Hypnotherapists Dealing with a Client's Choice of Suicide

HypnosisAustralia, May 2008

By Dr Tracie O'Keefe DCH, Clinical Hypnotherapist, Psychotherapist & Counsellor
Editorial Director of HypnosisAustralia Online.

Who is to blame?

If all you do all day long as a hypnotherapist is stopping smoking cures then it is unlikely you will ever have to deal with a client committing suicide and it is unlikely your tutors will have explored the issue very deeply either. If, however, you are trained in other professions such as psychiatry, psychology, counselling, nursing or naturopathy, or as a clinical hypnotherapist with a wide psychotherapeutic knowledge then it is likely you will have to deal with at least one patient committing suicide during your career, and maybe more or many. Let us remember right at the beginning of this paper that suicide is legal in every state of Australia even though different religions may depict suicide as a sin.

Even for therapists suicide is a dark and foreboding subject flooded with fear. One of the immediate issues that comes to mind when a patient commits suicide is culpability. Was there something more one could have done as a therapist, something one did not do that might not have been wise on reflection, or was there something you as a therapist missed? Are you legally culpable as a therapist for the actions of that client and might you get sued by a relative?

The Right to Suicide

If you have worked with terminally ill people you will know the terrible suffering that people can go through when their bodies not only give up on them, but also cause them pain and suffering. It is so sad when you see people you once knew to be vibrant and full of the joys of life descend into an awful death through diseases such as terminal AIDS or cancer.

The pure physical pain, blindness, incontinence, dementia, infirmity can reach devastatingly sad and unwanted levels, robbing people of their dignity. In MS and Parkinson's disease people can become former shadows of themselves, frustrated by their very existence and inability to use their bodies. Sure, for some people death can be beautiful and peaceful, but for others it can be a living nightmare.

There are also those people that suffer from severe and chronic mental illnesses such as schizophrenia who are tortured by the images in their own minds or people who suffer from multiple conditions such as bipolar disorder, attention deficiency disorder and severe autism. People with a multiple co-morbid psychopathological diagnosis find life very hard to cope with and often feel totally overwhelmed by their own journey. Writing this I have just returned from a conference where the organiser of the conference committed suicide 10 days before the it began. Having worked on helplines when I was younger and in projects and charities I am all too aware of the people I have encountered in life who have committed suicide in one form or another.

Many people have no desire to continue their lives in distressing states, artificially kept alive long beyond what they perceived was their sell-by date. When quality of life deteriorates to such suffering, keeping that person alive beyond their wishes, can only be cruel and disrespectful of the patient's/client's/person's wishes. We cannot as citizens aid people in their suicide because the law perceives that as us taking advantage of a person in a vulnerable state. People who do that can sometimes get off in court if they encounter a compassionate and understanding jury but for a therapist to assist a client in their suicide is seen as the ultimate forbidden act. We are, after all, the purveyors of life and resolution, and as hypnotherapists, often the client's last hope when they have exhausted all other therapies.

We must also be human beings as therapists and respect our client's wishes, not constantly attempting to impose our values on our clients' lives. Nothing, however, is cut and dried because by osmosis or direct suggestion clients do come to us for new sets of values that can help their lives work better and be more rewarding. Our values as therapists are to embrace, live and love life; however we need to be careful not to turn therapy into religion and fail clients for wanting different things than we might think are good for them.

There are of course those who are chronically melancholy such as the writer and poet Sylvia Plath (Hughes, 1998) who committed suicide and one can see the theme of suicide looming through her poetic writings. Freud (Freud, 1959) talked about the Thanatos instinct: "the death drive" that was opposite to the Eros: "the life instinct". He explored Thanatos as being the death instinct that manifested in many ways like huge risk taking behaviours, self-destructive behaviour and of course the killing of the self.

No matter how professional and good-willed we may be as therapists, we must respect a client's free will and right to suicide. Post-mortem, generalised blaming or reasons for suicide can only ever be speculations because each human soul encounters its own demons, gods and goddesses of death appearing to each of us in their own way.

The Occurrence of Suicide in Australia

We can only use estimations when we try to evaluate the occurrence of actual suicides because many people who apparently die by other means slip out of the statistical net. The official figures in Australia in 2004 for deaths by suicide recorded by coroners were 2098. Males were four times more likely to die by suicide. The highest number of deaths were from men between 30 to 34 years old and the second highest group were men between 40 to 44. In aboriginal cultures 4.2% of all deaths were from suicide while in non-aboriginal groups such deaths only accounted for 1.5% of the population.
(http://www.livingisforeveryone.com.au/files/updates/lifestats240406.pdf 2008)

What is obvious from these numbers is that men suffer more from a lack of faith in their own efficacy in modern-day society. This is compliant when we look at authors such as Mares (1999) who are involved in masculinity studies and observe that many men can feel displaced and ineffectual in a high-stress, consumerist-driven society. The disappearance of men's rituals and spaces leave many males without a sense of purpose in that their traditional roles have often been decimated by the encroachment of Western civilisation and commodity-driven philosophies.

Women too can feel isolated, disconnected from traditional resources like extended families that have traditionally provided social and welfare networks for the fragile members of society. Institutionalised care in hospitals and outreach can never replace the roles of kind aunties, supportive siblings and loving parents and friends, but in a Westernized society little is allowed to get in the way of the holy grail of profit. Women are constantly made to feel unattractive by television programmes such as Australia's Next Top Model where insecure young women are progressively eliminated from a meat rack because they are just not quite beautiful or worthy enough.
(http://en.wikipedia.org/wiki/Australia's_Next_Top_Model)

The Elephant in the Room

The difference between euthanasia and suicide is a thin line that is trepidatious to walk legally, morally and ethically. Euthanasia is a philosophical concept of assisting someone to die by what ever means, who is suffering and no longer wishes to live. Doctors practice euthanasia daily by withdrawing life support during intensive care due to a patient's or the family's wishes. Traditionally doctors also practise euthanasia by the act of failing to revive a patient when they may be considered too far gone, have severe brain damage, or is so terminally ill that it would be seen as prolonging suffering. Death by natural causes is generally recorded on the death certificate.

There are of course doctors who have been very much in the public eye in helping people undergo euthanasia when they may have been suffering from terminal diseases. Those doctors are often vilified by society and particularly by the media whose yardstick of measurable good behaviour is often based on religious concepts which sees death by choice as a sin. In countries such as Holland, however, the right for someone to die by choice is enshrined in law. In India yogis sit on a hill when they believe it is their time to die and self-induced death follows.

The elephant in the room in therapy is that hypnotherapists and psychotherapists are frequently obsessed with the concept that life is the right choice for everyone. Just recently in helping an association set up their code of ethics I wrote that therapists need to ethically respect the lawful right of a person to commit suicide. What followed was nothing less than unintelligible apoplexy. No one else wanted its inclusion, believing it would get them sued or leave them open for legal actions in the future, or even worse it was bad advertising. But people have an equal right to die as they do to live, and for a therapist not to recognise that is simply negligent.

Ethical Considerations

Most ethical codes of associations that deal with clinical practitioners have clauses that help to guide practitioners when they perceive their clients are a danger to themselves or others. These clauses are meant to cover a myriad of inevitabilities such as suicide, self-harming, overly destructive behaviours or when a client is so non-compus mentis and they are totally unable to function. They are also meant to cover the situation when therapists become aware that they may be out of their depths with clients and dealing with situations for which they are not trained. Such codes generally advise:

1/ The first course of action is to seek immediate supervision from a clinical supervisor in order to gain perspective on the situation. If you are a long way away from such supervision it can be acceptable to take that supervision by telephone.

2/ If a client has attempted suicide and is still alive and the therapist and supervisor believe the therapist is unable to handle the situation it is appropriate to refer the client on to someone more qualified in dealing with these situations. That may be a psychiatrist, psychologist or a more experienced therapist

3/ There may be times when it is more appropriate for the therapist to deal with the client as they may have built up a trusting relationship and the clients may feel betrayed and rejected if the therapist no longer wants to see them.

4/ Whatever decisions a therapist makes at this time they need to write everything down in their notes to keep a record of the process and their reasons for making their decisions. The law and professional indemnity insurers will require accountability and at a later date you may have to account to a coroner if the client has committed suicide.

5/ It is important to remember that client confidentiality survives death unless disclosure is ordered by a court that you reveal the client's notes.

6/ Codes of ethics often say that that confidentiality can be broken if the therapist believes that the client's life or the life of others are in danger but even then such disclosure must only on a need-to-know basis. This is somewhat of a grey area because whether one may disclose to relatives is often not well defined. Should a client be unhappy about that disclosure at a later date they may be able to lodge a complaint against you or sue. In such circumstances a clinician would have to prove duty of care as opposed to unnecessary breach of private information. Wherever possible it would be prudent to get a signature from the clients in advance to make any such disclosures but that is not always possible. Even then the therapist would need to protect the identity of the client.

Screening for Suicidal Ideation

Many years ago I spent some time with a telephone counselling service that insisted that the counsellors on the other end of the telephone asked every client if they had ever thought about suicide. Well of course if the client had not before the telephone call they certainly had that option planted as a suggestion in their minds after the call had ended.

Some clients one sees certainly may have attempted suicide in their past, particularly clients who have suffered from depression, addiction, family traumas, sexual abuse, a sense of relationship betrayal, or any of many other triggers. It is not absolutely necessary to ask a client if they have thought about suicide. In taking clients' histories a hypnotherapist would be wise to note all previous medical and psychological events meticulously. In fact it is the duty of any attending clinician to have a clear picture of the clien'ts past in order to see if any of the history may have any relevance to the client's situation today. In taking those histories a client would normally disclose any such suicide attempts when asked about their psychological history. At the end of the day if a client did not want to disclose such events then we as therapists should not cross the boundaries the client has set to pursue such information unless it becomes absolutely pertinent to what we believe may be happening with the client today.

While many psychologists and psychiatrists depend on clinical tools such as depression inventories, questionnaires and schedules, hypnotherapists should be sufficiently trained in observation, face and body language, linguistic analysis, and para praxis recognition to detect depressed moods and tendencies. Many clients that come in to see us show considerable signs of incongruence between their eye contact, facial and body language and sentence construction but depressed people clearly display a sense of defeatism. There is a profound difference between minor neurosis, occasional melancholia, panic, premenstrual syndrome and chronic or acute deep depression that can lead to suicide. Clinicians need to be proficient and practiced at spotting those differences.

Your line of treatment would be wise if it took as your clinical philosophy that diagnosis is the most important part of any treatment. Of Course clients come to a second or third session and tell you that there were things they forgot to tell you the last time. They may even tell you things then which they felt more comfortable disclosing to you as they have grown to trust you. Diagnosis does not mean you have to know everything about them but simply that you understand what might be broken, enabling you to offer a technique to help the clients heal themselves. Clinical judgment is often a matter of experience and intuition as it is of statistical and diagnostic form-filling analysis.

It is important to talk to your clients and build up a rapport that allows them to trust you so they can give themselves permission for you to help them. Sometimes you may also need to use indirect suggestions to help disclosure and sometimes you may need to use direct suggestion or even be confrontational.

The Temporary Loss of the Will to Live

Most attempts to commit suicide are just that: an attempt. They are cries for help, a person's last resort to seek attention and alert others that there is something terribly wrong for them. Sometimes in life people run out of resources and maybe their parents were unable to teach them resilience or perhaps they have faced some previously unimaginable trauma. They may even be having what Jean Paul Satre (1964) called an existential crisis of being, which is the "what am I doing, why am I doing it and am I getting it right?" question. Life wears us all down from time to time and sometimes suicide may seem a better option than the continued humiliation of not being able to cope. Most of us recover, lick our wounds, brush ourselves down and somehow are able to manage to find a way to start again or continue on in life.

The Chinese even have a saying, "It is the greatest sword that is forged from heat and bashing".

Not everyone, however, has the fortitude to forge their future from their past. As therapists we need to realise that some people have the misfortune to end up in dark places. The long night of the tortured soul is, after all, part of the human condition. Our job is only to help people find their way again if that is what they want and we do not have the right to commit others to our vision of nirvana. Many people who have attempted suicide, however, can come out of that experience and go on to lead a thoroughly rewarding life, with the right help and guidance.

If a person has a suicide attempt in their history it should be noteworthy to a therapist because it is an indicator that at that time the person was temporarily without the will to live. A therapist needs to ascertain if the person has managed to fix the problem or whether their system of coping is still inclined in that direction. Just to put that suicide attempt in the notes as part of history taking, without enquiring further, even if that is not what the client has come for, would be negligence. If you were a rocket painter at NASA and you spotted a fuel leak, would you ignore it just because you were only paid as a rocket painter?

Hypnotherapists Whose Clients Committed Suicide

Jane: I saw Mandy for three sessions to help her stop drinking with hypnotherapy. She had been raped by her brother's best friend when she was 17. He was a policeman so she had told no one, afraid they would not believe her and blame her. Her parents had never taught her much self-esteem and after the rape her self-confidence was heavily eroded under the alcoholism that she used to her cope with her terrible secret.

At the time I saw her she was living with another alcoholic who she had fallen in love with because he accepted her being drunk. It was very a dysfunctional relationship for a whole host of reasons but when she stopped drinking and became sober she found herself in a relationship with a drunk. After the third session she was sober but the boyfriend moved to another city and she followed him. I urged her to continue in therapy in her new location and I really don't know if she did.

A year later I had a telephone call from the police in the new city telling me a young woman had committed suicide and had my card in her purse. Of course I thought, 'If only she had rang me or got on a plane and come to see me maybe I could have helped her.' It threw me for some days and I had to keep reminding myself about all the other patients who I have helped get past suicide and go on to lead good lives. I lit a candle for her and think about her from time to time, hoping she has found peace.

Teddy: I am trained as hypnotherapist and NLP master practitioner. There were no warning signs when my client Robert inexplicably committed suicide. I saw him on the Wednesday for the second time and was helping him with depression - chronic but not life threatening. By all indications he seemed to be feeling much better, worked very well in the session, and was enthusiastic about his hypnotherapy. He was taking antidepressants prescribed by his GP and had never seen a psychiatrist or any other mental health professional before. When I rang him the following Monday, to remind him about his appointment, I was told he had committed suicide on the previous Thursday night. It was such a shock.

My father is a barrister and he told me that I must not contact the family or any other person to disclose Robert was my client. If I did that I would be legally breaching confidentiality that is supposed to survive death. I felt really uneasy about that because I knew they must have been going through such pain, but my supervisor concurred. Robert had a right to privacy and I as his therapist, although very briefly, did not have the right to disclose.

There was no indication he would commit suicide. I've gone over the notes again and again and all he had indicated to me was that he was hoping to get better. My aunt is a therapist and I have talked to her about it at length and as far as she was concerned there seemed to have been nothing I could have done. I had been in practice for five years at the time and dealt with very depressed people before but I just did not see this one coming and I doubt if anyone could have, but it does not make it easier.

Diane: I've been a psychotherapist, hypnotherapist and supervisor for many years, served on boards and committees for my profession, trained originally as a classical psychoanalyst, and before that I was a teacher specialising in child development with disadvantaged and socially maladaptive children. While I may use some cognitive behavioural work within hypnotherapy generally, I still us hypnosis in the process of assisting analysis.

My client Hector was in his seventies suffering from liver cancer and fully aware that death was knocking loudly on his door of life. His plight was that he was a staunch Catholic but did not wish the pain of his death to obliterate the memories of his life. He whole-heartedly believed suicide to be a mortal sin but was torn between the Hades of an unconsecrated burial and committing suicide, which was becoming more appealing as his health dramatically deteriorated and the pain increasingly became unbearable. The whole point of therapy was to help him find an answer without the cloak of morphine steeling his last moments. His fear of a natural death was that it would be out of his control and subject to the vagaries of loss of will.

I could not offer him counsel as I was not prepared to make the decision for him and bear the burden of his death while he enjoyed his ascension into the embrace of god, unscathed and repentant. Our only way out was for me to train him in self-hypnosis and pain relief so he could request cessation of medical assistance and die with his priest, doctor and family present. For Hector's sake I shall not call this suicide but simply the surrender to the arms of the almighty.

Not Committing Suicide

One size fits all can of course never be the stock standard prescription for any client. Direct suggestions, within the hypnotic context, have limited application within the circumstances of clients who may be considering suicide. If you can not see the future then the last thing you may want is a happy clappy hypnotherapist bouncing around in your face. In establishing rapport with your client it would be better to match them to begin with and to lead them once good rapport is established. NLP meta challenges are good questions to oust clients out of suicidal thoughts (Bandler and Grinder, 1975).

Client: "So you are my last hope and I've thought about suicide for weeks so if you are no good I may as well do it."
Therapist: "So well…I'm really good…at some things but really useless at others…If I were crap at therapy how would you do it?"

Clients become really uncomfortable when you join them in their personal dramas and they resent you being there. In indignation they often move positions.

Client: "I'm going to kill myself."
Therapist: "Can you pay me first?"

Anger negates apathy.

Client: "No one loves me, I might as well die now."
Therapist: "I'm sometimes really unpopular as…well…what do you think I should do about it? Oh, by the way your death would ruin me…do you think you can wait until I retire? What colour is green again?

Turning the client into the therapist - Time distortion - Third immediate unanswered question causes confusion and depotentiates consciousness critical mechanism and forces the client into trance.

There may be times when it might be appropriate to use regression to find the root cause of the suicidal thoughts or chronic hopelessness, and to see what triggers activate that gestalt (Morris, 2001, 2002). Many people grow up with little sense of self worth or a perception that they may contribute to the world.

Sometimes, however, tracking back thought patterns during regression can be unsuccessful because the unconscious mind may have put a block on their access. Tracking back kinesthetic sensations during regression, a technique called bridging, is much more effective because sensory memories are less complex and encoded within the body itself (Griffith & Griffith, 1994). The body remembers trauma much more readily than the mind remembers complex thoughts.

Finding the roots of suicidal thoughts themselves is not always enough to make reparation and a hypnotherapist must collapse recourses into those thoughts to dilute their perniciousness and also increase coping strategies (Erickson & Rossi, 1989). Inner child work can be very useful in clients whose traumas are childhood based. In clients whose traumas are more recent Eye Movement Desensitisation and reprogramming is much more effective (Shapiro, 2001). Both techniques fundamentally re-contextualise those earlier traumas and re-file memory patterns differently on a permanent basis.

Ego strengthening for these clients needs to be done indirectly because they are often resistant to direct interference in their negative states (Erickson, Rossi & Rossi, 1996). Many suicidal people are psychologically unstable and attention-seeking, with their behaviour having secondary gains. They resent therapists telling them directly not to commit suicide, because it is taking away their opportunity to act out a cry for help. Psychotherapeutic change is essential to help the clients find their own reasons to live and therapists must often teach them the skills it takes to be resilient and optimistic.

Changing context and content of suicidal thoughts can powerfully give the clients a new way of looking at things. The more bizarre the re-contextualisation, the weaker the foundations of the old suicidal thoughts become.

Client: "It took me so long to get a boyfriend and then he dumped me after two years for someone prettier. I'll never find some else; I just want to die."
Therapist: "If you were a rabbit and the same thing happened to you, what would your next move be? Not a pet rabbit of course because that would be just weird and artificial but a brown rabbit living in field…you can work out how to survive this."

When clients think you are crazier than they are, they sober up very fast as their self-preservation instincts kick in automatically. Confusion - followed by interrogative suggestion.

The comparative narrative approach, called the My Friend John Technique, is common to hypnotherapists as an induction technique but as Burns (2007) points out, each story can have multi-level communications and acts as indirect modelling tools for clients. They do not know the way out of their dilemmas and sometimes you need to show them.

With the advent of bigger, faster, and more violent films and television, much of the meaning of traditional stories has been subdued by attention-grabbing special effects. These were stories that in traditional cultures are used to guide people through their choices in life. How to deal with love, life, laughter, disaster and death have been traditionally taught for thousands of years through storytelling and drama. All therapists would be wise to have a story for ever occasion. Moving past a suicide attempt could be associated with the slaying of a monster, acquisition of wisdom, leaning of a craft or reeling against the slings and arrows of outrageous fortune, in trance or out. During story telling hypnotherapists can use instant somnambulism to bypass conscious resistance and affect immediate yes and no sets.

If the client is suffering from depression and not just recalling from current trauma or acting out PTSD then it is appropriate to treat that depression. This is why it is very important to be fully aware of the person's history and any medications they may be taking. While hypnotherapists such as Yapko (1992) generally advocate no drug treatment for depression we must be careful to work with general practitioners who may already have prescribed anti-depressants, to organise ethical withdrawal from any medication.

Jessie
I hated that first therapist analysing me. He pulled all the things out of my head from my childhood about my father abusing me and it was just too much to handle. Every week it was the same thing: "How did I feel about the abuse now?" It never felt right and I was so unsure about myself, I thought it was me. I had the pills on the table and vodka in a mug. My fiancé, who I had not slept with in four years, came home unexpectedly, and then took me straight to the hypnotherapist's office. I was in shock really because all she talked about was famous women who had achieved phenomenal things in their life and then she had me pretending to be these famous women inside my head. Then she had me doing mindblowing things in my life. I did not know whether to laugh or cry and did some of both.

Before I left that day she made me sign a document that made me promise to not attempt suicide before I saw her in three days time. We never talked about the abuse for a long time and then only to place it into the past very far away. Actually so far away it did not affect me anymore. I did my self-hypnosis daily just as she asked, although I was never quite sure I was getting it right but it didn't really seem to matter. I can't tell you everything I did in hypnosis but I do remember that each time I went to see her I left full of hope.

Who knew therapy could be that easy? When I eventually finished my degree she asked me to bring it with me and we had a party in that session and we sang a song we made up on the day and danced around the room laughing. Whenever I want strength I replay that song in my mind in or out of hypnosis. Why doesn't anyone teach you these things when you're growing up? I was allowed to keep the option of killing myself if there was a nuclear winter, I had lost both arms and legs, and if John Howard ever got back into government, but not otherwise. Seems like a good deal to me.

Matilda
Once upon a time I was a tennis fanatic. Played semi-pro and was considered very good. When I married I was still very active throughout having my four children, particularly because we had a nanny, help in the house, and the children boarded. I am so very proud of children and they have all done well and entered the professions they chose. The cancer has taken most of my stomach, parts of my throat, and intestines. I spend some of my time on oxygen because I have trouble breathing. The pain at times is unbearable and I am frequently unable to eat anything and am fed through a tube.

My husband is devastated but kind and he knows time is limited now. We have been so much in love, had a marvellous marriage and I really don't want him to be left with the memory of me shrivelling away to a cancerous heap. I have had a painting of our wedding photograph hung opposite our bed to comfort him when I am gone. He does not want me to suffer and the hypnotherapist has helped me practise dying and helped me decide the way I want to end my wonderful life on my own terms. I was asked not to disclose when that is or how I will end it but it will be soon now. Thank you to my hypnotherapist for not being a sticky beak. It was a a friend and a pragmatist I needed, not a moralist.

Arnold
I feel a bit of a fool talking about it now because my life has moved on a great deal. I suppose my suicide attempt was the pressure I felt I was under when I was doing my HSC exams. No honestly it was probably the pressure my parents put me under trying to get me to take those bloody exams like them. Man - you don't know how crap I felt about myself. I'm not the brainy type. So anyway all my mates were taking Ecstacy and I thought well, why not, but after six months I was doing them every day and I lost the plot big time. I couldn't get off them and the folks were getting more and more angry with me and I could not see a way out. So I thought bugger it and I did drugs daily for three years. When I came off them I had one mega comedown, cold turkey, and just felt like jumping off a bridge. So I did.

A year later and three broken limbs better I got some hypnotherapy. I suppose it helped me do many things like ignoring my parents and paying more attention to what I wanted. The hypnotherapist helped me to visualise myself as my own person and make up my own mind about everything. She helped me get other people's voices out of my head. The drugs really screwed with my life but I'm getting there bit by bit and doing my apprenticeship as an electrician so I can make good money. I know different people now and live a different life and it's good. I don't think I'll try and kill myself again because things are looking good and I reckon I could handle almost anything, no matter what happened these days. I suppose I'm grown up now.

Conclusion
Whatever collection of techniques you use as a hypnotherapist to help people get beyond a suicide attempt it is ultimately up to you as a therapist to be dependent on your resources; and dependent on what the client brings to the session. The speed at which one can work with interactive hypno-psychotherapeutic change is far faster than psychotherapies and counselling. Remember it is the client that needs to be the hero of the hour and if ultimately the client does commit suicide, the therapist needs to respect their choice.

It is important that both schools and associations dealing with hypnotherapists ensure that those therapists are extensively educated around the subject of suicide and how to rescue clients from those thoughts. Not to do so is nothing less than negligence on the part of the schools and associations. Suicide is a fact of life and often a real fact of caring professions and for teachers and regulators to ignore this not only leaves the therapist in a very precarious position but also is of no service to the public. Dogma, however, must never be inflexible and hypnotherapists need to have the gift of being the willow tree in the storm and never the unbendable oak.

When I personally am old and grey, which is not so far away, and I am losing my sense of who I am, I shall not want to live beyond my sell-by date. I shall not want to be simply a statistic with no identity in a home for those who no longer know who they once were. Life without awareness, when my brain has turned to the texture of cotton candy, has no appeal for me or my life partner. My love for myself will cease if I no longer know who I am and I hope others will respect my choice before I get to that awful state of decrepitude, to go into that gentle good night. Like all hypnotists I hope to go into a good deep trance and slip away peacefully before I awake, without the judgment of others.

Bibliography

Bandler, Richard & Grinder John, The Structure Of Magic 1. Science and Behavior Books, USA, 1975.

Bornstein, Kate, 101 Alernatives to Suicide for Teens, Freaks & Other Outlaws. Seven Stories Press. NY 2006

Burns, George, Healing With Stories. Wiley, USA, 2007.

Erickson, Milton, & Rossi, Ernest Lawrence, The February Man. Brunner Mazel, USA,1989.

Erickson, Milton, & Rossi, Ernest l., & Rossi, Sheila I., Hypnotic Realities: The Induction of Clinical Hypnosis and Forms of Indirect Suggestion. Irvington, USA, 1996.

Fabian, Sue, The Last Taboo: Suicide Among Children And Adolescents. Penguin Books, Australia, 1988.

Hughes, Ted. (Ed), Collected Poems Sylvia Plath & Ted Hughes. Buccaneer, USA, 1998

Freud, Sigmund, Beyond the Pleasure Principle. Bantam Book, USA, 1959.

Levine, Stephen, Healing into Life & Death. Gateway Books, UK, 1987.

Mares, Theun, The Quest for Maleness. Lionheart, South Africa, 1999.

Morison, Jacquelyne, Analytical Hypnotherapy Volume 1. Crown House Publishing, UK, 2001.

Morison, Jacquelyne, Analytical Hypnotherapy Volume 2. Crown House Publishing, UK, 2002.

Rey, Joseph, More Than Just the Blues. Simon & Schuster, Australia, 2002.

Satre, Jean-Paul, Nausea. New Directions Books Publishing Corporation, USA, 1964,

Shapiro, Francine, Eye Movement Desensitization and Reprogramming. Guilford Press, New York, 2001.

Yapko, Michael D, Hypnosis and the treatment of Depression. Brunner Mazel, USA, 1992.

Essays

Freud, Sigmund, Beyond the Pleasure Principle (Jenseits des Lustprinzips) in German 1920, translated into English 1922. "The Language of Psychoanlysis", Jean Leplanche & J. B. Pontalis, editor, W.W. Norton & Company, 1974,

Internet

Living For Everyone, Australian Suicide Statistics - key Findings 2004, Suicide Prevention In Australia, 2008.
http://www.livingisforeveryone.com.au/files/updates/lifestats240406.pdf

Wikipedia, Australia's Next Top Model, 2008.
http://en.wikipedia.org/wiki/Australia's_Next_Top_Model

Participants' stories

Jessie, 2003. Sydney

Matilda, 2005. Sydney

Arnold, 2006. Sydney

Therapists' stories

Jane, 2004. Sydney

Teddy, 1998. London

Diane, 2006. Sydney

©HypnosisAustralia, May 2008