EXAMPLE ANSWERS: Q27

Q27. How would you prioritise the client and specific, localised, contextual issues over inflexible, rule-based thinking? i.e. bottom up versus top down thinking.

Learning ou1tcomes: 1.4

Student answer As human beings we process information in different ways. In order to work effectively with a client it is important to identify and work with their own methods of information processing. Two classic methods of these are top down and bottom up processing. Top down processing is where the clients processing method is to start with the global picture and subdivides it into sections in order to understand it. An example of this would be a smoker who states ‘I gave up smoking for 7 years. Then I went through a relationship break-up and went to the pub with my friend. She gave me a cigarette and that was it. I was smoking again’. As the therapist I would examine this global statement as to its validity – was it really just the one cigarette that undid those 7 years? When did you next have a cigarette (because there must have been a next cigarette for them to be a smoker).What does smoking mean to you? What were your reasons for stopping? These would elicit underlying detail (e.g. a defiant act against the ex-partner who didn’t like the client smoking, a belief that smoking helps them to relax….). The aim of this would be to shift from the global statement to examining and addressing the more specific details. Bottom up processing is where the client processes information by building up from the smaller details into a larger picture. This is similar to how a jigsaw is built- from smaller pieces into a bigger picture. A bottom up client may be very focussed on the precise details of how they feel for example the need for a cigarette after a meal. “I can’t not have a cigarette after a meal, it makes the food taste better, it shows me that the meal has ended….” In this scenario the client may well respond well to examining the detail to build up the picture of being a smoker and to work with making changes in a step wise manner e.g. no cigarette after a specific meal- but may also benefit from shifting to a more top down process of challenging with a more global statement –‘what every single time you eat? Anything at all?’ “Are there every any occasions in which you don’t smoke after eating. How do you manage those occasions..” The aim would be top shift from specifics to a wider perception where the detail can be challenged. However if the client is adamant that they do smoke after every single morsel or food, it may be worth changing direction as this could become a false focus. In this circumstance the therapist could change to looking at strategies – what could you do instead? How else could you know that the meal has ended? (LO 1.4 Prioritising the client and specific, localised, contextual issues over inflexible rule-based thinking (i.e. 'bottom-up' versus 'top-down' thinking).

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table) Correct. You have prioritised the client and brought them to their own particular experience and map of the world. I enjoy your metaphor of the jigsaw and can envisage you using that one in an Ericksonian approach. The returning smoker example is a very valid one and I hope you get many opportunities to put it to good use as it is a common dilemma. Your ability to switch focus from one mode of thinking to another in order to help a person process, will serve you well in your engagement with clients and also with friends.

Further Example Student Answer:  All clients will have their own standard way of thinking and processing their life, the hypnotist must identify which processes the client utilises and ensure they use a hypnotic/therapeutic process that compliments the client.

The top down client sees the big picture/situation first and then has to break it right down to understand the finer details/workings of the situation whilst the bottom up thinking client sees the small details first and builds upon them to create the bigger picture.

To work with a top down client you would have to get them to accept more generalised suggestions, a process which would work well for a top down thinker is for general suggestions to be given and then to let their sub-conscious mind make the changes necessary to bring about the outcome they desire, utilising the Future paced process would allow them to just focus on the bigger picture or end result and allow the sub-conscious mind to work out the route to achieve the desired overall changes.

Where as the bottom up client would respond better to smaller suggestions that lead to the overall required outcome such as slow your breathing and notice how relaxed you become leading to a reduction in stress, utilising the new behaviour generator would work well for them as they do not need to be bothered with the end outcome consciously but to concentrate on the small changes which eventually results in the desired changes to the bigger picture.

One of the first challenges for the hypnotist is to identify the clients’ style of thinking and working out the best process for them, whilst keeping in mind the stated outcomes the client has requested.

Q27. Correct. Additional to this however, it is importance to recognise the value of working with swapping these constructs around. For example, when a client thinks themselves 'fat' at an identity level, believing that fat is very difficult to shift after the age of forty, this is an example of inflexible top down rule-based thinking programmed into the client. Encouraging them to swap to bottom up thinking could serve them well. For example, 'Yes, I understand you are saying your particular body has built up some reserve of excess energy at the moment and you would prefer that energy to be used up and shifted from your body. Maybe a deeper level of thinking about your own specific circumstances can encourage an experiment to change to how you live your life every day and what you may be able to do to use up some of that energy or reduce the amount of energy that is ingested into the body so that this situation is addressed and is more under your own personal control.'