So the 4 day orgy of sunshine and chocolate has come to an end here in the UK and what a thoroughly enjoyable Easter break I have had. We spent time with friends and family at the beach, hosted a party and basked in the sunshine while eating, drinking and being merry. Marvellous stuff.

Whilst talking to a friend at the weekend, he told me that he was enjoying hypnotherapy sessions with a hypnotherapist I had recommended for him in his locality in the North of England. Though he said he was initially unsure of the therapist because of something he considered to be bizarre in the early sessions.

The hypnotherapist did something with my friend that many may initially consider to be quite unusual but can have incredibly effective benefits. The hypnotherapist prescribed the symptom and I thought I would explain what that means here today and how to go about it.

My friend likened his initial understanding to one of our friends teenage experiences. Our friend was caught smoking when he was in his early teens and the rather unorthodox way his father decided to deal with the matter was to sit him in the garden, hand him a packet of 20 Benson and Hedges cigarettes and instructed him to smoke them one after the other until the packet was finished. He was sick and that was the end of his smoking days…

This is a bit aversive to be honest and does not really explain the rationale behind the notion of prescribing the symptom, but gives a little insight and introduction to what it is about.

Essentially prescribing the symptom encourages the therapy client to have more of their unwanted symptom. I know, it sounds crazy, right? I mean, the client is coming to stop those symptoms, aren’t they?

The client is encouraged to continue doing the unwanted symptom, but in a slightly altered and adjusted fashion. The therapist puts the client in control of the symptom by adjusting the way it occurs in some way. it then stops becoming something that the client does uncontrollably and frustratingly, it becomes something that happens in a different way and ideally becomes perceived as unnecessary instead of inevitable. The idea is that the symptoms lose their value, and as pointed out by many authors that have written about this previously; the symptoms lose their original meanings and associations too.

In his book Trancework, Michael Yapko gives an example of this as done with one of his clients who came to see him to alleviate her depression. He prescribed that his client lie in bed continuously  for four hours a day, and she was instructed to do this right in the middle of the day.

She was told to get up in the mornings, get showered, dressed and have breakfast and then in the middle of the day, she had to go and lie in bed for four hours. After a while of doing this, the bed which used to be her sanctuary for dealing with her depression, became a place she felt that she was being imprisoned in. She was there on “doctor’s orders” and not through choice. Her bed became far less desirable and she broke out of the pattern and association she previously had – along with the other interventions being conducted within therapy too.

Previously, the bed had been a place where she could avoid the world and it enhanced her depression. When it was prescribed, she found it inconvenient and helped her to alter her behaviours.

When the symptom is prescribed, it is no longer spontaneous and the symptom becomes weakened greatly when done on purpose. The client also gets to see that they are in control of the symptom.

It is not something to be used in every situation and must be chosen carefully in hypnotherapy sessions, as well as the adjustment to the symptom being made intelligently. The symptom needs to be prescribed in a way that ensures the client will follow it, and can actually follow it. Plus, it must be adjusted in such a way that it does not make the symptom more problematic or reinforced by repetition.

I’d recommend anyone read about it in more depth to be able to help themselves with this process. Perhaps read Foa and Wilson’s 1991 Stop obsessing!, Haley’s 1973 Uncommon Therapy book (which highlights Milton Erickson’s frequent use of this process) or Madanes 1981 Strategic family therapy where use of this process is described in much more depth.

In the past I have read accounts of hypnotherapists using this process to encourage an initially resistant client to be more resistant, thus showing that their resistance has become co-operation and heck, any ensuing confusion can be used to then induce hypnosis!

I have also encountered hypnotherapists who have prescribed a relapse in the unwanted symptom and made it acceptable and OK – smoking a cigarette at some point in the future, for example, making it acceptable and part of the therapy instead of it being deemed a failure… And if the client refuses to relapse, then that is a success too, right?

In short, prescribing a symptom hands over control to the client and gives them some defined parameters for the symptom that can make them easier to deal with and subsequently overcome.

My friend certainly found it very useful indeed after he had stopped being baffled by the notion and was no longer of our other friend going green in his garden following his Dad’s chain smoking therapy!