This is very often caused by a fear of not being able to sleep. This fear is so strong it can remain impervious to the most powerful sleeping pills.
The best method we have found may seem a little strange, but it does produce results. It consists of getting patients to promise that they will resist falling asleep for a set period of time. They soon become aware that if this instruction is really carried out, their anxiety disappears, and they feel they can sleep.
It is essential that patients keep their promise for the set time period, and that they fight to stay awake. If their phobia reappears when they try to get to sleep, they must start again. Results will not be long in coming, and they will soon regain their ability to sleep peacefully.
I have seen patients struggle with this method, not sleeping for one or two entire nights in a row. It takes quite some effort, but will always lead to success if they are sincere.
Another form of complete insomnia is when patients do not sleep because they aren't tired; they are not suffering from any phobias or clichés, their brain is calm but very awake, and they can rest without actually sleeping. This form is quite rare, and the exercises we suggest have hardly any effect, hypnosis being the treatment of choice in such cases.
We will not be talking about cases of insomnia caused by various organic problems, or by physical pain, since insufficient control does not affect these types.
We can now move on the exercises most appropriate for regaining the ability to sleep. All the exercises are effective, since they all work to calm the mind and re-establish cerebral control. Some, however, are designed for specific types of insomnia.
The procedure we have termed "de-concentration" almost always leads to sleep, as soon as patients are capable of producing a state of rest for a certain period of time. Patients concentrate on the number 1, then try to suspend their thoughts for as long as possible while progressively distancing themselves from the number 1. Any distrac tion or new thought is stopped by resuming concentration on the number 1.
Concentrating on the concept of calm and rest is also effective.
A simple method is to concentrate on breathing, making it regular and pretending to snore a little, as if asleep.
Visualizing the symbol of infinity (see page —) growing larger and larger works well for some patients.
A determined effort of will to fall asleep is sometimes effective, if patients can dispel their doubts.
To get results, these exercises require some training - obviously, if patients are unable to concentrate, they will not be able to put them into practice.
As for sleeping pills, we try to void them as much as possible. We are rarely forced to resort to them, and when we do it is only during the initial phase of the treatment. The great disadvantage of narcotics is that patients are invariably in a passive state the following day, not to mention the dangers of addiction and harmful side effects.
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