Tackle Anxiety

What is anxiety?

anxietyDefined as “A feeling of worry, nervousness, or unease about something with an uncertain outcome”. (Oxford English Dictionary). Anxiety is part of our fight-or-flight system originating from the region of our brain system, which works on instinct and habits to keep us safe from predators.

This system works well in protecting us from predators, such as lions. But in modern life, the unconscious can perceive threats everywhere, as it misinterprets our negative thoughts. Our unconscious minds use experiences to match similar experiences and project future outcomes without us being aware of the process involved.

Quick response

It was scientist Benjamin Libet who discovered that our subconscious response happens 350 milliseconds ahead of us being aware of it. So our subconscious motivates us to act quicker than our conscious minds can respond. See reference paper: https://www.ncbi.nlm.nih.gov/pubmed/6640273

That helps us react to a potential threat before rationalising it. If you were a human living out in the wild. The moment you saw something moving fast towards you, you would not be thinking, “I wonder what type of animal that is?” or “I wonder if it’s recently eaten?”. No, you’d be running up the closest tree, or as far as you could go before checking it had gone.

The difference between then and now is that the fight and flight response instead of being triggered occasionally sets off every time we worry about something. Our grades not being good enough to get into University, or enough money in your bank account to last the week.

Adaptive stress response allows your body to run away from a threat. Chronic stress causes many nasty modern-day diseases you rarely saw in your ancestors. Conditions such as high blood pressure, adult-onset diabetes, increase risk of ulcers, suppressed immunity, memory failure, fertility problems, and the list goes on.

Simon, his illness and his fear of driving

Simon was a professional in the IT industry. He’d been on holiday in Devon when struck down by a nasty virus that hospitalised him for two months. Finally recovered, the trauma of the events and the realisation there was no immunity to serious health problems meant the development of panic attacks. Mostly when driving to work. Simon lived about 45 minutes from work and was having to stop the car, get out and walk until he calmed himself down, virtually every day. He came for SF hypnotherapy to prevent this from happening.

Understanding how the brain works and thinking about why he might panic, Simon concluded that his subconscious had associated him being away from home as dangerous, as the last time he was away – on holiday – he became ill. Logically, he knew it was OK to be away from home. I suggested that next time he felt this way; he pays some attention to what his thoughts were telling him. That backed his theory about the danger of being away from home. Now we had to retrain his brain to realise these negative thoughts weren’t true.

Simon’s case is typical

During my career as a hypnotherapist, I have had many people who have developed driving anxiety because of conflicts at work, conflicts at home, ill-health and overwork.

Often clients why it manifests in the driving, but as it’s an activity that can be stressful, our capacity to operate past an amount of stress leads us to give in. It’s often called spare capacity and can be part of burnout. When loaded with too many stressful situations, any additional stress can cause a breakdown or a phobic response.

In Simon’s case, we initially worked on lowering his anxiety by relaxation, visualisation and tools to stop him panicking such as breathing techniques, NLP, and mindfulness techniques. We then looked at other things he could do if caught in a traffic jam and reframed the journey by visualisations on the drive to work being a positive experience. He could listen to his favourite music, for example.

We worked for over three months, and once he completed the programme, he could get back to a standard routine again.


The difference between Stress & Anxiety

Stress is a response to specific external circumstances. Having a moderate amount of stress can be an advantage as it can help motivate us. Anxiety is often persistent, and sometimes a person may be even unaware they are anxious until some significant problem like IBS (Irritable bowel syndrome) occurs.

Using Hypnosis for Anxiety

Fears and phobias respond well to hypnotherapy (1). A recent review of randomised controlled trials concluded that the use of hypnosis as a sole treatment for anxiety (2) worked best with the addition of talking therapies.
The addition of hypnosis helps the patient in several aspects of therapy, such as the preparation for real-life exposure ( such as handling an object which caused fear before), imagery exposure, developing coping skills, and cognitive restructuring. Patients using hypnosis develop a better sense of self-efficacy, which enhances self-regulation, lower psychological distress and better quality of life.

It also is a fantastic way to relax and switch off the fight and flight areas of the brain. If you feel more relaxed, you’re likely to have a clearer perspective on your situation, compared to someone just going through CBT thought sheets which could be stressful.

In 2006 they carried out a study into the anxiety suffered before operations. On entrance to the operating rooms, the hypnosis group reported a significant decrease of 56% in their anxiety level. In contrast, the attention-control group reported an increase of 10% in anxiety and the control group reported a rise of 47% in their distress.

In conclusion, they found that hypnosis significantly eases preoperative anxiety. We need future studies to examine the effects of preoperative hypnosis on postoperative outcomes. – There is evidence that pre-stress levels determine one’s health risks post-operation – and that stress affects one’s immune system; it is highly likely that hypnotised patients recover much quicker.


Panic and perfectionism

Liane was in her second year at University, and she was having problems focusing. The stress of having to keep at the top of her class was so bad she could no longer function. Liane had been for counselling but didn’t find it helpful; she also had been for CBT and mindfulness, which were more useful but hadn’t tackled the feelings of panic. She wasn’t sleeping, and she was missing deadlines as she became such a perfectionist in her work she couldn’t finish it in time. Tutors told her that if she didn’t buckle down, Liane would fail that year. Leading Liane to catastrophizing, not only about her life ruined forever, but she’d never amount to anything what so ever.

She looked gaunt and unhealthy, her hair full of product and wearing a lot of makeup. Crying one minute and wringing her hands the next. I gave her some water to sip and asked her to take a few deep breaths.
I explained what was going on in her brain and why she was experiencing these problems. I wanted to know what she wanted.

Goal for therapy

Her goal for therapy included an extensive list, so we first looked at all the minor changes she could make almost immediately, including producing a realistic timetable.

She concluded she needed to be stricter on herself to stick to the timetable. Her perfectionism meant she spent far too long agonising over the unimportant details. As a design student, a fair amount of her work was creative, and this creativity was drying up.

Her miracle questions the answer was to feel normal again to finish everything needed by the end of the summer term. We had 12 weeks, thankfully.

For a good few weeks, we worked solely on relaxation, breathing techniques for panic and getting her sleep back to normal.

Confidence returning

She also was taking too much time on her appearance as confidence in this area was low. She agreed to several experiments to see if leaving off her makeup and wearing different clothing lead to any negative remarks, which they didn’t. She could feel more confident in the company of others and took up several new hobbies, which would mean she interacted with others in a social setting.

She also ate more regular meals. Up to now, she would often skip meals because of time and because her anxiety was making her feel slightly nauseous. Gradually, as the stress reduced, she could start eating breakfast, and she noted it improved her concentration and focus.

By session ten, she was feeling much better, her eating had improved, and she realised how easily she could have developed an eating disorder. She took better care in her appearance and said others had noticed how withdrawn she had been, and she was balancing her life/work out more easily. She had timetabled her revision and had three weeks until her exams, and she felt terrific.


A second opinion

I always state categorically I am not there to make a diagnosis, but sometimes a clients symptom does not fit well with what I’m seeing, so I insist they get a second opinion.

Clara came to me because she kept falling over and felt shaky. Her private doctor put her on blood pressure medication and told her that her dizzy spells were her body getting used to the pressure levels. We thoroughly went through her lifestyle – her diet, exercise regime and general stress levels. There are two types of hypertension, one is a lifestyle the other associated with kidney disease. Her lifestyle appeared fine.

We started the usual six weeks of lowering stress levels using relaxation, breathing techniques, mindfulness and sleep hygiene. But her symptoms were getting worse, especially falling over. I was adamant she went back to her GP to check out her balance and ears. She came back the next week, her doctor was adamant; it was her blood pressure. Still not convinced, I suggested she was insistent on a second opinion, which I’m glad to say she took. After tests, it turned out she had early stage Parkinson’s disease.
Interestingly, during the first part of our session, her hands would often shake gently, but once on the couch and in a trance, this shaking stopped.


Wide range of problems

Anxiety covers an entire range of problems, from the nurse who develops hypochondria, because of her constant exposure to sick people; To those who have, or survive, cancer and the impact of the disease and sudden realisation that they are mortal sends them into a spin.

Amongst the elderly, a fear of falling over may develop into agoraphobia, or shaking which mimics Parkinson’s disease. In the young, it’s often just lack of experience and self-doubt which may bring someone to seek help.
It could even be the side effects of drinking too much energy drinks. Taurine, which is the principal ingredient in many famous brand energy drinks, has the same effect on the body as anxiety. People report feeling jittery. One young chap came to see me because he started suffering from panic attacks after nights out with friends. I was not at all surprised when asked what he was drinking he replied 8 or 9 Vodka and Red bulls. Once he realised that it could be the amount of caffeine in his system, we went through other beverages he could drink instead, and he settled on lager. I asked him to see me a week later, and he told me he’d suffered none of the previous nervousness or panic.


After an accident

J_ had contacted me after a friend had seen me for fear of singing in public. She had an accident at work which had caused trauma to the muscles which attach to her ribs. Consequently, J_ became anxious to make any movements. Placed on a high dose of pain killers, the anxiety meant she couldn’t leave home and had to have her husband bring her to the clinic.

Each week we worked building up small steps to recovery, starting with her managing to walk around the house calmly.  She pushed herself further and further, first down to the bottom of the road, then for a walk to the park. As the pain subsided, there were a few complications, but she began to take these in her stride.

Two Goals

There were two goals, one to get her fitness back so she could go to work, and to dance again. Listening to the MP3, practising the tools I taught her, J_ made good progress. It wasn’t fast, but it was at a pace which she felt necessary to recover.

Here’s J_’s testimonial –

“When I first met Penny, I was suffering a chest trauma which made me feel very anxious and stressed. Penny made me feel totally at ease. Over the following weeks, our sessions became life-transforming, I was having daily panic attacks and was unable to go out socially. Penny has helped to reignite my focus on positivity and purpose. Penny is a very kind and compassionate person, and I’m very grateful for all her help and guidance.”


References
1) http://www.ncbi.nlm.nih.gov/pubmed/9469526 - Stress-reducing strategies are useful in patients undergoing surgery. Hypnosis is also known to alleviate acute and chronic pain. Plus http://www.ncbi.nlm.nih.gov/pubmed/16632816
2) Alladin A. Handbook of cognitive hypnotherapy for depression: an evidence-based approach. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2007. http://www.tandfonline.com/doi/abs/10.1080/00207140601177897#.VLPxadKsWYc 

3) Coelho HF, Canter PH, Ernst E. The effectiveness of hypnosis for the treatment of anxiety: A systematic review. Primary Care & Community Psychiatry. 2008;12(2):49-63.

4) Kirsch I, Montgomery G, Sapirstein G. Hypnosis as an adjunct to cognitive-behavioural psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology. 1995;63(2):214-20.

Also:
Bryant, Richard A. (2008). Hypnosis and Anxiety: Early Interventions. In Nash, Michael R. (Ed); Bamier, Amanda J. (Ed). The Oxford Handbook of Hypnosis: Theory, Research, and Practice (pp.535-547). New York, NY: Oxford University Press.

Kraft, Tom; Kraft, David. (Nov 2006). The Place of Hypnosis in Psychiatry: Its Applications in Treating Anxiety Disorders and Sleep Disturbances, Australian Journal of Clinical & Experimental Hypnosis, Vol 34(2), 187-203,