“Don’t it always seem to go
That you don’t know what you’ve got ’till it’s gone.” — Joni Mitchell
Sometimes life feels like a charging beast, breathing down your back, hunting you down with its deadlines and responsibilities.
Electronic pokes, tweets and pings jolt your overloaded brain.
Must check this, have to get back to that! But I promised him that, and I’m supposed to meet her there. And I’m sure there’s something else I’m forgetting…
Your brain spouts out dopamine like there’s no tomorrow as its motivational pathway reacts and responds to each new expectation and demand.
Even your laptop seems to be against you, as the nine windows you’re juggling stare you down. But while your laptop draws greedily from a limitless supply of electricity, you must operate on mere flesh and blood.
Your trillions of cells fight to continue the intricate, infinitely complex dance that makes you who you are. But they are starving. They are thirsty. They’re not getting what they need: the pure balm that is regular, deep, healing sleep.
Sleep is nature’s medicine, a comforting friend, guide, and energizer. Like a good lover, it makes us feel alive.
We miss it when it’s gone.
Sleep is not an option – it’s a necessity
Sleep is vital, and without it we eventually get sick(1). It’s a pretty bold statement, but it’s an accurate one. I can’t overemphasize the importance of good sleep in keeping us alive, healthy, and sane.
As far as treating clients goes, understanding the ‘state of play’ of their current sleep patterns is central to understanding them. Sleep (or lack thereof) plays a role in depression, anxiety, and addictions(2).
I’ve covered sleep quite a lot. So maybe a little night… I mean recap is required.
We can all miss sleep sometimes. Maybe we have a busy schedule. Maybe we’ve developed bad habits, like overstimulating the retinas with late night web surfing. Maybe we’re drinking too much – too much alcohol before bed can rip through your sleep like thunder. Or worst of all, maybe we’re lying awake sick with worry.
Once these lifestyle factors are corrected, sleep will often fall into line. When it comes to improving your clients’ sleep, start by improving their state of mind. When you lift post-traumatic stress disorder, depression, or whatever other mental health issues your client might be battling, you also lift the chronic cortisol-inducing worry that goes with it – and it’s amazing how quickly sleep reflects that.
So if you’re serious about helping your clients sleep better, you should familiarize yourself with the basics first. By this I mean asking clients about their sleep patterns, helping them with their wind-down routines, ensuring their sleep ‘hygiene’ is healthy and their sleeping environment is optimal to allow sleep in, and addressing that most potent of stimulants: worry.
Sleeplessness can be caused by all kinds of conditions and life complications, and trying to treat it without looking at what lies behind it is an uphill battle to say the least.
But it’s a two-way street: by treating our clients’ insomnia directly, we can also help improve other conditions. But before we can do that, we need to work out what’s going wrong with their sleep patterns in the first place. And of course, that’s easier said than done…
How much sleep did you get?
It’s a notoriously difficult question. It’s impossible to tell exactly what time we get to sleep. At one of my hypnosis workshops I met a sleep lab technician who told me that in his experience most people actually sleep longer than they think.
That’s not to say you shouldn’t believe someone when they tell you they “barely slept a wink last night!” But also bear in mind that it’s really hard for your client to objectively tell how much sleep they’ve had.
Fascinatingly, there is also a placebo element: it not only matters how much sleep you’ve had, but also how much sleep you think you’ve had. A study revealed that people who believed they’d had more sleep performed better at cognitive tests than those who believed they’d had less, regardless of how much sleep they’d actually had(3).
But you probably don’t have an EEG machine or sleep lab handy. So we need to ask questions about sleep if we suspect it’s a real problem for someone. Questions like…
- Does it feel like it takes a long time each night to fall asleep? (More than 30 minutes?)
- Do you wake up multiple times through the night?
- Do you find yourself waking up really early in the morning and feeling you can’t get back to sleep? (Early waking syndrome is a symptom of depression, perhaps because the body is trying to self-correct the excessive REM [dream] sleep characteristic of depression.)
- Do you wake up exhausted each morning even though you’ve slept through the night? (This might indicate their sleep composition is out of whack. Too much REM sleep and too little recuperative slow-wave sleep is a major cause and symptom of depression.)
I’ve written about the importance of ‘kickstarting’ the REM state as a way of getting off to sleep. While we don’t fully enter the dream state as soon as we go to sleep, we do have dream ‘fragments’ – and we can stimulate these purposefully to improve our chances of drifting off. But that’s only the beginning.
Let me share with you three more techniques to help your clients sleep.
Technique 1: Turn the paradox on its head
If your aim is to get to sleep, trying to stay awake is actually more effective than trying to sleep. That’s your paradox right there. But as frustrating as it might seem, we can actually use it to our advantage.
Paradoxical tasking can help change patterns of behaviour and response. I was thrilled with how well it worked for one of my clients in particular.
Tom just couldn’t sleep. For hours, he told me, he’d wrestle with his thoughts – and his duvet.
“As much as I try to sleep, I just can’t!” he despaired. I didn’t have the heart to tell him that his valiant efforts were probably the reason he couldn’t get to sleep. Sleep needs to be invited in, not kidnapped and forced to comply. It is a guest, not a slave.
When I asked Tom what he thought about during those fitful awake hours, he was quick to answer. Self-employed, Tom would lie awake plagued by all the work he needed to do.
I saw my opening.
Tom was the kind of guy who does what he says he will. So I set him a task. I told him that while we were still learning about his particular insomnia it would be useful to harness these ‘bonus hours’ – a phrase Milton Erickson sometimes used with his sleepless clients.
So what was Tom to do?
Whatever you do, don’t try to go to sleep!
Tom was to lie in bed for around an hour, and if he hadn’t gone to sleep he was to get up, go into a dimly lit part of his apartment, and catch up on work for 30 minutes. It was quite monotonous work, filing accounts. After 30 minutes he was to go back to bed, and if he was still awake an hour later he was to again get up, go into that dimly lit place, and do 30 minutes’ more work since he was awake anyway.
In the first week he found that he caught up on a great deal of work, but that he started feeling reluctant to get up and work after the third session.
“It’s funny,” he told me, “I kind of want to stay awake, but I’m feeling sleepier.” By the second week he found he had stopped worrying about whether he got to sleep at all. And, what do you know, more often than not he was falling asleep before he even got to the second work session.
By the third week he was drifting off before any of the (boring) work got done. By that time he’d also caught up on his work arrears, so he was worrying about it less.
Actually doing tedious work doesn’t tend to be as stimulating as worrying about it.
I’d given Tom a therapeutic double bind: either he got work done, or he slept. A bind that, in his case, worked really well. When Tom started ‘failing’ at getting up to work he started ‘succeeding’ at getting more sleep.
Part of the success of this technique stems from the fact that, ultimately, we’re never going to feel terribly motivated to get up and do tedious work. And so our unconscious builds the motivation to just drift into sleep as a way of getting out of the boring work.
We have to consider motivation in all therapy – and how we can harness it. Often the first step to sleeping well is to make it okay not to sleep.
Technique 2: Three sights, three sounds, three feelings
I’d also set Tom a task to do while he was in bed between work sessions. I taught him the self-hypnotic technique of the ‘three things induction’. I suggested he could relax deeply not to get to sleep, but to just get some of the benefits of slow-wave sleep while he was awake. There was something important Tom needed to learn about sleep.
Sleep is an activity
Sleep isn’t passive.
The brain can be highly active during sleep (especially during the initial stages) so I reassured Tom that he didn’t need to ‘switch off’ to go to sleep – his brain simply had to become active in a different way.
As we drift into sleep we have dream fragments – flashes in which our creative, imaginative mind takes over from our conscious mind. Now, normally this happens unconsciously – but it doesn’t have to.
If we consciously start to prompt these imaginative flashes we can ‘kickstart’ the process and set the scene for sleep. Visualization mirrors the brain’s natural process of entering the mythic doorway to slumberland.
So I taught Tom to focus, without moving his head and with his eyes open to start with, on three things he could see. He was to inwardly list to himself such statements as:
- “I can see the outline of the wardrobe.”
- “I can make out the bookshelf.”
- “I can see shadows around the door.”
If the room is too dark (and darkness is very good for sleep!), then have your client go straight to imagining what they might see if the light was on.
Next I had Tom direct his attention to what he could hear:
- “I can hear the sound of my own slow breathing.”
- “I can hear a train going past in the distance.”
- “I can hear the gentle patter of rain on the glass of the window.”
Then he was to direct his focus to what he could feel:
- “I can feel the duvet on my skin.”
- “I can feel the air on my skin.”
- “I can feel the pillow on the back of my head.”
Once he had gone through this once – real things he could see, hear, and feel – he was to close his eyes and experience three things he could imagine seeing. (A kitten curled up asleep, a blue circle, a sunset merging with the sea’s horizon. Whatever his mind conjured up.)
Then Tom was to fleetingly focus on three things he could imagine hearing. (The sound of a bath running, birdsong in the trees, the sound of the sea on a summer’s night.)
Finally, he would come up with three things he could imagine feeling. (Swimming in a pool of water, having a wonderful massage, walking in the garden with the sensations of the soles of his feet over springy ground. It was completely up to him what he imagined.)
Because this exercise reflects what happens when we start to drift into sleep, it naturally brings us closer to true sleep. But I wasn’t about to tell him that! By telling him it was a ‘relaxation exercise’, not a ‘sleeping aid’, I made sure his expectations weren’t going to get in the way.
This last technique may be a little out there, but you might be surprised how effective it can be.
Technique 3: Keep your socks on!
Wearing socks in bed may not be the pinnacle of erotic allure. But if you have your sleepy eye on recuperation rather than procreation, they might be just the tonic.
For sleep to come – and stay – our core body temperature needs to drop in comparison to our extremities(4). Sleeping in a really hot room can be hard because our core body temperature may even rise. But having cold feet and hands – so that the temperature of our extremities is colder than our core body temperature – can be just as detrimental to sleep.
But if you are a player or a sexual free spirit, if you consider a night without sex to be a night wasted, fear not. You don’t have to go to bed each night in mittens and hiking socks.
You really don’t, and neither do your clients.
I’ve found, as long as the bed is not too cool or hot, getting clients to visualize their hands and feet becoming warmer has an amazingly soporific effect. Of course, this may simply be thanks to the sleep encouraging effects of visualization (mirroring the REM dream state), but it might be at least partly an independent effect. What we do know for sure is that body temperature is important when it comes to sleep.
You could ask your client to imagine shivering in a cold, snowy place, but then finding comfort around a warm open fire. They could imagine warming their hands and feet. You could describe the way the air around their hands begins to heat up the hands themselves.
Or you could ask them to visualize heat taking a physical form, such as streams of orange or yellow flowing into their hands and feet. This is likely to be even more effective if you combine this with an explanation of how the body’s core and extremity temperatures relate to sleep onset.
Sleep is your lifelong companion. Through your childhood, adolescence, and adulthood, it was a constant friend – and it always will be. It has great and generous gifts of health and wellbeing to offer us. But we in turn need to protect it.
For some of us, it can feel tempting to shun sleep, to try to maximize our waking time to manage all the challenges life throws at us.
But if we learn to allow sleep to ride gently alongside us through the twisting path of existence, we might just find that path a little easier to navigate.
- http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004589; http://www.sciencedirect.com/science/article/pii/S1087079212000986; http://journals.lww.com/psychosomaticmedicine/Abstract/1994/11000/Partial_sleep_deprivation_reduces_natural_killer.4.aspx
- http://link.springer.com/article/10.1023/A:1005230820074; http://www.sciencedirect.com/science/article/pii/S0306987709006999
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