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Dr. Sandra E.S. Neil

And the Serpent said, ‘On the day you eat,

there of your eyes shall be opened.’”

(Genesis 3:5)


The method of the ‘Snake’ uses the patient’s creative ability and a cataloguing of life events and turning points. The patient draws a snake which is unending. Early screen memories and conscious events are correlated with weight change.

We developed this method to provide an accurate developmental weight history, and to plot reactive obesity.

It is valuable for clinicians to use the ‘Snake’ to examine the correlation between psychosocial issues and weight changes. The patient is encouraged to re-examine major life events (both traumatic and triumphant) which occurred at particular weights. The telescoping of events is re examined in this fashion; significant periods are considered, illustrating the interaction of psyche and soma. Lastly, traumatic events which occurred at a particular weight are worked through.

It was devised in 1986, and developed over subsequent years in a long term study of 43 women, the obesity clinic of St Vincent’s Hospital (Neil, et al, 1986 & 1993).

Adolf Meyer (1958) taught about the value of life event tabulation bringing time-life events and socio-psychological relationships into focus, and Finesinger (1948), in his ‘Distributive Analysis’ technique, also presents analogous concepts. Yet, to our knowledge, they were not used as we have done. This new technique has the virtue of simplicity, and is easily understood.


In 1985, Neil devised this technique, and by 1987 had refined its clinical applications and had used the method with the obese. It involves drawing ‘The Snake’, (or ‘The Swan’ as one woman who feared snakes called it). Each obese patient is asked to draw a ‘Snake’ upon which he/she records every turning point in his/her life, starting at the ‘Snake’s’ forked tongue and ending up at the time of initial therapeutic contact. This then extends further into infinity; thus the patient can see how the coil of the ‘Snake’ can extend into the future.

The therapist begins with the patient’s earliest memories, recording the major turning points in life to date, including losses, gains, financial difficulties and windfalls, deaths, births, and any major triumphs or major losses which have occurred. Lastly, and most importantly, the patient then fills out the other side of the ‘Snake’ with the approximate body weights at the time of the various events marked on the ‘Snake’.

The great value in using the ‘Snake’ is that the therapist can examine and correlate age with life events and weight-related turning points wherein weight changes took place. The patient is then encouraged to re-examine the major life events, traumatic or triumphant, which occurred at those particular weights. Unconscious factors emerge during this analysis; and later in the group, transformation of awareness occurs. Later this new awareness permits the process of physical change to begin. Hence, the reactive and developmental history of obesity is elicited quickly and succinctly.

The following concepts are important to grasp the method of the ‘Snake’:

Lachmann and Lichtenberg (1990) refer to ‘screens’ (screen memories) which block recall of prior pathogenic events, attributing them to the separation-individuation process. Such ‘screens’ are then relevant to the obese patients’ understanding of later themes, eg, seduction and rejection, wariness about intimacy, or loss and isolation. The authors differentiate between ‘screen’ memories in the client and ‘model’ scenes created in therapy:

“Screen memories are created by the patient to depict an indifferent lived experience in order to prevent (defend against) the coming into awareness of something regarded as disturbing to know. In contrast, model scenes are created by the analyst and patient together to depict something previously unknown from a reconception of what is known.”

Whilst a screen memory serves to conceal or obscure, model scenes help to give full and complete affective and cognitive representation to prior repetitive pathogenic ideation and experience.

The Neil method of the ‘Snake’ uses model scenes to allow understanding changes of how life events and weight can be used to work concisely in therapy with the obese.
2. the introjections of the adult’s guilt feelings

Ferenczi (1952) described how children’s perceptions of their own bodies can be distorted and negated; for example by powerful adults who violate children by projecting their own guilt and anxieties onto the children. The children are then subjected to the adult’s will (which Ferenczi termed “introjection of the adult’s guilt feelings”); where the child once felt pleasure, it now begins to feel guilt. The child does not begin to think or know guilt or shame; only later when adult, will his/her forced receptivity to guilt feelings be filled with socially defined contents of specific transgressions. An obese opera star serves as an example; she described her bodily sensation when aged 8 years, when her father said “you are too fat”. She experienced wincing cramps, hollow feelings in the stomach and an urge to urinate, followed by nausea. This screen memory dominated her subsequent performances.

3. re-experiencing major traumatic UNRESOLVED Life events that occurred at a particular weight

Yalom (1989), in “Love’s Executioner,” describing the case of the ‘Fat Lady’ said:

“That despite her 250 lbs, Betty and I had rarely discussed her eating and her weight. She had often talked about epic (and invariably unproductive) struggles she had had with her mother and with other friends who tried to help her to control her eating. I was determined to avoid that role; instead, I placed my faith in the assumption that, if I could help remove the obstacles that lay in her path, Betty would on her own, take the initiative to care for her body. So far, by addressing her isolation I had already cleared the way of major obstacles: Betty’s depression had lifted; and, having established a social life for herself, she no longer regarded food as her sole source of satisfaction. But it was not until she stumbled on an extraordinary revelation about the dangers of losing weight that she could make a decision to begin her diet. It came this way...”

Yalom described how a group member had a remarkable and alarming weight loss which reminded Betty of how, over a twelve month period, she had watched her sick father shrink from an obese man to a skeleton wrapped in great folds of spare skin. Although acknowledging it was an irrational thought, Betty realised that since her father’s death she had believed that weight loss could make her susceptible to cancer. Yalom wrote:

“Not only did food represent her sole form of gratification, not only was this a method of assuaging her feelings of emptiness, not only did thinness evoke the pain of her father’s death, but she felt unconsciously that losing weight would result in her death.”

Later, Yalom described Betty’s period of rapid weight loss during which she experienced emotional flashbacks, spending much of the therapy hour tearfully discussing startling, vivid memories, such as:

“the day she left Texas to move to New York, or her college graduation, or her anger at her mother for being too timid and fearful to attend high school graduation. Betty realised that they were following a coherent pattern. As she lost weight she re experienced the major traumatic or unresolved events of her life that had occurred when she was at a particular weight.”. (Yalom, 1989, p 108)

Yalom confirmed Neil’s (1985) earlier clinical observations, which resulted in the development of the Neil method of the ‘Snake’; namely that the patient must examine the unresolved life events which coincided with weight changes.


This technique involves

1. Examining important model ‘scenes’ of development which can later be re-enacted using family reconstruction in the Satir Model (Satir, 1987, 1991) or a variety of other therapeutic techniques.

2. Assessing subjective weight correlations.

3. Reviewing the triumphs and tragedies, as reactive or constructive events and fixation points.

4. Discovering symbolic and other events in the person, study them for losses, unresolved issues and grief and bereavement, which appear to generate weight change.

5. Ignore weight but look to reinforcers and sublimated activities such as using food as comfort, oedipal struggles, ‘shaming’ by family, and family relationship struggles.

This technique, whilst used here in relation to weight, can also be used with regard to any other addiction, to employment malfunctioning, to forensic enquiries, and so forth. It can also be married with a wide variety of therapeutic schools. The method promises an efficient and rapid access to important material.


The person is asked to hand-draw an unending snake ** and:

  1. Mark off the turning points including tragedies and triumphs in their life, (on one side of the snake) starting with their earliest memory and consciousness eg: “2 yrs, I got first dog”).

  2. This continues until their current age and turning points are worked out: eg: “9 yrs, at school used to get laughed at”, “12 yrs, went to school, dog died”, “17 yrs, starting failing at school”, “22 yrs, went overseas for the first time and had a great time”, “24 yrs, returned to Melbourne, lonely”, “37 yrs, mother died”, “39 yrs, consulted a psychologist for the first time”.

  3. On the opposite side of the snake to the turning points, the person is asked to add their weight. This gives the history of their estimate weight in kilograms, combined with the life events.

The snake is unending, since the person has not lived their future.

As the person loses weight, they have to re-experience the traumatic losses and gains emotionally that happened at a particular weight.
** Please note that for purposes of confidentiality, the patients’ hand drawings in the following case studies have been redrawn by an artist.
(1) Wendy (see Appendix, Illustration A and Graph 1)

Wendy was a widow and worked in a helping profession. Her turning points and weight changes were as follows:


21 Brother and sister both married 75

25 Moved out of home 75

30 Married 74

37 Father killed 79

38 Uncle died 83

38 Met friend 80

42 Husband died 88

43 Mother died 88

44 Friend (lover) died 83

44 18.6.1990 79.5

44 Tubal ligation 77

45 People liked her 74

45 3.6.1991 73

Note that her father’s death blighted her life, escalating her weight gain. As she began to lose weight during therapy, she wept almost continuously in the group. She had to renegotiate her past relationship with her father, his tragic death in a car crash, followed by the further loss of her husband, who effectively was a replacement for her father (he was twenty-five years older than Wendy), then her friend and lawyer, who was also her lover, died, and lastly, her mother’s death. As she lost weight she began to have far more positive feelings toward others and increased her professional activities, mirroring the therapist’s dress and ornamentation, bringing cases for discussion, having dreams that revealed the absolute pain of the four losses and dealt with the re-emergence of old feelings.

More case studies have been documented and are available for illustration purposes.


This qualitative and quantitative technique is helpful in various medical and psychological disciplines, as is, or modified across cultures, and prove useful in other bio psycho-social contexts. The method is universal and all that is needed is a pencil and paper for the assessment to be complete.

From 1994 onwards, this method has been used in clinical practice and is the qualitative and quantitative measure of psychological and physical change in person who present who present for weight change. From 2004-2006, a long and complex case study has been undertaken, the results of which are in press.

During this time, it has become apparent that colour coding of periods of life change and weight change makes it simple for the patient to monitor their progress. Existentially, once the person begins to lose weight and get close to their ideal weight, they may see dieting and spectres of skeletal thinness as triumphant or tragic (depending on their life history with illness). Also, it is then that the spirits of ancestors and weight history in the family come to the fore. The implementation of the ‘Snake” highlights the interconnectivity between body, mind and spirit.


Ferenczi, S., Further Contributions to the Theory and Technique of Psycho-analysis, London Hogarth, New York, Basic Books, 1952.

Finesinger, J. E., Psychiatric Interviewing I, Some Principles and procedures in Insight Therapy. American Journal of Psychiatry 105, 187-195, 1948.

Lachmann, F. M. & Lichtenberg J. L., Model Scenes: Implication for Psychoanalytic Treatment pp 17 - 37. Paper: F M Lachmann at Institute of Psychoanalytic Study of Subjectivity; and J L Lichtenberg, Editor in Chief of Psychoanalytic Inquiry, 24 May, 1990.

Meyer, A., Psychobiology: A Science of Man, Thomas, Springfield, 1958.

Neil, Sandra E.S., The Persistence of Obesity: Examination of a Psychodynamic Treatment of Obesity, Thesis, Baillieu Library, Melbourne University, 1986.

Neil, Sandra E.S., The Psychodynamics of Obesity, Thesis, Baillieu Library, Melbourne University, 1993.

Satir, V., Neil, S., Personal Communication at Family Therapy and Behaviour, Three Weeks at Gabriola Island, British Columbia, “Through The Family and Beyond” Canada, 1987.

Satir, V., Banmen, J., Gerber, J. & Gomori, M., The Satir Model: Family Therapy & Beyond, Palo Alto, California, Science & Behaviour Books Inc, 1991. Chapter 3: The Survival Stances, pp 31-84. Chapter 9: Family Reconstruction, pp 205-51.

Yalom, I. D., Love’s Executioner and Other Tales of Psychotherapy, Bloomsbury, London, 1989.

Illustration A – Wendy

Graph 1 - Wendy

*The Satir Centre of Australia


1.Андрис Данфельд - ведущий врач оздоровительного рекреационного центра «Медилор».

2.Артемьева В.А. - кандидат психологических наук, доцент кафедры практической психологии.

3.Бахшян А.Ж. - аспирант Санкт-Петербургского государственного инженерно экономического университета.

4.Белоходжаева А.Е. - аспирант Санкт-Петербургской академии экономики и управления.

5.Бисько А.Т. - доцент кафедры менеджмента Санкт-Петербургской государственной академии сервиса и экономики.

6.Бисько К.Т. - студент Санкт-Петербургской академии сервиса и экономики.

7.Бразевич Д.С. - студент Санкт-Петербургского государственного инженерно-экономического университета.

8.Бразевич С.С. - доктор соц. наук, профессор кафедры социологии Санкт-Петербургского государственного инженерно-экономического университета.

9.Власова И.М.- аспирант Исследовательского Центра проблем качества подготовки специалистов г. Москва, преподаватель информатики ГОУ СПО Социальный колледж №25.

10.Войцеховский Н.С. - кандидат филологических наук, доцент кафедры социологии Санкт-Петербургского государственного инженерно-экономического университета.

11.Давтян Л.А. - аспирантка Санкт-Петербургского государственного инженерно-экономического университета.

12.Даринский Ю.А. - доктор биологических наук, профессор, заведующий кафедрой физиологии им. А.И. Герцена.

13.Жилина Э.В. кафедра практической психологии Санкт-Петербургского государственного архитектурно-строительного университета.

14.Ирецкий А.Н. - соискатель кафедры гигиены и экологии Санкт-Петербургского государственного медицинского университета.

15.Каменская В.Г. - заведующая кафедрой психологии и физиологии ребёнка РГПУ им. А.И. Герцена, доктор психологических наук, профессор.

16.Караткевич С.Г. - соискатель Университета природы, общества и человека, г. Дубна, кафедра САУ.

17.Комаревцева Е.А. - аспирантка кафедры практической психологии Санкт-Петербургского государственного архитектурно-строительного университета

18.Кузьмин П.В. - аспирант Московского государственного университета, факультет повышения квалификации и профессиональной подготовки МГПУ. Заместитель директора Научно-методического центра Центрального округа Управления образования г. Москвы.

19.Лобанова Ю.И. - кандидат психологических наук, доцент кафедры практической психологии Санкт-Петербургского государственного архитектурно-строительного университета.

20.Манько Ю.В. - доктор философских наук, профессор, зав. кафедрой социологических наук университета технологии и дизайна.

21.Оганян К.К. - студентка Санкт-Петербургского государственного инженерно-экономического университета.

22.Прохоренко И.М. - аспирант 2 курса дневного отделения кафедры теории и истории культуры по специальности «Теория и история культуры» (факультет философии человека) Российского государственного педагогического университета им. А.И.Герцена.

23.Рудкевич Л.А. - доктор психологических наук, профессор кафедры практической психологии Санкт-Петербургского государственного архитектурно-строительного университета.

24.Скворцова Е.А. - магистрант Российского государственного педагогического университета им А.И. Герцена.

25.Созаев В. - аспирант Российского государственного педагогического университета им. А.И. Герцена.

26.Товбин Г.М. - кандидат психологических наук, доцент кафедры БЖД СПбГЭТУ.

27.Троицкая И.В. - кандидат психологических наук, доцент кафедры практической психологии Санкт-Петербургского государственного архитектурно-строительного университета.

28.Dr. Sandra E.S. Neil Ph.D., World Area Chair The Satir Centre of Australia

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Влияние социального окружения на формирование

личностных свойств “Трудного ребенка”
Иванов И.А., Новикова М.А.
Проблема социального окружения… (текст статьи)


1. Иванов И.А. Социальное окружение “трудного ребенка”. – СПб, Lux, 2000, 190 c.

*Петербургская академия педагогики

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