Of Pain and Lice

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.

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

“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.

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…

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

“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.

The Lipoma

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


The Silent Hand

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).

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 Villa

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

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.[

Placebo III

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.”

Regarder dans les yeux du lion

Cette histoire me fut raconté par le Kényan M. Mniyka. « Si tu croises un lion », ainsi me raconta-t-il, « Tu dois le regarder droit dans les yeux. Un seul petit regard de côté, et seulement un dixième de seconde suffit pour que le lion attaque. Il bondit plus vite que tu ne peux bouger, ou parler ou bien penser. C’est pourquoi, quand tu croises un lion, il faut le regarder droit dans lex yeux. Regarde-le, regarde-le simplement sans bouger, jusqu’à ce qu’il s’en aille. »

Illness on Order

Promoting health- Infections, allergies, autoimmune diseases

The story “Illness on Order” illustrates how believing that “anyone who calls in sick must really be sick” can result in real illness, and how pretend or inconsequential illnesses can develop into real ones. The story can also be used as a metaphor for mental and social blocks.

A doctor once told me, “Once I decided to spend part of my working day at home so that I could make headway on a mountain of paperwork. I hung a ‘Closed due to illness’ sign on the door of my practice – and fell ill straight away. Yesterday I told my daughter-in-law about it. ‘I know just what you mean,’ she said. ‘I fall ill every time you give me a sick note as a favour.’”

Placebo II

Promoting health- Heart, circulation, bleeding and blood flow

The case study “Placebo II” demonstrates a similar procedure for sluggish circulation, in which the patient imagines a Kneipp hydrotherapy treatment.

“My feet often feel as cold as ice,” said the man. “That’s why I catch so many colds. I used to have Kneipp treatments and that really helped, but I can’t do that everywhere.” “Let me tell you a secret,” said the other man. “An imaginary Kneipp treatment will work just as well if you imagine it hard enough.”