Cognitive behavioural hypnotherapy for habit reversal training

Habit reversal training is an evidence-based cognitive behavioural intervention that, when used in trance when the client is more relaxed and disinhibited, becomes that much more effective! This technique helps clients to resolve all kinds of repetitive semi-involuntary compulsive movements and behaviours including checking, hand washing, skin picking, nail biting, tics, scratching, Tourette's, hair and eyelash pulling, etc.

The process has 4 simple stages which allow the hypnotherapist to guide the client to a point where the problem behaviour is replaced with an alternative competing behaviour which eventually, with repeated practice which starts in trance, becomes extinct.

The 1st stage is bringing awareness to the behaviour e.g., what it is, when it happens, and how the pattern of that particular behaviour runs for that person. Also becoming aware of the very early signs of it happening i.e., a signal they get that tells them that the behaviour is about to occur. Capturing this early-stage sensation, thought or feeling is an important first step in this process.

Secondly, the therapist helps the client to find a competing action that will replace the problem behaviour at times when it appears. So for a compulsive nailbiter, where the early sign identified by the person is to e.g., feel 2 fingers or a finger and thumb coming together, and sensing the roughness or chips on or around the fingernail as they rub the two together, could be an early sign that the nail is going to enter the mouth and start the nail biting process.

This new competing behaviour has to ideally come from the client, however if they are not insightful about what this could be, hypnotherapy enables us to intervene by providing direct or indirect suggestions for the client to consider. Some clients may need more coaching than others e.g., children or vulnerable adults.

The third stage is to capture the early signs that the behaviour is about to happen e.g., the fingers rubbing together, and practice the different/new competing behaviours in trance that doesn't involve the fingers entering the mouth. This would be very individual to the client, however, many clients have found parting the fingers and sitting on the hand to prevent access until the urge has passed works well which we can suggest if desired.

A very effective alternative that we commonly use in hypnotherapy is to install a resource state anchor. This is installed during hypnosis where the client is highly associated kinaesthetically (emotionally and physically) with a pleasant experience such as being in a favourite place, engaging in a favourite pastime, or being with a special friend. It's important that the resource state is not connected in any way to the compulsive behaviour the client is going to be ceasing. The trigger to the resource state could be pinching a finger and thumb together or creating a fist.

The client practices using this new motion during trance and induces the early sign of the problem behaviour by thinking about the trigger to it. Then once the client becomes aware of the early signal of the fingers about to touch, they are asked to 'fire' the resource state anchor to compete with the unresourceful state of the urge to bite the nails. The trigger e.g., a pinch of finger/thumb or making a fist, is held in place until the positive feelings of the resource state replace the urge to put the fingers in the mouth, and the urge has completely dissipated.

The resource anchor is so powerful, and during trance the client is given post-hypnotic suggestions to fire this in the real world whenever the problem behaviour would have occurred. Given the installation of a resource state anchor is all done internally, a discrete trigger action can be enacted anywhere, anyplace, and anytime without anyone else being aware of it. And whilst using CBT only, is very effective for habit reversal training, the extinction of problem behaviours using hypnosis can occur rapidly with very little practice required so long as the resource state anchor installed is a powerful one.

Feel free to get in touch if you need a chat about anything hypnotherapy related.