Hypnotherapy is a relaxation based therapy, it is therefore an
ideal method for helping people to deal with a wide range of
stress and anxiety related problems, among others. Essentially
what a hypnotherapist does is to use the natural processes
that allow a problem to develop in the first place and to
teach their client to use those same processes for their own
benefit.
A common problem is what we
call free floating anxiety. Free floating anxiety is the
anxious feeling that people get when there is no apparent
reason for it, hence ‘free floating’. Now it is perfectly
natural to feel anxious from time to time. For example getting
lost late at night in a strange town would cause a certain
amount of anxiety in most people. It is nature’s way of
motivating us to get to somewhere safe. However when anxiety
becomes chronic to the point where it is affecting your
ability to socialise, sleep, go to work, do a good job when at
work, or even leaving you fearful of leaving the house, then
it is time to seek professional assistance.
A lady that we will call
Brenda asked for assistance with anxiety problems. She
reported at least 12 panic attacks in the last 2 months, was
having trouble at work because of the amount of time taken off
due to illness, and was also now in danger of seeing her
relationship with her partner breaking up. Brenda was young,
21 years old, and had recently begun working in her ‘dream
job’ after completing a vocational training course. Although
her dream job could fairly be considered a menial position she
was initially delighted because it was within her chosen
profession, where apparently everyone starts at the bottom.
Her anxiety was becoming compounded because she was fearful
that she could end up losing her job. She was quite desperate
for help.
We scheduled an initial 90
minute session. Brenda showed up an hour early and began to
have a panic attack in the clinic waiting room because she was
convinced she was late and that I wouldn’t agree to see her. I
was in session but another therapist was able to calm her
down. Our session began promptly at the appointed time.
We began with a
comprehensive history taking. It became clear that she didn’t
drink anywhere near enough water, her diet was very poor and
her alcohol intake was fast becoming a problem. She had no
known medical problems and had just had a doctor’s visit where
they discussed possible depression. She refused a prescription
for anti-depressants because the idea of using them scared
her.
Her main concern was the
panic attacks. She had recently broken down while speaking to
her manager at work, hence the reason for the doctors visit,
her employer insisted – good for them!
I asked Brenda what she did
to relax. Her idea of relaxing was to watch television with a
drink in one hand. She couldn’t tell me much about what she
watched; it became clear that it was just a way of distracting
her mind and stopping her thinking.
We discussed her panic
attacks in some detail and discovered some common factors.
They were always preceded by a hollow feeling in the stomach,
followed by becoming ‘detached’ from the situation as her
ability to think and speak properly deteriorated.
Her first panic attack had
occurred about a year earlier on the night before she took her
final exams from the 2 year course she had been studying. This
was a big event for her as she had not done very well at
regular school and treated the exams as a bit of a joke. She
bitterly regretted that afterwards and was determined to make
up for it.
At this point we began the
process of learning how problems like this develop. I
explained that this kind of thing was more common than most
people realised. She had worked hard for 2 years and placed
herself under considerable pressure to succeed. The exams that
she was facing were unforgiving, you either knew your stuff or
you failed. I explained that when faced with a new situation
the mind looks for similar examples in the past that can be
used to provide a template for how to deal with this new
situation. As her previous experience with exams were that
they were not to be taken seriously they counted as a negative
learning experience. In this case she was reminded that she
had not done very well in any exams that she had taken
previously. This is what triggered the panic attack. Where
there is no previous favourable situation or learning
experience to call upon, the mind has to fill a void. All too
often the mind responds by reacting to the situation as if it
were an actual danger and triggers what we call the fight or
flight response.
The fight or flight response
is one of our most basic natural responses, which without
going into too much detail, exists for one reason and one
reason only, to keep us safe from danger by preparing us
mentally and physically to face or run away from danger. The
fact that it is a perceived danger and largely metaphorical
does not dampen our minds response to it.
A panic attack makes perfect
sense if you look upon it as a good thing if you have to
escape a danger, panic adds wings and literally allows you to
run faster than if you were in your normal state. It is a bad
thing if the danger is a perceived danger and the response is
inappropriate to the situation.
Part of the problem with the
fight or flight response is that it changes the way our brain
functions, many practitioners call the associated panic attack
a brain hijack! This happens because during a panic attack the
parts of the brain that we use to think clearly and
communicate experience reduced blood flow as the parts of the
brain concerned with immediate survival are prioritised. This
explains Brenda’s report of becoming ‘detached’ from the
situation as her ability to think and speak properly
deteriorated. Simply put, the parts of the brain involved in
thinking and speaking lose their ability to function properly
under stress unless the stress reaction is controlled.
We then discussed anxiety –
I asked Brenda if she knew what it was exactly? There is
nothing like knowing the enemy! Although she knew exactly what
anxiety felt like and how much it was hurting her, she was
surprised when I explained that it was an abuse of our
imagination. The more developed someone’s imagination, the
greater the anxiety when things go wrong. It was Mark Twain
who said that we spend most of our time worrying about things
that will never happen and he was quite correct.
One thing that we do know as
hypnotherapists is that the more you think about something,
especially where emotion or fear is involved, the more of it
that you will get. So our strategy was devised:
Learn to recognise the
onset of a panic attack and to switch off the fight or
flight response before it takes over
Learn to relax properly
and practise it on a regular basis
Learn to get back in
control of the runaway imagination
Look at improving
hydration and diet, for which a follow up doctors
appointment was recommended
We began the working part of
the session by guiding Brenda through a basic hypnotic
induction procedure so that she could benefit from relaxation,
and appreciate the difference between real and perceived
relaxation. With perceived relaxation you are generally just
moving from one state of tension to a slightly lower one, the
difference in the states of tension leading to a false sense
of relaxation.
The hypnotic procedure used
is detailed briefly as follows:
Brenda was asked to take a
number of deep slow breaths by inhaling deeply, filling her
lungs to the bottom, holding the breath for a mental count of
2, and then releasing the breath in a long slow deep sigh. His
was repeated several times.
I pointed out at this point
that this is the technique for switching off the fight or
flight response, and that this is exactly how emergency
services and military personnel are trained to breathe to keep
themselves calm and thinking when faced with a situation.
Brenda reported feeling much
calmer than she had done for ages, simply by taking several
deep breaths.
We continued, I asked Brenda
to allow her eyes to close when she felt comfortable enough to
do so, they closed instantly. I then pointed out that if she
wished to interrupt or stop the session at any point that all
she would have to do would be to open her eyes, at which point
she would return to complete conscious awareness. I explained
that we were going to use her ability to imagine to help her
to relax each part of her body in turn. We were going to do
this by asking her to send thought energy to each body part as
I directed, and that as soon as she thought about whichever
part that she would mentally say to herself, relax relax,
while thinking about the part to be relaxed. We began with the
top of her head, her scalp, and then worked our way down to
the soles of her feet. In all this took about 10 minutes.
At the end of the physical
relaxation exercise Brenda’s head had rolled forward onto her
chest and her breathing was free and easy. When asked how she
was doing tears flowed down her cheeks as she said she was
feeling great!
I then asked her to enhance
her relaxation and that we would do this by helping the mind
to relax – and that to achieve this all she would have to do
was to visualise a set of numbers as I mentioned them. I
explained that she should form the numbers clearly in her
minds eye, and that with each number that I counted down she
would clearly ‘see’ each new number and double her existing
state of relaxation. We began at 8 and worked down to zero.
Brenda reported feeling very calm and relaxed by this point.
At this point I asked Brenda
to visualise the panic attack that she had when she arrived at
the clinic and explained that she would be able to do so while
remaining perfectly calm. After she reviewed the scene I asked
her at what point would she be both aware that a panic attack
was pending while still able to stop it?
Without hesitation she
responded that this point would be as soon as she got the
hollow feeling in her stomach. I asked her to go back into her
imagination and to replay the scene again, but this time to
see herself taking the slow deep breaths that she had learned
at the beginning of the relaxation exercise as soon as she got
the hollow feeling, and to see what difference it would make.
She reported that she saw
herself regaining control and the panic attack didn’t happen.
I asked if she could see that by taking those deep breaths she
was preventing the brain hijack that we had discussed earlier?
She could, and reported that this new insight was a relief as
it relieved her of the fear that she was going mad.
This was good progress, by a
simple combination of imparting knowledge about how problems
develop and teaching some very simple coping strategies.
We used suggestion to
‘anchor’ the hollow feeling to taking a deep breath –
"each time that you
experience that hollow feeling in your stomach in the future
you will instinctively take a slow deep breath in exactly the
way that you learned here today, and you will repeat this as
often as necessary to remain calm".
I generally employ a
standard suggestion to the effect that
"your subconscious mind will
implement the suggestions used here today to the precise
degree that is required to ensure your well being and
continued good health".
I do this because in some
cases, for example escaping a mugger, a panic attack might be
a good idea. If the subconscious decides that panic is the
best way of getting you out of danger then go with nature.
However, thankfully most of our dangers these days are
metaphorical, and it is useful to be able to understand this
and control our natural responses to them.
I asked Brenda to tell me
the kinds of thoughts that commonly passed through her mind in
a typical situation at work just as an example. Not
surprisingly she reported that she spent most of her time
hoping that no-one would ask her anything in case she made a
fool of herself. I asked her to visualise the situation, and
that this time she would use the mental number count down
exercise combined with deep breathing to calm down her
thoughts. She did this and reported feeling more confident.
I explained that practising
this would provide valuable mental discipline and that we
would discuss the use of affirmations after bringing this part
of the session to an end. I then asked Brenda to open her eyes
at the end of a count up to 5, at which point she smiled and
said she wanted the session in a bottle to take with her.
I explained that of course
she would be taking the session with her, just not in a
bottle. We then looked at affirmations. I explained that at
the moment she already knew their power because she was
already using very negative affirmations, "I’m no good, can’t
do this, thing’s will never get better, etc", and guess what?
They work!
The thoughts that we allow
to live in our mind eventually become our reality, literally a
case of being very careful what you wish for. Without
realising it each and every one of us makes a wish or wishes
every single day of our lives. However, we don’t recognise it
as such, because our wishes are just the way we think! Carry
on thinking that you are useless for long enough and you will
be; this is a natural law of nature. This is why the use of
positive affirmations is so important. Through repetition
affirmations become embedded in our subconscious, they become
part of us, they define our reality. The quality of our
thoughts is reflected in the quality of our lives.
In this case Brenda
developed the following affirmations which she agreed to use
on a daily basis:
I am calm and confident
I am more relaxed
I have skills and I know
how to use them
It is important that the
affirmations mean something to the person who will be using
them. Standard affirmations such as ‘each and every day, in
every way, I am getting better and better’ will help most
people. Personalised affirmations will help more people, and
better.
Through a combination of
sharing knowledge, relaxation training, visualisation and
affirmations we now had a self-help program in place that was
both common sense and simple for Brenda to use. All she had to
do now was to practice what she had learned; the suggestions
imbedded during the session would help her get a good start.
We ended the session on a
high note and I asked Brenda to contact me in 2 weeks to let
me know how she was getting on.
When she did contact me she
reported that she had experienced one panic attack in the last
two weeks, right after she got home following the session.
However, it was low intensity compared to the other attacks
that she experienced. She reported faithfully practising her
deep breathing and affirmations, having them on slips of paper
in her purse, on her desk at work, the bathroom mirror so they
were the first thing she looked at in the morning.
Over the course of the next
4 months we had a total of 5 sessions in total, each designed
to build up on the benefits reported from the preceding
session and to allow Brenda to work out some personal issues
that had been lurking behind her panic attacks. The great
thing about hypnosis is the speed that it can work. In this
case the benefits were reported from the first session, one
more panic attack and then no more being reported.
Brenda has since moved to a
new job within her profession after passing her driving test.
Although she did split from her partner she reports feeling
more optimistic about life now than she ever has…
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