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Psychotherapists’ Guide: Body Composition Transformation – Case Study


Table of Contents

I recently received a call from a client, whom I’ll refer to as Akshay, seeking guidance for his weight loss journey. Akshay expressed feelings of stress, overwhelm, and uncertainty regarding how to begin this endeavour. Recognising the potential benefits of coaching, he reached out to me. Following our initial conversation over the phone, we scheduled our first session to delve deeper into his challenges.

During our initial session, I encouraged Akshay to provide further details about his specific challenges. Here’s a summary of what he shared:

Akshay expressed a profound lack of confidence and an overwhelming sense of being weighed down by the excess weight he had gained over the past few years. Despite having ample domestic assistance at home, his demanding corporate job and familial responsibilities left him with no time to prioritize his health and fitness.

While Akshay thoroughly enjoyed his work and cherished spending quality time with his wife and three-year-old daughter, he realized the importance of taking care of himself in order to effectively care for his loved ones. The burden of these thoughts weighed heavily on his mind, causing unhappiness whenever he caught sight of himself in the mirror.

To address his concerns, Akshay had previously joined a gym and consulted with a dietician, following their prescribed schedules for a few days, resulting in a modest weight loss of 5 kilograms. This initial progress provided him with a sense of accomplishment and well-being. However, he soon found himself slipping back into old habits and losing the momentum he had gained.

Body Composition Transformation – Complete Session Flow

Initial Consultation

During the initial consultation session, I took the opportunity to provide Akshay with an overview of the core concepts behind my approach, Cognitive Hypnotic Psychotherapy, which encompasses various therapeutic techniques. To ensure clarity and transparency, I then guided him through the pre-coaching process.

After familiarising Akshay with the coaching process, I emphasised that in his particular case, we would begin by clearly defining the current problem and the desired outcome. This would lay the foundation for our sessions, enabling me to assist him in the following key areas:

  1. Defining the Existing Situation: We would thoroughly examine Akshay’s current circumstances, understanding the factors contributing to his challenges and identifying any underlying issues.
  2. Defining the Desired Outcome: Together, we would establish a clear vision of the outcomes Akshay aims to achieve through our coaching sessions. This would serve as a guiding light throughout the process.
  3. Creating a Future Vision: We would explore Akshay’s aspirations for his future, enabling him to envision the kind of life he wants to create for himself, taking into account his health, well-being, and overall fulfilment.
  4. Task Assessment: We would analyse the various tasks Akshay is currently required to undertake and assess their relevance to his desired future. This evaluation would help us identify areas where adjustments or improvements are necessary.
  5. Addressing Thoughts and Emotions: By delving into Akshay’s specific thoughts and emotions related to each task, we would gain insight into any mental or emotional barriers hindering his progress. Through targeted interventions, we would work on restructuring unhelpful thoughts and reconditioning disruptive emotions.
  6. Identifying Triggers: Together, we would identify the specific triggers that prompt Akshay to fall back into old patterns, hindering his ability to prioritise and complete the necessary tasks. Recognising these triggers would empower him to proactively manage and overcome them.
  7. Time Management: To enhance Akshay’s productivity and effectiveness, we would collaboratively develop a personalized planner tailored to his needs. This tool would assist him in managing his time more efficiently and ensuring that essential tasks are prioritized.
  8. Cognitive Restructuring and Emotional Conditioning: By employing evidence-based techniques, we would work on reshaping Akshay’s thoughts and emotions that are currently impeding his progress. This process would enable him to cultivate a more positive and empowering mindset, facilitating his journey towards sustainable change.

Session 1: Defining Challenge and Desired Outcome

During the first Body Composition Transformation coaching session, I employed the SOFT SEA Coaching Framework in conjunction with the Meta Model Questions to guide Akshay in defining his current situation, desired outcome, and envisioned future. To begin, I requested that Akshay summarize the challenge he sought to overcome through coaching, using his own words.

Akshay shared his feelings of overwhelm and apprehension about his life when confronted with his reflection in the mirror. He expressed a fear that his current physical state would hinder his ability to provide optimal care for his family. To further refine his problem statement, I asked Akshay to reframe it using the format: “I feel… about… when…”

Akshay’s reframed statement read as follows: “I feel scared about my weight when I look at myself in the mirror, and I worry that my family deserves the best version of me.”

Next, I instructed Akshay to contemplate and articulate his desired outcome for the coaching sessions using the format: “I wish…”

Akshay responded, stating, “I wish to regain confidence and improve my fitness level to fulfill my role within my family.”

Moving forward, I encouraged Akshay to envision his dream future. Although he had not given it much thought before, I urged him to delve into this during our session. Akshay initially struggled to articulate his aspirations, often focusing on what he didn’t want or the emotions he wished to avoid. In response, I prompted him to reframe each negative reference by asking, “If not this, then what?”

Gradually, Akshay was able to paint a clearer picture of his desired future, incorporating more specific and observable details.

To identify triggers that hindered his progress towards weight loss, I requested that Akshay compile a list of situations where he felt unable to engage in the necessary tasks. This exercise aimed to shed light on the factors impeding his efforts.

In the final ten minutes of the session, I introduced Akshay to a self-guided hypnosis technique called “submarine,” known for its effectiveness in weight loss. Providing him with the necessary instructions, I guided him through the process, equipping him with a practical tool for his journey.

As homework, I assigned Akshay the task of expanding his trigger list and practicing the submarine technique every morning upon awakening.

Session 2: Working with Task List and Hindrances

Therapist helping client create a task-list during the Body Composition Transformation Coaching Session

In our second session of the Body Composition Transformation Coaching, we began by discussing any notable changes Akshay had observed in his behaviors, thoughts, or emotions over the past week.

Akshay shared that as he wrote about his future aspirations, he began to genuinely believe in the possibility of achieving them. This newfound belief was something he had previously considered too good to be true and distant.

Additionally, Akshay mentioned that although he initially had reservations about the submarine technique, he had managed to practice it for the past three days.

Next, we proceeded to create a comprehensive list of tasks necessary for Akshay to attain his desired outcome. We distinguished between tasks he could perform independently and those for which he experienced mental obstacles, such as waking up an hour earlier to incorporate a morning workout. To address these mental hindrances, we identified and documented the triggers associated with the thoughts impeding his ability to wake up early. Employing thought restructuring techniques, I assisted Akshay in transforming these thoughts.

To illustrate how new thoughts can become automatic, I offered an example: “What comes to your mind immediately when you hear ‘hare rama’?” Akshay responded with “Hare Krishna.” I explained that this illustrates how the new, desired thoughts can gradually become automatic responses.

As part of Akshay’s homework, I emphasized the importance of daily practice with the thought restructuring technique, as it facilitates the integration of these new thoughts into his automatic thinking patterns.

Once Akshay had compiled a comprehensive list of activities, we proceeded to prioritise and schedule each task. Additionally, I prompted him to identify the specific thoughts and emotions he associated with each activity, providing further insights into his mindset and emotional responses.

Session 3: Working with Task List and Hindrances Cont…

Psychologist using hypnosis to help clients overcome hindrances preventing them from experiencing body composition transformation

During our third session, Akshay shared the positive progress he had experienced in the past week. He expressed feeling better overall and reported successfully waking up early, increasing his workout frequency, and adhering to a healthier diet plan on most days. Akshay acknowledged that creating a task list and prioritising his activities had significantly improved his productivity.

Reviewing his homework, I examined the specific thoughts and emotions Akshay had identified in relation to each activity. It became apparent that he faced challenges primarily with consistent gym attendance and maintaining a healthy diet.

Through our discussion, we uncovered the triggers associated with these challenges. Akshay identified feeling lazy and opting for leisure activities, like watching Netflix, instead of going to the gym. In terms of diet, he acknowledged a pattern of allowing himself indulgences after a few days of following the plan, undermining his progress.

To address these triggers and transform his thoughts, I guided Akshay through the thought restructuring process. I taught him the “When = Trigger, Then = New Thought” technique, empowering him to reframe his thinking in response to these triggers.

During our exploration of emotions, it became evident that motivation and confidence were the feelings Akshay desired most. I prompted him to recall a past situation where he had felt the highest levels of motivation and confidence. Additionally, I asked him to select three future situations from his list in which he wished to immediately experience motivation and confidence.

To cultivate and anchor these desired emotional states, I introduced Akshay to the NLP anchoring technique. By the end of the session, Akshay appeared enthusiastic and energised about the progress made.

Session 4: Reframing for binge eating 

During this week’s session of the Body Composition Transformation Coaching, Akshay shared that he had been successfully managing most of his tasks. The “When = Then” statements we had worked on proved helpful in establishing a regular gym routine and maintaining the rest of his schedule and plan effectively. However, Akshay faced occasional challenges when sudden cravings for junk food arose. He found himself indulging in these cravings before being able to think rationally and resist them.

To address this compulsive eating behavior, I introduced finger signals as a tool for our reframing work. Once the finger signals were established, we proceeded with the six-step reframing process. As we delved deeper, we uncovered that the positive intention behind Akshay’s binge eating was to find comfort and alleviate feelings of loneliness.

Through the reframing process, we were able to identify alternative behaviors that could fulfill the positive intention originally associated with the binge eating. Akshay felt positive about uncovering the underlying reasons behind his compulsive eating habits and exploring new ways to address those needs.

Concluding the session, I assigned Akshay the homework of maintaining his task chart and continuing to stay focused on his goals.

Session 5: Inner child for the feeling of loneliness

Despite our previous reframing work, Akshay continued to face challenges with instances of binge eating, although to a lesser extent than the previous week.

Considering that we had previously identified loneliness as the underlying cause of his binge eating, I decided to utilize the EET delayering technique to ensure that loneliness was indeed the core issue and that Akshay wasn’t trapped in a cycle of being alone and feeling lonely.

To address this, I guided Akshay into a deep state of hypnosis. Within this state, I facilitated an exploration of the inner child that was still holding onto the feeling of loneliness. The process unfolded smoothly, and Akshay was able to navigate through the different versions of himself that were entangled with this deep-seated emotion.

Following the session, Akshay appeared calm and relieved. We concluded by assigning him the task of maintaining his task chart and staying committed to his goals.

Session 6: Future Pacing

During this session on , Akshay shared a positive update, expressing that he had begun experiencing feelings of motivation and confidence while engaging in his tasks. To further reinforce these emotions, I utilized a hypnotic process to guide Akshay into a deep state of relaxation. Within this state, I encouraged him to imagine how the activities he was currently undertaking were ultimately contributing to the realization of his desired future. Additionally, I installed another anchor associated with his desired emotions, further enhancing his positive mindset.

Over the course of seven sessions, Akshay made significant progress in regaining control of his life and developing confidence in managing his activities. He reported positive outcomes, including weight loss and improved fitness. Akshay maintained regular contact with me over the phone for an additional four weeks, providing updates on his feelings and progress.

Throughout our work together, I observed that the use of imagination, thought restructuring, and the organization of action steps played vital roles in Akshay’s therapy. It is crucial for the therapist to possess the necessary skills to understand the client’s individual pace and employ appropriate techniques that align with their specific needs.

References for Coaching techniques used during Body Composition Transformation Session:

  2. Meta Model
  3. Thought Restructuring
  4. Anchoring
  5. Hypnosis
  6. Inner Child 
  7. Six step reframing 

The concepts and techniques discussed during this case study are based on the topics covered during the Cognitive Hypnotic Coaching® Diploma and the Cognitive Hypnotic Psychotherapy™ Diploma Program.