Grieving Heals the Wound of Loss

 

Stuck for months unable to decide to stay in or leave a decaying marriage, my client began to cry as she talk about all that had been good about it. By the next session she had talked with her husband about separating and setting divorce into motion.

 

Grieving processes loss in a way that allows one to get on with living.

 

Grieving heals the wound of loss.  It is a natural, restorative process--like a scraped knee bleeding, scabbing over, tissues mending and perhaps leaving a visible scar, perhaps not, and getting on with “being all the knee it can be.” In the course of grieving a loss we shift from living in the pain of What No Longer Is to living and fully inhabiting What Is Now.

 

Suffering incremental losses

During the first four years that I worked with Steve, a 40 year-old man with multiple sclerosis, he suffered numerous incremental losses of his physical and mental capacities caused by this progressive disease. It affected his ability to balance, walk, and write legibly; sometimes it affected his ability to quickly focus his gaze.  He noticed it was harder to concentrate.  Muscle tension and pain had increased in various areas and interfered with sound sleep. He said he felt “locked down” and it was just getting worse. He gradually became more depressed and less expressive. When he spoke, it was increasingly about what he couldn’t do.

 

Upwelling of grief

One session, he had more difficultly than usual walking into my office and sitting down. He said he woke up two days ago and had lost some control of his left foot. He began to cry. I had never seen him do this.  He sobbed and told me how helpless and hopeless he felt. For about 20 minutes feelings just welled up in waves. And then it all subsided.

 

In subsequent sessions, he begin to talk about various interests he was exploring, what he has doing, how he had figured out the logistics of traveling to someplace he wanted to go. During one session as he told me what he was up to he said,

 

“I’ve never been happier in my life. I’m doing more of what I like than ever before.”

 

Grieving as a restorative process

In the years since, as we continued working together, I watched and learned from Steve as he repeatedly suffered degradation of various abilities. And each time he grieved his losses, it was as if he reset the counter from what had been to what now was… and each time regained being enlivened and engaged in his capacities as they had become, rather than how they had been.

 

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Your comments are welcomed.
                                                                                                                                 
Footnote: About examples
Stories and vignettes that are inspired by my own or my clients’ coming to change are not intended to accurately portray therapy and are most often fictionalized syntheses written to make clear some point. When drawn from a particular interaction, they are used with permission and are always altered to protect client anonymity. 

All are offered with gratitude to my clients—all of whom teach me that our capacity for intelligent and life-affirming responsivity and change exceeds conscious imagining. And all are offered in support of people making enlivening change in their own lives and in support of those of us who, in turn, support others opening to more options for being alive and vital.

 

When old strategies become problems, Part 3

A third example of the sanity and logic that underlies a problem behavior, in this case, worries about an upcoming adventure (and plane flight).

Threads:                        Getting unstuck, breaking up old patterns
Relevant recent posts:    2/22/2013     When old strategies become problems: Part 2
                                    2/12/2013     When old strategies become problems: Part 1
                                    8/23/2011     Getting unstuck: Part 2
                                    5/13/2011     A frame for how we learn
                                    2/14/2011     Unconscious Learning

                                                                            

But how do you prepare enough for such a thing?
  





Locked in
When an old strategy is triggered, you more or less lock into the set of responses and options dictated by the associated old learnings. For instance, in Part 1, snakes triggered paralyzing fear; in Part 2, waking up in the morning triggered the feeling that it was safer to stay in bed.

No replacements, just room for something new
Therapy is most often not a case of learning a new behavior to replace an old one. Rather it involves becoming free of the constraints of the old pattern in a way that one’s natural, unfettered intelligence emerges to meet the circumstances in this moment now, not as they were then. 

Example 3

In this example, drawn from work with a client and used with permission (see “Footnote: About this example,” below), an ostensible fear of flying turns out to be rooted in an old learning about the dangers of going on an adventure. The therapeutic work consists of the client becoming aware of the functioning of her old patterned response in a way that she can gently interrupt it. Here’s a shortened and simplified telling of our interaction.

The problem: Anxiously thinking about what might go wrong
A client I’ll call Bett, a resourceful woman in her fifties, wanted my help to “overcome irrational, silly fears…” including the fear of flying. Up to this point, she had avoided flying; now she wanted to go on a vacation that required plane travel and had booked it, non-refundable. She couldn’t stop anxiously thinking about what might go wrong.

Where did you learn to do that?
I asked where she learned to think so hard about what might go wrong. She said her father was a worrier. She vividly remembered when going outdoors on some adventure he would call after her, “You’re going to get hurt; be careful not to break your neck.”

This was Dad’s earnest attempt to make sure his little girl would take care of herself. Bett took it to heart.

The old strategy is an attempt to accomplish something good
When she went outside on an adventure she certainly didn’t want to get hurt or break her neck. What preparation and amount of vigilance go into being careful enough? She didn’t know.

It became clear: In a well-meaning effort to take care of herself Bett had learned to think and think about what could go wrong… without ever arriving at the sense that she had thought and prepared carefully enough to avoid something bad happening.

A new adventure triggers the old strategy
Now, with respect to the old learning, Bett’s booked plane travel qualified as an adventure… triggering this old strategy.

Learning to recognize the old pattern
Bett recounted a number of past instances of being anxious and thinking about what might go wrong in anticipation of an adventure. We both could appreciate this old behavior, although ineffective, was an effort to accomplish something good.

Gently interrupting the old pattern
We explored the possibility of Bett comfortably preparing for and going on an adventure. She said she’d like that. I suggested, “Although this old strategy of worrying means well, it may be time to refine it. Perhaps whenever it starts up—and you find yourself endlessly thinking about what might go wrong, see how it feels to say something like:

“Thank you for being so persistent in trying to take care of me. I have thought about how to take care of myself on this adventure, and I think I’m okay. If there’s something specific I missed, let me know.”

A new learning: Knowing when you’ve done enough
She liked how it felt, and said she would do it. We did a few minutes of hypnosis to support the interruption and refinement of this old learning in a way that would allow Bett to more comfortably and adequately plan for her upcoming travel. Suggestions included the following metaphor:

"And when everything that can be done that should be done has been done… then there can be a natural settling. Just like breathing: The diaphragm engages and inhalation comes to you… and when enough has been taken in… then there is a natural settling into the exhalation that happens of its own accord."

At the end of the session I asked if there was more work for us to do with this. Her response both answered my question and broke with the old pattern: “I think that’s enough. I feel ready to go.”


About these examples

In this and the previous two posts, thanking old and obsolete habitual behaviors “…for being so persistent in trying to protect me…” could seem a bit cookie-cutter-ish. There is more to it.

First, there is therapy that precedes and then follows the work portrayed in these vignettes. A lot of the old behavior is already dismantled by the time someone can recognize its functioning clearly enough to be able to talk about it (rather than be blindly in the thrall of it). Also, there may be follow-on work in support of the client accomplishing a sustainable and satisfying outcome.

Second, out of session, 1) doing the work of recognizing when you’re in the middle of enacting the problem behavior, 2) understanding that it is old and obsolete, and thinking to thank it… all contribute to the pattern losing traction.

And third, there are many kinds of old and obsolete behaviors and equally many ways to therapeutically address them. I chose these three vignettes because they share an underlying template: An old behavior, learned at a young age as a protective strategy, continues to function even though it has become outmoded. After reading about it in three different settings, it may be easier for you to become aware of old obsolete habits functioning in your own life—that may mean well but that you no longer need. 

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Your comments are welcomed.
                                                                                                                                 
Footnote: About this example
Stories and therapy vignettes that are inspired by my clients’ coming to change are used with permission, are always altered to protect client anonymity, are not intended to accurately portray therapy, and are often fictionalized syntheses written to make clear some point.

All are offered with gratitude to my clients—all of whom teach me that our capacity for intelligent and life-affirming responsivity and change exceeds conscious imagining. And all are offered in support of people making enlivening change in their own lives and in support of those of us who, in turn, support others opening to more options for being alive and vital.

When old strategies become problems: Part 2

What good is trying to be accomplished? A second example of the sanity and logic that underlie problem behavior, in this case, wanting to stay in bed in the morning.

Threads:                        Getting unstuck, breaking up old patterns
Relevant recent posts:    2/12/2013     When old strategies become problems: Part 1
                                    8/23/2011     Getting unstuck: Part 2
                                    5/13/2011     A frame for how we learn
                                    2/14/2011     Unconscious Learning
                                                                           

It’s easy to support a curious, interested child learning something new.
How will you be as generous with yourself as you solve this problem?
    -to a client, frustrated with their own behavior





 
A new client often arrives with a problem behavior they hate. No matter how crazy, weird, counterproductive, or self-sabotaging the behavior seems, I have learned there is likely some past circumstance in which the behavior was learned and adopted to accomplish something good. Although the behavior persists in its attempt to accomplish something good, it may no longer fit the current circumstances—it is now a problem.

What’s the behavior trying to accomplish that’s good?
When a client can see and appreciate the problem behavior as an old strategy on behalf of their well-being that can be refined and updated, it often helps change the behavior. Because of this, I immediately become curious: What’s the behavior trying to accomplish that’s so important that it has resisted the client’s every effort to change it?


Example 2

I don’t want to get out of bed in the morning
A client I’ll call Matt, in his thirties, is competent and resourceful. His parents recently moved from across the country into the town where he and his family live. Their proximity has triggered some of Matt’s old childhood feelings and prompted him to seek therapy. The following vignette, drawn from work with Matt and used with permission (see “Footnote: About this example,” below), exposes the sanity which can underlie a problem behavior.

During our work to change the nature of his responses around his mother, Matt said he often didn’t want to get out of bed in the morning. I asked, “How does it go? What do you think or feel that is a part of not wanting to get out of bed?”

He said, “It’s easier to stay in bed if there’s nothing pulling me out of bed.”

Me: “Where do you imagine you learned this? What circumstance have you been in where it really was easier to stay in bed if there’s nothing pulling you out of bed?”

Matt: "Growing up around my mother. It felt like anything I’d do would set her off. Then she’d yell at me and be mean. I could never tell what I’d done wrong, so I didn’t know what to do differently.”

Me: “So, if nothing was pulling you out of bed, like having to go to school, it was easier to stay in bed.”

Matt: “Yeah, so I won’t do something wrong around Mom.”

Me: “Ah, makes good sense.”

Matt: “Yeah.”

Me: “That’s a pretty good strategy, staying in bed, to avoid the risk of setting her off.”

Matt: “Yeah, I never thought about it that way.”

Me: “Where you live now, with your wife and son, do you feel at risk of doing something wrong and setting either of them off?...”

Matt: [laughs, shakes head ‘no’].

Me: “So, you believe now it might actually be okay to get out of bed in the morning…?

Matt: [nodding ‘yes’]

Me: “This strategy of staying in bed to protect you from upsetting your Mom has been persistent for decades, so it’s probably not going to drop away just because we’re talking about it. But we can add something to it. Would that be okay?

Matt: “Yes.”

Me: “So, on those mornings when you wake up and it still might happen that you have that experience of it being easier to stay in bed… see how it feels to say, ‘Thank you for being so persistent in trying to protect and take care of me. I know it’s okay now for me to get out of bed. Thank you.’”

Matt: “Huh. Yeah. [pause] I can do that.”

Me: “Only if you really know it is okay for you to get out of bed, that it is different now than it was growing up around your Mom.”

Matt. “Yeah, I know that, it is different. I can say that.”

There was more
Matt went home and the next morning, when he felt it was easier to stay in bed than to get up, he said, “Thank you for being so persistent in trying to protect and take care of me. I know it’s okay now for me to get out of bed.” Then he got out of bed and began doing his morning things. In a few minutes he started feeling anxious—tight chest and stomach. By mid-morning he realized he was feeling like he used to as a little boy when he got out of bed. By ignoring the old strategy of staying under Mom’s radar, and instead, getting out of bed, Matt triggered the old feelings he would have had as a child when getting out of bed: Anxiousness and at risk of setting Mom off.

He was able to realize this while it was happening. He stayed with his experience throughout the day and his anxiousness gradually lessened.

I understand this as a work in progress: As Matt continues to refine and update old learnings he acquires more options for how he responds now than were available to him as a child. He grows.

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Your comments are welcomed.

                                                                                                                                 
Footnote: About this example
Stories and therapy vignettes that are inspired by my clients’ coming to change are used with permission, are always altered to protect client anonymity, are not intended to accurately portray therapy, and are often fictionalized syntheses written to make clear some point.

All are offered with gratitude to my clients—all of whom teach me that our capacity for intelligent and life-affirming responsivity and change exceeds conscious imagining. And all are offered in support of people making enlivening change in their own lives and in support of those of us who, in turn, support others opening to more options for being alive and vital.

When old strategies become problems: Part 1

The underlying logic and sanity of problem behavior rooted in old learning.

Threads:                        Getting unstuck, breaking up old patterns
Relevant recent posts:     2/14/2011     Unconscious Learning
                                     5/13/2011     A frame for how we learn
                                     8/23/2011     Getting unstuck: Part 2
  

 “I’d like to take it out behind the barn and shoot it!”
        client, referring to their fear of flying

In this and the next two post we explore the logic that underlies three different problem behaviors involving snakes, getting out of bed in the morning, and vacation adventures.


Example 1
 
The old learning: All snakes are dangerous and to be feared
For years I understood my reaction to snakes was phobic: Snakes seen close up or at a distance, garter snakes, teeny six-inch baby snakes, dead road-kill snakes—all triggered a strong startle response and paralyzing fear.

Identifying my response as phobic, while descriptive, obscured more than it revealed. As a child I loved spending time with my Grandmother. I remember being in the backyard with her when she saw a garter snake. She rushed to get her garden shovel and with a look of horror and repugnance, chopped the snake into pieces!

Given the wisdom and knowledge of The World that I granted to Grandma, from that time on, I intuitively understood snakes were to be feared and destroyed. It is no surprise that my mother also had learned to fear snakes; growing up, I had no adult to show me a different way to relate to snakes. Although the fear part persisted, I never felt compelled to harm them.

The old learning becomes a problem
Throughout my adult life I have liked to hike, particularly in the deserts of the Southwest and have had plenty of encounters with these creatures. My old learned response was not fun; whenever I saw a snake on a hike, it was an unpleasant act of will to keep going.

Seeing a problem behavior differently
I learned much from working with my clients as they made changes in their old patterned reactions—and it gradually became clear to me: My own habitual and strong response to snakes could be understood as an attempt to protect me from danger. I never consciously decided to have this protective response. It’s as if the part of me that learned and subsequently managed this response was entrusted with protecting me and, for decades, it earnestly persisted in its efforts—despite my conscious attempts to overpower or otherwise defuse it.

Responding to my own behavior differently
My attitude shifted: When I felt the familiar startle of spotting a snake (or a snake-like twig in the path, which would do it too), I said, as if talking to my unconscious: “Thank you for being so persistent in trying to protect me. I’m okay.”

The old response began to shift
I did this over and over and became aware of how many times the old circuitry triggered while on a hike. I thanked it every time. Gradually it triggered less and less and the startle and fear lessened. One way to frame this change: The old childhood learning was being refined and updated.

Making sustainable change often involves a number of shifts
Seeing an old behavior as an outmoded attempt to accomplish something good is often supportive of change… and likely only part of a larger body of entwined old learnings that need be addressed and untangled as part of the process of making sustainable change.

For example, I suffered a number of frightening traumas as a child. For me, snakes became a trigger not only for the fear associated with seeing my Grandmother kill one, but also for the fear associated with other frightening childhood events. I had to address those first before having a clearing in which to begin to change my response to snakes.
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Unconscious learning
 
We learn many things—walking, talking, attitudes, how to respond in various situations, what to avoid, or what a snake is and how to respond to it—without knowing we have learned them. I call this unconscious learning (see post Unconscious learning). What is learned reflects both the circumstances in which we learn it and our understandings and resources available at the time.

In other words, in the past, what we learned about how to be and behave, how to act, how to think, how to respond—was the best learning we could do at the time. In my case above, given my circumstances, learning to strongly fear snakes can be seen as a sane and self-protective response.

The  old  learning can become outmoded
When we learn something unconsciously—like our attitudes and strategies towards adventures, snakes, or getting out of bed in the morning—it functions on autopilot (see post A frame for how we learning). The upside: We can function based on that old learning without having to consciously think about it. The downside: As we change, or as our circumstances change, our functioning doesn’t change to reflect the new conditions… which may be okay… or it may generate a problem.

The old learning can be refined
In other words: As we change and as our circumstances change, an old learning may no longer fit our circumstance and, as a  consequence, can  become a problem. In my case, as an outdoor-loving adult, I was able to refine my old learning about snakes in a way that now allows me more ease and comfort while still taking adequate care of myself.

In my story, above, and in the subsequent examples in the next two posts, hypnosis was used as support for refining the old, constraining learning.

More in the next two posts.

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Your comments are welcomed.
                                                                                                                                 
Footnote
Humans may be born with a self-protective fear of snakes. David Haskell describes this in his book “The Forest Unseen”:

“My fear of predators was likely imprinted on my psyche by millions of years of natural selection…. Like all other living creatures, I am the descendant of survivors, so the fear in my head is the voice of my ancestors whispering their accumulated wisdom”

Refining and updating my response to snakes likely involves striking a balance between an old childhood learning of intense fear and dysfunctional paralysis and an even older wisdom of self-protection.

The quote is from David George Haskell (2012). “The Forest Unseen: A Year’s Watch in Nature.” Penguin Group (USA) Inc., 375 Hudson Street, New York, NY 10014, p137.

Therapy is a Zen koan

Threads:                        Not knowing
Relevant recent posts:     12/3/10     What is hypnosis?
                                      6/29/11     In support of not knowing

I think any theoretically based psychotherapy is mistaken because each person is different.
   — Milton Erickson (1980)

What is psychotherapy? A process where two people get together to try and figure out what the hell one of them wants.
   — One of Erickson’s descriptions of psychotherapy (Gilligan, 1987, p. 82)

This post is certainly for therapists and their clients; but it also for anyone who knows the freedom and depth of connection that comes with shedding old patterns of thinking, behaving, and relating to self, other, and world.

I found a lovely description of the sensibility with which I was taught and mentored to practice therapy. It’s from paper by Hillary and Bradford Keeney published in the Journal of Systemic Therapies. I’ll include an excerpt and two other quotes below, but first, I’d like to provide a bit of context to make clearer what the Keeney’s are pointing at.
 
 
The problem with categorizing
 
We categorize things based on similarities and differences. This process has inherent limitations. For example, the act of recognizing that something is a cat emphasizes what similarities it shares with all other cats while deleting (or at least downplaying) all that make a particular cat different and unique from other cats. Some cats like laps; some cats like their belly rubbed; some cats will scratch if you try to pet them. You can’t treat all cats the same; best to learn about each cat.

Let’s switch from cats to therapy clients.

Fear of flying: I know how to work with that!
Assume I start work with a client who tells me they have fear of flying. My big brain could easily serve up the following: “Fear of flying—I recognize that! I’ve worked with lots of folks with that. Great, I know how to do this… just like I have before. Let’s go!” Three minutes into the exchange and I’ve already generated a diagnosis (fear of flying) and sketched out a treatment plan (what I’ve done before).

Who are you actually with?
I was taught to see this as a problem of my own creation: In categorizing my new client as being like other clients with fear associated with flying, I miss how they are different from the others.

What makes this particular person different from other people?
For example, what exactly are they referring to as fear of flying? Getting on the plane? Being in a cramped space? The doors shutting? Having no escape? Lift off? Turbulence? What are the details of their internal experience? How did they learn to have this fear? Given their unique personal history, what resources do they have which will enable them to solve this problem and be more comfortable—in a way that is both possible and natural for them?

Everyone is different. There is no normal. The most profound fortune cookie I ever got said,

Normal only means you don’t know them well enough.

Best not to treat all people the same
It quickly becomes clear: Any codified approach, method, model, treatment plan, or recipe blinds me to seeing the individual in front of me. How will I drop all that and see who I am with as we both try to learn to collaborate with each other on behalf of clarifying and promoting what this client wants?


In it together: In any relationship we mutually affect each other…

…and so to between therapist and client. But let’s start simply: We could model therapeutic interaction as one in which the therapist is responsible for causing a change in the client (and not the other way around). Systems in which A affects B but not vice-versa are formally called first order cybernetic systems. There are more insightful and useful models.

Systems of mutually affecting parts
Gregory Bateson (1904 - 1980), among other of his far reaching explorations, developed ways of thinking about living systems as consisting of mutually affecting parts, formally called second order cybernetic systems.

The family as a system of mutually affecting parts
For instance, if we take the family as our system of living things, each family member influences every other family member and each family member is influenced by every other family member: Mom affects Dad, Dad affects Mom, kid affects parent, parent affects kid, and kids affect each other.

Lots of complexity
Inviting you a bit further into a second order cybernetic way of thinking, consider just the relationship between Mom and Dad: Mom's behavior affects Dad, and then the reaction of Dad to Mom's behavior affects Mom's behavior, which in turn will affect Dad's behavior, and so on. Add more parts to the system (for instance, kids) and it becomes even more complex.
 
When you are part of a system you can’t just step outside of it
While enmeshed in the family, no family member can stand outside of the family system. You can’t just suddenly take a break from the family. Your break-taking, your thinking, your perspective on the family is—all of it—still enmeshed within field of the family system.

Nobody in the system has a perspective outside of the system
Consequently, no family member can claim a perspective outside of the family from which they can then objectively comment. Each family member’s story is but a single facet of what’s going on in the family; and no member’s story is more complete or more true than any other member’s.

So to, therapist and client form a system of mutually affecting parts
As therapist and client spend time together they form a system of mutually affecting parts. It is as if they both get in a little boat, cast off from shore, and hope they together figure out how to get back to land. Movement towards what the client wants arises out of the in-the-moment mutually influencing interactions between client and therapist. Together they make use of themselves and each other.

A fundamental assumption
You have to be part of a system to affect it; and if you are part of a system, you no longer have a perspective that is outside it.

This is one of the assumptions that underlie my training as a hypnotherapist… and which has become part of the lens through which I see the workings of the world.


Approaching therapy

Here the excerpt from Hillary and Bradford Keeney's paper (2012):

Therapy is a Zen Koan: it has no answer that is right and is no more likely to solve life than theatre, religion, or weather. When we make therapy a game in which theory (or meta-theory) gets to sit in the throne, we all lose. The art of helping bring forth change asks us to go beyond theoretical discourse. It asks for its embodiment in ways that seldom need to be spoken except in those occasions in which it naturally expresses itself without preplanned intent or purpose.

If your therapy of tomorrow is the same as it is today, then your therapy is dying. Its particular form is only true for the moment in which it arose for the client who inspired it. In the changing forms is found the wise process therapist, the practitioner of change who is always changing in order to help others change. Whereas first-order cybernetics asked us to take responsibility for changing the client, second-order cybernetics ups the ethical imperative by asking us to change ourselves in order to foster change in others….

It is time that therapists realize they are in the same domain of interaction as the Zen master and other interlocutors of transformation who mediate in the unknowing of fettered knowing. Let us become emancipated from being fenced in by any architect of an over-schooled approach. All schools of therapy are actually the same: prescriptions to follow someone else’s arbitrary rules rather than being more flexibly responsive to what each session invites…. Here we find an invitation to be more creatively alive in a session and not be attached to any habit of thought that limits other possible ways of serving therapeutic transformation.
  

In keeping with the sensibility expressed above, here is Milton Erickson's response to one of his students, Steve Gilligan (1987, p. 83), asking, "How do you know what to do?"

I don’t know. I don’t know what I’m going to do. I don’t know what I’m going to say. All I know is that I trust my unconscious to shelve into my conscious what is appropriate. And I don’t know how the clients are going to respond. All I know is that they will respond. I don’t know why. I don’t know when. All I know is that they’ll respond in a way that best suits them as individuals. And I become so intrigued with wondering exactly how their unconscious will choose to respond that I can comfortably wait for their response, knowing that when it occurs I can accept and utilize it. I know that sound ridiculous, but it works.

And finally this from Abu Yazid Al-Bistami (circa 874) , the prince of Sufis in his time:

Nothing is better for a man than to be without anything, having no asceticism, no theory, no practice. When he is without everything, he is with everything.

                                                                                                                                 
References
Gregory Bateson (1904 - 1980) was an English anthropologist, social scientist, linguist, visual anthropologist, semiotician and cyberneticist whose work intersected that of many other fields (see wikipedia). For me, reading him is both rewarding and exhausting: so many new ways of seeing the world, two or three pages and I’m done for a while. Here are three of his books.
 
Gregory Bateson (1987). “Steps to an Ecology of Mind.” Jason Aronson Inc., Northvale, NJ.
 
Gregory Bateson (1980). “Mind and Nature: A Necessary Unity.” Bantam Books, Elsevier-Dutton Publishing Co., Inc., Two Park Avenue, New York, NY 10016.
 
Gregory Bateson (1991). “Sacred Unity: Further Steps to an Ecology of Mind.” Donaldson, R. E., ed., Harper Collins Publishers, 10 East 53rd Street, New York, NY 10022.
 
Stephen Gilligan (1987). “Therapeutic Trances.” Brunner/Mazel, Inc. 19 Union Square, New York, NY 10003.
 
Milton Erickson (1980). “A teaching seminar with Milton H. Erickson.” Edited J. K. Zeig. Brunner/Mazel, NY, 1980.
 
Hillary Keeney & Bradford Keeney (2012). “What is systemic about systemic therapy? Therapy models muddle embodied systemic practice.” Journal of Systemic Therapies, v31:1, p 32-33.
 
Abu Yazid Al-Bistami from Stephen Mitchell, ed. (1991). “The Enlightened Mind: An anthology of sacred prose.” HarperCollins Publishers, 10 East 53rd Street, New York, NY 10022. p 75.

Hypnosis and weight loss: An example of unconscious learning

With hundreds of diets and programs for weight loss,
in the long-term, why don’t they work for many people?

Threads:                        Context, Learning
Relevant recent posts:     2/14/2011     Unconscious Learning
                                     5/13/2011     Getting unstuck: Part 1
                                     8/23/2011     Getting unstuck: Part 2

Some people, for whom being overweight is a problem, successfully and sustainably lose weight while others do not. Most people I see for weight loss already have experience adopting a variety of self-imposed regimens, either counting calories, measuring quantities, or adopting a prescribed diet—and regular exercise. Their success has been limited: After a while there is often an internal rebellion, discipline breaks down, and old habits return—sometimes with a vengeance.

What follows is written through the lens of my experience as a hypnotherapist. Here, I will not address medical issues or medications that make maintaining a healthy weight difficult.
 

What’s missing?

A simple equation
It seems like it should be simple: First, eat healthy foods. Second, a) maintain weight by eating just enough to fuel your activity level; b) gain weight by eating more or being less active—or both; c) lose weight by eating less or being more active—or both.

For many who have tried to lose weight it’s not simple
Overweight people who want to lose weight know it is not that easy. It is often more than a calories-in/calories-out math problem to solve by upping your activity level and changing what and how much you eat. That’s because the old habits that make up our relationship with food and eating are rich with meaning and emotion—and they run far deeper than a calorie count would indicate.

Our underlying relationship with food
My clients who want to lose weight have taught me this: Being unhealthily overweight is the problem and weighing less is the solution. But for some people, the means of accomplishing this sustainably involves changing the underpinnings of one’s relationship with food and physical activity on behalf of health, well-being, and feeling good.


Where do we learn our particular relationship with eating?

We learn most of our habits about eating and food from the environment in which we grow up. Nobody sat us down and taught us about this. We simply absorbed it—like a sponge and mostly unconsciously—from our family of origin.

When old habits become a problem  
As adults, these old learnings, now our habits, function without our conscious awareness. It is fair to say we don’t do them, they do us. If we don’t like the results of our old and habitual relationship with food—for instance, we steadily weight gain—it’s hard to change, precisely because we aren’t aware of our old learnings or the details of their functioning.

As a result, no one—doctor, friend, hypnotist, yourself—can demand that you “eat healthier, eat less, and exercise more” and expect it to work over the long haul. It’s too simple a directive; it fails to address the complexities that go into making changes in our relationship with eating.

Somehow we need to untangle the problematic old learnings in a way that allows us new, less restrictive options. Hypnotherapy is a good tool for that.


Hypnotherapy: Accessing the glue that binds us to habits

Hypnotherapy is great at accessing unconsciously held learnings in a way that allows for some new options of behavior. Specifically, it’s a good tool for breaking up old patterns about food and eating in a way that allows for the emergence of a sustainable, healthier relationship with food and eating.

As with learning anything new, this is an incremental process that takes intentionality, time, and effort… which proceeds in a way that makes use of one’s abilities… and evolves to a sustainable change in a way that is entirely natural for the individual.


Examples of how and what we learn about food

Below are several fictional vignettes that illustrate circumstances in which we might have learned a particular relationship with eating… that subsequently became problematic for us… and that we might untangle in a way that allows us healthier eating habits.

Most people I work with already know the details of what constitutes a healthier relationship with food and exercise for them. If they don’t, our work together starts by focusing on their learning some of the specifics of a healthy diet and activity level. They might need to see a nutritionist or their doctor as part of their research.


Example 1
Old habits of likes and dislikes
A client, in his 50s, grew up in a meat and potatoes household, no salads, no green vegetables, and rarely any other kind of vegetable or fruits… and always a big bowl of cereal or ice cream as a snack before bed. He’s overweight, knows he still eats like he learned to growing up, and can’t get himself to try anything new, but says he wants to.

With encouragement to finally discover for himself what foods he likes and dislikes—rather than go along with whatever he happened to be served as a kid—and with hypnosis to support his accessing his ability to learn something he doesn’t yet know… he began exploring.

Discovering new tastes
We went through some recipes: he was intrigued w/ grilled asparagus with olive oil and roasted pine nuts. He went home and tried it. He liked it! Shortly after that he began to experiment with different kinds of salad greens and his own dressings. He discovered he liked salad. And as he changed and broadened his tastes in food, he gradually carried less weight; and his confidence in his ability to make changes that mattered increased.


Example 2
Old associations of food and rebellion
Growing up we can learn to use food to rebel against—or try to maintain a balance of power with—our parents.

When I was a youngster, my parents were occupied with some issues my Dad was having with his job and I wasn’t getting the attention I wanted from my parents. Without consciously plotting it out, I became a fussy eater and refused to eat just about everything except scrambled eggs for dinner. I remember disgust with most other dinner foods. (The fact that meat and vegetables were both cooked until equally grey and tasteless probably contributed to my behavior.) I did this for several months, and then got over the just-eggs thing, but kept my dislike of vegetables and refused to eat them. I gradually rediscovered them for myself—either raw or lightly cooked—in my late twenties.

A variation on rebellion: Eating what is forbidden
Other children learn to sneak away and eat forbidden or strictly regulated foods—candy, desserts, junk foods—behind their parent’s back. For some this can persist into adulthood as a stealth and guilt-ridden overeating of certain foods.

In this case, part of the therapy might involve unraveling an old eating habit—then an act of autonomy and freedom from parental authority—that is now obsolete and unhealthy.


Example 3
Eating for temporary calming and comfort
We can easily learn to use food for comfort when we’re young. As an infant, when we are hungry, we cry, and we get fed. But we can be uncomfortable in a variety of ways, and we also cry. And this crying can be misunderstood as “baby needs food,” so we get fed, and we get Mom or Dad’s attention to boot.

Besides eating because we’re hungry, we learn to associate eating with being comforted. When we’re anxious, lonely, or physically or emotionally uncomfortable, we turn to eating as a means to provide ourselves a temporary sense of well-being. Comfort and well-being are good things to experience; but using food to accomplish good feelings often has the side effect of steady weight gain.

Learning more options (besides eating) for accessing comfort
None of the people with whom I’ve worked who had learned to eat for comfort could get themselves to just give up this strategy—a testimony, I think, to the importance of being able to access comfort. In this case, therapy consists of learning more options for accessing feelings of comfort and well-being that don’t have unhealthy side effects.

This differs for each person. At its simplest, one client learned to use self-hypnosis instead of eating to quell the tensions that arise in the course of their normal work day. Another client addressed and resolved a long-standing family issue rather than eating in order to bear the tension of ignoring it.


Example 4
Eating interwoven with meaning beyond physical nourishment
Food can become imbued with meaning beyond nourishment of body. For instance, some people grow up in a family culture where food is love—the women buy, prepare, and serve food as tangible love for family, and food is received and understood as love. It is an act of love itself as Grandmothers and Mothers teach the young girls about food, to shop for it, to cook it, and how to bring the family together and nurture them with it.

Some individuals in such families can grow large under this diet of love-food.

Keep the love, modify the old eating habits
Here, the therapeutic work consists of separating food-as-love and food-as-physical-nourishment—and in doing so, developing other options for experiencing and expressing love and connection besides food.


Example 5
Being overweight as self-protection
I have worked with women who grew up suffering abuse, or who watched Mother suffer abuse from her partner. They may have unconsciously adopted the strategy of becoming overweight to discourage attention from a potential abuser. One can appreciate this is a brilliant strategy developed under “battlefield” conditions—and it comes with a high cost: It is painful to be overweight, feel unattractive, and have all of one’s efforts to lose weight fail.

Here, the old strategy of self-protection must be separated from the undertaking of losing weight. This involves learning new strategies such as how to set limits and hold boundaries while exploring relationships with others in ways that feel safe and satisfying. As new strategies for self protection are developed, the need to be overweight for protection drops away, and possibilities for sustainable weight loss emerge.


Conclusion

Motivation
Contrary to a popular myth, hypnosis cannot make someone lose weight or eat differently. Therefore, if you or your doctor think you should lose weight but you really don’t want to, hypnosis won’t help. (Some people want to want to make a change, but that’s different from actually wanting—and being ready—to make a change.) It is a choice: Not everyone wants to make the effort involved in changing old eating habits.

Hypnosis as a useful tool
Although hypnotherapy can’t force you to change, it is an exceptional tool for sifting through old, unconsciously held learnings, and keeping what’s useful and letting go of what is no longer useful—on behalf of health and well-being.

Separating out what’s useful from what’s no longer useful
In each vignette above, what was learned in an old setting persists into later life, becoming a constraint and problem. The therapeutic task is freeing up your relationship with eating from the entanglements of the old and obsolete learnings.

Sustainability: Getting the feedback of feeling good
Your initial motivation to lose weight may be because you don’t like the way you look or how you feel. Losing weight is often about self-imposed discipline and denial—with not a good feeling in sight.

When you actually have the experience that eating well and being active inherently contribute to good feelings—then there is motivation to keep doing what provides you what you like. This is a sustainable feedback loop.