by Michael O’Sullivan
Names and identifiable details have been changed in order to protect client confidentiality.
John was 42 years old when I saw him. He said he was unable to use trains or the tube (metro). He had no problems with buses, trams, coaches or driving in cars.
Although he became extremely nervous on the occasions when he tried to overcome his ‘irrational’ (clients word) fear by visiting his local station in preparation for using the train, he experienced a full blown panic attack when he actually managed to force himself to step onto a train once about 18 months previously. He managed to travel one stop before he staggered off onto the platform. He reported he was soaking wet, unable to speak and very cold, despite it being a hot day. As a result he developed a cold which lasted a week and had to take time off work to recover. He was very shaken and he reported that this incident was very frightening. He’d tried will power and ended up ill, so what other options were available? Since he had forced himself onto the train he reports that he now gets nervous passing a rail station and he avoids railway crossings as much as possible when driving. This situation causes real inconvenience for John and he is keen to get over it.
He decided to try hypnosis because he had read a press report about a lady who overcame a far of spiders after a single session with a hypnotherapist.
John was otherwise fit and healthy and had attended a recent medical check up under his private medical plan. This fear of trains had developed suddenly about 3 years earlier, previous to which John reported that he’d never experienced any problems.
One day he simply became nervous getting on the train, remaining tense until the end of the journey. Gradually the situation worsened until he was unable to board the train at all.
After history taking we found no causal affect (i.e. he had not witnessed any train related incidents and nor had he been involved in one). However, since his unexplained fear had developed he finds himself obsessing about why he had this fear, has read lots of theories but still remains as confused as ever. His big concern was that his reading had led him to believe that the way to deal with a phobia was to go back to and deal with the sensitising event or incident that started it. In this case there wasn’t such an event, so how could he be helped?
I drew a parallel for him – lots of people have snake phobias, this is well known. Even harmless grass snakes can cause phobics to panic and demonstrate extreme fear reactions. Many people who have snake phobias come from countries where there are no snakes outside of zoos, for example Ireland, my own country of origin. However, show these people a snake on TV and they’ll run from the room. It’s not logical, and is not rational. They have never seen a snake in real life, so a sensitising event is impossible, yet the phobia is real and exists. We’re dealing with the human condition: expecting everything to make sense all of the time is a sure fired recipe for disappointment.
I also explained that recent developments in phobia treatments, such as the fast phobia cure (rewind technique) meant that often it was possible to help phobics very quickly indeed. John was willing to try after being given an explanation of how we’d used hypnosis to calm the fight or flight response and incorporate the rewind technique into the treatments. John was also going to learn to use self-hypnosis and as the rewind technique had originally been developed as self-help, he was also going to learn how to use that technique as well to help him self-manage if required.
The following explanations were given to John before proceeding with the initial session. Including history gathering and discussions with John, total time for this first consultation was 90 minutes.
Self hypnosis process
We began with diaphragmatic breathing exercises.
A standard body relaxation approach would be used to induce physical relaxation and reduce muscular tension. Deepening using mental imagery, i.e. count down from 10 to zero I asked John to visualise each number as I spoke it, allowing each number to double his existing state if relaxation.
A personal safe place was established using visualisation, this being a private place that John could recreate during his self-hypnosis sessions where he knew he was free to relax and take things easy. John created his own safe place; it did not evolve in response to any suggestions about what I thought his safe place should be. In John’s case it was a small dark and warm room with a comfortable bed and red curtains with a low ceiling.
John was asked to select 3 brief statements which he would use as self-suggestion during his self-hypnosis sessions. He wanted an example so I introduced him to Coues affirmation:
“Everyday, in everyway, I am getting better and better”
John liked this and decided to use it, in addition be also selected:
“I am cool, calm and collected”
“I think clearly and logically at all times”
He agreed that he would write these affirmations and leave them where he could see them during the day and that he would repeat them regularly.
After completing the relaxation training John was brought out of hypnosis and the second stage of the process, the rewind technique, began.
The Rewind Technique
The Rewind Technique is also known as the Fast Phobia Cure or V/K Dissociation technique (V = Visual, K = Kinesthetic)
It was initially developed by Dr David Muss who published what was probably the first self-help book in the UK for PTSD sufferers: Book Title – The Trauma Trap. It is now out of print in the UK but copies may occasionally still be found on Amazon.
The Rewind technique is deceptively simple to use, yet it is highly effective. Dr Muss himself claims an 80% success rate using his technique; however this figure is likely to differ from therapist to therapist and to be influenced by client group. As well as PTSD the technique is also used to help with panic attacks and phobias.
The aim of the technique when used with PTSD is to help sufferers put the traumatic incident behind them by stopping unwanted thoughts and images intruding during their day to day lives. It is known as the Rewind Technique due to the use of the clients memory of the event to ‘experience’ rewinding occurrences of the incident(s) in their own mind’s eye. It was later discovered that this technique, when used in the treatment of phobias, produced good results and was often able to help people overcome phobias in a single session.
The technique can be practiced ‘content free’ which means that the therapist can use the technique without having to know details of the incident, although this is not ideal. However, this approach can be considered for clients who may otherwise have difficulties discussing their experiences. It is also an advantage as the client does not experience unnecessary re-telling of their story, and the upset that this can cause.
It is believed that the process works as the traumatic memory is ‘re-processed’ and re-encoded in the brain. This re-encoding stops the automatic triggering of the fight or flight response whenever the memory is accessed and it is this process which stops the unwanted symptoms of PTSD from occurring.
The process used may be slightly different from therapists to therapist; however the following basics should be employed:
The therapists should first of all relax you and make sure that you are comfortable and at ease. Relaxation can be achieved in many ways, the use of a hypnotic induction is ideal here. There should be no need to discuss the incident in any great detail and as suggested earlier, the entire session may be conducted content free, without having to discuss the incident at all. The therapist should be able to provide you with clear and concise instructions on what they want you to do during the session. The Rewind Technique is carried out in a very structured way, don’t be concerned about this – it is the therapist’s job to ensure that they explain exactly what will happen and to ensure that you are comfortable with the process. It may be useful to practice the Rewind Technique several times during the same session. The therapist should not, however, attempt to deal with more than one incident per session using the technique. The Rewind Technique is a masterful desensitisation technique and its power lies in its simplicity and ease of application.
In this case we decided to use the rewind on John’s experience when he had boarded the train and experienced a panic attack. The process was as follows and includes instructions to John:
The rewind: Most of us have had the experience of being in complete and total control over ordinary everyday items such as the image displayed on our television screens by means of a video recorder. At the touch of a button, without leaving our chair, we decide whether or not a certain image is going to be allowed to play. We further decide when it is going to be played, for how long, how bright it will be, you decide how fast to play it, you can slow it down, turn the sound up or down, or even switch it off completely … you have total control. Now using the power of your imagination see yourself sitting in a room watching a video film on a television screen. You have control over the remote control; it is in your hand. You are watching a film of the event that you were involved in from a point in time 15 minutes before it began. In a moment, when I say begin, press the start button on the remote control and the film will begin at a point just before the incident began. The film will play through in great detail, showing every sight, playing every sound as you watch yourself on the screen until the incident finishes and memory fades. When you reach this point simply nod your head and say GONE. So ready now:
Wait until the client nods his head and says GONE.
Now in a moment you will hear me say REWIND and when you hear this a wonderful thing will happen. The film on the video will begin to rewind and play backwards. You will see yourself in the film, and you will see everything that happened, backwards. You will see hear and experience everything differently, backwards. When you rewind to a point before the incident, when you felt good about yourself then simply nod your head again … and relax completely.
So ready now … REWIND
We used this method to play through the incident 4 times during this session. On each play the speed that John completed each cycle decreased. He reported that his feelings about the scenes lessened with each play so that by the end of the 4th cycle he didn’t feel the need to do anything more.
We finished the session by walking down to the local station and I boarded a train with John and went one stop. John was smiling throughout the journey and reported not feeling in the slightest bit nervous. I asked him to phone me a week later which he did. John reported that he was practising his self-hypnosis (but not the rewind) and found himself quite relaxed as a result. He had invested in a few self-hypnosis tapes. He had been on several train trips since and had been a bit nervous on two of them but he found the deep breathing exercises we’d practised enabled him to manage this. We arranged a second session as a ‘booster’ when we had a week later, two weeks after the initial session. John was feeling extremely confident by then and we concentrated on helping him learn to deepen his state of relaxation while his eyes were open so he could use his techniques while commuting. All in all an excellent result.
Article extracted from “7 Phobias Cured, by Seven Internationally-Known Hypnotherapists”
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Articles Author: Michael O’Sullivan
Michael has practised hypnotherapy since 1987. He is a former Special Forces Soldier and specialises in traumatic stress syndromes, anxiety and phobias. He is currently Director of Studies with the College of Integrated therapies: