Stop Smoking Cardiff:
Which Hypnotherapy treatment will help you achieve your goal?
It would be dismissive to think that hypnotherapy is the same treatment with every hypnotherapist. But if you have tried a hypnotherapy treatment and have not had a favourable outcome, there could be numerous explanations for this. The cost, the style, the approach, the focus, the emphasis, the techniques and the rapport is different with each hypnotherapist. Then you also need to take into account your hypnotisability and what history, beliefs and expectations that you bring into this process. You are an individual, even if you share a common goal that you want to stop smoking.
A successful hypnotherapy treatment involves some cautious research on your part – and only too right! You are spending money on a professional service that could help you make an important life change. Going for the cheapest hypnotherapist could backfire if they are inexperienced and are using hypnotherapy as a part-time hobby. You could also be fooled by persuasive advertising “jargon” because you are desperate to receive help. So what happens? You hastily go along with claims of a “quick fix – one session cure” because you are longing for that magical silver bullet! Understandably, you want to be free of your cigarette smoking chains and will do anything that draws your attention.
So how can you differentiate the good from the bad?
Stop Smoking Cardiff
Can you ask the question “what’s your success rate?”
If you were to ask a hypnotherapist what their success rate was for helping patients to stop smoking, do you think that they would honestly be able to give you a real percentage rate answer? Very few hypnotherapists have undertaken any research worthy of appearing in a reputable medical journal. It’s difficult enough to standardise “hypnosis” let alone reliably measure the outcomes with a large enough sample and with controls in place. They may refer you to other online hypnotherapy research as the standard to expect, but is the online method exactly the same as the method that they are using? Can it be applied to every patient equally?
If they did tell you that they are achieving 80%, ask them which journal does their research appear in or ask them to see a copy of the raw data and you might never actually receive the information you want! When they tell you their success rate “is very good”, is this just them giving you what you want to hear i.e. “common sales pitch” to get you through their clinic door? At that precise moment, you have no way of verifying whether their success rate is good or bad.
So, will you be asking the question “what’s your success rate?” – I think it’s pointless.
Stop Smoking Cardiff:
What does the research say?
Some research has been done with positive outcomes. For example, research by Elkins & Rajab in 2004, here referenced in abstract, reports that 81% of the 30 patient sample stopped smoking after 3 hypnosis sessions. But other grouped research analysed in the Cochrane Review states that hypnosis has not been able to consistently show its effectiveness as a “one-therapy-cures-all” type of treatment.
But don’t ditch hypnotherapy as an option just yet!
You may be puzzled by my selling technique here. I am not exactly portraying hypnosis in a sensationally positive light and raising your expectation to “buy this stop smoking treatment now”. That’s because, even as a practising hypnotherapist, I consider that there’s a lot more to the hypnotherapy process that makes it work or in some cases, not work. So disregard the “one session smoking cure” adverts and consider them as nothing more than “attention grabbing”. Let’s face it, if anyone has a treatment that can be demonstrated to be say, 90% effective, the NHS would buy into that method and save itself a fortune.
It’s far cheaper to use a reliably tested method to help patients quit smoking than it is to treat their smoking-related illnesses.
Stop Smoking Cardiff:
What is the common approach with hypnotherapy?
Hypnotherapists commonly focus the stop smoking treatment into a longer one-session consultation e.g. 2 hours. To make a big impact, you are there for a longer time and charged a double fee (and some more!) to commit you to this short interaction. Do you consider this approach as two separate sessions squeezed into one visit? They will analyse your smoking behaviour, use a stop smoking hypnosis induction (scripted or unscripted) and then they may offer you a generalised stop smoking hypnosis CD to take home. Very rarely, the CD has been tailored to your personal needs.
This is a reasonable approach which can work for some patients, some of the time. And when it does change the behaviour (and beliefs) of a smoker after just one (double) session, it can be “headline news”. It’s quite an achievement because for some patients, a twenty year habit has been broken after just one meeting. But according to The Cochrane Review, one-session stop smoking hypnotherapy is no more successful than any other methods available to help you quit smoking.
Whether the hypnotherapist’s advert mentioned any follow-up consultations and possible additional costs if the change has not taken place after the first session can be variable. The hypnotherapist may not want to mention more therapy (and costs) after the first session because it could affect your beliefs about being able to stop in one session i.e. if they say that you may need follow-up sessions then maybe the one-treatment approach is destined to fail (even if it is a double session). And this is an important point with psychological treatments: your expectations or what you believe can have an impact on the outcome.
What makes stopping smoking such a challenge for you on your own?
Smoking cigarettes involves both:
1. A physical addiction to nicotine and
2. A psychological habit
Smokers place varying emphases on each part; some of the cigarettes smoked in your day will be related to the nicotine addiction and others related to what you habitually associate with nicotine e.g. it’s time for a break time, it helps you to concentrate, it releases your frustration etc.
In order to help you stop smoking (in the short and long term), the successful hypnotherapist will aim to treat your nicotine addiction and its psychological associations. Sometimes, if you smoke infrequently, treating just one part (usually the psychological associations) can be sufficient to help you to stop smoking. A skilled experienced hypnotherapist will analyse what you present in the consultation and treat your relevant issues rather than taking a rather generalised approach and hoping for the best!
But I just smoke cigarettes…
Yes, over time it ends up that way, which is why it can be arduous trying to stop smoking using willpower alone. When you have been smoking cigarettes for many years, it’s likely that the physical and psychological aspects of smoking have overlapped.
Help from an objective professional can benefit you if your own attempts have previously failed. Your personal habitual associations with nicotine can be analysed and treated. In group therapy, the trainer/therapist would need to spend individual time with you to treat your personal smoking issues, rather than treating the group’s needs as a whole. Each smoker is different.
You are living “within” the addiction/habit. You respond to the physical needs of nicotine and the associations you have made with it. This means that you confuse physical tension and irritability from a lack of nicotine with that created by stress. Smoking just takes over your life.
What does the one-session treatment fall short of addressing?
Stopping smoking in one session is not impossible; it just means that several “future” issues need to identified and treated in one go. I’ve helped many patients stop smoking in one session, but it doesn’t mean that the process is over.
For some patients, one session is a tall order because once you have left the therapy room (by definition) you are on your own- you’ve had your one session. If you haven’t adapted to your new lifestyle as a non-smoker, then you can easily slide back to smoking without any further help. How do you know that the job is done when the critical stages are yet to come?
The one-session approach appears attractive to the smoker who is looking for the cheapest quick-fix. But it needs to have treated these “future” issues without really knowing that they have been treated until the time comes. The critical period is around three days and up to two weeks after you have stopped smoking. Each smoker has different responses to stopping smoking.
• Cravings – Withdrawal symptoms begin after a few hours, peak at around three to five days, diminish and then stop after two weeks. Symptoms can include irritability, tension, headaches, restlessness, frustration, anxiety and even depression. Everyone is different with the severity of their symptoms, but after this period, any symptoms are related to the psychological habit or associations you have made with nicotine. If you have found these symptoms unbearable on previous stopping attempts, support over this period (to keep you focused on the goal) is essential.
• Accepting change – Removing a “comfort” leaves a void to fill in your mind (and body). It can be stressful filling this void depending on what other issues you bring to this treatment. The comfort of what you have known and done (smoked cigarettes) has now become ingrained as a way of life. Changing these habits requires a transitional period of adjustment where you replace the old unwanted habits with more desirable ones and embrace those as your new comforts.
The confidence that you have accepted this change comes from being in those situations and demonstrating that you can cope. For example, if smoking and drinking alcohol has been one of your social habits, it’s not until you have been out socialising that you can assign confidence in this situation without a cigarette. Yes, you can visualise coping (which will be a big help), but you can only say that you have managed it after the event has happened.
I have treated patients who have stopped smoking after the first hypnotherapy treatment, but have been fearful of coping with a social situation involving large groups. They started the treatment with social anxiety and with the goal to stop smoking. The support leading up to the event in the second session is what helped them to confidently socialise in large groups without the need for a cigarette as their comfort. It would have been too much to have helped them stop smoking and prepare them for this social situation in just one session. Before the treatment, their social anxiety trait acted as a block to them stopping smoking and being able to cope socially with large groups of people.
• Stress and anxiety associations with nicotine – If you smoke more cigarettes when you are stressed or anxious, then treatment to manage how you handle your stress or anxiety is an important part of converting you into a Non-smoker (see below).
Low nicotine levels, stress and anxiety can all create a similar feeling of tension, but smokers forget how to differentiate one from the other over the years of smoking. The deep breathing (used independently by non-smokers) is an essential part of releasing emotional tension; you’ve probably heard the expression “take a deep breath!” So as a smoker when you feel stressed or anxious, you will smoke out of habit to ease your emotional tension (and get your breath). This repletes your nicotine levels and you feel calmer, but it’s the deep breathing that is creating the benefit in this situation; you don’t need the nicotine. When you are under extreme stress, your high nicotine levels can reach a distasteful peak. You may continue smoking excessively until you feel slightly nauseous, but it’s the emotional release from stress that you are seeking, not the nicotine.
Stress and psychological associations to nicotine are a big part of what keeps you smoking. You fear that you may not be able to cope with your stress without cigarettes, “so it’s better to keep the habit going just in case”.
Stress and psychological associations to nicotine also contribute to your restarts. The intensity of a new trauma (e.g. bereavement) links your mind back to how you “coped” with previous traumas. If you believe that smoking got you through your initial trauma, then the deep need returns when you go through another distressing experience. Sometimes, this can be months (or years) after you last smoked a cigarette.
The hypnotherapist (in some cases) can begin to identify and treat a few of these issues in the one (double) session and (according to the Cochrane review), only sometimes gets it right to help you stop smoking.
What does the one-session treatment rely on?
There is a small percentage of the population (about 10%) who are highly suggestible and respond very quickly to hypnosis. The majority of the population (80%) are moderately suggestible and can benefit from a reasonable course of treatment. The other 10% are unresponsive usually because they have a fixed attitude about what to expect (e.g. if you are not sleeping then it’s not hypnosis) or can terrified of the process (e.g. you fear losing control). You can assess your level of suggestibility here.
As you can imagine, the highly suggestible population are the ones who respond well to the one-session stop smoking treatment and this is what this approach relies on – highly suggestible patients who seek hypnotherapy as their treatment. But since they only make up a small percentage of the population, it is for this reason (I believe) that the Cochrane Review only gives an average success rate for hypnotherapy for the whole population.
If this realistic (two-stage) approach was used with the majority of the population, I think it would increase the overall success rate of hypnotherapy stop smoking treatments. It just needs someone to do empirical research using this approach.
The moderately suggestible population desperately want to be “cured” rapidly (and who doesn’t!?) They are in awe of their friends who have been quick-fixed and want the “same” treatment to work for them. They can be “hypnotised” to accept these initial suggestions to stop smoking for a short period of time, but it usually takes longer than one stop smoking session to fully internalise suggestions beyond this stage.
New suggestions in the second stage are more effective to help you dissociate your psychological associations with nicotine after you’ve stopped smoking for the critical three to five days. These suggestions can focus you beyond the nicotine depletion stage to assist your progression in the stop smoking programme. This is what converts the (recently stopped) Ex-smoker into the lifestyle-changing Non-smoker (see below).
The Ex-smoker vs. The Non-smoker
Have you previously stopped smoking for months or even years and have still felt like the cravings have never really gone away?
When you stopped smoking, did you still feel like you needed a cigarette in certain situations?
Have you frequently stopped smoking for more than a week and then lapsed back into your smoking habit?
If you have answered yes to any of these questions, then consider the two very different perspectives of the Ex-smoker and the Non-smoker:
• As the Ex-smoker, you have broken free of your nicotine addiction for at least a week. You have taken a very determined “will-power” approach to “stop-no-matter-what” and come out of the other side. You deserve recognition for doing something that smokers lack the courage to do – stop smoking! But many of your psychological associations to your nicotine habit still remain. You are given constant desperate reminders of your old habit. A certain mood like anxiety draws you back into smoking cigarettes because you find it hard to breathe through your tension. You are tempted to give-in during socials, when there are other smokers around you or when you are enjoying drinking alcohol. You may even carry cigarettes on you “just in case” the cravings overwhelm you. You constantly fight an internal battle that surrenders when the demands of the situation are high. “Just one cigarette won’t do me any harm…” are your last desperate words before you surrender and get your hit of nicotine. You’re back into the smoking habit again!
• As the Non-smoker, you have stopped smoking for at least a week and have detached all of your psychological associations with nicotine. You are liberated from your old smoking habits that once frustrated your life in so many ways. As a Non-smoker, you can now appreciate the benefits because you have embraced positive lifestyle habits. You have new independent ways to manage your stress and anxiety. You lead your life as if you have never smoked a cigarette
You may pity your friends and work colleagues who are addicted to nicotine; it serves as a reminder of the life that once defined you. But smoking is their choice; you are proud to have asserted your choice. As a Non-smoker, you may able to tolerate having smokers around you. Or, maybe now you find the smell of cigarette smoke repulsive, just like the majority of the population who have never taken up the smoking habit.
When your stop smoking hypnotherapy treatment has helped you embrace the perspective of the Non-smoker, the therapy is complete. Your life is smoke free!
Only when you have distanced yourself from your nicotine addiction can the hypnotherapist realistically analyse and treat any of the remaining psychological associations that remain. The hypnotherapist will help you accept that having stopped smoking:
• Nothing in your life is “missing”
• You don’t need to avoid any situations
• You believe that you can deal with your stress/anxiety without nicotine
When these issues are clearly visible, then the job of quitting cigarettes has been achieved.
What is my treatment approach?
In the early part of my first consultation, I want to:
• Identify any significant health issues – This is standard practice, you may have some contra-indications to hypnotherapy.
• Explore any relevant lifestyle habits – Analyse your stress/anxiety levels and associations with nicotine.
• Discuss the background to your smoking habit – Establish your motives for stopping, your emotional blocks and reasons for re-starts (if any).
Then, using this information:
My first goal in the stop smoking hypnotherapy programme employs techniques to help you stop smoking so that your nicotine levels can deplete. I include teaching you techniques to counter your cravings.
My second goal in the stop smoking hypnotherapy programme is to help you dissociate any psychological habits that you may attach to your nicotine addiction/smoking cigarettes.
These goals can combine to create an advanced change in your smoking behaviour. This often depends on the issues presented in the early part of the consultation.
How many sessions are usually needed and what is the frequency?
The stop smoking hypnotherapy programme is usually between one to four sessions. Most patients stop within one or two sessions. Allow up to four sessions to achieve the confidence that you are a non-smoker. The psychological habits are analysed in the early stages but are targeted more intensely as the nicotine levels have depleted.
For optimum results the second consultation should be booked three to five days after the first consultation to counter the effects of any remaining cravings. Any follow-up appointments will then be made according to your progress/needs, but are usually made weekly. By committing to becoming a non-smoker, it ensures that you leave the stop smoking hypnotherapy treatment in an independent and confident state.
Can stop smoking hypnotherapy courses take longer than four sessions? Where there are background medical conditions such as depression or anxiety disorder that is heavily dependent on smoking as a way of coping, it is advisable to stabilise these conditions first with medication through your GP. Or you can seek therapy e.g. hypnotherapy, that focuses on stabilising these medical conditions. This then places you in a better position to be ready stop smoking.
How should you prepare for the first consultation?
To achieve maximum benefit from the first hypnotherapy treatment, aim to have your last cigarette prior to your first appointment to stop the smoking process. This helps you to focus your mind on a stopping date which often gives the best results. The sooner you can reach those three to five days of not smoking, the sooner the nicotine will diminish from your body. But everyone is different and if you have already planned to decrease your number of cigarettes in gradual stages, then the treatment can be adapted to your needs. The hypnotherapy techniques will help motivate your mind to stop smoking, break the cycle of your smoking habits and help you cope with your nicotine cravings.
Be prepared to get rid of any remaining cigarettes as a clear intention of your goal while your nicotine levels are depleting. The “comfort” of having cigarettes with you can leave you vulnerable if you are under stress from external issues. Yes, it’s easy to get hold of cigarettes from a local shop, but the time it takes you to go and buy them, can be the time it takes for a cravings to develop and subside using the techniques taught in the treatment.
Tell people around you about your intentions to stop smoking if it helps them to be more sensitive to your smoking cessation goal. Family and closer friends will make allowances for any craving symptoms. They may also smoke away from you to help you adopt your new habits.
Can I combine the hypnotherapy treatment with any other methods?
Yes, hypnotherapy can be combined (to help you cope) with any negative symptoms (e.g. an increase in stress, cravings etc.) acquired from stop smoking prescription medication or nicotine replacement, including electronic cigarettes. You can mention your situation in your initial contact.
The treatment course length may vary where you seek help with a small change in your behaviour.
Stop Smoking Cardiff:
Can your fears associated with stopping smoking be treated early in the programme?
Yes, these fears act as your personal blocks to you quitting smoking and are discussed in the first consultation. They can relate to your ability to cope with your cravings in the early stages or some of the latter negative effects that may have accumulated before (and caused you to lapse back into smoking again). Common fears of stopping smoking include gaining weight or not being able to deal with your stress. It is important to take these issues into account because your mind will not be fooled into stopping smoking if you believe that by stopping, you will suffer in another aspect of your life.
Stop Smoking Cardiff:
What can you expect after the first appointment?
Most people stop after the first session, but it’s important to consider that each person is different in the way that their addiction and psychological habits have affected them over the years. Just because a friend as stopped immediately using hypnotherapy, it doesn’t necessarily mean that you will follow the same pattern of behaviour.
Some patients prefer to gradually cut down the number of cigarettes, building confidence into their ability to delay the time between each cigarette. If you have successfully coped with delaying the first cigarette of the day (which is usually in the morning), then this helps your confidence to believe that you can then extend the interval between other cigarettes in your day.
Other patients are prepared to stop smoking in some situations e.g. around work, but may feel vulnerable and want to smoke in other situations e.g. socially. This gradual process of cutting down of the number of cigarettes you smoke extends the “stopping” treatment stage of the therapy, but can be better suited to your individual needs. The follow-on sessions will treat what is remaining in your smoking habit.
Aim to stop smoking, but don’t be disheartened if a situation has triggered a small lapse and you smoke the odd cigarette e.g. you became stressed over an external issue that causes you to cave in and smoke. In these cases, the psychological associations to nicotine have become unconscious, but can be treated as they become apparent to you. Many patients have reacted to their lapse by then becoming more determined to deal with these underlying stressful issues that have caused the lapse.
With the first stage of the stop smoking hypnotherapy treatment, you are focusing on stopping smoking and on depleting your nicotine levels. Temporarily, you may choose to constructively avoid situations that you believe would be a threat to you lapsing at this stage of the treatment. After the nicotine depletion stage, your confidence to participate in these situations will form part of the follow-up sessions and the conversion to being a Non-smoker.
Stop Smoking Cardiff:
How can patients feel after having stopped smoking?
There can be numerous withdrawal symptoms to nicotine. You may experience some of these in varying intensity or none of them at all.
• Extreme cravings for a cigarette
• Disturbed sleeping patterns
• Feeling anxious or depressed
• Restlessness, frustration and difficulties with concentration
• Changes in appetite
These nicotine withdrawal symptoms are temporary and subside after the nicotine levels deplete. Hypnotherapy suggestions can be used to counter the effects of your nicotine withdrawal.
If you have temporarily stopped smoking before and can recall struggling to cope with any of these symptoms, the treatment can specifically prepare you to cope with what you anticipate with stopping smoking on this occasion.
Stop Smoking Cardiff:
What happens in the follow-up sessions?
If you have stopped smoking in the first session, the follow-up session will help you deal with any remaining craving symptoms (depending on the timing of the second treatment). It will also focus on any remaining psychological associations that you have with nicotine; the “fears” that you will encounter without having cigarettes available. This process converts the vulnerable Ex-smoker into the Non-smoker. It is important to follow this process through because even though you have stopped smoking, it’s only after the nicotine levels have depleted that these psychological associations become fully understood. It’s tempting to “jump ship” to save money, but there are very few patients who feel ready to embrace life as a non-smoker at this early stage.
There are several psychological associations that can be made with nicotine. They are often the “excuses” or fears that people make to keep you smoking. Or these associations act as the reason for your previous relapse and you fear that the situation could overwhelm you again.
This process of “undoing” is built into the four session treatment. If you have few (or no) psychological associations however, the treatment is likely to be a shorter course.
Stop Smoking Cardiff:
What psychological associations keep people smoking?
When you are converted you to the Non-smoker, you will embrace an alternative to your “excuse” (or fear) that has previously prevented you from stopping or has caused your lapses back into smoking. When the new perspective is accepted at the cognitive, emotional and behavioural level, the treatment is complete.
Smoking is nothing more than an addiction to nicotine, anything else is the addiction fooling your mind!
Have you justified (or heard someone else justify their) desire to keep/lapse back into smoking with the following “excuses” or fears?
• It’s just a habit; you can stop any time
• X… is just as unhealthy as smoking
• You’re only harming yourself
• Stopping smoking will stress you out/smoking helps you to relax
• You will stop cold turkey when you are ready
• You don’t buy them/people hand you them
• You can’t cope with the withdrawal symptoms
• You enjoy smoking
• You are healthy in other aspect of your life
• You don’t have the willpower/you’ve tried everything
• You will quit when…work quietens down/after the holiday etc.
• Smoking helps you to concentrate/You work better when you smoke
• Smoking gives you a break
• You fear putting on weight (you believe that smoking keeps your weight down)
• Smoking is your best friend (you fear loneliness)
• Cigarettes help you to socialise (you have social anxiety)
• Smoking and a drink (alcohol, tea, coffee etc.) go together
• Smoking has become part of who you are
• It’s your reward
• You fear failure (you have failed before)
• It’s something to do with your hands
• It helps you deal with boredom/waiting around
• It helps you cope with…stress/moods (or any other negative emotion)
• It wakes you up
• Without cigarettes you feel depressed
• It helped you cope with a tragedy or bereavement, so you keep smoking just in case of another
• It helps you cope with a bad relationship (or it helped you cope with a previous break up/divorce)
• Medication/therapy costs too much
• Smoking helps you feel important/cool/mature (empowerment)
• You would be giving in to defiance (you love to do the opposite of what people tell you to do)
• You would be giving in to your partner who wants you to stop smoking (revenge)
• Smoking is your only pleasure/vice
• Nobody’s perfect
• Everyone dies of something
• What’s the point? It’s too late/I’m too old, the damage has been done
• There’s no evidence that smoking harms your health
• You’ve just cut down/you smoke low tar cigarettes
Being a Non-smoker involves changing your thoughts, beliefs, emotions and behaviour. Some of your excuses to keep smoking (or restarting) can be reactions to comments and situations that have been held for years.