It's important to have a variety of ways to get access when you are dealing with people who have severely dissociated sequential incongruities. If you're not satisfied with the access you get using one maneuver, you can always shift to another.
Once you have access, anchor it so that you can get it back. When you have a good anchor for both his sober part and his alcoholic part, then you are ready to «blow his brains out," technically speaking. You collapse anchors for those two states by firing both anchors simultaneously, making both of those states occur at the same time. I generally use kinesthetic anchors for this, because he cannot get away from my touch.
The visible results of collapsing anchors on two states as different as sober and drunk states are remarkable. It definitely induces an altered state. I've seen a client reeling in states of semi–consciousness or unconsciousness for anywhere from three minutes up to an hour and a half. You will see what looks like total confusion; he will literally be unable to organize any coherent response. Sometimes his body movements are out of control, and he has whole–body convulsions. I've actually had a client go into a psychotic break and attempt to do anything he could to get my hands off him, because he knows that his experience is connected with my touch.
What's going on is that I'm jamming together two physiological states that were absolutely dissociated. He has never had those feelings simultaneously in his body. He has never tried to breathe the drunk way and the sober way at the same time, or had the muscle tone or the internal states of consciousness associated with those two states at the same time. In a sense, he was a multiple personality, and you are slamming those two parts together. This really is a sort of shock treatment, and some people have even spontaneously described it that way. The difference is that it's not externally induced, and it will only attain intensities that people can cope with. It's ecological in that sense.
When you have finished collapsing those two anchors, the integration is in no way complete. It simply allows you to have a bridge, so that the alcoholic and the sober person co–exist in the same body at the same time. The two parts are no longer mutually exclusive and completely dissociated. That makes it possible for you to do reframing. This is a precondition for establishing an effective channel of communication through the sober part to the alcoholic part which knows about the drinking problem and what needs it satisfies.
Woman: What do you do while you hold the two anchors and the person is confused for an hour and a half?
I only have to hold the two anchors until the integration is well underway. Then I just make sure he is in a place where he won't hurt himself; that's about all that's necessary. It's also useful to introduce lots of post–hypnotic suggestions while he is in this state of confusion. He will be utterly defenseless at that point. Make sure that your post–hypnotic suggestions are content–free so that you don't impose. You might say «As you continue to thrash around, notice that there's a direct relationship between how intense the feelings are now and how rapidly you'll gain the behavioral choices you want with respect to drinking.»
Since he can't defend against suggestions at that point, you have a tremendous responsibility for the way you frame the suggestions. «You will no longer want to drink» would be the most disastrous way of approaching it. It would be better to keep your mouth shut than to say something like that. You need to talk in positive terms about what will happen in the future, rather than what won't. «You will be able to find alternative ways to satisfy yourself in the way that alcohol used to» is much better. When you talk about the alcohol, you need to speak in the past tense, presupposing that he will no longer use it. All of the hypnotic language patterns described in Patterns I and Trance–formations are appropriate here. If he says «But I don't understand you," you can respond «Of course you don't understand me, and the less you understand me consciously, the more you will be able to reorganize unconsciously in positive ways.»
Man: When you collapse anchors for being drunk and being sober, don't you run the risk of making the person act drunk all the time?
That is a reasonable concern. Giving hypnotic process instructions such as those I've been describing is a way to make sure that the integration you get from collapsing anchors is useful. You say things about how those two states can begin to blend in such a way that the person incorporates all that is useful and valuable in each state, losing nothing, so that the integration can serve as the foundation for more choice, etc.
Let me remind you that this is only a preliminary step. I'm deliberately breaking down barriers between two dissociated states and inducing confusion. I'm literally violating a discrimination, an internal sorting process, that the alcoholic has unconsciously used to make himself effective in life. After doing this, I'm going to have to clean it up with reframing. All I've done is create the precondition for reframing. I now have access to the drunk part and the sober part at the same time. I have reduced a very difficult situation of sequential incongruity to something I can cope with: simultaneous incongruity.
After he recovers and is relatively coherent, I would simply proceed with six–step reframing to secure specific alternative behaviors, and to future–pace the new behaviors appropriately. At that point you reframe in the same way that you would reframe anything else.
However, one thing is very important. If you're working with something like drinking, smoking, or over–eating, you have to be sure that the new alternatives not only work better than the old choice, but that the new alternatives are more immediate. You need to be very sensitive to criteria, and «best» in addictions usually has a lot to do with immediacy. If your new choice for relaxing is taking a vacation, that's not nearly as quick and easy as eating a piece of chocolate cake that's already in the refrigerator. It's a lot easier to smoke a cigarette than to meditate or go running on the beach. You can't run on the beach when you're in an elevator, but you can smoke a cigarette.
You can build in immediacy by specifying it at step four. «Go in and find three choices that are more acceptable, more immediate, more available, easier, and faster than the one you are using now.» Often people don't do that when they do reframing. Their clients then come up with long–range alternatives that don't work, because they need something really immediate.
Another thing you can do with any addict is to make his actual feeling of desiring the drug an anchor for something else. The person needs to experience the feeling itself as having a different meaning. Right now he has a certain feeling that he interprets as a craving for a drink, and it pumps him into drinking. You can put him in a trance and make that feeling mean something else. The feeling of «craving» could now lead to intense curiosity about his surroundings, for instance.
I've used this approach of collapsing anchors and reframing effectively with alcoholics and heroin addicts in one session. I have up to two–year follow–ups now, and it's been successful.
After you've done reframing and found new choices for the secondary gain of the alcohol or the drug, you need to test your work. With an alcoholic, my test is to give him a drink and find out if he can stop after just one. I consider that the only valid test of whether I have done a complete and integrated piece of work. With heroin, I'd find out what anchors used to trigger off shooting up, and then I'd send the client out into that context to test his new choices.