Free floating anxiety

by Michael O’Sullivan

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…

Submitted by:

Michael O’Sullivan FNCP GHR Reg

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