Suggestions are literally being given to us all the time – from friends and family, colleagues, acquaintances, television commercials, billboard advertisements and so on. Whilst suggestions do not necessarily need to be delivered during hypnosis to be effective, when a client enters this highly focused, suggestible state the client allows suggestions to be taken on board more easily. Therapists should, therefore, be vigilant of their suggestions both in and out of hypnosis.
When Should We Use Suggestion?
There are two circumstances that suggestion therapy can be applied to a client; the first is during inductions and deepeners to encourage the client to relax and focus on self, and the second is post-hypnotic suggestion, designed to bring about change in an individual after the session has ended – and it is this part that delivers the therapy.
To be most successful, suggestion therapy alone is best used when there is little subconscious resistance and the individual whole heartedly wants the expected outcome. Certain problems that a client presents with will not give way to suggestion therapy alone and these include Obsessive Compulsive Disorder, severe trauma and depression. A as a result, for these types of problems, suggestion therapy has been referred to as “band aid therapy” - at worst, it will not work; at best, it may have a limited lifespan.
Before any suggestions are given to the client, it is essential that the therapist gets to the root of the problem. Occasionally what a client presents as their problem, e.g. wanting to lose weight, isn't actually the cause of their anxiety. In this example, further probing could identify that the client has a self-image problem and is in need of confidence and self-acceptance.
Additionally, clients may state that they want to be confident, motivated, successful, etc. These are all examples of nominalisations. The therapist must discover how exactly the client wants to change, as confidence to one person is unlikely to mean the same to someone else. Allowing the client to specifically state what they want to achieve enables the therapist to tailor the suggestions accordingly and ensures they are meaningful and relevant to the client's situation. Therapists may find the Neuro Linguistic Programming Meta Model style of questioning to be very useful in this context, as it avoids any kind of ambiguity as far as the client's desired outcome is concerned.
Before proceeding, both client and therapist must agree on the suggestions that will be given to minimise resistance from the client, as any undesirable suggestions will be rejected by the subconscious.
Direct vs. Indirect and Personality Types
There are two distinct ways in which suggestions can be given. The first is direct, also known as authoritarian or paternal and this method was adopted by Dave Elman. It involves actually giving the client a command, such as “ your eyes become heavier and heavier ”. At the other end of the spectrum are indirect suggestions, or permissive/maternal, favoured by Milton Erickson, which give the client the illusion of choice by deciding whether they will carry out the action requested by the therapist; for example “ …and you might discover that your eyes are becoming heavier ”, Therefore, this type of suggestion is often less likely to be met with resistance and is best employed for analytical characters, particularly Resolute Organisational personality types.
Another method that gives the illusion of choice is powerful Double Bind technique, which can be direct or indirect. For example: “You can relax now, or you can relax later…whatever's best for you” gives the illusion of choice, but carries the presupposition that the client WILL relax, no matter which option they choose. Again this is useful for analytical types who want to maintain control.
When formulating suggestions for relaxation or visualisation, the “art of being vague” can be adopted, also known as the Milton Model. This technique purposely avoids being specific, so that the client can “fill in the gaps” and create their own meaning. For example, a therapist could say “Imagine yourself walking towards a door” . There is no mention of what sort of door it is, what colour, whether it has a handle, etc. and so this allows the client to shape the experience for themselves. If the therapist were to suggest that the client turns the door handle, it could be that there is no handle on the door and it just pushes open, or perhaps it is already open!
However, it is imperative that when structuring post-hypnotic suggestions, any ambiguity is avoided. Many words within the English language have a number of different meanings and the therapist can never be sure how a particular word will be understood by the subconscious, as this will depend on the client's own view and experiences of the world. Some example words with double meanings include “easy”, “straight”.
Suggestions should always be phrased in a positive manner – for example “ You will feel comfortable ”, rather than “You will not feel insecure ”. Due to the Law of Reversed Effect, the subconscious does not recognise negatives and so will literally hear “feel insecure”. It is worth noting, however, that this does not ring true when turned the other way around. For example, “ You will not feel confident ” will unsurprisingly not help the client!
A clever suggestion also makes use of embedded commands within its structure. An example would be “ From this day forward, you will remain a confident, happy relaxed individual and you will find that you can control your weight easily and effortlessly .”
The Law of Compound Suggestion states that once a suggestion has been accepted by the client's subconscious, it becomes easier for additional suggestions to be accepted. Therefore, in the above example, the therapist could continue with: “…and you are delighted to find that each time you begin one of your daily meals, you will discover that you are only able to eat one half. You will be amazed at how easily and effortlessly you can do this”
To make a suggestion even more powerful it can be combined with an anchor, which can be visual, auditory or kinaesthetic (also olfactory or gustatory, although generally not as powerful), depending on the client's preferred representational system. Whenever the client needs to access a particular state of mind, he or she can trigger the anchor and the suggestion is realised.
For example, after the anchor has been installed during a session, the therapist can deliver the post-hypnotic suggestion of: “ From this day forward, whenever you want to feel motivated, simply push your thumb into your palm, and you will feel a surge of excitement and enthusiasm ”.
When delivering post-hypnotic suggestions to the client, there is a far greater chance for these to be accepted if they are spoken with meaning and emotion, rather than in a monotonous tone, as often used in inductions and deepeners. The aim here is not to relax the client, but for the client to share the strong emotions associated with the suggestion so they are absorbed by the subconscious.
Furthermore, we know that repetition aids in bypassing the CCF and whilst this method alone is slow and not always successful, when combined with hypnosis, it can make suggestion far more powerful. Therefore, there is a widely known “Rule of 3” within hypnosis, where all suggestions should be repeated at least 3 times for maximum impact.
It is best practice to always undo suggestions that would serve no useful purpose after the client emerges from the hypnotic state. If a therapist has used the Rapid Induction Eye Closure method, on the count out, he or she might say “As I count up from 1 to 5, your eyes will feel absolutely fine and you will feel wide awake, refreshed and alert”. Similarly, it is also recommended to undo suggestions if suggestions of amnesia or catalepsy have been given.
Therapists should also be very careful with the type of suggestions offered during hypnosis and this is particularly relevant when helping a client with an issue that could damage their emotional or physical health.
An example of a type of aversion therapy for a smoking client could include “…and if you continue to smoke, your body will gradually wear down...you'll find that your cough becomes worse, your breathing is laboured until eventually, your lungs will give out completely. In fact, your whole body begins to shut down”. This carries the danger that the client's subconscious will actually start to realise this fact and consequently, they could become very ill indeed.
When constructed and delivered correctly, suggestions can be a very powerful technique for helping individuals with a wide range of symptoms. Whether this type of therapy it is used will be dependent on the outcome of the initial consultation with the client. However, it is essential to remember that whilst suggestion therapy will help all clients some of the time and some clients all of the time, it will not help all clients all of the time.