The Patient Was…

The patient was a 60-year-old male who was Vice-Chairman of an influential company, in a vital industry, with global reach and interests. His medical problems included mild hypertension (high blood pressure), “normal” but not ideal levels of cholesterol, moderate personal and business-related stress for which he saw a therapist, and early signs of chronic lung disease.

He smoked one-and-a-half packs of unfiltered cigarettes daily. Clearly, smoking represented the greatest risk to his health and well-being, despite his claim that it helped reduce his stress levels.

Since the early-to-mid portion of the twentieth century, the health risks of smoking have been well and increasingly recognized. Tbe popularity of smoking in the United States grew after World War I when returning soldiers brought the habit back with them. By the 1930s, lung cancer rates were noticeably increasing, but while this information was known to scientists public awareness of it and the connection to smoking were largely unknown. By the  mid-1940s, almost half of the adult population in the country were reportedly smokers.

In the early 1960s, the U. S. Surgeon General, Luther Terry, commissioned a study on smoking and health. In 1964 the report was released, calling attention to the risks of cigarette smoking. Although the report cited “other diseases” as well, the emphasis was on lung disease, especially lung cancer. The risk of heart disease was noted, but less attention was paid to that finding.

In more recent years, while lung cancer risks are still prominent, the impact of cigarette smoking on heart disease has become increasingly important; cardiovascular disease is the leading cause of death globally. Of interest, while the risks to the lungs are not reversed when smoking ceases, the cardiac risks almost disappear by one year after smoking stops.

Although the patient understood the risks of smoking intellectually, he did little to try to curb his habit, in large part because people around him smoked and nobody consistently made the argument that he should quit.

I did.

One major problem in trying to help heavy smokers to give up cigarettes at the time of this encounter was the lack of very effective treatments. Even now, with current pharmaceutical therapies and counseling techniques, quitting the cigarette habit is not easy. Back then, there was little except “willpower” and that wasn’t usually too successful.

At that time, I had developed an interest in hypnosis as a method of curbing cigarette smoking. Because of the lack of ancillary treatments, and the recognition that smoking was having a negative effect on my patients’ health, I wanted to help in that way if I could. Hypnosis had been tried by some practitioners, without much success. They were able to induce hypnosis, but the negative messages that cigarettes were bad, dangerous, tasted terrible, and so on, seemed to have little lasting effect once patients returned from the hypnotic state to their normal sense of awareness.

Interestingly, many patients who were heavy smokers and really wanted to quit still resisted the idea of even trying hypnosis. It wasn’t fear of the hypnosis itself, or concern that they would “lose control” and be forced to do dangerous or foolish things. Rather, they thought of hypnosis as the “last straw,” and as one patient told me, “If I fail that, I’m doomed.” So, by not trying it, they had the idea that there was still something that could work if they were desperate.

A psychiatrist with whom I was doing some research was an expert in hypnosis. Recognizing that the negative messages being transmitted to patients were not having the desirable result, he created new messaging around smoking that he delivered to patients while they were in a hypnotic state. He claimed that he achieved success in about one-third of subjects. While that may not seem like much, it is quite notable relative to the lack of success with other means.

The new messaging was “positive” instead of “negative.” Rather than focus on the bad aspects of tobacco, the new content focused on the patient’s need and obligation to promote respect, protection, and health of their body if they wanted to live.

I discussed hypnosis with my patient, and he agreed to try it. He easily entered a hypnotic state, and I went through the “script” that been developed by my psychiatry colleague. When the session ended, the patient was confident that he would no longer smoke. And to the delight of both of us, he remained “smoke-free” for the next year.

About a year later, he made an urgent appointment to see me. He appeared distressed, and explained that he had  begun smoking again, and wanted very much to be hypnotized once more. I had not had the experience of repeating the process in any patient but could see no downside. So, I agreed. But, first, I wanted to know what had happened to make him start smoking again after such a successful result.

Well, it seems that he was in a very tense business meeting, negotiating with people from a major organization who owed his company many millions of dollars, without apparently the ability or willingness to repay it. As Vice-Chairman of his company, he had solely approved the loan and now was facing the responsibility of losing that money. At one particularly stressful point in the negotiation, his recently hired assistant looked directly looked into his face and, addressing him by his full name, added, “I didn’t know you smoked!”

As the assistant’s eyes went from the patient’s face to his hands hovering above the conference table, the patient himself looked down and saw that he had a burning cigarette in each hand. In the stress of the moment, he had apparently picked up a pack from the table, doubled down and lit two, and was alternately inhaling one and the other.

I hypnotized him again. Once more, it was successful.

And he never smoked again.