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Re-evaluating Hypnosis For Smoke Cessation
by Maurice Kouguell, Ph.D, BCETS  

According to the Well Spring Media from the Internet: ”giving up cigarettes is a challenge faced by millions of people. About 90% of America's 51 million smokers want to quit, but only 20 to 30% manage to do so permanently." At the root of all addictions is the search for happiness and contentment from outside sources. Most of us are addicted to some object external to us. This includes the use of drugs, use of food, addiction to a person, addiction to sex, to compulsive buying and so on.

Children learn how to become addicted by discovering and abusing methods which allow them to achieve comfort states by turning to food or acquiring a new toy for example and later in life as they grow into adolescence and adulthood, they discover certain things that can make them feel good. This could be turning to food, to a cigarette, a drink, drugs, relationships, compulsive buying, to name a few. The pattern leading to addiction is quite simple. It always begins with the time when we used a pacifier or tranquilizer to relieve our discomfort. At a future time as we re-experience a similar feeling, which could be fear or anxiousness, we remember the relief we received from that pacifier and resort to it. As the pattern is repeated, one uses the pacifying/stress relief addiction to achieve momentary relief.
       
Addictions are a way of evading the demands of life by choosing to live without pain or effort. When their addictions are not satisfied, addicts live in an ongoing state of anxiety. People experiencing anxiety tend to over-estimate the dangers they need to confront and underestimate their own ability to control them. I became addicted to cigarettes in my teens. How clearly I remember my clumsiness in my social interactions.
I completed my secondary education in French Schools and was one of the tallest students in my class at the age of 14. I also had hair on my chest and was 5 feet 11. Not only was I mistaken for an older person but was expected to behave as such. Some of my sophisticated friends smoked. Most movie stars smoked and they all seemed to be so confident. So I found a cure for my shyness and became a smoker too. In time, I conquered my shyness but the addiction remained and I was convinced that cigarettes made me feel confident and good.

Answering the telephone was accompanied by a cigarette. The car could not start unless I had a cigarette. I had developed the thought that I had to feel good at all times therefore I smoked almost all the time, after all why not feel good all the time? Comments made to me by people who cared for me were invariably followed by smoking even more. After all I needed immediate gratification and if they really knew how I felt and if they really loved me they would understand how I felt and thus endorse my actions or even suggest I should smoke more if it made me feel better.

I also learned that if it made me feel good in the past, it should make me feel good now. The vicious cycle was established and my cigarette became my best friend. I have not smoked in 10 years after having been addicted to at least a couple of packs a day. I overcame the addiction through self hypnosis
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Standard hypnotic procedures for smoke cessation work for many people. However there are some smokers who must stop smoking for medical reasons and some who come to us with ambivalent feelings. At first, those people do not always respond to hypnosis. At the basis of this lack of responsiveness is the conflict they experience between knowing that they need to stop and not wanting to stop, hence the ambivalence.
Ambivalence can be described as a state of mind where an individual experiences conflicting but co-existing feelings. The ambivalence is between doing the addictive behavior and resisting it. This can be interpreted as resistance or denial. It also is verbalized by many as being afraid to give up the sense of security and being well provided for by their addiction. I believe the above pattern is typical for all addictions.

Addictions become our best friends for they relieve our discomfort temporarily by blocking or diverting us from a reality which is perceived as producing anxiety. Most addictions share similarities yet each addiction has its own specific characteristics. Each addict has his own agenda as well. Some characteristics of an addict can be described as a person trapped, stuck in a pattern of behavior to the point that they can not be freed from it. Addicts recognize that their pattern of behavior is self-destructive. They have usually been unsuccessful in overcoming their compulsions. Most have poor self-esteem. Those seeking help have frequently surrendered to the plea of others or threats to their ill health.  Some are self motivated.

So how do we proceed? What are our goals as therapists in this helping process? Following an evaluation of the client, the hypnotherapist will need to discuss the procedure and what needs to be done. Regardless of one’s theoretical orientations, therapists are in agreement that certain things have to happen as part of therapy: Clients will benefit from altering their perceptions of themselves by re-examining their self image. This is achieved by exploring feelings, ideations or experiences.

All these are usually related to current fears and difficulties of adjustment. The common denominator is frequently a lack of ability at managing stress. In some situations regression to the initial precipitating event may be necessary.
The resistance from a patient gives the clinician an important clue. In many cases the unwillingness or inability to be receptive to change is linked to self confidence, fear of how they will adjust without the crutch or support of the addiction. Therefore one needs to attend and address first other factors such as stress, fear and self confidence. For some addicts, the thought of being without their choice addiction creates anxiety and can take over and affect the individual. Clients have reported fear and apprehension, if not panic, at the thought of being without the addictive outlet. As they share their thoughts, one can notice increase of heart rate, even shaking and some report feeling dizzy and all these are symptoms of anxiety.

After the initial evaluation I have in some cases come to suggest starting with procedures incorporating stress reduction and self confidence before approaching a smoke cessation session. Of course not every one who smokes is an addict just as not every one who drinks is an alcoholic. So, we need to go beyond limiting ourselves to the use of a standard script.



Dr. Kouguell is a diplomate of The American Academy of Experts in Traumatic Stress. He offers free consultations to individuals and groups related to the September incident.
His website www.brooksidecenter.com. features extensive resources and self help techniques for individuals affected by PTSD
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