take even just
a short while to notice and acknowledge your strengths . . . well, isn’t that quality of being able to acknowledge what’s
right with you a virtue as well? . . .

Theme: Rumination and Self-Doubt Cloud Self-Awareness

The ability to notice and acknowledge what’s right in yourself or someone else is, indeed, a virtue. . . . It’s an
important component of empathy and compassion for both yourself and others. . . . There’s an experience I had I’d
like to share with you that I believe you’ll find both relevant and helpful. . . . In one of the clinical demonstrations I
conducted not long ago, I was doing hypnosis with a bright and kind woman who had recently retired from her long
career as a schoolteacher . . . and she described to me how she was filled with distressing doubts about whether she
had been a good teacher. . . . And when I began to describe some of the characteristics of good teachers . . . the
ones who have a personal investment of empathy and compassion for their students and treat them as valuable
human beings . . . the ones who want to be prepared in order to use each lesson hour well because they generously
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want to impart some valuable knowledge and experience . . . the ones who have a loyalty to the higher principles, the
code, of the profession . . . the ones who actually teach their students how to think for themselves instead of dictating
what they “should” think. . . . Well, somewhere during the course of that session she went from wondering . . . from
years of wondering, ruminating, and having self-doubts about her effectiveness as a teacher . . . to seemingly all of a
sudden becoming quite clear that she really was good at what she did. . . . She just hadn’t ever gotten so specific in
her thinking before . . . about what personal character strengths and virtues she brought to her classroom. . . . She
had never articulated the code of honor that she had lived by all those years, that she now recognized defined her as
a teacher with great integrity. . . . Now, I have no way of knowing what self-doubts you might entertain . . . but when
you’re in this very different internal space of comfort and acknowledgment right now . . . it’s entirely possible and
reasonable to expect how uncertainty can become certainty . . . and how you can shift from questioning and doubting
to recognizing your strengths . . . a process which has started by noticing and acknowledging what’s right with you. . .
.

Theme: You Can Recognize and Acknowledge Strengths in Others, Too

And how easy it then becomes to notice and acknowledge what’s right with the people around you . . . especially the
ones you choose to bring into your life . . . because you appreciate their integrity as well. . . . What an extraordinary
experience to develop a new layer of confidence . . . that you have something to say, something to contribute . . . and
that you have the character strength and the virtue to go ahead and say it . . . to be one of those endearing people
that can recognize the positive in others . . . and being aware of the virtues you hold that allow you to actually go the
next step of actually saying something about it. . . . You know how very far a kind word can go. . . . And as it becomes
easier for you to recognize your own strengths and virtues . . . as it can and will over time . . . and those of others, too
. . . you might wonder how that became possible. . . .

Theme: Integrity Means Honoring Your Code of Conduct

But it will become increasingly obvious to you . . . that it became possible when you declared your personal code of
conduct to yourself . . . your self-defined sense of what is and isn’t right for you . . . that allows you to evolve and
maintain strong self-respect. . . . It also helps a lot to know that all people, even smart and self-aware ones . . . can be
influenced by circumstances or strong feelings to behave in less than ideal ways. . . . But what might be a useful way
to regard yourself when you catch yourself acting in a way you really don’t much care for? It can really provide you
with a great deal of comfort when you step outside what happened . . . and can see more clearly what the situational
influences were . . . that gave rise to your response . . . and with the clear thinking of knowing that there may be
something valuable to learn from what happened. . . . It helps to be clear that there’s a quality of consideration that
makes it easier to learn from what happened without being unnecessarily harsh with yourself. . . . When you learn to
be specific in your thinking . . . you can more easily recognize that an all-or-none view of yourself isn’t an accurate
viewpoint . . . because, as you’ve learned, a really smart person can sometimes make a foolish mistake. . . . A nice
person can sometimes do something that isn’t quite so nice. . . . A sensitive person can do something that isn’t so
sensitive . . . just as a mean person can do a nice thing and a dull person can do something bright. . . . And when
you’re able to hold on tightly to the bigger picture of who you are . . . what you’re capable of . . . the code of conduct
you’ve defined for yourself as the basis for living with integrity . . . well, these are things that you’ve already done and
are still doing that highlight your talents . . . your skills . . . your strengths as a person. . . . And it’s important that you
take the time to notice these things in yourself . . . and to remind yourself that you’re actively seeking out ways to
continue to improve . . . ways to continue growing as a person . . . to live with values you hold dear and choose to live
by . . . because they give your life meaning and provide you with the satisfaction of knowing you’re not just living . . .
you’re living well. . . . And it certainly helps to be able to be specific about what your values are . . . what the
guidelines are that you set for yourself in striving to live with integrity . . . also knowing that other people prioritize
other things that they value . . . that you might not . . . just as you might value things that they do not. . . . And this is
what paves the way for a respectful acceptance of the differences between people . . . but especially accepting for
yourself that which matters to you . . . what your personal code of conduct requires of you. . . . That’s what helps
create the internal atmosphere of self-confidence, a greater belief in yourself and what you define as important in
living your life in a way that’s true to your values. . . . What an easy way to protect yourself and your self-esteem. . . .
What an important way to manage your internal atmosphere to keep it comfortable. . . . Well, certainly you’ve learned
through all your years of experience in living that there isn’t only one right way to live . . . only one right personal code
of conduct. . . . In reality, there are many right ways. . . . How valuable it is to appreciate that each way has some
value. . . . What a wonderful ability to choose what you’re willing to say to someone else and what you’re not . . . what
you’re willing to say to yourself and what you’re not . . . and what you are and are not willing to do in living your life
with integrity. . . . And I’ve been talking about the value of the specifics in your self-definition . . . the details that come
with experience that help you create a calm, self-respectful internal atmosphere. . . .

Posthypnotic Suggestions for Integration

And now you’re creating the possibility for yourself of shifting your own focus to be able to notice and acknowledge
your strengths as a unique person. . . . And I’m curious just how many ways across your lifetime you’ll maintain that
connection to your strengths . . . and what that connection will bring forth in your life. . . . And you can certainly
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anticipate that the future holds countless opportunities for you to act in a way that reveals your character strengths
and virtues . . . as you live by your personal code of conduct . . . as a person with honor that you yourself can respect.
. . . So, having said all of those things I’ve said now, what you’ll absorb, what you’ll stay connected to, as always, is
up to you. . . . But if you find yourself paying more attention to what’s right with you, well, I won’t be surprised. . . .

Closure and Disengagement

It’s time to bring this session to a close now . . . a comfortable close. . . . And when you’re ready to do that because
you’ve had enough time to integrate these enriching ideas about acknowledging your strengths and virtues . . . then
you can start the process of reorienting yourself slowly, comfortably . . . at a rate that suits you well. . . . And then
when you’re ready, you can reorient yourself completely . . . and let your eyes open whenever you’d like . . . fully alert
. . . and feeling good.

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Chapter 14

Evolving Foresight
For tomorrow belongs to the people who prepare for it today.
—African proverb

The Case of Janet and Mark

Janet and Mark arrived early for the appointment, clearly eager to get things going as quickly as possible.
Holding hands, radiating an easy comfort with each other, Janet began by saying, “Mark and I have been
married for almost five years now. He’s 34, I’m 32. We’re both healthy and happy with our lives independently
as well as together. We each have great jobs, a really good income, a really great lifestyle, and we don’t want
to screw it up.”
Mark jumped in at that moment and said, “We’re here because we’ve been having this ongoing discussion
lately that doesn’t seem to end, and it’s starting to get both tiresome and stressful. We want to hash this out
with a professional who can give us a reality check and make sure we’re not missing something.”
Janet jumped back in and said, “It’s about having kids. When we were dating, we were really clear with each
other that neither of us wanted to have kids. We got married, and that didn’t change how we felt. We both still
don’t want kids. But we are getting pressure from both our families, who see that we’re financially capable, the
marriage is stable and healthy, we’re good people that could be good parents, and they have started to plant
the seeds of doubt about this in us. Actually, more in Mark than in me.”
Mark again: “My folks lived for their kids, which I appreciate, but whenever I say, ‘That’s not for us,’ they say,
‘This is a big decision. You don’t want to regret it later after the time has passed. Why are you being so selfish?’
And a lot of other things that make me wonder if am I missing something.”
To make an irreversible decision that is so consequential, regardless of what that decision is, poses a great
challenge to make the best one possible. Best for what, though?
If you ask which is the best car to buy, the same question applies: Best for what? For speed? For gas
mileage? For resale value? For luxury and comfort? For pickup? For cargo space? For what? What is the most
important criterion to base the judgment upon?
In the case of Janet and Mark, what are the criteria for making a decision as to whether to have a child? Best
to have the experience of parenting together? Best for satisfying their curiosity about what a child of theirs
would be like? Best for their financial security? Best for having kids that can take care of them when they’re
elderly? Best for getting their parents off their back? Best for what?
Pressure from families to have children can be intense. When you’re attacked and called defective by your
own parents for not wanting to have kids (“Why are you being so selfish?”), you can start to doubt yourself. You
can ask yourself why you don’t want to have kids and wonder if there’s something wrong with you. Is it because
you are, indeed, selfish? Is it because your own childhood was so lousy that you don’t want to relive it through
anyone else? Is it because you are so rigid and orderly that the idea of the chaos of children scares you? Is it
because you feel the need to contradict cultural norms to compensate for your fragile ego? Are you afraid your
kid will turn out to be a loser and will reflect badly on you? Or what?
This is a serious decision. To make it effectively, Janet and Mark need to consider how well they really know
themselves. How well can they predict how they’ll react to future circumstances? Their capacity for foresight is
going to be tested in this process and further developed through therapy, especially with hypnosis. A primary
goal in facilitating a good decision is that it has not only treatment value, but also prevention value. No one
wants them ever to regret what they decided to do. Twenty years and 50 years from now, you still want them
saying to each other, “I’m so glad that’s the choice we made!”
The content of their problem is a decision about whether to have kids. The process is how they make

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 decisions (this one as well as others in the future) based on sufficient self-knowledge and a refined predictive
ability.
Hypnosis with the two of them together (couples hypnosis) provided a much-needed break from
overanalyzing what they had been ruminating about separately and together for months. During hypnosis, I
introduced the topic of how and when self-awareness develops. I used simple examples of being a toddler and
starting to learn your body’s signals, such as when you’re hungry or thirsty or when you need to go to the
bathroom. I firmly pointed out that no one can look at you and say, “You’re thirsty now. Drink!” This is
something you have to learn for yourself, just as you have to learn to take yourself to bed when you’re tired and
grab a bite when you’re hungry. You learn yourself, and as you get older, you learn more complex things, like
whether you enjoy sports or reading a book, whether you like lots of friends or just one or two close ones. You
learn what matters to you and what brings out the best in you. And no one can tell you that you’re wrong to
want only one or two friends instead of many, and no one can tell you that you’re wrong for liking baseball but
not football. You discover many times in many ways what you want your life to be about, and no one else can
do that for you.
I added in some suggestions to jump ahead some years (i.e., age progression) and have some detailed
experience of what it’s like to live with the choice you’ve made.
Interestingly, when the session was over, the first thing Mark and Janet said to me was, “Wow, that was
really a nice experience.” The next thing Mark said was to Janet: “If it’s selfish, then I’m all for it.” Janet smiled
broadly and replied, “I’ll be glad to be selfish with you!”
Decision made. Some months later, I received a short note from Janet. It said, “We both feel like you took a
10-ton boulder off our backs. Family is still disappointed with our decision . . . but we’re not! Thanks so much for
your help.”

The Role of Foresight in Quality of Life

One of the exercises I encourage students in my clinical hypnosis training programs to carry out
is to take all the case files of every client that they’ve seen in the last six months and separate
them into two piles. One pile is for the clients who are suffering with problems that were not of
their own creation; that might include people who were rear-ended sitting at a stoplight and now
deal with chronic pain issues, or people who were sexually abused as children, or people who
suffered the loss of someone they loved and are grieving, and many other such problems people
suffer that they had no hand in creating.
The second pile is for those cases where the client played a clear and direct role in the creation
of their problems. That might include the person who persisted in smoking cigarettes who now,
depressingly, has lung cancer, or the spouse who had an extramarital affair that gave rise to the
marriage and family splintering and their young kids suffering, or the person who drove drunk
and killed someone.
Almost invariably, what therapists discover when they do this exercise is that the second pile
is bigger than the first. The short-sighted and destructive paths that people take don’t need to be
nearly as dramatic as the examples above. An insult hurled in anger, a lack of follow-through on
a promise made, an apathetic response to an important moment in someone else’s life are milder
indiscretions that can still yield some very painful consequences for oneself and/or others.
When people are so limited in their ability to anticipate—or care much about—the
consequences of their actions, it reveals a startling lack of foresight. Foresight is generally
defined as the ability to predict what will happen or to anticipate what actions or materials might
be needed in the future. It is obviously an orientation to the future and serves as a complement to
the process of building expectancy presented in Chapter 6. Expectancy is about the quality of
one’s expectations for the future, such as optimism or pessimism, or positive expectancy or
negative expectancy. Foresight is about the ability to realistically anticipate and plan for a future
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event or development, whether good or bad. It features a specific skill: taking some known or
possible factors and extrapolating them and planning one’s actions accordingly.

Foresight as a Means of Enhanced Self-Regulation

Psychologists Alan Strathman and Jeff Joireman edited an excellent volume called
Understanding Behavior in the Context of Time. It includes an illuminating chapter by researcher
John Boyd and social psychologist Philip Zimbardo that I recommend clinicians read. It features
a review of their research on the Zimbardo Time Perspective Inventory, an instrument that was
designed to assess individual differences in temporal orientation.
In their review, Boyd and Zimbardo (2005) highlight the value of a future orientation and
describe future-oriented people as tending to be more successful, better at saving money, and
better at making healthy lifestyle choices. Foresight leads to greater career planning, encourages
saving money for a rainy day (e.g., if you were to become ill or lose your job), and leads to better
choices about how you treat the body you’re going to be living in for a while.
The lack of foresight thus exerts a powerful influence on one’s quality of life. Engaging in
risky behaviors that don’t seem risky until something goes wrong can land someone in a hospital
—or the morgue. The lack of impulse control, as discussed in Chapter 8, speaks to the lack of
foresight in a different way, but the two are obviously related. A moment of yielding to a
dangerous impulse can generate consequences that will echo throughout the rest of your life.
Every therapist who has been in clinical practice for more than an hour has heard this woeful
line way too many times: “But it seemed like such a good idea at the time.” The regret that
comes with hindsight can be life consuming and the shame emotionally devastating.
Can therapists do more to teach their clients to think ahead? Of course. But the primary
limitation of therapy is its past focus: People come in for help when they have already suffered
terrible adversities, and the whole focus of therapy then is how to help someone get past the
residuals of those adversities. “Healing the past” is the mantra of countless therapists, while
many others are advocating that the client be more mindfully present. So the past and the present
temporal orientations get a great deal of attention. The future? Not so much.

Therapy and Its Relationship to Time

Some therapies are clearly past oriented in their structure, placing a heavy emphasis on
childhood developmental processes, attachment histories, and significant past events as
presumed determinants of current problems in a person’s life. Other therapies are more
structurally oriented to the present, paying much less attention to historical causes of client
problems and much more attention to the here-and-now life circumstances and their
consequences. And some therapies, most notably that of the late psychiatrist Milton H. Erickson,
are structurally oriented to the future, focusing on variations of this key question: What can I do
or say to interrupt the rigidity of this person’s symptomatic patterns in order to introduce
flexibility and thereby facilitate a therapeutic outcome?
At a time nearly a century ago when the mainstream practice of therapy was almost
universally focused on analyzing the patient’s past and interpreting the presumed symbolic

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nature of their symptoms and underlying psychodynamics, Milton Erickson went in a markedly
different direction. Erickson made a simple observation that carries profound implications:
“People don’t come to therapy to change the past. They come to therapy to change the future.” I
agree wholeheartedly and have integrated that powerful perspective into virtually every aspect of
my work.
Consider your reply to this question: In your view, does the future merely unfold, or do we
create it? How you answer this question says a lot about you and what you do in your life,
especially your approach to therapy. It’s important to consider how your personal orientation to
time influences the type of therapy you become attracted to and then choose to practice.
Many therapists are genuinely ambivalent about having a future focus. They often express
beliefs that “the past is what makes us who we are,” or concerns that “the past won’t be
honored,” or “the traumas will be skimmed over,” or “the past won’t be sufficiently learned
from, thereby ensuring unfortunate repeats,” and so on. The justifications for maintaining a focus
on the past are seemingly endless in the world of psychotherapy. But as the field continues to
evolve, and as the future becomes more threatening and anxiety provoking, it’s important that we
question whether the past orientation is truly the most effective focus for enhancing people’s
lives. It certainly isn’t a helpful focus if the goal is to evolve foresight.
Learning from the work of Milton Erickson, who took on unusual and complex cases and
succeeded with them in innovative and sometimes even shocking ways, highlights how much
good therapy can be done without analyzing people’s childhoods. But despite this nudge to look
ahead much more than behind, the ambivalence about a future orientation has largely continued.
I wish I had a dollar for every time someone came up to me at one of my workshops and said
some variation of, “Gee, Michael, I really like your work a lot, but . . . you’re so goal-oriented!”
(I think to myself, okay, here it comes!) They say, “Don’t you know, it isn’t about the
destination? It’s about the journey!” But—only therapists say that! Clients never say that. Clients
never show up for therapy and say, “Uh, hi, I’d like to go on a journey.”
Therapists lead the way into a sphere of time, a temporal orientation, with the type of therapy
they choose to practice and thereby encourage the client to focus upon. Encouraging the
development of foresight should be a basic part of clinical practice, in my opinion. Why isn’t it?
Because the future hasn’t happened yet, it is an abstract potential in our consciousness. It is an
ambiguous stimulus. Ambiguity represents a particular challenge to human consciousness, as
discussed in Chapter 5. How well we handle ambiguity as individuals directly shapes our
vulnerability to some of the most common disorders that we as clinicians are asked to treat,
especially anxiety and depression. Substantial research evidence highlights that people who have
a low tolerance for ambiguity have a greater vulnerability to these disorders. For them, ambiguity
is a risk factor for suffering emotional distress when their negative, scary projections are then
responded to in the moment as if they are both true and inevitable. This isn’t foresight—it’s only
fearmongering.

Foresight and the Ability to Predict

This brings me to one of the most interesting aspects of a consideration of future orientation
relative to evolving foresight, a domain of research called affective forecasting. When people
look ahead to the future, they not only predict what events will take place, they also predict how

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they will feel at that time. Both research and real-life examples show us this process is terribly
error prone. Some examples:

Why do people say, “I will love you forever until death do us part” only to divorce soon
after?
Why do so many people think they’ll be happy if only they could make more money or go
to Tahiti, only to discover that when they do, they’re not?
Why do so many people think “I’ll diet and exercise starting tomorrow” and then do
neither?

Affective forecasting, the ability to predict how you’re going to feel, is obviously important in
lots of ways. After all, people base their life decisions on their predictions, ranging from whom
they’re going to marry, to what career they’re going to pursue, to which house to buy, to where
to go on vacation. As clinicians, can we teach people to make better predictions and, hopefully,
prevent regrets? This is a primary goal of process-oriented hypnosis, as illustrated in this
chapter’s session transcript.
Many clinicians who utilize hypnosis in their work are familiar with Erickson’s (1954a)
widely cited article, “Pseudo-orientation in Time.” In that article, Erickson described a
therapeutic approach with hypnosis that was quite unique. Recognizing that people often, some
would argue always, have an idea at some nonconscious levels of where their life is going or
what their solution path may be, Erickson used hypnosis to carry out a procedure called age
progression. Age regression orients people to their past, while age progression orients people to
their future, to experience the future as if it’s happening now.
Erickson’s pseudo-orientation in time technique was to conduct the age progression to a future
time when the problem that brought the patient into therapy was solved, then ask his patient to
describe some of the specifics of how they changed or solved the problem. Then Erickson would
suggest his patient develop an amnesia for having told him what the path to success would be,
and then he carried out the successful intervention just as the patient described it! The patient’s
ideas of what would be therapeutic were often somewhere within, and Erickson simply created a
pathway for bringing them forward and utilizing them. One of his most telling comments related
to this was how the patient could be encouraged to “have hindsight in advance.” That, in a
nutshell, is the structure—the process—of foresight.

Foresight Depends on a Firm Grasp of Cause and Effect

What good hypnosis sessions utilizing age progression strategies do is help people extrapolate,
that is, it teaches them to get a better read on where a particular trend or pattern is headed. That is
how foresight creates an avenue of prevention, not just treatment.
We as a profession are so pleased with ourselves for learning to think systemically that
sometimes we forget how valuable it can also be to think linearly as well. How many times do
your clients tell you a “What the heck were you thinking?” story such as, “How was I supposed
to know I’d get fired just because I was sleeping with the boss’s wife?” People tell you about
preposterous things they do that are just like that and you think to yourself, “Gee, who could
have seen that coming?”
This makes it essential to the endeavor of evolving foresight to help the client develop a full
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grasp of the relationship between cause and effect. A process-oriented hypnosis session that
addresses that relationship is valuable, of course. It is also valuable for the client to be given the
associated task assignment of looking for and identifying cause-and-effect relationships in daily
life. Instead of life events seeming random, and even magical when there’s no apparent cause for
something other than divine intervention, the client is being trained in the process of identifying
causes and effects. Ten or 20 times a day, the client can see linear relationships: flipping the
switch to make the light go on, the traffic light turning red and cars stopping, paying someone a
compliment and appreciating their smile, and on and on.
When people don’t really grasp the relationship between cause and effect, it’s hard to develop
a sense of agency. “Things just seem to happen to me” is the explanation you settle on when you
don’t see the role you play in what happens. Without a sense of agency, a sense of responsibility
to take action on your own behalf with a goal in mind, foresight remains an undeveloped human
capacity.
It isn’t easy to learn to think ahead, and often what foresight would lead to is having to do
things that are unpleasant. It’s more fun to spend money than save it, it’s more gratifying to have
the ice cream than follow a restrictive diet, and it’s more exciting to take the risk than it is to play
it safe. So much of human misery could be prevented but thinking in preventive terms doesn’t
come easily. We are trained to do treatment, not prevention, unfortunately. But the better we are
at understanding and teaching the relationship between cause and effect, the more opportunities
there are to behave preventively. So many of the people I’ve treated over the years could have
prevented a lot of their problems but missed the opportunity to do so simply because prevention
came disguised . . . as inconvenience.

Typical Problems Derived From a Lack of Foresight

The types of problems that people might present for treatment that reflect an inability to think
ahead and plan accordingly can seem quite diverse, and may include such problematic patterns
as these:

An inability to make detailed future plans

Subscribing to the global and narrow philosophy that the future can’t be predicted
Difficulty seeing or understanding the relationship between cause and effect
Believing that things “just happen” but with little or no insight as to why or how
Routinely picking the path of least resistance in decision making (e.g., easiest, not best)
A general inability to predict other people’s behavior or emotional reactions
A low sense of agency, thereby missing the role one plays in generating outcomes
A greater proneness to magical thinking
An impaired ability to make accurate risk assessments

These represent the kinds of problems clients might present that all reflect a lack foresight.
The content of what they want help with is what they will naturally describe to the therapist, but
it is up to the therapist to recognize the client’s inability to think ahead and plan accordingly as
the process needing intervention.

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 Defining the Salient Therapeutic Targets

The building of foresight is, of course, a multistep process. As a starting point, it helps to define
the client’s role in the process in two important ways: first, to declare they have the necessary
internal resources to make it possible and, second, that their actions today will be what shapes
tomorrow’s consequences. We want the client to feel resourceful and also to develop a sense of
agency across their experiences.
Consistent with those messages is encouraging the recognition that the future is filled with
possibilities and that the client’s quality of life will be determined in large part by the decisions
they make and enact. This starts to build the awareness for agency as well as a more personal
appreciation of cause and effect. Tied to these is the offering of two meaningful rewards for
learning to think ahead: greater personal successes and the chance to prevent regrets.
Metaphors can be offered that highlight the bad decisions people sometimes make when they
find thinking ahead inconvenient in some way. Maybe it took too much time; maybe it made the
workload bigger and harder; maybe it cost more money than they wanted to spend; but whatever
the reason, the story ends with how a preventive opportunity was available but missed because it
just wasn’t convenient.
Learning to think preventively and becoming more skilled at recognizing cause-and-effect
relationships go hand in hand. These are elaborated further and encouraged in the client through
the suggestions provided in the process-oriented hypnosis session that follows in Table 14.1.

TABLE 14.1. GENERIC SESSION STRUCTURE FOR EVOLVING FORESIGHT

Induction

Response set: Thinking ahead

Theme 1: You can use your resources as your actions take you forward
Theme 2: The future isn’t just more of the past
Theme 3: Thinking ahead can prevent regrets
Theme 4: Thinking ahead means taking preventive action even if it’s inconvenient
Theme 5: Making prevention a priority of your life
Theme 6: Learn to think in cause-and-effect terms when making decisions

Posthypnotic suggestions for integration

Closure and disengagement

SESSION TRANSCRIPT

Induction
You can arrange yourself in whatever position is comfortable for you . . . a position that you can sit in for a while . . .
easily . . . and effortlessly . . . one in which you can be deeply comfortable and yet still remain attentive enough . . . to
focus on the things that I’ll be talking about . . . so you can easily absorb their deeper meaning . . . and recognize their
deeper value . . . as they relate to your life experience. . . . And when you’re ready to focus yourself . . . you can begin
by taking in a few deep, relaxing breaths . . . breathing slowly . . . and rhythmically . . . feeling the rise of your chest . .
. as you inhale . . . slowly . . . and deeply . . . and feeling your chest gently fall . . . as you gradually . . . exhale. . . .
And each breath . . . in . . . and out . . . can relax you more and more. . . . Steady, easy breathing can calm you . . .
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and reacquaint you . . . with the deeper parts of yourself . . . that you sometimes may get too busy to notice. . . .

Response Set Regarding Thinking Ahead

You know . . . it’s very easy . . . to get caught up in day-to day living. . . . There is always so much to do . . . so many
obligations to attend to . . . that can keep you occupied in the moment. . . . But, certainly . . . one of the most important
things that you’re comfortably positioned now to have learned. . . . and really absorbed . . . is that unless you
deliberately take some meaningful time for yourself . . . the way you are right now as you focus on this session . . .
unless you deliberately take the time to think through and even think preventively . . . it’s too easy to miss how being
in the moment . . . is a lead-in to the next moment . . . a stepping stone from now to later . . . just as each breath of
comfort leads to the next . . . and today gives rise to tomorrow. . . . And how valuable to have the ability to focus on
being in the moment at times . . . and how valuable it is to be able to think beyond the moment at times. . . . And you
have both capabilities . . . but this session is going to focus on what’s next . . . what’s beyond the present moment of
your life. . . .

Theme: You Can Use Your Resources as Your Actions Take You Forward
You know as well as I do how many challenges we face each day on many different levels . . . and we recognize how
stress can build up because of the demands we face that can be quite burdensome at times. . . . But with each
hypnosis session you experience . . . and learn from . . . you acquire new insights, and new possibilities begin to
emerge. . . . You discover and make better use of your strengths and resources . . . and you evolve more helpful
strategies for managing your life well. . . . You absorb ideas and get new perspectives . . . and develop ways to
respond to the challenges you face that you can feel good about. . . . You’re learning that you can take time . . . quiet
time . . . to be with yourself in a way that is kind and supportive . . . rather than being harsh with yourself. . . . After all,
people grow best in positive conditions . . . the kind that nurture and encourage what’s best in you . . . and you’re
learning to talk to yourself in a way . . . through your thoughts . . . that’s helpful . . . and focused on . . . developing
solutions . . . and not just identifying problems. . . . And you’re also learning that you don’t necessarily have to go
dredging up the past . . . in order to take steps that help you move forward into the future. . . . You’re learning a lot
about how to think . . . in terms of what you want to have happen . . . and what the steps are . . . that you can
courageously take to bring your goals to fruition. . . . You’re learning that taking action is vital. . . . Action . . . not just
thinking . . . not just contemplating . . . not just analyzing . . . but taking sensible action . . . action with foresight . . .
knowing that it’s what you do in this moment that helps determine what will happen in the next moment. . . .

Theme: The Future Isn’t Just More of the Past

There are many times each day . . . when you come to a place of needing to make a decision of some significance. . .
. And how you did things in the past can still work in some places . . . but in other places the conditions have since
changed. . . . And at those times, doing things just as you did before won’t work in bringing you the outcome you
want. . . . And for you to be able to look ahead . . . beyond the moment and beyond the familiar . . . is an opportunity
to grab with both hands . . . as you keep your focus on what’s possible . . . because the future isn’t just more of the
past. . . . And the future is where you’re going to be living. . . . And the decisions you make in the moment that will
shape your future . . . are decisions where you can either limit yourself unnecessarily . . . or you can take a sensible
risk to try something different that offers the potential of a better result. . . . And as you continue to develop yourself . .
. and your life skills . . . you can find it so much more automatic to . . . recognize an opportunity to experiment with
how you do things and try something new . . . not just anything, of course . . . but something well thought out and
planned . . . perhaps based on something you’ve observed others do that works well . . . or perhaps based on
something you simply believe can work as you extrapolate current conditions and anticipate in detail the likely
consequences of your actions. . . . You can continue to train yourself to think more clearly in terms of what is possible
. . . and what is realistic. . . .

Theme: Thinking Ahead Can Prevent Regrets

It’s an especially important skill to have for living well . . . to recognize the differences that can arise between . . . what
is really true . . . and what you have come to believe. . . . Too often people think things, especially self-critical or self-
limiting things . . . and then make the mistake of actually believing themselves. . . . That recognition can lead you to
be more skilled at looking for credible evidence before you just simply believe something . . . and can lead you to ask
more questions . . . and gather relevant information . . . before you reach a sensible conclusion. . . . And these are the
tools for making forward-looking decisions that can prevent regrets . . . from poorly made decisions or reckless,
impulsive actions. . . . How many times people have told me that what is now the source of distress . . . seemed like
such a good idea at the time. . . . These are the famous last words of regret: . . . “It seemed like a good idea at the
time” . . . and the other famous last words of regret are . . . “I guess I didn’t think far enough ahead.” . . . Gathering
good information and thinking well ahead are two of the most important skills that you need to live life well. . . . And
these are the skills necessary to prevent many problems from arising. . . . And you’re learning them and gradually
mastering them . . . and you can feel good about that. . . . What you’ve been learning through these hypnosis
sessions . . . are skills in thinking . . . skills that are important for relating to others . . . skills in knowing yourself. . . .
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Your strengths as well as your vulnerabilities . . . and appreciating them and knowing how to manage them with
insight and foresight. . . .

Theme: Thinking Ahead Means Taking Preventive Action Even If It’s Inconvenient
You’re made up of so many different parts . . . and what you’re now in a comfortable position to appreciate . . . is that
each part of you . . . can be valuable somewhere . . . but isn’t necessarily going to be valuable everywhere. . . . And
knowing which parts of yourself to express and which to purposely contain at any given time is one of the keys to
preventing problems from arising. . . . It’s what makes it possible to think of possible consequences, good or bad,
before you speak your mind. . . . It’s what makes it possible to go outside yourself and your feelings in the moment
just long enough to read a situation carefully . . . so you can choose whether to say or do something and, if so, then
what to say or do that will be helpful. . . . Learning to think ahead is the essential ingredient in prevention . . . and
there are so many examples of prevention opportunities that people have missed . . . sometimes with truly terrible
consequences. . . . Let me share an example with you. . . . Not long ago, in a city in the American Midwest, a heavily
used bridge handling an average of 140,000 cars per day collapsed during rush-hour traffic. . . . More than a dozen
people died, and more than 100 people were injured as their cars fell into the river below. . . . Many years earlier,
structural engineers reported the bridge as unsafe and needing repairs . . . but the government agency responsible
for the bridge didn’t think it was an imminent danger and claimed they didn’t have the substantial amount of money
that would be needed for such a repair. . . . Yet, when the bridge collapsed and the magnitude of the tragedy was
incalculable . . . they somehow managed to find the money virtually right away, and they were able to build a new
bridge in record time. . . . And why did there have to be a bridge collapse and a loss of life before sensible action to
reinforce the bridge was taken? . . . Well, prevention isn’t always easy or cheap . . . but whoever said an ounce of
prevention is worth a pound of cure knew what they were talking about. . . . How much misery in the world could be
prevented if people would just think ahead. . . . After all, no one has to be psychic to know that if you keep dumping
toxic waste into the air we breathe and the water we drink that it’s going to be a problem for us all one day. . . . And
no one needs to be a fortune teller to know that when you hurt people for your personal gain, there will be a painful
price you’re going to have to pay one day. . . . And no one needs to be a genius to know that if you get behind the
wheel of a car when you’re drunk that it isn’t going to end well for you and whomever you might injure or kill. . . . The
examples of bad decisions that people didn’t have to make are endless . . . small and large tragedies that could have
been prevented . . . but that would have required thinking instead of reacting . . . thinking beyond the moment and
anticipating. . . . And what happens when that is inconvenient? . . . Or when it isn’t fun to think preventively? . . .Or
when it isn’t very easy? . . .

Theme: Make Prevention a Priority in Your Life

It brings into sharp focus now . . . what the role of prevention can be in your life . . . how well you develop your ability
to think ahead . . . how important it becomes to you to see a step or two ahead on the path you’re on. . . . And, of
course, not everything can be anticipated. . . . Not all problems can be prevented . . . but there is an important
distinction to be made between the problems that find you through no fault of your own . . . and the problems you
unintentionally create for yourself by missing the chance to think ahead and take the necessary preventive actions
even when they’re inconvenient. . . . And one of my favorite newspaper columnists said this really well when she
wrote, “Most people’s problems could be prevented, but too often the opportunity is missed because it came
disguised as inconvenience.” . . .

Theme: Learn to Think in Terms of Cause and Effect When Making Decisions
There are many different ways to think, of course . . . thinking that is concrete . . . and thinking that is abstract . . .
thinking that is reflexive, often called automatic thoughts . . . and thinking that is a slow pondering . . . thinking that is
one-dimensional and thinking that is multidimensional . . . thinking that is the global big picture and thinking that is
richly detailed. . . . And I’m drawing your attention to a linear style of thinking . . . a style that makes the relationship
between cause and effect so much more obvious. . . . And how well can you think in these terms . . . to be able to
recognize that this action led to that outcome? Or that these words triggered that reaction? Or that thought gave rise
to those feelings? Not everything is so obvious in terms of cause and effect . . . but more than people generally
realize. . . . And learning to think linearly . . . first this, then that . . . can start early if we care to teach those skills . . .
to read to a child and midway through the book stop reading and ask what they think will happen next and why. . . .
And ask a child questions such as why you put your socks on before you put your shoes on, or why you put the
toothpaste on your toothbrush before you brush your teeth. . . . And you start learning early on that this leads to that .
. . an obviously important skill when thinking in terms of prevention. . . . And so what does it take to live well and
happily? . . . I think it takes being able to move from . . . situation to situation . . . knowing your different parts . . . your
strengths and resources . . . and using them skillfully. . . .

Posthypnotic Suggestions for Integration

And to be able to think preventively . . . you can use your ability that is ever growing in sophistication . . . of being able
to think ahead . . . and to choose paths . . . that take you where you want to go in the long run . . . and not just to
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follow the path that is easy and familiar to you but takes you to someplace you really don’t want to go. . . . That’s what
gives rise to the self-blame and self-doubt . . . that can be prevented by doing what’s best . . . not what’s easiest . . .
doing what will provide a good result . . . not doing something that may seem okay in the moment that will only bring
unhappiness later. . . . And it can really be quite comforting . . . to realize . . . at a very deep level within yourself . . .
that you can be so . . . tuned in . . . to what it means to live life well. . . .
You can continue learning . . . continue experiencing . . . continue observing. . . . And all the principles of effective
living . . . come down to you knowing . . . what it means to be powerful . . . in your ability to choose. . . . You have the
ability to choose. . . . You get to choose . . . so much of what happens in your life . . . such as where you go and what
you do that can serve you well . . . and who you bring into your life . . . that will enhance your life rather than make it
harder. . . . And one of the best preventive tools that you can develop and continually refine . . . is the ability to
recognize ever more efficiently . . . what you are in control of . . . and what you are responsible for . . . and likewise. . .
. what you’re not. . . . It’s really quite a great and worthy challenge . . . to be able to keep moving forward with your life
. . . seeking out new challenges . . . facing them with courage and integrity . . . rising to them . . . always bringing out
the best . . . of your deeper self . . . through the life that you lead. . . . And so, as you move into the future . . . you can
take great comfort in knowing . . . that you carry with you . . . many wonderful skills and resources . . . the things that
you’ve already learned and experienced . . .and other things that are yet to come. . . . You can use these resources . .
. to your own best advantage. . . . You can use your power with insight and foresight. . . . And so . . . now you can
take some time to process your thoughts and feelings . . . and integrate deeply whatever you need to or want to, in
order to start to make thinking ahead . . . and thinking preventively more reflexive. . . .

Closure and Disengagement

And then you can start to bring this experience to a comfortable close. . . . And then when you’re ready . . . you can
begin the process of gradually reorienting yourself. . . . You can begin to refocus yourself now at a rate that is gradual
and comfortable . . . so that when you’re ready . . . you can reorient yourself fully . . . and open your eyes . . . fully
alert and refreshed . . . feeling good . . . feeling really good. . . .

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References

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Yapko, M. (2001). Treating depression with hypnosis: Integrating cognitive-behavioral and strategic approaches. New York:
Brunner/Routledge.
Yapko, M. (2010a, April–June). Hypnosis in the treatment of depression: An overdue approach for encouraging skillful mood
management. International Journal of Clinical and Experimental Hypnosis, 58(2), 137–145.
Yapko, M. (2010b, April–June). Hypnotically catalyzing experiential learning across treatments for depression: Actions can
speak louder than moods. International Journal of Clinical and Experimental Hypnosis, 58(2), 186–200.

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Yapko, M. (2011). Mindfulness and hypnosis: The power of suggestion to transform experience. New York: Norton.
Yapko, M. (2016). The discriminating therapist: Asking “how” questions, making distinctions, and finding direction in therapy.
Fallbrook, CA: Yapko.
Yapko, M. (2019). Trancework: An introduction to the practice of clinical hypnosis (5th ed.). New York: Routledge.
Zeig, J. (2014). The induction of hypnosis: An Ericksonian elicitation approach. Phoenix: Milton H. Erickson Foundation Press.
Zeig, J. (2019). Evocation: Enhancing the psychotherapeutic encounter. Phoenix: Milton H. Erickson Foundation Press.

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Index

acceptance
cancer-related, 130–33
case example, 130–33
defined, 135, 139
encouraging, 130–48, 140t (see also encouraging acceptance)
in hypnosis, 139
lack of, 136
in mindfulness-based approaches, 138
power of, 136–37
promoting, 139
in quality of life, 133–34
radical, 138
as starting point, 134–36
acceptance and commitment therapy (ACT), 30
dissociation in, 118
ACT. see acceptance and commitment therapy (ACT)
action(s)
amplification of benefits of, 171
meaningful (see meaningful action)
past, 177t, 179
personal resources and, 213t, 214–15
revealing, 170
speak louder than words, 170
taking, 177–78, 177t
in therapy, 172–73
action orientation
problems derived from negative, 175–76
in quality of life, 170–71
action-oriented
passive-oriented vs., 14
“action speaks louder than words,” 170
actions plans
steps to follow in, 177t, 179–81
adaptation
in mental health, 9
affective forecasting, 209–10
agency
building response set regarding, 159t, 160–61
age progression, 210
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age regression, 43, 43t, 210
airplane phobia, 6–8
ambiguity. see also recognizing and tolerating ambiguity
anxiety and, 13
case example, 51–53
as challenge to human consciousness, 209
coping with, 55–56
defined, 13, 44, 54
lack of tolerance for, 56
mental health issues related to, 54–55
in quality of life, 53–55
recognizing, 13, 51–62, 57t (see also recognizing and tolerating ambiguity)
responses to, 13
rumination related to, 55–56
salient therapeutic targets for, 57–58, 57t
tolerance for, 51–62, 57t (see also recognizing and tolerating ambiguity)
uncomfortableness of, 55–56
American Journal of Clinical Hypnosis, 35
American Psychological Association (APA)
2019 Stress in America survey of, 12
amnesia
psychogenic, 117
amplification
focus and, 71t, 74–75
anticipation
in overcoming impulsivity, 104t, 107–9
anxiety, 12–14
ambiguity and, 13
case example, 51–53
COVID-19–related, 12–13
factors contributing to, 13
how one generates, 52
at individual level, 13
social, 19–23
worry vs., 51–53
anxiety disorders
as future-oriented phenomena, 99–100
anxious people
global thinking among, 85
APA. see American Psychological Association (APA)
apathy, 14–15
hopelessness and, 14–15
Aronson, E., 156
ascendance
how now attains, 100–1
association

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 described, 41
dissociation with, 117
in hypnosis, 30
in process-oriented hypnosis sessions, 41
attribution(s)
making sense of responsibility and, 154–56
automaticity
in hypnosis, 42
of suggested responses, 42
BA. see behavioral activation (BA)
Barlow, D., 13, 99
behavior(s)
self-harming, 95–98
behavioral activation (BA)
described, 172
behavioral activation (BA) therapy, 172–73
goal of, 173
behavioral elements
in therapeutic dissociations, 41t
behavioral rigidity, 10t
“believed-in imagination,” 54
Bernheim, H., 116
bioreductionism
defined, 5
blame
recognizing, 159t, 163–64
Boston University, 99
boundary(ies)
personal, 17
Boyd, J., 207
Brach, T., 138
brain
mind influencing, 116–17
brain-scanning devices
in how mind influences brain, 116–17
Buddha, 80
building expectancy, 63–79, 71t. see also expectancy; expectation(s)
case example, 63–65
generic session structure for, 71–79, 71t (see also building expectancy generic session
transcript)
salient therapeutic targets in, 70–79, 71t
building expectancy generic session transcript, 71–79, 71t
building response set regarding expectancy in, 71t, 72–73
closure and disengagement in, 71t, 79
developing realistic goals to pull yourself forward in, 71t, 75–76
expectations can mislead you in, 71t, 73–74
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 expectations in shaping experiences in, 71t, 73
induction in, 71–72, 71t
looking ahead to positive possibilities in, 71t, 78
looking and moving forward in, 71t, 77
personal resources for use in new ways in, 71t, 76–77
planting seeds for future in, 71t, 77–78
posthypnotic suggestions for integration in, 71t, 79
themes in, 71t, 73–78
what you focus on, you amplify in, 71t, 74–75
Burns, G., 136–37
cancer
acceptance of, 130–33
catalyzing meaningful action, 167–83, 177t. see also meaningful action
case example, 167–70
generic session structure for, 177–83, 177t (see also catalyzing meaningful action generic
session transcript)
hypnosis well-suited for, 171
in quality of life, 170–71
salient therapeutic targets in, 176–83, 177t
catalyzing meaningful action generic session transcript, 177–83, 177t
action plans’ steps in, 177t, 179–81
building response set regarding taking helpful action on your own behalf in, 177–78, 177t
closure and disengagement in, 177t, 183
danger in thinking too much in, 177t, 181–82
induction in, 177, 177t
making decisions to act in, 177t, 178–79
past actions don’t predict future possibilities in, 177t, 179
posthypnotic suggestions for integration in, 177t, 182–83
themes in, 177t, 178–82
cause and effect
in decision making, 213t, 218–19
foresight and, 210–11
CBT. see cognitive-behavioral therapy (CBT)
challenge(s)
encouraging acceptance related to, 140t, 141–42
character strengths
defined, 190
Character Strengths and Virtues: A Handbook and Classification, 190
checking in with client
during process-oriented hypnosis sessions, 31t, 33–34
Chefetz, R., 117
childhood trauma, 10–11
choice(s)
life and, 54
Churchill, W., Sir, 149
clarity
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 in defining responsibility, 159t, 164–65
closure and disengagement
in building expectancy, 71t, 79
in catalyzing meaningful action, 177t, 183
in defining responsibility, 159t, 166
in developing impulse control, 104t, 110
in encouraging acceptance, 140t, 148
in evolving foresight, 213t, 220
in facilitating compartmentalization, 122t, 129
in instilling integrity, 194t, 201–2
in making better discriminations, 89t, 94
in recognizing and tolerating ambiguity, 57t, 62
code of conduct
honoring your, 194t, 200–1
personal, 192
code of honor
develop personal, 194t, 196–97
cognition
global (see global cognition; global thinking)
cognitive-behavioral therapy (CBT), 30
action in, 172–73
described, 44
dissociation in, 117–18
meaningful action in, 172–73
cognitive distortions, 44
cognitive elements
in therapeutic dissociations, 41t
cognitive psychology
defined, 83
cognitive rigidity, 10t
compartmentalization
case example, 111–14
defined, 11, 115
described, 115
dissociation and, 116–17
facilitating, 111–29, 122t (see also facilitating compartmentalization)
goal of, 121–22
of guilt, 157
problems derived from, 119–20
in quality of life, 114–16
roles in life and, 114–16
therapies facilitating, 11
compartmentalization skills
hypnosis in facilitating, 113–14, 121–22
conclusion(s)
jumping to, 55

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 strong need for, 55
conduct
code of (see code of conduct)
connection
hypnosis in, 14
consciousness
ambiguity as challenge to, 209
consequence(s)
impulsivity overcome by anticipation of, 104t, 107–9
content
distraction of, 19–25
to process focus, 19–23
content suggestions, 28
context of meaning
hypnosis in creating, 46
contextual rigidity, 10t
contradiction(s)
in defining responsibility, 159t, 162–63
control
impulse (see impulse control)
controllability
determination of, 137
cooperation
treatment-related, 67–68
coping skills, 15–16
coping style(s)
rumination as, 52–53, 174
Cornell University
Laboratory for Planetary Studies at, 191
Cosmos, 191
couples hypnosis, 205
COVID-19
anxiety related to, 12–13
curiosity
therapeutic, 40
Dalai Lama, 136–37
Darwin, C., xix
DBT. see dialectical behavior therapy (DBT)
decision(s)
in shaping quality of your life, 83
decision making
cause and effect in, 213t, 218–19
defining responsibility, 149–66, 159t. see also responsibility
case example, 149–52
generic session structure for, 159–66, 159t (see also defining responsibility generic session
transcript)
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 salient therapeutic targets in, 159–66, 159t
defining responsibility generic session transcript, 159t, 160–66
being clear in, 159t, 164–65
building response set regarding agency in, 159t, 160–61
closure and disengagement in, 159t, 166
contradictions in, 159t, 162–63
induction in, 159t, 160
making better discriminations about personal responsibility in, 159t, 165–66
past not needing to define us in present in, 159t, 161
people as more than one-dimensional labels in, 159t, 162
posthypnotic suggestions for integration in, 159t, 166
recognizing blame in, 159t, 163–64
taking responsibility for your mistakes and reducing guilt in process in, 159t, 163
themes in, 159t, 161–66
deGrasse Tyson, N., 191
depressed people
global thinking among, 84–85
depression
as past-oriented phenomenon, 99
sharp rise in, xx
Depression is Contagious, xix
detachment
across all therapies, 117–19
developing impulse control, 95–110, 104t. see also impulse control
case example, 95–98
generic session structure for, 104–10, 104t (see also developing impulse control generic
session transcript)
salient therapeutic targets in, 101–10, 104t
developing impulse control generic session transcript, 104–10, 104t
amplifying space between perception and reaction in, 104t, 106–7
anticipating consequences in, 104t, 107–9
become more future oriented in, 104t, 109–10
closure and disengagement in, 104t, 110
experience as reflexive in, 104t, 105–6
induction in, 104, 104t
posthypnotic suggestions for integration in, 104t, 110
response set in, 104–5, 104t
themes in, 104t, 105–10
dialectical behavior therapy (DBT)
dissociation in, 118
DID. see dissociative identity disorder (DID)
“die-hard liberals,” 81
discontent
sides of, 134
with status quo, 133–34
discrimination(s)

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 case example, 80–82
defined, 83
making better, 80–94, 89t (see also making better discriminations)
meaningful, 82
personal responsibility–related, 159t, 165–66
in quality of life, 83–84
representing repetitive issues to address in therapy, 88–94, 89t
response set regarding, 89t, 90–91
discrimination issues
responsibility-related, 157
discrimination skills
lack of, 84–86
dissociation
across all therapies, 41t, 117–19
association with, 117
compartmentalization and, 116–17
defined, 11, 41
described, 41, 102
evidence in routine hypnotic suggestions, 119
example of, 103
as foundation of hypnotic responsiveness, 11
in hypnosis, 30, 119
in impulse control, 102–3
in process-oriented hypnosis sessions, 40–42, 41t
types of, 41–42, 41t
dissociative experience(s)
hypnosis as, 102
pathological vs. nonpathological, 117
dissociative identity disorder (DID), 117
distinction(s)
socialization in blurring, 89t, 92–93
distortion(s)
cognitive, 44
Draw-a-Person Test, 53
EFT. see emotion-focused therapy (EFT)
ego state therapy
dissociation in, 118
“emotional differentiation,” 96
emotional elements
in therapeutic dissociations, 41t
emotional rigidity, 10t
emotion-focused therapy (EFT), 30
dissociation in, 118
encouraging acceptance, 130–48, 140t. see also acceptance
case example, 130–33
generic session structure for, 140–48, 140t (see also encouraging acceptance generic session
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transcript)
salient therapeutic targets in, 136–48, 140t
encouraging acceptance generic session transcript, 140–48, 140t
accepting and using your resources in, 140t, 145–47
building response set in, 140t, 141
challenges related to, 140t, 141–42
closure and disengagement in, 140t, 148
induction in, 140–41, 140t
making judgments not necessary in, 140t, 143–44
no sense in fighting inevitable in, 140t, 142–43
posthypnotic suggestions for integration in, 140t, 147–48
shifting your focus to notice what’s right in, 140t, 144–45
themes in, 140t, 141–47
engaging
imagining vs., 19–23
Ericksonian hypnosis
dissociation in, 118
Erickson, M.H., 9, 19, 38–39, 46, 63, 139, 172, 208, 210
evolving foresight, 203–20, 213t. see also foresight
case example, 203–5
generic session structure for, 213t, 214–20 (see also evolving foresight generic session
transcript)
salient therapeutic targets in, 212–13
evolving foresight generic session transcript, 213t, 214–20
closure and disengagement in, 213t, 220
future as not just more of past in, 213t, 215–16
induction in, 213t, 214
learn to think in terms of cause and effect in decision making in, 213t, 218–19
make prevention a priority in, 213t, 218
posthypnotic suggestions for integration in, 213t, 219–20
response set regarding thinking ahead in, 213t, 214
taking preventive action even if it’s inconvenient in, 213t, 217–18
themes in, 213t, 214–19
thinking ahead in preventing regrets in, 213t, 216
use your resources as your actions take you forward in, 213t, 214–15
expectancy
building, 63–79, 71t (see also building expectancy)
building response set regarding, 71t, 72–73
case example, 63–65
defined, 206
negative, 67, 69–70
in quality of life, 65–66
expectation(s)
in deciding whether to seek help, 67
effects on experiences, 65–66
as filter through which we make evaluations, 69

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 hopeless, 68
in misleading you, 71t, 73–74
power of, 65
recovery impacted by, 68
in shaping experiences, 71t, 73
treatment cooperation impacted by, 67–68
experience(s)
creating new opportunities, 89t, 91
dissociative, 102, 117
expectations effect on, 65–66, 71t, 73
expectations in shaping, 71t, 73
global, 122t, 123–24
hypnosis in highlighting malleability of, 29, 29t
hypnosis in highlighting subjective nature of, 28
life, 98–100
micro- and macroviews of, 5–6
multiple components in, 122t, 124–25
as reflexive, 104t, 105–6
subjective, 29, 29t
symptomatic, 84–85
temporal orientation in shaping, 98–100
you generate your, 194t, 196
experiential learning
hypnosis as vehicle of, 173
facilitating compartmentalization, 111–29, 122t. see also compartmentalization
case example, 111–14
generic session structure for, 122t, 123–29 (see also facilitating compartmentalization generic
session transcript)
hypnosis effects in, 121–22
salient therapeutic targets in, 121–29, 122t
facilitating compartmentalization generic session transcript, 122t, 123–29
building response set regarding specific components of global experiences in, 122t, 123–24
closure and disengagement in, 122t, 129
experiences comprised of multiple components in, 122t, 124–25
feelings-related, 122t, 127–28
focus shaping reactions in, 122t, 125–26
induction in, 122t, 123
posthypnotic suggestions for integration in, 122t, 128–29
prioritization in, 122t, 126–27
themes in, 122t, 124–28
feeling(s)
compartmentalization of, 122t, 127–28
Fernbach, P., 24
flexibility
as counter to rigidity, 9–10
hypnosis in encouraging, 29, 29t
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 relationship-related, 17
focus
amplification resulting from, 71t, 74–75
from content to, 19–23
future-oriented, 104t, 109–10
hypnosis in encouraging, 46
problems of, 8
reactions shaped by, 122t, 125–26
shifting to what’s right, 140t, 144–45
forecasting
affective, 209–10
foresight
ability to predict and, 209–10
case example, 203–5
defined, 206
described, 207
evolving, 203–20, 213t (see also evolving foresight)
firm grasp of cause and effect in, 210–11
lack of, 207, 212
as means of enhanced self-regulation, 207
in quality of life, 206
Franklin, B., 167
Frankl, V., 51
free will
described, 154
social influence and, 171–72
fugue states, 117
future
as not just more of past, 213t, 215–16
planting seeds for, 71t, 77–78
future-oriented focus
embracing, 104t, 109–10
future-oriented people
as more successful, 207
future-oriented phenomena
anxiety disorders as, 99–100
Gazzaniga, M., 111, 154
generic session structures. see also specific types and process-oriented hypnosis generic session
structures
note about, 49
gestalt therapy
dissociation in, 118
global cognition, 168. see also global thinking
emotional and behavioral consequences of, 168
symptomatic experience and, 84–85
global cognitive style, 168
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 procrastination and, 168
global experiences
building response set regarding specific components of, 122t, 123–24
global thinking
among anxious people, 85
among depressed people, 84–85
among people with relationship problems, 85
lack of discrimination skills for understanding how people develop problems and, 84–85
problems derived from, 85–86
symptomatic experience and, 84–85
goal(s). see also specific types
of compartmentalization, 121–22
of paying attention with intention, 26–36
in pulling yourself forward, 71t, 75–76
of therapy, 18
guilt
compartmentalization of, 157
as paralyzing, 156–57
reducing, 159t, 163
responsibility presupposed by, 156–57
Haley, J., 9, 18, 19, 26, 48
Hamilton, A., 95
“have hindsight in advance,” 210
helplessness, 14
as powerlessness, 14
Hilgard, E., 54, 116–17
homework assignments
posthypnotic suggestions for doing, 48
process-oriented hypnosis sessions–related, 47–48
“seeding” of, 47–48
types of, 47
honor code
personal, 194t, 196–97
self-esteem and, 193
hope
good vs. hurtful, 69
hopefulness
from hopelessness, 66
hopeless expectation(s)
client’s, 68
hopelessness, 14–15
apathy and, 14–15
described, 66
effects on therapeutic process, 66–68
hopefulness from, 66
personalization of, 66–67
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 pervasiveness and, 66
rate of treatment impacted by, 67–68
realistic vs. unrealistic, 68–69
as statement of negative expectancy for future, 67
human consciousness
ambiguity as challenge to, 209
human experiences
commonalities of, 5
micro- and macroviews of, 5–6
hypnosis
acceptance in, 139
as active process, 173
association in, 30
automaticity in, 42
benefits of, 8
for catalyzing meaningful action, 171
compartmentalization and dissociation in, 116–17
in connecting people to their resources, 14
context of meaning created by, 46
core of, 189
couples, 205
defined, 38
described, 29–30, 54
dissociation in, 30, 119
as dissociative experience, 102
effectiveness of, 8
Ericksonian, 118
evidence-based applications of, 27
in facilitating compartmentalization, 113–14, 121–22
flexibility encouraged by, 29, 29t
focus encouraged by, 46
in highlighting malleability of experience, 29, 29t
in highlighting subjective nature of experience, 28
indications for, 11
individualized vs. scripted approaches to, 34–35
mindfulness vs., 139
positive psychology in, 189–90
process of, 26–36 (see also paying attention with intention)
process-oriented (see process-oriented hypnosis)
reasons for learning and practicing, 27–29, 29t
in shifting perceptions, 168–69
shifts in subjective experience during, 29, 29t
strengths of, 173
suggestions in, 27–28
terminology associated with, 39
various abilities in responding to, 39–40

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 as vehicle of experiential learning, 173
hypnosis sessions
generic structure of, 31–34, 31t (see also specific topics and process-oriented hypnosis
session(s))
hypnotic responsiveness
addressing, 39–40
dissociation as foundation of, 11
hypnotic suggestions
dissociation in, 119
identity rigidity, 10t
imagination
“believed-in,” 54
imagined events
projections of, 55
imagining
engaging vs., 19–23
impulse
to self-harm, 97–98
impulse control
case example, 95–98
developing, 95–110, 104t (see also developing impulse control)
dissociation in, 102–3
lack of, 101, 207
in quality of life, 98
response set in, 104–5, 104t
skills required for, 102–3
teaching, 102
impulse disorders
as present-oriented phenomena, 100
impulsivity
anticipating consequences in overcoming, 104t, 107–9
individuality
paradox of, 3–4
induction
in building expectancy, 71–72, 71t
in catalyzing meaningful action, 177, 177t
in defining responsibility, 159t, 160
in developing impulse control, 104, 104t
in encouraging acceptance, 140–41, 140t
in evolving foresight, 213t, 214
in facilitating compartmentalization, 122t, 123
in instilling integrity, 194–95, 194t
in making better discriminations, 89t, 90
in recognizing and tolerating ambiguity, 57t, 58
inevitable
no sense in fighting, 140t, 142–43
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information
how people gather and use, 83
inkblots
of Rorschach Test, 53, 67
instilling integrity, 184–202, 194t. see also integrity
case example, 184–87
generic session structure for, 194–202, 194t (see also instilling integrity generic session
transcript)
salient therapeutic targets in, 189–91
instilling integrity generic session transcript, 194–202, 194t
building response set regarding changing self-definitions in, 194t, 195–96
closure and disengagement in, 194t, 201–2
develop personal code of honor in, 194t, 196–97
discover, define, and own your strengths and virtues in, 194t, 197–98
honoring your code of conduct in, 194t, 200–1
induction in, 194–95, 194t
posthypnotic suggestions for integration in, 194t, 201
recognize and acknowledge strengths in others in, 194t, 199
rumination and self-doubt cloud self-awareness in, 194t, 198–99
themes in, 194t, 196–201
you generate your experiences in, 194t, 196
integration
posthypnotic suggestions for (see posthypnotic suggestions for integration)
integrity
case example, 184–87
as code to live by, 191–92
defined, 191–92
instilling, 184–202, 194t (see also instilling integrity)
lack of, 188–89
in quality of life, 187–88
intention
paying attention with, 26–36 (see also paying attention with intention)
Janet, P., 116
Joireman, J., 207
judgment(s)
not necessary to make, 140t, 143–44
jumping to conclusions
cognitive distortion off, 55
Kennedy, R., 134
knowing
value of, 57t, 59–60
Laboratory for Planetary Studies
at Cornell University, 191
lack of acceptance

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 problems derived from, 136
lack of clarity about responsibility
problems derived from, 158
lack of discrimination skills, 84–85
problems derived from, 85–86
lack of foresight, 207
problems derived from, 212
lack of impulse control, 207
problems derived from, 101
lack of integrity
problems derived from, 188–89
lack of tolerance
ambiguity-related, 56
Lankton, S.R., 35
Larson, G., 137
learning
experiential, 173
as we grow, 89t, 91–92
life
choices and, 54
as most ambiguous stimulus, 54
roles in, 114–16
life challenges
encouraging acceptance related to, 140t, 141–42
life experience(s)
temporal orientation in shaping, 98–100
looking forward
in building expectancy, 71t, 77
to positive possibilities, 71t, 78
making better discriminations, 80–94, 89t. see also discrimination(s)
case example, 80–82
develop ability for, 89t, 93–94
generic session structure for, 89t, 90–94 (see als making better discriminations generic session
transcript)
salient therapeutic targets in, 86–94, 89t
making better discriminations generic session transcript, 89t, 90–94
closure and disengagement in, 89t, 94
develop ability to make better discriminations in, 89t, 93–94
induction in, 89t, 90
learning what to value as we grow in, 89t, 91–92
new experiences creating new opportunities in, 89t, 91
posthypnotic suggestions for integration in, 89t, 94
response set in, 89t, 90–91
socialization can blur important distinctions in, 89t, 92–93
themes in, 89t, 91–94
making decisions to act
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 in catalyzing meaningful action, 177t, 178–79
making judgments
as not necessary, 140t, 143–44
marshmallow test, 103, 108–9
meaning
context of, 46
meaningful action
case example, 167–70
catalyzing, 167–83, 177t (see also catalyzing meaningful action)
CBT and, 172–73
rumination gets in way of, 173–75
mental health
adaptation in, 9
mental health issues
ambiguity and, 54–55
metaphor(s)
therapeutic, 45–47
Milton H. Erickson Foundation, 28
mind
brain influenced by, 116–17
mindfulness
described, 139
hypnosis vs., 139
Mindfulness and Hypnosis, 134–35, 139
mindfulness therapy
acceptance in, 138
dissociation in, 118
Mischel, W., 103, 108–9
misconceptions we form, 22
misleading
expectations in, 71t, 73–74
mistake(s)
taking responsibility for your, 159t, 163
Mistakes Were Made (but Not by Me): Why We Justify Foolish Beliefs, Bad Decisions, and
Hurtful Acts, 156
moodiness
case example, 149–52
moving forward
in building expectancy, 71t, 77
Munk, A., 137
myths we live by
case example, 21–22
negative action orientation
problems derived from, 175–76
negative expectancy
hopelessness as statement of, 67
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 problems derived from, 69–70
neodissociation model, 116
Nolen-Hoeksema, S., 174
not knowing
accepting, 57t, 60
value of, 57t, 59–60
now
ascendance attained by, 100–1
one-dimensional labels
people as more than, 159t, 162
oneself
responsibility for, 14
opportunity(ies)
new experiences creating, 89t, 91
overcompartmentalization
examples of, 120
problems derived from, 119–20
overgeneral thinking, 84–85, 168
passive-oriented
action-oriented vs., 14
passivity
rumination as catalyst for, 174
past
future as not just more of, 213t, 215–16
past actions don’t predict future possibilities
in catalyzing meaningful action, 177t, 179
past not needing to define us in present
in defining responsibility, 159t, 161
past-oriented phenomenon
depression as, 99
paying attention with intention, 26–36
building process of hypnosis sessions, 30–34, 31t (see also process-oriented hypnosis
session(s))
goal of, 29–30
individualized vs. scripted approaches, 34–35
people as more than one-dimensional labels
in defining responsibility, 159t, 162
people’s problems. see also repetitions in therapy
airplane phobia, 6–8
familiar sounding, 8–18
uniqueness of, 4–5
perception(s)
hypnosis in shifting, 168–69
space between reaction and, 104t, 106–7
perceptual rigidity, 10t
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personal boundaries
defining and maintaining, 17
personal code of conduct, 192
honoring, 194t, 200–1
personal code of honor
develop, 194t, 196–97
personalization
of hopelessness, 66–67
personal orientation to time, 207–9
personal resources
accepting and using, 140t, 145–47
identifying and mobilizing client’s, 189
use as your actions take you forward, 213t, 214–15
use in new ways, 71t, 76–77
personal responsibility. see also responsibility
deflecting, 157
determination of, 153
making better discriminations about, 159t, 165–66
pervasiveness
hopelessness and, 66
Peterson, C., 190
phobia(s)
airplane, 6–8
physical elements
in therapeutic dissociations, 41t
Picasso, 35
Piper, W., 137
planting seeds for future
in building expectancy, 71t, 77–78
positive possibilities
looking forward to, 71t, 78
positive psychology
in hypnosis, 189–90
possibility(ies)
looking forward to positive, 71t, 78
posthypnotic suggestions
for doing homework assignments, 48
posthypnotic suggestions for integration
in building expectancy, 71t, 79
in catalyzing meaningful action, 177t, 182–83
in defining responsibility, 159t, 166
in developing impulse control, 104t, 110
in encouraging acceptance, 140t, 148
in evolving foresight, 213t, 219–20
in facilitating compartmentalization, 122t, 128–29
in instilling integrity, 194t, 201

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 in making better discriminations, 89t, 94
in recognizing and tolerating ambiguity, 57t, 61–62
power
of acceptance, 136–37
of expectations, 65
quality-of-life decisions related to feelings of, 14
powerlessness
helplessness as, 14
practical questions
suggestions revolving around, 38
predict
ability to, 102, 209–10
present-oriented phenomena
impulse disorders as, 100
prevention
as priority, 213t, 218
priming strategies
in influencing unconscious processes, 154
prioritization
in facilitating compartmentalization, 122t, 126–27
process
salience of, 19–25 (see also salience of process)
process of hypnosis
paying attention with intention in, 26–36 (see also paying attention with intention)
process-oriented hypnosis. see also process-oriented hypnosis session(s)
association in, 41
automaticity in, 42
basis of, 28
building expectancy in, 63–79, 71t
catalyzing meaningful action in, 167–83, 177t
defining responsibility in, 149–66, 159t
developing impulse control in, 95–110, 104t
dissociation in, 40–42, 41t
eliciting hypnotic responses in, 28
encouraging acceptance in, 130–48, 140t
evolving foresight in, 203–20, 213t
facilitating compartmentalization in, 111–29, 122t
foundation of, 1–48
goals of, 139–40, 190
instilling integrity in, 184–202, 194t
making better discriminations in, 80–94, 89t
methods of, 49–220
recognizing and tolerating ambiguity in, 51–62, 57t
process-oriented hypnosis generic session structures. see also specific topics, e.g., instilling
integrity
for building expectancy, 71–79, 71t

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 for catalyzing meaningful action, 177–83, 177t
for defining responsibility, 159–66, 159t
for developing impulse control, 95–110, 104t
for encouraging acceptance, 140–48, 140t
for evolving foresight, 213t, 214–20
for facilitating compartmentalization, 122t, 123–29
for instilling integrity, 194–202, 194t
for making better discriminations, 89t, 90–94
note about, 49
for recognizing and tolerating ambiguity, 57t, 58–62
process-oriented hypnosis generic session transcripts. see specific topics, e.g., evolving foresight
process-oriented hypnosis session(s), 30–34, 31t. see also process-oriented hypnosis
accessing and contextualizing resources in, 42–44, 43t
case example, 21–22
checking in with client during, 31t, 33–34
generic structure of, 31–34, 31t
homework assignments, 47–48
innate structure to, 31, 31t
kind and gentle approaches embedded in, 39–48, 41t, 43t
primary target of, 103
reframing in, 44–45
response sets in, 31t, 32
rumination as coping style as target of, 52–53
“seeding” assignments in, 47–48
setting stage for, 37–39
suggestions revolving around practical questions, 38
themes in, 31t, 32–33
therapeutic metaphors in, 45–47
process suggestions, 28
procrastination
case example, 167–70
global cognitive style and, 168
projection(s)
of imagined events, 55
making sense of, 154–56
recognizing and interrupting process of, 57t, 60–61
projective tests, 53
“Pseudo-orientation in Time,” 210
pseudo-orientation in time technique, 210
psychodynamic therapy
dissociation in, 118
psychogenic amnesia, 117
“psychologically aware,” 80–81
quality of life
acceptance in, 133–34
action orientation in, 170–71
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 ambiguity in, 53–55
catalyzing meaningful action in, 170–71
compartmentalization in, 114–16
decisions in shaping, 83
discriminations in, 83–84
expectancy in, 65–66
foresight in, 206
impulse control in, 98
integrity in, 187–88
responsibility in, 153
quality-of-life decisions
feelings of power and, 14
quality of your decisions
in shaping quality of your life, 83
“radical acceptance,” 138
reaction(s)
focus shaping one’s, 122t, 125–26
space between perception and, 104t, 106–7
reality
fighting against, 134–36
recognizing and tolerating ambiguity, 51–62, 57t. see also ambiguity
case example, 51–53
generic session structure for, 57t, 58–62 (see also recognizing and tolerating ambiguity generic
structure transcript)
recognizing and tolerating ambiguity generic session transcript, 57t, 58–62
accepting not knowing in, 57t, 60
building response set regarding uncertainty in, 57t, 58–59
closure and disengagement in, 57t, 62
induction in, 57t, 58
posthypnotic suggestions for integration in, 57t, 61–62
recognizing and interrupting process of projection in, 57t, 60–61
themes in, 57t, 59–61
value of knowing and not knowing in, 57t, 59–60
recovery
expectations and, 68
reflexive
experiences as, 104t, 105–6
reflexive responding, 83
reframing
in process-oriented hypnosis sessions, 44–45
regression
age, 43, 43t, 210
regret(s)
thinking ahead in preventing, 213t, 216
relational elements
in therapeutic dissociations, 41t
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relational rigidity, 10t
relationship(s)
boundaries in, 17
flexibility with, 17
relationship problems
global thinking among people with, 85
relationship skills, 16–17
repetitions in therapy, 3–18
airplane phobia, 6–8
anxiety, 12–14
apathy, 14–15
coping skills, 15–16
helplessness, 14
hopelessness, 14–15
of people’s problems, 4–5
relationship skills, 16–17
rigidity, 9–10, 10t
trauma, 10–11
types of, 8–18
resource(s)
accepting and using your, 140t, 145–47
accessing and contextualizing, 42–44, 43t
personal (see personal resources)
for use in new ways, 71t, 76–77
responding
reflexive, 83
response sets
agency-related, 159t, 160–61
in building expectancy, 71t, 72–73
changing self-definitions–related, 194t, 195–96
in developing impulse control, 104–5, 104t
in encouraging acceptance, 140t, 141
in making better discriminations, 89t, 90–91
in process-oriented hypnosis sessions, 31t, 32
in recognizing and tolerating ambiguity, 57t, 58–59
regarding specific components of global experiences, 122t, 123–24
in taking helpful action on your own behalf, 177–78, 177t
in thinking ahead, 213t, 214
uncertainty-related, 57t, 58–59
responsibility, 149–66, 159t
case example, 149–52
defining, 149–66, 159t (see also defining responsibility)
deflecting, 157
determination of, 153
discrimination issues related to, 157
guilt presupposes, 156–57

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 making better discriminations about, 159t, 165–66
making sense of, 154–56
for oneself, 14
for one’s mistakes, 159t, 163
perceptions of, 155
problems derived from lack of clarity about, 158
in quality of life, 153
refusing to take, 156–58
taking, 156–58
where it lies, 159t, 164–65
responsiveness
hypnotic, 39–40
restraint(s)
merits of thoughtful, 102
rigidity, 9–10, 10t
defined, 9
flexibility as counter to, 9–10
forms of, 10t
Robinson, K., Sir, 37
roles in life
defined vs. fuzzy, 114–15
lifetime vs. transient, 114–15
multiple, 114–16
Rorschach Test
inkblots of, 53, 67
Rozoff, J., 3
rumination
ambiguity and, 55–56
as coping style, 52–53, 174
meaningful action impeded by, 173–75
rationalization of, 174–75
self-awareness clouded by, 194t, 198–99
self-doubt increased by, 174
Sagan, C., 191
salience of process
case example, 19–23
social anxiety–related, 20–23
in treatment, 19–25
script(s)
described, 34–35
“seeding” assignments
in process-oriented hypnosis sessions, 47–48
self-absorption, 16
self-awareness
rumination and self-doubt cloud, 194t, 198–99
self-definition(s)
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 developing new, 97–98
response sets regarding changing, 194t, 195–96
in therapeutic dissociations, 41t
self-discovery
process of, 97–98
self-doubt
rumination in increasing, 174
self-awareness clouded by, 194t, 198–99
self-esteem
described, 193
honor code and, 193
“self-fulfilling prophecy,” 65
self-harm
impulse to, 97–98
self-harming behavior
case example, 95–98
stress and, 96
self-regulation
foresight as means of enhanced, 207
self-rejection
pattern of, 137–38
Seligman, M., 190
sentence completion tests, 53
shifting perceptions
hypnosis in, 168–69
skill(s)
compartmentalization, 113–14, 121–22
relationship, 16–17
Sloman, S., 24
“social activists,” 81
social anxiety
case example, 19–23
social influence
free will and, 171–72
socialization
in blurring distinctions, 89t, 92–93
split-brain patients, 154
Stanford Laboratory of Hypnosis Research, 116
status quo
discontent with, 133–34
strategic therapy
dissociation in, 118–19
Strathman, A., 207
strength(s)
character, 190
discover, define, and own your, 194t, 197–98

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 in others, 194t, 199
stress
self-harming behavior related to, 96
stressor(s)
coping skills for, 15–16
subjective experience
shifts in, 29, 29t
suggested responses
automaticity of, 42
suggestion(s)
content vs. process, 28
delivery style, 28
inevitability of utilizing, 27–28
revolving around practical questions, 38
symptomatic experience
global cognition and, 84–85
Tavris, C., 156
temporal elements
in therapeutic dissociations, 41t
temporal orientation
defined, 98
in shaping life experience, 98–100
The Consciousness Instinct, 111
The Discriminating Therapist, 137
The Knowledge Illusion: Why We Never Think Alone, 24
The Little Engine That Could, 137
The Marshmallow Test: Why Self-Control Is the Engine of Success, 103
Thematic Apperception Test
enigmatic pictures of, 53
theme(s)
in building expectancy, 71t, 73–78
in catalyzing meaningful action, 177t, 178–82
in defining responsibility, 159t, 161–66
in developing impulse control, 104t, 105–10
in encouraging acceptance, 140t, 141–47
in evolving foresight, 213t, 214–19
in facilitating compartmentalization, 122t, 124–28
in instilling integrity, 194t, 196–201
in making better discriminations, 89t, 91–94
in process-oriented hypnosis sessions, 31t, 32–33
in recognizing and tolerating ambiguity, 57t, 59–61
therapeutic curiosity, 40
therapeutic dissociations
in hypnosis, 40–42, 41t (see also dissociation)
therapeutic metaphor(s)
in process-oriented hypnosis sessions, 45–47
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therapeutic process
hopelessness effects on, 66–68
therapeutic themes. see theme(s)
therapy(ies)
actions in, 172–73
attachment across, 117–19
goal of, 18
hypnotic side of, 26–36 (see also paying attention with intention; process of hypnosis)
relationship to time, 207–9
repetitions in, 3–18 (see also repetitions in therapy)
thinking
global (see global thinking)
overgeneral, 84–85, 168
too much, 177t, 181–82
thinking ahead
in preventing regrets, 213t, 216
response set in regarding, 213t, 214
taking preventive action even if it’s inconvenient, 213t, 217–18
thinking too much
danger in, 177t, 181–82
thoughtful restraint
merits of, 102
time
personal orientation to, 207–9
therapy’s relationship to, 207–9
tolerance
lack of, 56
Trancework: An Introduction to the Practice of Clinical Hypnosis, xvii, xxi, 34–35
transcript(s)
described, 34–35
trauma, 10–11
childhood, 10–11
treatment
salience of process in, 19–25
treatment cooperation
client’s expectations and, 67–68
Twain, M., 25
2019 Stress in America survey
of APA, 12
uncertainty
building response set regarding, 57t, 58–59
unconscious
described, 154
unconscious processes
priming strategies in influencing, 154
undercompartmentalization
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 examples of, 120
problems derived from, 119–20
Understanding Behavior in the Context of Time, 207
uniqueness of people’s problems, 4–5
University of Michigan, 187–88
untrustworthy
defined, 156
virtue(s)
discover, define, and own your, 194t, 197–98
Weitzenhoffer, A., 116
what matters
asking how to get to, 23–25
what’s right
shifting focus to, 140t, 144–45
“what you focus on, you amplify,” 169
WHO. see World Health Organization (WHO)
Who’s in Charge? Free Will and the Science of the Brain, 154
will
free (see free will)
World Health Organization (WHO), xx
worry
anxiety vs., 51–53
Yapko, M.D., xvii–xviii, xx, 34–35, 134–35, 137, 139, 187–88
Zeig, J.K., xvii–xviii, 9, 28
Zimbardo, P., 207
Zimbardo Time Perspective Inventory, 207

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About the Author

Michael D. Yapko, Ph.D., is a clinical psychologist residing in Southern California. Author of

15 books, including the leading hypnosis text Trancework (5th edition), he has taught hypnosis
in more than 30 countries and received lifetime achievement awards from the American
Psychological Association (Div. 30), the International Society of Hypnosis, and The Milton H.
Erickson Foundation.

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Acknowledgments

While quarantined at home due to the COVID-19 pandemic, I had the opportunity to bring this
long-percolating book to fruition. It has provided a nice closure to a project I wasn’t sure I’d ever
get around to completing. Being quarantined, though, was hardly a welcome condition. The
suffering of so many millions worldwide really drives home the point, in the worst of ways, of
how inextricably tied to each other we all are. But this is a challenging time that also brings out
the best in many people: The courage of the doctors, nurses, and other frontline health care
professionals who selflessly care for the sick and dying despite their individual fears of infection
or death is inspiring beyond words. All those who gave and continue to give so much, who find
courage through the power of their mission, whether it’s restocking shelves or sanitizing the
facility, show us how much we are capable of when we commit to something greater than
ourselves. That lesson of what makes humans become our best selves should never be
overlooked by anyone, ever.
My wife, Diane, and I have now been happily married for 44 years. This isn’t a story you hear
much anymore, but it is our story; we’re so grateful to have found each other so early on and that
we’ve had the chance to spend our lives together. And what amazing lives they have been!
Diane’s love, wisdom, and relentless positivity are wonderful gifts she shares generously. And
that smile . . .
My family and friends add a richness to my life that I never take for granted. My siblings,
Brian, Jerry, Ken, Jackie, and Mitchell, are individually and collectively the wonderful, loving
family I would choose to have, not just have by default. And my lifelong best friends, Wendy
and Richard, and our “shared” daughter Megan, are my best friends for so many reasons, all of
which I hold in my heart.
Many friends and colleagues have given so much of themselves to my personal and
professional development. I want to acknowledge two in particular: Jeff Zeig has been an
especially important part of my life for more than four decades; I am deeply grateful for his
unwavering support and friendship. Jeff has given so much to so many, and I am often awed by
his generosity, vision, stamina, and perceptiveness. Erving Polster is a dear friend who holds a
special place in my life. He reminds me every day of just how far grace, depth, and a sense of
humor will take you in life. Erv is a role model in so many ways, and I am deeply inspired by
what he does and, especially, the way he does it.
Two of my most revered mentors are no longer with us but still deserve my note of
appreciation here. Jay Haley and William S. Kroger were two of the most brilliant people I have
ever known. Both challenged me in the best of ways to keep pushing beyond the limits of my
comfort zone, and I am grateful for the many lessons they taught me that I continue to rely on
virtually every day of my life. I never had the chance to meet Milton Erickson, unfortunately, but
his influence on my work is profound. His unique perspectives supply a seemingly endless array
of therapeutic options, encouraging creativity and a deeper appreciation for all that hypnosis can
offer.
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 My editor at Norton, Deborah Malmud, was receptive to the idea for this book from the very
beginning and provided valuable feedback. Mariah Eppes, project editor, then guided it through
the various stages of development and did so with a clarity and efficiency I appreciate greatly.
Karen Fisher was the copyeditor, and she did a wonderful job of smoothing out the book’s
wrinkles and modeling what a great attention to detail looks like. She improved my work
substantially, for which I’m very grateful.
Finally, I want to acknowledge how important my students and colleagues around the world
have been in shaping my ideas and perspectives. I am so fortunate to have had the chance to
teach to and to interact with talented professionals in many different parts of the world. Each
brings a different point of view to even the most basic things in life that then give me reason to
pause and give them further consideration. Ideas go through revisions, and the revisions go
through revisions. Thank you one and all for all you have given me. I hope you’ll see some of
yourself in these pages.
Michael D. Yapko, Ph.D
www.yapko.com

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 Other Books by Michael D. Yapko

Trancework, Fifth Edition

Taking Hypnosis to the Next Level
The Discriminating Therapist
Keys to Unlocking Depression
Essentials of Hypnosis, Second Edition
Mindfulness and Hypnosis
Depression is Contagious
Treating Depressing with Hypnosis
Hypnosis and the Treatment of Depressions
Hand-Me-Down Blues
Suggestions of Abuse
Breaking Patterns of Depression

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Note to Readers: This book is intended as a general information resource for professionals practicing in the field of
psychotherapy and mental health. It is not a substitute for appropriate training, peer review, and/or clinical supervision. Standards
of clinical practice and protocol change over time. No technique or recommendation is guaranteed to be safe or effective in all
circumstances, and neither the publisher nor the author can guarantee the complete accuracy, efficacy, or appropriateness of any
particular recommendation in every respect. All case subjects described in this book are composites. Any URLs displayed in this
book link or refer to websites that existed as of press time. The publisher is not responsible for, and should not be deemed to
endorse or recommend, any website other than its own or any content that it did not create. The author, also, is not responsible for
any third-party material.

Copyright © 2021 by Michael D. Yapko

All rights reserved

First Edition

For information about permission to reproduce selections from this book, write to

Permissions, W. W. Norton & Company, Inc., 500 Fifth Avenue, New York, NY 10110

For information about special discounts for bulk purchases, please contact

W. W. Norton Special Sales at [email protected] or 800-233-4830

Jacket design by Anthony D. Paular/anthonypaular.design

Cover photo by VarnaK/Shutterstock
Production manager: Katelyn MacKenzie

The Library of Congress has cataloged the printed edition as follows:

Names: Yapko, Michael D., author.

Title: Process-oriented hypnosis : focusing on the forest, not the trees / Michael D. Yapko.
Description: First edition. | New York : W. W. Norton & Company, 2021. | “A Norton professional book.” | Includes
bibliographical references and index.
Identifiers: LCCN 2020041738 | ISBN (hardcover) | ISBN 9781324016342 (epub)
Subjects: LCSH: Hypnotism—Therapeutic use.
Classification: LCC RC495 .Y369 2021 | DDC 615.8/512—dc23
LC record available at https://lccn.loc.gov/2020041738

W. W. Norton & Company, Inc., 500 Fifth Avenue, New York, N.Y. 10110
www.wwnorton.com

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