The story “A Walk Along the Beach” illustrates another simple method of hypnotic anaesthesia. The problem is not that it is difficult to induce an anaesthetising trance, but that we often do not believe that everyday trances can fulfil the same role. What is more, we do not generally notice that our pain has disappeared when we are either in a pain-free trance state between painful waking states or at a later stage (because we are absorbed by something else, and because the change from a trance state into a waking state is associated with amnesia).

T:  Amputation, anxiety, operation, pain

I: Age regression, hypnotic anaesthesia, unreal reframing (example / metaphor, positive model)

A doctor had to carry out an operation to remove a patient’s large toenail, but the patient could not tolerate painkillers. “What should I do?” he asked her. “I’d feel like I was torturing you if I operated on you while you were still fully conscious!” The patient shrugged her shoulders. “Where do you most like going on holiday?” he asked. “The Baltic Sea,” she answered. “My husband and I have had some wonderful walks along the beaches there.” “Tell me about them, and immerse yourself in the tale,” said the doctor. “Dive deep down into your memories and describe everything you see, hear, feel, taste and smell on your walks there.” The woman started her story and kept on going. “Now a storm is brewing,” she said as the doctor began the operation. She saw the storm approaching but remained quite calm.

“The Unscrewable Body” can be used in connection with medical interventions or as mental preparation for sport. Sportspeople must however be particularly aware of the risks of anaesthetising oneself while training. Care must be taken to avoid any possibility of injury or the worsening of physical conditions as a result of eliminating pain signals through suggestion.

T:  Competitive sport, pain

I: Dissociation of body parts, hypnotic anaesthesia, inner team, unreal reframing (example, positive model / searching model)

I once knew a man who had a very strange talent; he could simply unscrew the lower part of his body from the upper part whenever he went for a walk – like unscrewing the lid from a jam jar or vice versa. Then the lower body would walk alongside the man while his upper body supervised from above. Sometimes the legs, stomach and backside would move a couple of hundred metres away from the upper body, but they never ran away and always came back. At the end of the walk, the upper body and lower body would screw themselves tightly back together again. Then the head would say, “What a good job I didn’t have to listen to the legs moaning all the time on our long walk.” And the legs would say, “What a good job that we didn’t have to listen to the head’s unkind warnings and pep talks.” Everyone would be happy and content, and they would sit down together for a cup of tea and a chat about the different things they had seen during their walk

The following stories demonstrate various techniques for hypnotic anaesthesia. The case study “Go Away” involves taking the pain as a starting point and then rapidly minimising it through a plausible chain of associations. It illustrates a typical feature of verbal pacing and leading, namely that the pain (the problem) is referred to directly at the beginning, but only mentioned indirectly as an “inconvenience” by the end.

T: Pain

I: Hypnotic anaesthesia, pacing and leading (example, positive model), reversing the focus of attention

A woman attending a psychotherapy session suddenly developed a bad headache. She explained that it was linked to a problem with her cervical vertebrae for which she was undergoing medical treatment. Her face was screwed up in pain, and it was clear that she was struggling to focus on anything else. I told her, “That must really hurt. It must hurt a great deal, and you must be wishing that it would go away soon, that it would perhaps go away in three minutes or in two minutes, or that it would go away in one minute or in half a minute, or perhaps even sooner. When do you think this inconvenience will go away?” “It has almost gone already,” she answered very calmly.

The story “Of Pain and Lice” illustrates how hypnotic anaesthesia can be prevented. We activate and reinforce anything we address and request, whether pleasant or unpleasant, and the only logical purpose of asking for something we do not want is therefore to pick up on an experience we have already had and turn it into something different and positive. What patients refer to as “distracting themselves” and “thinking about something else” can be a very effective form of anaesthesia, and their efforts can be promoted by the medical and care staff who engage in small talk with them.

T: Attention, pain

I: Pacing and leading, psychoeducation, reversing the focus of attention (example, negative model)

I waited in the doctor’s office and wondered how I could distract myself from the treatment I was about to undergo by focusing my attention on something else. The doctor came in, greeted me and started the procedure. “Does that hurt?” he asked. He could have achieved a similar but more pleasant result if he had said, “The patient before you had lice. I hope you’re not feeling itchy?”

“The Worry Catapult” is an intervention which can be used at a somatic level to avoid or reduce stress-related facial wrinkles, at an emotional level for relaxation and at a social level to practice new behavioural patterns for dealing with interpersonal stress.

T: Aggression, anxiety, Bell’s palsy, body language, burnout syndrome, cosmetic concerns, facial wrinkles, self-confidence, teeth grinding, tension, work-life balance

I: Unreal reframing (example / metaphor, positive model)

One of the games we used to play at school was to stretch a rubber band between two fingers of one hand and then shoot folded bits of paper at the other pupils, or even at the teacher when his back was turned at the blackboard. It was against the school rules, of course, but it was still great fun and a good way of keeping boredom at bay. A sawn-off forked branch and a rubber ring from a preserving jar could be used in a similar way to make a stone catapult, and even now I still often think of these different kinds of catapults.

Sometimes wrinkles appear on my face because I am afraid, annoyed, sympathetic or troubled. I know that if they become a fixed part of my repertoire of facial expressions, in a few years’ time these expressions will turn into basic facial characteristics which determine my neutral appearance regardless of my mood – wrinkles and all. This is not what I want, and it is also not what I need.

My face muscles are like a worry catapult which is stretched between my ears. Whenever my skin tenses up in one spot and forms wrinkles in another, and whenever a particular level of tension has been exceeded, the catapult goes “pop” and the muscles relax. All the worries, all the annoyance, all the anger – catapulted away into time and space. Sometimes they are fired into nothingness, and sometimes they are sent to someone who – unlike me – will give them a good home. The only thing left on my face is a smile, as I know that the worry wrinkles have not made a home for themselves this time.

“If You Can Manage…” demonstrates how symptoms which occur spontaneously can be eliminated by an attempt to induce them intentionally (symptom prescription).

T: Hiccups

I: Paradoxical intervention, reward and punishment, symptom prescription (example, positive model)

“If you can manage to hiccup another ten times, you can have an ice cream,” said Nikolas to Vita and started counting, “1 – 2 – 3 – 4 – 5 – 6 – 7 – 8 – 9…” He never reached 10, but she got the ice cream anyway.

T: Lipoma, warts

I: Cosmetic concerns, real placebo, reversing the focus of attention, ritual, magic spell (metaphor, negative model / positive model).

Many years ago I had a small round bulge on my thigh, which I ignored for around 18 months. Then I happened to be visiting my GP, and asked him what it was. “It’s a lipoma,” he answered, “a fatty lump. Keep an eye on it. If it doesn’t change it can stay, but if it grows it will have to come out.” I kept a close eye on the lipoma, and it started to grow, for the first time in 18 months. I went back to the GP, who removed it surgically.

Years later I told someone this story in order to highlight the fact that noticing something makes it grow; a small problem can turn into a large one if you pay it a lot of attention. I don’t know whether it was because of this conversation, but two weeks later the lipoma reappeared, at the same spot where a scar indicated that its predecessor had been removed.

“If the lipoma can grow by suggestion, it can also shrink by suggestion,” I thought. I remembered the wart charmer’s old folk remedy; “Rub the wart with spit three times every morning and every evening, using a different finger each time, and repeat three times; ‘Wart, wart, rub away.’” I wondered to myself whether the same would work for a lipoma, and decided to try. The lipoma had disappeared after three days

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As a story or a practical exercise, the story “The Silent Hand” represents an intervention for reducing skin moisture, or in other words for regulating the formation and absorption of oil and perspiration, and reducing the production of dandruff. During therapeutic work with bulimia and emetophobia (fear of vomiting and vomit) the story can be used to teach clients that they have involuntary control over their excretions, even their sweat. For patients suffering from colds (including blocked-up ears), the story can be used metonymically (as an example of an adjacent phenomenon), since it is associatively linked with the idea of reducing the swelling of the mucous membranes and the production of secretions. Finally, the story can be used to teach clients how to influence the production of endogenous substances through suggestion, for example a change in the quantity of tears secreted in the case of patients suffering from dry eyes. The story also illustrates how events experienced by the therapist can be turned into a third-person narrative – which is automatically more detached than a first-person narrative – using the phrase “my friend Peter” (the “My Friend John” technique).

T: Acne, bulimia, common cold, cosmetic concerns, dandruff, emetophobia, eyes, hyperhidrosis, oily skin, rhagades, sweating, tears

I: Metonymy (example, positive model) 

My friend Peter belongs to an African drumming group led by a Congolese drummer. The leader was teaching a piece to the group which ends by getting quieter and quieter until the music stops entirely and the drummer’s hand is lying motionless on the drum. The leader lifted his hand away from the drum without making a sound. The other drummers copied him, but each of them made an audible squelch because of the sweat and oil on the skin of their hands. They tried repeatedly to lift their hands soundlessly, but time and time again the leader lifted his hands in complete silence while audible squelches could be heard from the others. In his thoughts, Peter said to his hand, “Dear hand, please absorb all the oil and sweat which is currently on your surface.” Seconds later, he lifted his hand in absolute silence. “How on earth did you manage that?” the others asked hm. Within a matter of seconds, they too could regulate the sweat and grease on their own hands.

The case history “The Villa” illustrates the technique of influencing an immune disease or other somatic disorder through metaphorical instructions which imply progress alone and exclude any possibility of relapses. It is also useful for promoting the healing of wounds or bone fractures

T: Allergy, bone fractures, colitis, convalescence, Crohn’s disease, immune disease, immune system, inflammation, sarcoidosis, wound healing

I: Metaphorical reframing, use of the patient’s career (metaphor, positive model)

I once had a patient who was an architect and who suffered from Crohn’s disease, an inflammatory bowel disease. The cortisone preparations and surgical interventions used to treat it had placed an enormous strain on her body. After attending a number of therapy sessions, the disease seemed to have remitted somewhat. I said to her, “Imagine your body is a magnificent old house awaiting renovation – what does it look like?” She described a Wilhelminian-style villa surrounded by lush greenery, with exquisite stucco work, superb wallpaper and elegant furniture. The house appeared to have been neglected for many years. Wherever the eye turned, there were traces of water damage, cracks in the walls and crumbling plaster. Many of the formerly beautiful features now looked neglected and derelict. “What does the restoration team need to do?” I asked. She listed a number of jobs, and we discussed the order in which they should be done.

I asked for an update on the renovations at each of the following therapy sessions, and was always told that the workmen had made progress. What choice did they have? After all, renovations go forwards, not backwards. Once the woman told me, “The original features in this room have been damaged to the extent that the workmen are unable to restore them faithfully. They replace what is missing to the best of their ability, and try to make it look like it might once have done.” After another few weeks she told me that the renovators had finished their work, and that the villa had been fully renovated.

That was around four years ago, and her state of health has been significantly better ever since.[

The story “Placebo III” demonstrates how the placebo effect can be actively used to heal a cold, even if the relevant medicine is not currently available and has never been taken by the patient before.

Someone once told me the following story; “I was visiting my sister. My niece was getting confirmed, and my brother-in-law had a terrible cold. He was sneezing, sniffing and coughing, and clearly felt terrible. ‘The homeopathic remedy Schuessler Salt No 3 would help,’ said my sister. ‘But we don’t have any in the house.’ ‘That doesn’t matter,’ I replied, and turned to my brother-in-law. ‘Say to your body, “Dear body, please check whether Schuessler Salt No 3 would help, and if it would then respond as if you had taken it.”’ ‘But he’s never tried it before,’ objected my sister. ‘That doesn’t matter either,’ I replied, citing as evidence the case of a patient treated by some doctor or other. In the meantime, my brother-in-law had stopped sneezing and sniffing and looked a little better in general. I cried out, ‘Great job! You must have an incredibly powerful subconscious – that’s truly impressive! Brilliant! What a feat of the subconscious – and you managed it so quickly! I think Schuessler Salt No 3 has done you a lot of good! You’re doing a brilliant job…’ My brother-in-law gave a lopsided grin and looked a little embarrassed, but his symptoms had reduced significantly, and stayed like that all day.”