Both stress and anxiety are natural responses from the artillery of responses the human is equipped with. They are both necessary and vital to ones existence and survival. Nonetheless, if either stress or anxiety begins to exceed the levels that are safe and beneficial for the client, and start to impinge on their psychological and even physical well being, then this is when professional help would be required. While they are distinct, stress and anxiety are closely related. It has been clearly illustrated above that anxiety is often born out of stress, and can perpetuate the stress, which in turn feeds the anxiety. There is between them the potential for a downward cycle of degeneration.
From the consequences of anxiety is that the client may begin to avoid certain situations, in the hope that this would relieve them of the negative feelings they experience. In doing so the client allows themselves to believe that avoidance of a given situation grants them relief from their condition, thus reinforcing their avoidance. If perpetuated over a long enough period, this may result in a phobia of the situation, person, place, animal etc that they are avoiding. The subconscious mind is a literal faculty, and will have accepted the perceived source of anxiety as threatening enough to legitimise permanently avoiding it, thereby accepting the phobia. Some clients will acknowledge their phobias as being illogical, but a great many will not, as the mind has made an excuse for their behaviour. As Dave Elman observes, ‘we are all apt to rationalise actions which do not appear to be within the norm.’
As with stress and anxiety, fear too is an inherent and crucial human response. It is imperative that we have some fear, for example, of a violent encounter; one would do well to avoid such a situation. However to avoid going out entirely because one is in a perpetual state of fear of encountering a violent situation, even though there is nothing to warrant such fear, is when this fear has gone beyond what is reasonable and beneficial, and has impinged on a person’s ability to function efficiently. As with stress and anxiety, this is when professional help would be valuable. So a phobia is an abnormal fear, and there are several types. Simple phobias are of a single stimulus, for example fear of heights or enclosed spaces. Complex phobias are where there are a number of fears at play. For example a person may have a fear of flying but within this are fears of a plane crash, enclosed places and a fear of losing control. Social phobias are those associated with what may happen when one is in the company of others. (Module 5 Class Notes)
Phobias may be as a result of a number of possibilities. As was elucidated above, stress and anxiety may result in forming phobias directly linked to the stimulus. However, stress can also result in what is termed, ‘displaced phobias’. This is when a person is under a great deal of stress in one aspect of their life but it manifests as a phobia in another cause. For example a person who is highly stressed at work may develop a phobia of a bridge they have to pass on their way to work, thereby ‘displacing’ their stress from work, to the bridge.
A phobia may also be caused by a series of negative personal experiences that strengthen each other. For example a person may have been pushed under water in the bath tub by a mischievous sibling as a child, they may then have had an experience of not managing to stay afloat at their first swimming lesson on another occasion they may have watched a movie depicting a danger in the water and thus have over time developed a fear of being in water.
Similar to anxieties, phobias too can be learned or even inherited. If a person has grown up witnessing their mother scream and panic at the sight of a spider, the likelihood is they too will develop this fear of spiders.
A phobia may also be the result of a severe past trauma. If a person has a strongly emotional experience, this may create an unreasonable fear of that circumstance. (Hadley and Staudacher)
Finally, there are habits. Habits are those behaviours people commit without giving them any thought. The brain is a complex organ that is required to deal consciously with an infinite number of stimuli, therefore it relegates some actions to the subconscious where the actions are done in ‘auto-pilot’ thus allowing the brain to free up conscious thought to other inputs. It is a learned process that is made habitual through repeated practice. Most habits will start life as something that was at the very least perceived as positive but has since, through repeated practice, become a habit that is more damaging than beneficial. For example, a person may have been anxious about an exam and been offered a cigarette to calm their nerves, the nicotine caused their body to relax and they mentally registered the calming affect it had. The next time they were stressed they recalled this experience and sought out a cigarette once more to induce calm. Over time they started to become habituated to smoking and now the health risks far outweigh any gains made.
When considering a strategy for treatment for any one of these conditions, a number of issues must be addressed by an ethical therapist. In the case of stress and anxiety, it is sometimes the case that these are actually the result of mental disorders. If this is the case then it would be irresponsible to seek to treat the client through hypnotherapy, and they should instead be referred on to health professionals that are suitable for their needs. In this sense, the initial consultation is crucial in establishing whether the underlying cause for the behaviour is because of a neurosis or a psychosis as Schizophrenia, Bipolar, Alzheimer's, Parkinson’s can all present symptoms of anxiety too. Additionally, it has been noted that these symptoms can also be as a result of neurological conditions in which case any therapeutic work would need to be done with the consent and collaboration of the client’s doctor.
In addition to this, whether the treatment is for stress, anxiety, habits or phobias it is of utmost importance that no matter how trivial, strange, illogical or even absurd the behaviour of the client may be, the therapist must always retain a respect and an empathy for the client’s condition and not ever belittle or trivialise it.
Once it has been established whether or not hypnotherapy is the relevant course of action for a client, it would be necessary in any of the stated conditions to try establish a root cause; an initial experience that caused the client to form the beliefs they have which in turn have caused them to behave in the manner that has been presented to the therapist. As Karle and Boys explain, ‘...whether this problem is generalized or episodic anxiety on the one hand or phobic reactions to one or more specific stimuli on the other, the anxiety is a manifestation of an underlying disturbance. It will therefore diminish satisfactorily only if the symptom-directed treatment is accompanied by some degree of recovery and resolution of the underlying processes.’ Thus the importance of uncovering the underlying cause is crucial to the success of any treatment, because as long as this cause has not been worked through then the client’s perception cannot be reframed as their initial justification/s for their behaviour is still present in the subconscious mind, and therefore its potential to resurface in negative behaviour is still significant. In order to excavate the underlying cause simple discussion may not prove sufficient, in which case age regression techniques could be utilised.
Once a root cause can be established it would be essential to address these and a vital tool for a therapist seeking to free a client from the hold of certain experiences or beliefs is the use of metaphors. Once in a trance state a client can be encouraged to visualise themselves surrounded by a protective shield and to really focus on fortifying themselves within this shield. Once that is established they can then be directed to visualise the source of their anxiety or stress in a physical form and to see it coming towards them. As it comes towards them they can then witness it be repelled forcefully away from themselves by the shield, causing it to be pushed further and further away until it completely disappears from the clients sight and mind.
In addition to this the use of the imagination is also of great importance. I believe this can be particularly useful when dealing with phobic clients. As Emile Coue preached, imagination is much more powerful than will alone, so in a trance state the client can be encouraged to approach the subject of their phobia at a distance which they are comfortable with. This would of course be discussed with the client before hand and they would be the ones to decide what distance is comfortable for them. Once they are comfortable imagining the subject at a certain distance, it could then be brought a little closer and each time the client would be encouraged by the therapist to feel calm and relaxed. This is considered systematic desensitisation. Similarly, when dealing with stress or anxieties, the client can be made to imagine their qualities, strengths and abilities and to imagine themselves facing their stressful or anxiety inducing scenarios with confidence and vigour. Of course reliving an experience of that which has troubled the client, would not be recommended for the client who has come with a habit they wish to leave. In such a case, once a client has left a habit they should not be made to revisit it.
Prior to practising any of these techniques though, it would be of the utmost importance that the client is well relaxed, especially when considering Wolpe’s work and his perfectly logical and well established assertion that anxiety and tension cannot co-exist with relaxation and peace of mind. If the process of arousing anxiety and then repressing it by relaxation can be repeated then this will reduce overall anxiety. In fact Karle and Boy state, ‘If this cycle is repeated frequently enough, the anxiety produced in reaction to the original stimulus, even if biologically appropriate, will be extinguished.’
As has been mentioned, most of these behaviours are as a result of learned beliefs, therefore reframing would also be a crucial tool. Someone with a bad habit can be made to focus on all the benefits of abandoning their habit. In addition to this they can be encouraged to allow their powerful subconscious minds to find an alternative, healthier means to seeking out the objective they believed they were achieving when engaging in the negative habit.
In conclusion, it is evident from the essay that while each of the conditions has distinct characteristics, there are many overlaps and much potential for one condition to lead to another and to perpetuate a degenerative cycle of negative behaviours for the client. Individual cases need individual care and concern, in particular with regards to surmising what the root cause of the behaviour is. Each case also requires individual tailoring of therapy, but there are general techniques and strategies that may be applied across the conditions.
Bibliography
Allen, R P, Scripts and Strategies in Hypnotherapy
Hadley, J and Staudacher, C, Hypnosis for Change
Heap, M and Dryden, W, Hypnotherapy A Handbook
Hellmut, W. A K and Boys, JH, Hypnotherapy A Practical Handbook
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lionpoo (student)
