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Hypnotherapy and phobias
Structure and applications of hypnotherapy in the treatment of phobias.
Asaf Rolef Ben-Shahar LicMT LHS LNCP LCPS
A phobia is group of anxiety-related disorders, in which an excessive fear is perceived in the absent of real danger. The DSM-IV (Diagnostic and statistical manual of Mental Disorders 4th edition) divides phobic disorders into three categories - simple phobias, social phobias and agoraphobia. In simple phobias the anxiety is provoked by a specific event, subject or situation, whereas social phobias are evoked by a social situation. There are many kinds of social phobias, but a common theme is uncontrollable fear or incompetence in social contexts. Agoraphobia is fear of being alone or in a public place when escape might be difficult or impossible. Essentially, it is a fear from having a panic attack.
The basic feature of any phobia is a conflict between conscious and unconscious processes. Hypnotherapy is an efficient agent in alleviating phobias because it can communicate with these unconscious processes.
In this short article I will give a sketch of the structure and applications of hypnotherapy in the treatment of phobias. It may serve as a possible treatment methodology, although one should approach each case individually.
Hadley and Staudacher (1996) gave 5 main causes for phobia:
Severe stress.
Building up of series of negative experiences.
Fear of fear.
Transmission from someone else.
Past trauma.
The phobic will also develop avoidance patterns, which will strengthen the phobic Stimulus-Response reaction [Stimulus-Response, or S-R responses are the structural description of behavioural conditioning] (Gindes, 1951). The sufferer usually experiences lack of self-control, anxiety and stress and sometimes depression (Peiffer, 1996; Naish, 1986).
Hypnosis can consequently be used in multiple levels, aiming at several systems: the following ways are only examples of possible angles to approach a phobia.
Relaxation and stress management: Teaching the client to relax and managing his or her stress is a first and fundamental step in treating phobia. Relaxation supplies the client with a 'safe place' to use later in the treatment (Alman & Lambrou, 1996). The stress that accompanies both the phobic stimuli and the phobic response is creating a positive feedback loop, which further enhanced the fear. Stress management and relaxation can break that pattern.
Increasing self-confidence: Ego strengthening is always a recommended step when the client lacks control (Hadley & Staudacher, 1996; Rowley, 1986). Most sufferers are aware of the irrationality in their fear, thus feeling lack of control is most likely to occur. More than anything, ego strengthening rebuilds ego structures towards better coping mechanisms. When stressed, high cognitive functions are often diminished and confidence can rehabilitate those skills.
In-vitro systematic desensitisation: Systematic desensitisation is a behavioural-therapy method to deal with phobias. A list of fearful stimuli is created and therapist and client are gradually climbing up the ladder of fearful stimuli, while applying relaxation methods, to methodologically eliminate the phobic response. This hypnotherapeutic method is an elegant way to use systematic desensitisation without exposing the client to the 'real' phobic stimuli. It includes establishing a hierarchy of fearful stimuli, relaxation techniques and gradually confronting the fears using imagination, rather than 'in-vivo' confrontation (Rowley, 1986; Hadley & Staudacher, 1996; Naish, 1986; Karle & Boys, 1987).
V-K dissociation: Visual-Kinaesthetic dissociation is a quick technique, which uses visualisation, dissociation, reframing and confusion techniques to achieve the same goal as in systematic desensitisation (McColl, 1998).
Age regression: whether a conscious memory is needed to cure phobias is a controversial issue. Some argue that it is very beneficial (Elman, 1964); others consider it unnecessary or even harmful (Alman & Lambrou, 1996). However, age regression can be a way (even through the use of Time-Line therapy) to tackle earlier triggers of the phobia, and to change the past paths of reaction.
Age progression: Used after wither of the three previous methods, age progression can be used to ensure and strengthen solutions. It involves reorienting to the future, using various approaches, and examining both the present (future) and the past in the light of the treatment changes. Secondary gains can be tracked here and dealt with. Age progression uses the client's own resources to create change and anticipate progress (Alman & Lambrou, 1996).
Post hypnotic suggestions & anchoring: Both tools are used to ensure and strengthen the continuity of the therapeutic achievements, to give access to internal resources and to enhance confidence. Anchors are sensor-association which are created to establish a reaction and use positive feedback loop to promote the new behaviour. They are in fact applied post-hypnotic suggestions. Creating unconscious associations can be useful when the stimuli is apparent (Alman & Lambrou, 1996; McColl, 1998).
IMR's: The use of Ideomotor Responses (IMR's) is a respectful way to access the unconscious material and resources, to receive permission for change, to create dissociation and to establish a change without conscious interference (Elman, 1964).
Self-Hypnosis: Teaching the client the principles and practice of self-hypnosis will enable him or her to achieve better self-control, to be able to relax and strengthen his or her coping mechanisms. Self-hypnosis also helps to prevent dependency in the therapist (Naish, 1986). In the context of phobia-treatment, the practice of self-hypnosis will enable quick relaxation and control over the phobic reaction.
To conclude these points, there are numerous approaches, methods and techniques in the application of hypnotherapy on phobias. Phobias can limit your life greatly and provide a constant source of shame, fear and distress. Suffering from a phobia is not, however, a natural and necessary life-long fact - it can be changed, and hypnotherapy is very efficient in doing that.
Asaf
Rolef Ben-Shahar
Integrative Massage therapy
Hypnotherapy & Psychotherapy
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