I. Internal Voice Tempo Change
Whenever I see a client with a problem, I always start by asking myself the question, "How do they do that?" I began to realize that there are a number of elements that are very similar in a wide range of conditions, which on the surface may seem very different, but actually are not that different when taking a closer look at the client’s internal experience. With a wide variety of problems that create tension and anxiety, the client has been talking to themselves in a fast tempo that creates and sustains their intense feeling response.
They are usually talking to themselves at such a fast tempo that they become hyper alert and stimulated, and aren't able to access other choices—rather like driving a car on the freeway while stuck in high gear, unable to change down into lower gears. At that fast speed, it's not possible for them to exit and turn off onto side roads, or stop for lunch.
Before beginning the exercise below, I do a congruence check, "Does any part of you have any objections to having a more comfortable response in all the situations in which you have had these intense feelings?" Any objections or incongruences need to be satisfied before proceeding. In the outline below, sentences in quotation marks give the exact language that I use, with explanatory remarks in parentheses, or in plain text without quotes.
"Now I know from what you have told me that up until this point (implication of future change) you have experienced this intense feeling on a number of occasions. Bring one of these times to mind now, and let me know what you are either thinking or saying to yourself at these times."
Notice that this language is more immediate and associated than, "Think of a time when—" which is more ambiguous, and could result in the client thinking of an experience dissociated, or running through a listing process of scanning through different examples. Usually they are able to tell me immediately what they are saying to themselves.
If the client doesn't know what they are saying to themselves, they may be too disassociated from the experience at this moment. When this is true, sometimes I ask them the following: "If I were to draw a picture of you in one of these experiences as in a comic book where the artist draws "thought bubbles" above the person's head, what should I put in the bubble to indicate what is being thought at this precise moment?"
Or you can use some version of the "as if" frame: "If you did know, what might it be?" or simply, "That's OK, just make up something." Since I will be adjusting the tempo, not the content, the exact content of what the voice says is not important.
"So the phrase you have said to yourself (the past tense provides a gentle implication that the old sentence will stay in the past) is, 'The plane is going to crash into the sea.' When you have said this to yourself, do you say it in your normal conversational speaking voice, or is it said at a faster tempo? (The tense shift from past to present tends to elicit full association into the experience.)
Here I am offering the client just two options; most will immediately confirm that they are using a faster tempo of speaking. If they suggest it's otherwise, I ask them to check; to date out of the more than 300 clients I have done this with, everybody has been able to notice a much faster tempo."OK, now I am going to ask you to do three things. The first is to say or think this phrase exactly as you have done to date and notice how you feel in response to doing so." . . .
"OK, now I am going to say your sentence, slowed down by about one third. After I have said it, I want you to say or think this sentence to yourself at this slowed-down speed and notice what's different." . . . (Note the presupposition that something will be different, which of course will be the case as by slowing down the speed they have to change the way they think about it, "shift gear," change breathing, etc.)"OK, now I am going to say the same sentence even slower, and then I want you to do the same, and let me know when you have done so."
I then slow down the tempo dramatically, allowing long pauses between each word—at least two seconds—often matching each word to the client’s breathing out. I watch the client carefully to observe how they are anticipating when they will hear the next word, and make sure that I say the word somewhat later than they anticipate. I usually pause even longer between the next-to-last and last word of the sentence—at least double the length of the previous pauses. This tempo shift effectively deconstructs the meaning of old sentence, and changes their response.
"OK, now when you try (presupposition of failure) to think of this as you used to, what are you noticing that is different?" (Note the verb shift from present, to past, to present tense.)
Visual variation Another way to do this exercise is to ask the client to see the sentence in front of them, translating the sentence from the auditory to the visual. I ask them to notice what it looks like, and tell me the submodalities of the sentence—distance, size, color, type font, etc. Then I ask them to begin to stretch the sentence apart, creating spaces in between the words—first noticing the new locations of the words, and then paying attention to the spaces in between the words, rather than the words themselves (a figure/ground shift). If I don't see a dramatic shift, sometimes I ask them to separate the letters as well, and again pay attention to the spaces, rather than to the letters. This further changes the meaning of the sentence, and is also a demonstration that the client can voluntarily change their feeling response.
In some instances I may then get the client to run both the auditory and visual versions of this exercise at the same time. To date I have used this with around 300 clients and in a single pass, no client has been able to get back their original sentence with the original response.
After doing this, it is imperative to do a thorough congruence check again, by carefully future-pacing and testing the new response in all the different contexts in which they previously had the old response. Any concerns or objections need to be respected and satisfied in order to preserve any other useful outcomes that may have been served by the old response
Here is a demo of this
http://www.youtube.com/watch?v=5FHIVIAyxhI( Special thanks to Steve Andreas for encouraging me to write this up and for editing)
Historically around one in five of the clients I see in private practice would be for anxiety related issues. In the last 12 months this has increased to one in two!
Having worked in private practice for a number of years I am always fascinated by the trends that can occur with different client problems. Of course some types of conditions have a certain predictability about them such as spider phobics which are always a good bet for Oct/Nov when the little creatures come out to play!
This morning was spent writing 2000 of copy on the definitions for Hypnosis, NLP, Provocative Therapy and Provocative Change Works. These will be the next articles to appear on 
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