Noeline H. is a 36 year old female who was referred by her chiropractor for treatment of her Rheumatoid Arthritis.

Rheumatoid Arthritis often starts without evident cause (although a history of emotional shock is common) in early adult life and affects the small joints of the fingers and toes. No infective process has been discovered, yet the disease tends to be chronic, sometimes better, sometimes worse.

It is a disease commoner in temperate climates and in women and can be seriously disabling. Rheumatoid Arthritis may be a stress reaction in which the secretion of cortisone by the suprarenal glands is inadequate to protect the body from responding too strongly to injury

Cortisone, although less useful than it was once thought to be, is still used in treatment along with many other drugs and forms of physiotherapy.

Engineered antibodies designed to combat the symptoms of Rheumatoid Arthritis inactivate a protein called tumour necrosis factor, a chemical messenger which triggers immune responses. In patients with Rheumatoid Arthritis these immune responses turn against the body, destroying cartilege and bone in the joints.

Noeline H. was first seen on 14th November and presented as an extremely intelligent, insightful and sensitive Sales Manager for a large insurance company in Wollongong. She described having her first symptoms 12 years ago.

Since that time the problem has become steadily worse, with occasional short periods (no more than 3 weeks) when it seemed not so bad. After a "good period" it usually came back "with a vengeance" and then seemed to be much more severe than in the past.

She had run the gamut of mainline medical therapies and had tried acupuncture, meditation, tai chi and herbal remedies none of which had much effect and all of which had been abandoned after a fair trial. She had consulted a hypnotist in the past but he "couldn't get me under" and had advised her that she wasn't able to be hypnotised.

She was adamant that she wanted Psychophysical Therapy because she had been "psyched up for it by my chiropractor who thinks you are probably the only one who can help me". However in this first session it was decided that hypnosis should be used to access the mental blueprint so as to facilitate changes from the top down.

It was also decided that since the problem was an ongoing one that success would require that she have a sense of being in control of the healing process, hence teaching her some self hypnotic techniques would be necessary.

In order that she not be disappointed by this decision, all of the following was presented as a form of "mental Psychophysical Therapy" (which in a way it is, being a combination of both Psychophysical Therapy & Hypnosis).

She was tested for open and closed eye suseptibility and found to be able to respond well on both parameters. This led into the 5 - 0 exercise which was then deepened into a hypnotic state which was tested for successfully.

She was then told that I would direct energy down through the top of her head and that she would be able to both see and feel it as it spread down through her body. She might notice that it moved more sluggishly through the joints, and perhaps other parts of her body as well, but that eventually it would reach all the way to the tips of her toes.

I then placed my hand on the top of her head and directed energy down into her body. She was instructed to advise me when the suggestion she had been given had been fulfilled. After several minutes she assured me that whilst the energy had changed colour as it had travelled down through her body it had ultimately arrived at her "toe tips".

She was then instructed to let this energy sit quietly within her while it did its work, and that she should now concentrate on her breath and especially on the energy of the air she was breathing. She was able to notify me that the energy of her breath was a spearminty green which felt very clean. Following instructions she directed this energy into the sluggish areas she had observed earlier so that the whole body became homogenously calm and peaceful and filled with "quiet light".

She was then told to notice that the energy of her breath was now just like the energy which I had directed down through her body at the beginning. When she agreed that it was, she was told that from now on every breath she took would reinforce this original healing. After counting out 1,2,3 she said that she felt wonderful and "floaty" but that she was afraid to move because she expected that the pain would return as soon as she did. She was advised that the pain would probably return from time to time as the toxins causing her rheumatism were being flushed from the system. However she should notice some relief from this just by taking a deep breath to increase the energy flow.

Noeline was next seen 2 weeks later on the 28th November when she reported that she had had painless times lasting up to 3 days in a row. Non-pain free days were also less severe than in the past. She was very excited that today we would be doing "real Psychophysical Therapy" as promised at the conclusion of the previous session.

After disrobing and lying on the bench face down she was instructed to take a couple of big deep breaths to get the energy flowing freely.

The Susumna, Ida and Pingala channels were then cleaned and an emotional block (her dependence on others caused her to feel like a child at times, but the world tended to treat her as an adult so that she felt guilt because she was masquerading as a grown up) was removed from the right side of the torso in the region of the liver. Sluggish patterns were encountered in virtually all of the joints in the body and were disrupted so that the energy from them was put back into circulation.

The cakras were then balanced and some fine tuning of the energy in the left side of the neck and in the forehead was carried out to remove the after effects of drugs which had lodged in these points.

She was then taught the pwanamuktasana series of yoga asanas with the emphasis on bending each part "just as far as you comfortably can". Her range of movement in this session was quite small, approximately ¼ of a normal level of flexibility. She was told that in addition to doing the 5 - 0 exercise she would have to make time to do this series every day in order that the healing proceed as quickly and smoothly as possible. She informed me that that was not a problem as her secretary had been locking her in for an hour each day and refusing to let her out until she was finished her "homework".

Her 3rd session was 2 weeks later on the 12th December where she reported that she felt "fantastic, totally pain free for the past 2 weeks, happy and cheeky, and sex is great now".

In this session she was taken quickly through the 5 - 0 exercise then down to step 80 and taught the mind mirror. She was shown how to create her ideal self image and to see herself participating in 'sports, sex and dance movements that she could only have imagined enjoying before'.

After counting out she concluded that perhaps she wasn't unhypnotizable after all. She promised that she would have no trouble keeping up with her exercises because they were so much fun.

Noeline returned for a final session on the 19th March in the following year for a "kick up the bum" - she had felt so terrific that she had stopped practicing her exercises 2 months ago and now "the first signs of a twinge or two" had made her realize that she needed to keep it up permanently. Her secretary had refused to take any dictation from her until she had been to see "the magician" again to revise her "homework".

In this session she was taken through the 5 - 0 exercise, the staircase and the mind-mirror. She was then given a balance to clean out the accumulated rubbish associated with "catching up on the last 12 years of parties and having fun".

The confrontations she had been having with her mother about her newfound independence had caused a freezing of the energy in her left ovary. This was released whilst at the same time talking about how parents are redundant as primary care givers once their children have grown. She was advised to re-negotiate her relationship with her mother so that they could now be friends and equals.

As she was taken through the pwanamuktasanas it was noted that her flexiblity was much improved and in some joints approximated a normal level.

4 years later Noeline H. continues to be free of the symptoms of Rheumatoid Arthritis. She also continues (irregularly) to "do her homework", "just to be on the safe side".

Volume 27

CASE STUDY - HABITUAL FREEDOM

by Leonie Sorensen

Robin came to see me on the 14th of September. He was in his early 50's and happily married, retired on country acreage, of independent means but still with 'plenty do around the place'. He presented as articulate, analytical but somewhat lacking in confidence. He said he was in good physical health although in the past had badly jarred his body with what he described as pretty obsessive running. He said he sometimes had trouble getting back to sleep though be could think of no cause of stress in his life.

Robin said be was looking forward to an "interesting experience" but seemed embarrassed about needing help. He had failed to control what he called inappropriate behaviour. This was the habitual chewing of his inner cheek and it had been going on for many years A callus had formed inside one cheek so he had switched the biting over to the other cheek and now a callus was forming there too.

A second habit that bothered him was that he constantly sang to himself without realising what he was doing, and it was driving his wife crazy. He admitted with some discomfort that even his friends had told him to stop it. He thought he used the word "sorry" a lot. There had also been an isolated panic attack during which he had felt he was unable to breathe.

While this was not established Agoraphobia his underlying tension indicated that Robin was not feeling safe and didn't know why. The irrational nature of his nervousness meant it could well intensify into future panic attacks. The habits had probably arisen from his attempting to gain a sense of comfort and control over the underlying tension.

Robin had never been in hypnosis before but said be was prepared to give it a go. In our opening discussion it was clear that he was uneasy about anything "irrational", but was intellectually curious. He said he was aware that he held rigid attitudes and said he thought it could be risky being entirely open to new ideas.

He said his rational brain, his logic, was very important to him, It was suggested that people are not so much logical or rational, but really just "rationalisers", justifying old worn out beliefs because they are comfortable.

His eyes lit up at this and he said, "Well that is very interesting, a very interesting idea indeed." We had moved from the solidity of fixed ideas to a proposition of attitude and with this shift in perspective put in a wedge. If we really were rationalisers then we could work with this truer flexibility of mind for change. It wasn't that he was a weak-willed failure, but had simply been coming at it from the wrong angle.

The truth of any of this didn't matter. Robin had been convinced his strength was in rigidity and holding on, and that had failed him. Now, it was not so much that he wasn't strong, he had just been coming at it from the wrong angle. His comment was "This is intelligent thinking" and he was hooked.

Robin had attended Yoga classes for several years and it had relieved what he described as paralysing pain in his arm and neck. He said he liked the Yoga and still practised a few physical exercises, but explained, "I never did the meditation bit, it irritated me, I felt I didn't need it, I always used this time in class to repeat my affirmation."

Robin had been relentlessly and without any success, using the one idea over and over again. Trying to force himself to become aware of and stop his compulsion, he constantly mentally repeated: "I am always fully aware of what my body is doing."

It was suggested that the seeming loss of control in letting go of a rigid idea (even when we suspect we are wrong) can be a fearful experience. He agreed heartily and gave me some examples of that in his life.

It was discussed that perceived loss of that rigid control could create nervousness and so produce adrenalin. His habit had arisen as the result of inappropriately (he had used this word early in the session in relation to his habit) produced adrenalin. If he had been misjudging the true nature of his mind and its true strength lay in its adaptability, change seemed possible and all we had to deal with was a chemical problem. In his mind it was all becoming manageable.

It was suggested that what we could do in hypnosis is easily teach the brain to respond differently. We could tell it to release a different chemical, a feel-good endorphin. All he needed to do was let go of the inappropriate response.

This final idea was quite revolutionary for Robin. When it clicked, the smile really spread across his face and there was a sigh of relief. Forcing his will was the only way he knew. It had never occurred to him that he could let go of his problems.

It was explained that success in achieving the hypnotic state was really a matter of concentration, and he was good at this.

Susceptibility testing showed he was quite visual as well as auditory. It was decided to use the 5-0 as an induction, (lingering on and emphasising the value of 5 and 4 because these were the problem areas of the body). adding the staircase for deepening so Robin could use this as a getting-back-to sleep technique. The word "relax" would be avoided.

Robin understood the idea of the mind/body relationship and when it was suggested that "when we release the muscles they automatically close down the adrenalin centre and open up a new feel-good endorphin centre in the brain" he was more than happy to start the 5-0 exercise. He was told that when he released the muscles, he released the inappropriate response. It was becoming simple. He knew the numbers would relate to muscles, and was very comfortable with the idea of numbers. Relaxation was becoming a less scary concept.

When Robin had tested positive to hypnosis it was suggested that the old habit was now sufficiently loosened and that all he had to do was release it from the cheeks and jaw and larynx where it had lodged. His feeling associated with check chewing was connected with, built up and released into a ball and he double-checked to make sure it was all gone. He was told that from now on every exhalation of the breath would send it further out of his life.

Using the breath in this way seemed a good idea because of the direct physical connection of the breath and the cheeks and larynx. Before bringing Robin out of hypnosis he was reminded that numbers in the 5-0 exercise always released the endorphins, ever increasing his calm and strength. He later reported that the old habit had been caught in his cheeks, jaw and larynx.

Robin had of course personally experienced the increased mental focus of a deeply relaxed state. He now knew he could safely relax without losing control.

It was also explained that in future any trace of that "adrenalin" feeling in his body should be released immediately so the calming endorphins could flood through his body. It was discussed how adrenalin will quickly build up like a bush fire and take over, but it is easily replaced if done straight away, and was made aware that practising the 5-0 exercise would increase his ability to do this.

Rather than make a follow-up appointment, he wanted to continue working in this new way on his own for a while.

He had had an early Monday morning session, on Tuesday at 9.30 am Robin sat down and wrote a letter full of pleasure, stating that apart from a flicker of habit in the cheek at 7.30 that night, be had experienced complete freedom from his problems. He had been inspired to place a large number 5 in the kitchen, one next to his bed and another on the car dashboard to remind him to let go of tension.

He wrote, "The great assistance you have given me to shed physical habits has reminded me to attend more to the releasing of thinking habits - therefore to approach each moment like a child, as if all was new and I had no preconceived ideas ... sometimes we need a push to pass from seeing and knowing towards actually doing and being."

I heard from Robin 2 months later and he came in on the 23rd of November, when he wanted to confirm the end of his cheek chewing, increase his listening skills and increase eye contact.

He was very happy and stated that the work we did "has been more than a great help ... for over 10 years I had tried unsuccessfully to stop myself."

Robin was anxious when people (he was mainly concerned about his friends) looked him in the eyes, because then he became uncomfortable and wanted to look away.

It was discussed that rather than trying to critically examine him, when friends looked at Robin they may be trustfully opening themselves up to him. It was suggested that people communicate with their eyes, not just the voice and that when we relax into their eyes we receive a fuller message. He had not considered it to be communication on their part, felt he had been missing out on this, and was keen to now gain a more subtle knowledge of people's thoughts through this new medium.

In the first consultation Robin had said he thought be apologised a lot so now we would go through what was basically a confidence building exercise.

After relaxing easily into hypnosis via the 5-0 exercise, deepening with the staircase and confirming the freedom in his cheeks, jaw and larynx, some of this relaxed freedom was sent into the muscles around the eyes and it was suggested that this freedom would now flow into another area of his life.

It was suggested that when people like you they open their real self; friends look at you deeply because they like you. They are comfortable with you. When friends look at you they allow you to look into their heart with trust because they are comfortable with you, they are relaxed and feel o.k. with you. You are confident because they like being with you. You, just being you is enough for them, the more people look at you the more relaxed and confident you become. He was given a trigger to connect with this relaxed feeling whenever he was in company and it was added that naturally he would listen better with this relaxation and increased concentration on the other person.

Robin said he was very pleased with the work we had done and would call me if he needed a "top-up". It was considered that with his ability to create habits, he would easily continue his relaxation exercise and use this new tool of self-hypnosis to create other useful visualisations.

I also now realise that the "always saying sorry" in Robin's case study could have been handled differently. It indicated that he was feeling inadequacy that indicated he was not living up to his or someone else's expectations in some way. This should have been pursued rather than handle it simply as a confidence issue. Whilst other people reading the article may well realise this, it should be a "rider" at the end of this case study.