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What Medicine March-April 2005

Hypnotherapy and Stopping Smoking
by David Botsford

In 1992, the New Scientist magazine reported research by scientists at Iowa University who analysed the results of 600 studies of nearly 72,000 people in Europe and the USA who had used different methods to quit smoking. They found that hypnotherapy is consistently the most successful way to become a non-smoker. Among those ex-smokers who had successfully quit the habit, 30 percent had done so through hypnotherapy, compared with 25 percent through aversion therapy, 24 percent through acupuncture, ten percent through nicotine gum, nine percent through books and mail order advice, and six percent through willpower.¹
Hypnotherapy is defined as communication with the unconscious part of the mind, in order to bring about an improvement in a person's life. At a conscious level, each of us is aware of five to nine (7±2) items of information at any given moment.² Everything else is part of the unconscious mind: our memories, our habits, our beliefs, our values, our imagination, our representation of the future. The unconscious includes all those bodily processes which take place without us being consciously aware of them: the heartbeat and circulation of blood, the digestion of food, the immune system, the replacement of cells, and thousands of other functions which take place outside of our conscious awareness and control. All these functions are coordinated: the unconscious has its own intelligence and its own way of making sense of the world. It deals with the world in an "irrational" way: forming associations which are symbolic and which may not make sense from a logical point of view. The unconscious always does its best to help us in any given context. It has its own "language" in which the skilled hypnotherapist knows how to communicate effectively.
Every problem was once a solution. Eighty-two percent of people who smoke today started as teenagers. At that time in life, young people want to be part of the gang, to prove themselves, to rebel against authority, to seem to be more grown-up than they really are, and to be cool, glamorous and sophisticated. These are all positive values. The unconscious part of the mind forms an association between those positive values and the smoking habit. Therefore the unconscious accepts smoking as a symbolic way of achieving those values. The same process takes place with those 18 percent of smokers who take up the habit as adults. Typically, a young adult starts smoking as a way of identifying with colleagues in a workplace where most employees already smoke, or to fit in with a new group of friends, or to strengthen a relationship with a partner who smokes. In each case the unconscious has positive intentions in adopting the smoking habit.
As the smoker moves through life from being a teenager to becoming an adult, so the unconscious significance of smoking can change. The adult smoker no longer feels a need to prove himself or herself, or rebel against authority, or be part of the gang, so the smoking habit can become a "crutch", a source of emotional support, a means of obtaining a moment of introspection, or of dealing with stress, anxiety, boredom or some other unwanted emotion. In short, the unconscious significance of the smoking habit changes, while the habit itself remains the same.
The central function of hypnotherapy in smoking cessation is to mobilise the creative faculty within the smoker's unconscious mind. This creative faculty then enables the client to find a new and more useful way of achieving that same positive intention than through smoking. The work of transformation takes place entirely within the client. The hypnotherapist induces a trance state, in which the client is physically relaxed and his or her conscious mind wanders. The unconscious mind actively seeks a means of living life without smoking under the guidance of the therapist's suggestions. The therapist communicates with the client's unconscious mind in order to draw on inner resources to find new and more useful associations and ways of achieving those positive intentions than through the smoking habit.
As we go through life, we leave back in the past all sorts of things that once fascinated us, but no longer hold any interest for us. Children are fascinated by toys, fairy stories, cartoons, jelly and sandcastles - but when they become teenagers they lose interest in those things. Likewise, when people move from adolescence to adulthood, they develop new and more useful ways of dealing with adult life - taking more responsibility, thinking more about long-term values, and building careers, homes and relationships - and they leave behind teenage habits like showing off, blowing tantrums and bunking off from things. The hypnotherapist's role is to draw on this process of continual adaptation to new situations, and to create a context in which the client's creative faculty finds the way to leave the smoking habit back in the past where it belongs. Once this creative moment of transformation is complete during hypnotic trance, smoking and cigarettes are simply of no interest to the client any more. He or she has become a non-smoker.
Just as important as enabling the client to become a non-smoker is for the hypnotherapist to educate the client to remain a non-smoker in all future situations. In the real world outside of the consulting room, the client will experience situations like stressful days at work, arguments, unexpected difficult situations, late-night drinking sessions with friends who still smoke, and other contexts in which the temptation to have "just the one" cigarette might arise.
Therefore the hypnotherapist teaches the client a set of simple but effective methods for ensuring that he or she always has more useful alternatives in each of these situations than smoking "just the one" cigarette. First among these is self-hypnosis. The therapist shows the client how to create a relaxed, calm, resourceful state in which he or she can gain control over momentary internal experiences and "programme" his or her own future. Second is gaining awareness of inner "triggers" for the smoking habit and learning how to neutralise and reverse them. Third is the use of cognitive self-talk: teaching the client how to get control over the inner monologue going on inside his or her head and altering it to provide a "running commentary" that is consistent with the healthy life of a non-smoker and the benefits achieved from that. At the end of the session, the hypnotherapist gives the client a self-hypnosis CD to take home and play any time he or she feels the need to reinforce the work done in the session.
The two keys to success in hypnotherapy are tailoring and utilisation. The hypnotherapist's communications must be adapted so that they connect powerfully with the way the individual client makes sense of the world. The hypnotherapist utilises the client's unique personal resources in order to ensure success. This means making use of experiences such as previous success in stopping smoking or other achievements, and focusing on the positive values which are most important for that particular client in becoming a non-smoker: longer life, better health, more energy, social advantages, saving money, the happiness of those closest to the client, a sense of freedom, or whatever the client values most in living smoke-free.

David Botsford is a hypnotherapist in practice at 10 Harley Street, London W1G 9PF. His website is www.stop-smokingforever.co.uk and his telephone number is (020) 7467 8461.

1 New Scientist, 31st October 1992, p. 5.
2 George Miller, "The Magic Number Seven" (1956), in George Miller, The Psychology of Communication, Penguin, Harmondsworth, 1975, pp. 23-34.