This calls for casting a circle because you are using your subconscious mind, and not your conscious mind.
Use a round, blessed mirror.
Light Patchouli incense. Smear a light coating of allspice around the outer Circle, starting at the top, going in counter clockwise position.
Bind this (man/woman) I name ________
Bind him/her from our home and life.
Give us peace, remove the strife.
Let their will be free, as long as he/she stays away from me.
Protect our family from this day forth,
Allow _______ to never darken our door.
Reflect back now and please be Quick.
Keep him/her away, if _______ breaks the spell.
Make him/her hear well,
If _____ Comes back here
Make _____ become violently ill.
As I have Willed, So it shall be.
Thank all Elements for attending the right.