April 22nd, 2014
Why do people smoke? And can hypnotherapy do more to stop them?
The good news is that smoking, especially cigarette smoking, is on the wane. According to figures compiled by the ASH organisation (Action on Smoking and Health), in 1974 about 51% of men and 41 % of women in Great Britain were cigarette smokers. Today, about 22 % of men and 19% of women in Britain smoke cigarettes. This is a considerable decline – from nearly half the adult population in 1974 to roughly one sixth of the adult population today. The bad news is that there are still 10,000,000 adult smokers in the UK, half of which will die as a direct result of their habit. And a recent estimate suggests that about 200,000 children between the ages of 11 – 15 take up the habit each year. Smoking has not gone away and will be with us for some time yet.
Today, most people accept that cigarette smoking incurs grave risks to health. Figures from Cancer Research UK suggest that around 86 % of lung cancer deaths in the UK are due to smoking and that smoking accounts for nearly a quarter of deaths from cancer in the UK.
In view of this, two questions arise. Firstly, why is it that people take up such a dangerous and expensive habit to begin with and, secondly, given that withdrawal symptoms are so mild, why do so many fail to quit the habit?
When discussing such a large percentage of the population it is tempting, if hazardous, to fall back upon generalizations. Nevertheless, as an ex-smoker I suspect that my own reasons for smoking are similar, at least in part, to others of my generation. I began smoking regularly in 1972, at the age of thirteen. Even at that age I was aware of the health implications of smoking. There used to be a tiny government health warning printed along the side of each cigarette packet. Peer pressure was certainly a factor. I would estimate that about one third of pupils at the all-boys secondary school I attended were regular smokers who would pursue their clandestine habit behind bike sheds and huts or in other places around the school grounds. To become part of this group was to identify with an attitude of defiance towards much-resented authority and of nonchalance towards the risks and perils of later life. It felt liberating.
As a hypnotherapist I find that many of my smoking cessation clients also recognize this behind-the-bike-shed aspect of the smoking habit. Today, smokers are banished from the workplace, the pub, the club and the restaurant and are forced to congregate outside in groups. This can create a feeling of camaraderie both among both friends and strangers and also a sense of standing up for individual preference against the wishes of society or the establishment.
There was also a rites-of-passage element to taking up smoking. Smoking is a “grown up” activity. To take up smoking is to turn one’s back on childhood – something we were very keen to do in 1972 – and to show oneself capable of making a choice or taking a stance. And although in 1972 cigarettes were relatively inexpensive and freely available, to be a regular smoker meant that you had some source of income, that you were employed. Again, this is further identification with adulthood. As said above, around half the adult population were smokers in the early 1970s.
For young smokers of my generation, then, smoking quickly became associated with some very strong and positive concepts, such as maturity, independence and autonomy. And although smoking is more widely disapproved of today I strongly suspect that many children today are drawn towards it as a means of demonstrating independence and autonomy if not outright defiance. Today, children have little chance of legitimately earning money, are kept within the school system for longer and longer, are feeling increasingly forced into tertiary education and are unlikely to start work until their mid-twenties. One can see why smoking might retain its attractiveness as a statement of maturity and a gesture of defiance.
The positive associations outlined above are further reinforced by the context in which smoking tends to occur. Especially for people of my generation, occasions such as parties, family gatherings, visits to the pub or club, holidays, Christmas, all of these activities tended to involve smoking. One can see, then, how the smoking habit could be bolstered by a very wide range of powerful positive associations.
But what of smoking itself? Is it really so inherently pleasurable that it is worth spending thousands upon thousands of pounds over the course of a lifetime and putting oneself at risk of death from highly unpleasant diseases?
Nicotine simulates the production of epinephrine, or adrenaline. This in turn produces an increased secretion of the neurotransmitter dopamine, and this substance is intimately associated with areas of the brain which generate a sense of pleasure and reward. More powerful and addictive drugs such as cocaine and methamphetamine act in much the same way. Cigarettes may taste disgusting, they may generate a sense of nausea when inhaled and a feeling of wheeziness in the lungs, they force the heart to beat faster than it should do and it increases blood pressure. The “pleasure”, such as it is, comes from an almost indescribable sense of “reward” caused by the increase of dopamine levels.
As far as hypnotherapy is concerned, smoking cessation techniques are often among the first things taught by hypnotherapy training establishments and, on the basis of this training, hypnotherapists will often formulate a treatment process often consisting of only one session of hypnotherapy in which the therapeutic suggestions revolve around two basic themes – it is good and liberating to give up smoking; it is bad and dangerous to continue. Suggestions may be direct or indirect but will usually not stray far from those two basic themes. And in many cases, where a client has simply outgrown all or most of the positive associations of smoking and is left with an increasingly annoying habit, such treatments may well be successful.
But some clients are more resistant to such an approach. However, that doesn’t mean that hypnotherapy may not be used to help them. In such cases, hypnotherapy may be used to explore the deeper roots of the smoking habit, taking particular heed of the positive associations mentioned above. In probing these roots it is highly likely that other issues will rise to the surface, issues involving self-esteem, confidence and overall feelings of security which can also be treated using hypnotherapy. Or maybe hypnotherapy may be used to encourage behaviours which tend to increase dopamine production, such as regular exercise.
I believe that any smoker, for whom hypnosis is not contra-indicated, can be weaned off the smoking habit by the use of hypnotherapy. But for the more stubborn, ingrained, died-in-the-wool smoker more time is needed to explore the attachment to a habit which almost certainly goes beyond physical addiction. And, as Shakespeare said, there’s the rub. Customers or clients of hypnotherapy tend to see the process as some sort of magic wand which can be waved over the course of just one or two session. Failure to produce near-instantaneous results leads to a perception of failure on the clients’ part. This is partly due to the elusive and ill-defined nature of hypnosis itself and partly due to the “magical” perception of hypnosis encouraged by performers such as Paul McKenna and Derren Brown and films such as The Manchurian Candidate. But in real life there are no magic wands.
Of all the many and various forms of psychotherapy which exist at the moment, I believe that hypnotherapy has by far the greatest potential for further development. But for this to happen we need to nurture the perception of hypnotherapy as a therapy, not a wonder cure. Clients expect treatments such as counselling, CBT or psychodynamic psychotherapy to produce therapeutic movement over time, not instantaneously. Why should expectations of hypnotherapy be any different?
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