This essay will look at what stress and anxiety are and how that can challenge diagnosis and impact treatment. before going on to other limitations of treatment. I will address phobias; the difference between fears and phobia and how that impacts on choices of treatment before finishing on other challenges of treatment for these issues.
When looking at limitations for hypnotherapeutic treatment for stress, anxieties, and phobias it is important to understand that while some may be similar all have their individual challenges, which this essay will highlight throughout First, stress. It is good to remember that, much like anxiety, you can only feel it in the now, and not the future or past. Like any issue brought to therapy, if the client does not put the effort both in and outside of the session, the therapy simply won’t work.
Stress may manifest itself as low self-esteem, feelings of inadequacy or failure. It might not always be clear that what you’re treating is stress, as it could be something else entirely. For instance, it could even be related to deeper issues such as phobias, IBS, panic, depression, insomnia and more. If this is the case, you need further study before you can even attempt to treat these. Working as a hypnotherapist requires being knowledgeable on a wide range of subjects and continual professional development. Whether the stress is a result of a major life change, a culmination of several small changes or everyday annoyances, it is how the person responds to these events that determines the impact it will have on their life.
To help demonstrate this idea we discussed in class the idea of a pocket in your unconscious and to prevent this pocket from filling to the top and exploding. Your unconscious creates outlets such as screaming or punching a pillow, to help let loose some of the stress. However, whenever something enters this pocket it cannot come out until the issue has been dealt with. This is where using hypnotherapy can help, as you work together to find better ways alleviate some of the stress.
This is how stress and anxiety are linked: as the pocket (discussed above) starts getting filled, getting closer to the critical level, it can manifest itself as anxiety, psychological or physical symptoms such as depression or nausea. Because of the issue of stress and anxiety being masked, it can sometimes make it hard to get to the root cause of the anxiety as it may not be what the client thinks, or it may not be known. A limitation of hypnotherapy for anxiety is that it relies heavily on the client to take the steps discussed in therapy, outside of the session, such as going to a shopping centre if this is where they feel that sense of anxiousness. It simply will not work if they do not put the effort in.
Within the session you work with the client to help them try and not use avoidance; this is where the second regains come in. In particular ‘safety’, this is where the unconscious mind tries to protect the conscious by making up excuses not to do a certain activity. It will create thoughts such as ‘you might trip and fall’, or ‘get lost’. This case of avoidance is the most common response to a situation that makes us feel anxious, on edge or nervous and often increases the level of anxiety, making it harder to do it the next time round.
The client needs to take charge of their own path and take these steps towards a positive change outside, but it is solely up to them whether they do it or not. However, if their anxiety is severe they need referring on or need to have extra help such as a counsellor or a psychotherapist can help make these changes possible
Phobias bring other challenges, starting with determining whether it is a fear or phobia they have, which cannot always be done. For example, if the client has a fear of flying you can’t test this easily without boarding an aircraft. One way to address this is asking them how much money it would take for them to conquer their fear. If they say none then it is a phobia; if there an amount then it is a fear. The best way to help remember this is that all phobias are fears but not all fears are phobias.
When working with phobias you have to identify the second regains secondary gains: whether the client is aware of the source, as this might be unknown. If it is a complicated case, such as a client with claustrophobia or agoraphobia, then you may need to refer the them on to a counsellor or psychotherapist to help them actually take that step to go outside or be in a confined space.
The client may decide they want it to go away but not necessarily be in a position to test it to see if it has worked. Keeping with the example of flying, it may be that they aren’t going on a plane for a few months, so you are unable to actually test it out, which in turn can cause them to go over and over the session in their mind and start doubting the effectiveness of the therapy.
No matter what it is that you are treating, one of the major preliminary tasks of therapy is to ask the client to clarify for themselves the situation and the feelings that have brought them to therapy. To make sure you understand, you can summarise back to them; this also provides both the therapist and the client with a complete picture of the concerns or issues raised. Additionally, as mention above, hypnosis will not work if the client does not put in the effort as well, as therapy is a path taken by both the therapist and the client.
Much of the treatment for stress in hypnotherapy revolves around getting them to relax and learn coping mechanisms, this could include using techniques such as saying ‘calm’ to yourself on every out breath. Although this word may be short it has a long digraph because it cannot be said fast. Other techniques include a breathing technique such as 4-7-8 this is where they breathe in for 4 seconds, hold for 7 then breathe out for 8 and you repeat this twice. This technique creates a shift in the nervous system from a fight or flight reaction to a calmer state known as a parasympathetic response
and is responsible for the body's rest and digestion response. In this state there is a decrease in respiration and heart rate and an increase in digestion after a stressful or anxiety provoking situation. This is one that I personally use and find works well; that is not to say, however, that it will work for everyone. Much like stress and phobias, it is very subjective and personal to each individual. For some, it could be helpful to say the word ‘calm’ on every exhalation.
Anxiety is a state of apprehension that is caused by fear. Mild anxiety can be unsettling whereas severe anxiety can be debilitating and have a serious impact on someone’s life. Severe anxiety can be a result of long-term stress or a reaction to a situation where you feel threatened. It is wise to understand the differences between Mild and Severe anxiety as well as know the signs and symptoms.
There can be tension between the conscious and the unconscious because the conscious can see different perspectives whereas the unconscious only sees in black and white. Sometimes the unconscious works overtime and responds to all situations that feel similar to the original source of anxiety. Cyclical process can then come into play, which is where the more anxious we feel the more anxious we become. This process can be a precursor to depression. It is also important to remember that anxiety can be a side-effect of medication, so it is always a good idea to check with the client’s doctor. Additionally, when treating anxiety or fears/phobias, it is commonly the case that the reaction that they have to their fear/anxiety , they are actually reacting as the age they were when the fear first started.
Hypnotherapy for anxiety can help boost your self-confidence and develop the ability to deal with overwhelming situations. The therapist can teach the client techniques to use when they feel overwhelmed. By using suggestion, the state of hypnosis aims to access the client’s unconscious mind and help to promote positive change, learn what triggers their anxiety and why, as well as help them change the way they react to this trigger. To help the client relax and reach this state of hypnosis you can ensure the script is tailored to the client. To help with this - and help the client to relax - you can tailor the script to suit their own rep-system (auditory, visual or Kinaesthetic). You can find out which one they prefer to use just by listening to how they talk.
Before starting treatment for phobias, it is best to understand what type of fear they have and to try and identify where this phobia originated. This might be an initial sensitising event or a learned behaviour from a primary caregiver during childhood. Knowing where this started will help the therapist understand the client’s reaction to said phobia. As stated beforehand you also need to gauge the depth of the fear and whether it is in fact a fear they have and not a phobia. It is best to start treating individuals for a specific fear such as Arachnophobia (fear of spiders) as this can be treated well under hypnosis, compared to deeper phobias such as Agoraphobia (fear of open spaces); as they may end up replacing one phobia with another.
A useful tool for all therapy, is reading and understanding body language. This can help you understand what the client is feeling even they are not saying it. There are different things we can look out for such as verbal clues. Here they might be giving not enough detail or too much, you can look out for emotion, tone of voice and both voluntary and involuntary movements. All this and more can help you understand the client and see if what they are saying is contradicted by their body language. It is also useful to keep an eye out for micro movements: involuntary small movements that we cannot control and usually are not even aware are happening.
Reading body language is a truly valuable tool to have and to use. Bearing in mind that 55% of our communication is shown through our body language, 38% is our tone of voice and only 7% is actual words (Chrysallis,2020). Despite being useful for all therapies it is particularly useful when working with stress, phobias and anxiety as usually these present themselves as physical or psychological symptoms. As a therapist you can look out for signals during the session and understand how the client may be feeling in the moment.
Now as you feel relaxed calm and safe, I would like you to imagine how happy you are being in a car, seeing the beautiful scenery slowly pass you by. You see the leaves on the trees gently dancing in the wind, you hear the birds singing lovely songs and as you slowly put your hand out the window. You feel the wind passing through your hand. It feels amazing, you feel happy and safe….you see the hot sun beating down on the car, it makes you smiles. You feel happy and at peace. Your fears slowly disappear, much like the clouds in the sky as you see it turning a lovely shade of blue.
Imagine all the places you can see, the people you can see, the trips you can have with your friends and family. I want to you imagine these things. Go where you want to go. See the places you want to see. It makes you smile. It makes you happy. Imagine that you’re going on a trip with your best friend: you’re going somewhere you have always wanted to go. You check the car and you see and know that it is safe. That you are safe. You both are safe and happy. Everything is in perfect working order. And you’re excited to be taking a trip.
You look forward to all the positive and exciting things that are coming. You look forward to making some new happy memories. You know you’re safe, your sat in the car smiling and laughing with your friend. You feel happy and safe. Feel this positive feeling taking over. As you sit there in the passenger seat, you look out of the window at the road; you see it leading off. It can go anywhere, you can go anywhere. You’re safe, happy and calm.
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