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brief therapy

Brief Therapy hypnosis

I met a client today with travel anxiety problems.  He told me that he had been seeing another therapist for almost a year. This therapist had charged him thousands of dollars without creating any change in how he felt.

I find it astonishing that a client can continue charging someone week after week even though the client is getting no benefit. I find it even more disturbing that there are therapists who are so unprofessional as to encourage that. To my mind, applying the same therapy technique over and over, and producing no a significant change, is verging on fraud.

Hypnotherapy is brief therapy. In my practice, if I cannot make a definite, obvious difference in two session, then I advise the client that they may be better to find a different treatment.

Hypnotherapy is brief therapy

Hypnotherapy should be a brief therapy. The common distinguishing features of brief therapies of all types are:

1. Typically between one and twenty sessions.

2. Uses a rapid assessment to identify a core issue

3. Establishes and agrees  a specific therapeutic goal.

4. Focuses each session on that therapeutic goal

5. Active and direct interventions from the therapist.

Most common number of sessions = one

Research on therapy effectiveness investigated how many psychotherapy sessions clients actually attended (Talmon, 1990). It was found that:

(1) the modal length of therapy for every one of the therapists monitored was a single session;

(2) 30% of all clients chose to come for only one session in a given twelve month period; and

(3) there was essentially no correlation in a follow-up study between what the client stated helped them, and what the therapist thought was helpful in that session:

‘in most of the single-session therapy cases where patients reported particularly successful outcomes, the therapist appeared to have conducted a rather simple, almost dull session. In fact, in many successful single sessions, it is the patient who appears in control and sets the pace for change’ (p111).

This truth needs to be made clear to most hypnotherapists: you will probably only see the client for one session, whether you are successful or not. So you better get better at brief therapy.

 

What do you think of brief therapy? Would you go on seeing a client for years? 

 

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home invasion anxiety

Home invasion anxiety removed

I had a client yesterday who told me she needed help with anxiety. She said she had been diagnosed with Generalized Anxiety Disorder. She said she had been on anti-anxiety medication for five years. Five years ago her marriage was on the rocks, she was being made redundant at work, and a parent was seriously ill. In her own words 'she went into meltdown' and had to be put on anxiety medication. This is a fairly normal description of a cluster of life events that triggers anxiety. However, I wondered why she was still anxious five years later.

Home invasion anxiety

I asked her what she thought the cause was. She immediately said "it is all about a home invasion I had when I was a kid. I woke up to find some man sitting on my bed". She was convinced that she had dealt with that. However, her current anxiety focussed on night-time, on being left alone, and on a fear of someone harming her.

I recently read a book by Peter Levine 'In an unspoken voice'.  His belief is that almost all anxiety comes from being in a situation that you feel powerless to escape from. Not dealing with the situation properly at the time leaves you trapped in that feeling for ever. The symptoms of this client fitted that description completely.

I thought this might be an ideal opportunity to try out the therapy recommended by Levine. This treatment basically involves muscle memory. You get the client to remember the incident, if possible to get into the fear. Then you get the client to use their muscles as they would have if they had made their escape. His theory is that the fear is 'frozen' into the victim's muscles, and needs to be released.

Releasing the home invasion anxiety 

He does not mention hypnosis at all but his recommendations lend themselves ideally to application in trance. I therefore put her into trance used a modified form of regression. I took her back to the home invasion, but instead of getting her to relive it, I suggested that she focus on the feeling. Then I told her to tense and release the muscles in her shoulders, and then her chest, and so on down her body.

I then suggested that she focus on her hands, and to become aware of what her hands wanted to do. I encouraged her to make micromovements as she thought about what she wanted to do. Then I asked her to imagine what muscle movements she would do if she was to fight the intruder, or she quickly got out of the bed, or if she pushed an alarm button. I took her through various scenarios that I thought might be appropriate ways of dealing with the situation. I tried to get her to talk through what she might have done, but she was unwilling or unable to hold a conversation while in trance.

After that, I brought her out of trance, and showed her how to go back into trance by herself using self hypnosis. I did this to teach her a technique that would allow her to turn off her chronic anxiety by resetting her feelings back to a calm level.

Clearing the Home Invasion anxiety

At the end of the session I asked her what she felt about the micromovements. She told me that had felt a tingling all over her body as she tensed and relaxed. She then said that the feeling of 'waiting for something to happen' that she always had, was gone.

I wonder to what extent the 'cures' that are credited to hypnosis are actually the result of the induction that most therapists use, the Progressive Muscle Relaxation Induction? It may be that it is the progressive tensing and relaxing that are doing the work, and all the 'patter' is actually irrelevent. It is maybe something to think about?

 

What do you think of this technique? Do we hold fear in our muscles for years? Share your ideas below.

 

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say nothing

Train yourself to say nothing

I got an email today from someone looking for help with their client.

I'm looking for a script that will help eliminate a person from using aahs and ands when he is speaking to groups. He strings his sentences together with and and when he is thinking what to say next he says aah. Do you have anything that would work or that I could tweak to help him?

My reply was:

I have been a university lecturer for over 40 years. Like most speakers, I too used to uummm and ahhhhh during lectures. I only became aware of it after I had to  transcribe some of my lectures. It was embarrassing the number of 'hesitation' noises I made when talking to my classes.

I set out to get rid of them and I have succeeded totally. The trick is to become aware of them. As soon as you become aware of them you can avoid standing there making noises just to fill in the gaps. I found that there are two methods you can use.

Make sure you have something to say.

The first one is to not start speaking without knowing what you're going to say. When you are a teacher or a lecturer you feel there is an intense pressure to talk all the time. You need to show that you have something to say. This in fact is not true. It is immensely freeing to be able to say "I don't know". You can then say "what do you think the answer might be?" Or you can say, "I'll do my best to find out and I will explain it in class next time we meet." Or  just say "let me think about that for a moment, talk amongst yourselves". Once you realize that that is no need to keep up the continuous flow of speech your speaking becomes much more natural.

Train yourself to say nothing.

The second thing you can do is when you don't know what to say next, say nothing. This is my preferred method. When I am searching for the next word, looking for the right phrase, or even when I got no idea whatsoever, I just pause. I make no sound whatsoever. And the great thing is, that most people don't even notice. And certainly, nobody cares.

That is by far the easiest way to get rid of the unnecessary Ummms, Ahhhhs, "youknow", 'like' and all the other fillers. So what I suggest you do with your client is to plant a post hypnotic suggestion that he will become acutely aware of every time he utters a filler noise. And that when he is about to say some pointless syllable he actually stops, pauses in silence, and gives his brain time to catch up with his lips.

I think that will be the easiest way to help your client.

 

How would you deal with this ? Share your ideas below.

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procrastination perfectionism

Procrastination Perfectionism

Every day brings an interesting client. My client today had procrastination. He is finishing university this year. He has one more course to finish and his degree will be complete. He failed the course last year and now he cannot get down to studying what he has to do for this year. If he fails this time he will fail the whole degree.

Typically a therapist would suspect that this client either is afraid of failing or is afraid of succeeding. And indeed when he gets his degree he will be taking up a job overseas. He will have to give up the comfortable life of a student, so there is the fear of the unknown.

Procrastination Perfectionism

However, when I questioned him further it was obvious that he was actually suffering from undiagnosed depression. He had all the symptoms, and in particular, black and white thinking. In his case this was in the form of perfectionism. Procrastination Perfectionism is very common. 

He felt that if he was not going to do well in the exam and pass with outstanding marks then he was a complete failure. He had failed before so he wasn't sure that he would pass this time. That little voice in his head was saying  'You might as well not bother'. And so he was demotivating himself over and over. As the deadline crept nearer it got more and more likely that he would indeed fail. So it became an ever diminishing circle of anxiety and recrimination, and negative thinking. And the more pressure he put on himself the less work he did.

Once the situation was explained to him he could see what was happening and that the key to preventing his procrastination was dealing with the negative thoughts first. We will have to wait and see how this turns out, but it is interesting to me that in all the books I have read on procrastination none has ever suggested the link with depression, expectations and perfectionism.

I think it might be worth researching further.

What do you think? Leave a comment below.

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fear of flying hypnotherapy

Fear of flying hypnotherapy

Fear of flying hypnotherapy

I had an interesting client today who wanted fear of flying hypnotherapy. This client said that she was afraid of flying. Or rather, she was only afraid when they shut the doors. She felt like panicking because she could not get out.

Fear of flying is a difficult thing to deal with therapeutically because you cannot test it directly except by getting on an aeroplane. But this case gave me confirmation of what I believe about fear of flying. Fear of flying has nothing to do with flying. It is simply that the flying experience has been linked unconsciously with some other source of fear, and the flying triggers that original fear. No amount of dealing with the flying will help - you have deal with the original fear.

It all started when she was on a plane about six months ago, waiting to take off. She was reading about some trapped miners. She was already empathizing with the trapped miners, and feeling their fear, when the attendant said several times that the doors were going to be closed. This increased the feeling of suffocation. She immediately wanted to get off but couldn't, and that increased the feeling of suffocation.

Fear of flying control

Every time she got on a plane after that she had that same feeling of being shut in. This then began to be transferred to the car and to lifts. She suggested that it might come from when she was locked in a cupboard by her brother, or locked in under the house with her other brother. I suspected it was something emotional, so asked her about the big things that happened when she was growing up.

She said that her father was unfaithful when she was 13 and the family threatened to break up, although it never did. But there was always tension, and she felt she had to look after both of them after that.

She also said that along with the suffocating feeling, since the flying incident she felt increasingly that she had to be in control and worried about lack of control. Mother had been very controlling.

Also said she had recently begun to have tinnitus.

This was quite a collection of symptoms, and I was wondering what on earth could connect them all together, or even if they were connected.

I started by discussing her feelings of lack of control. It quickly became obvious that she had many symptoms of dysthymia, the little cousin of depression. One of the main symptoms of depression is called black and white thinking. Things are either right, or they are totally bad. Things are either going the way you think they should or they are out of control.

It never occurred to me before that feelings of lack of control can actually be linked to depression. On reflection, the escalating fear was making her feel bad all the time so it would not be surprising to start to get depressed if you were already susceptible to it.

Fear of flying Hypnotherapy session

For the hypnotherapy, I started with a rapid induction, she started laughing part way through. I interpreted this as fear of losing control. I switched to kinaesthetic induction, feel your breath as it goes in, and got better results. Then to a countdown induction, going into an old house, more laughing but I kept going. As the countdown continued I was suggesting that she was going deeper into that house and down a corridor.

As I was talking she went into trance and then she was ahead of me and started weeping. I asked what she was getting - she said the corridor took her back in time, and she getting a feeling of suffocating in her throat and ears.
When I get such a clear feeling I always go with Metaphor Replacement. I asked what the feeling most resembled. It was a rectangle, dark red, about 30 x 10 cm. It was filled with fear.

Clearing the fear

I used the replacement therapy to shrink it. When I asked what she wanted to replace it with, she wanted air in its place.
So we filled it with air. She was no longer suffocating. I then tested it with a visualization of being in a plane. Said she felt OK.
Then I did an extended metaphor on the air theme. I led her into a visualization of being in that old house. She threw open all the windows, let the fresh air in, looked outside to the future, then started walking away from the house. I took her to a stream and put her naked in the stream to wash away all that old stuff. Then she got new clothes and walked away from it. I had no idea what it was that she was fearing but I felt that as long as I was taking her away from it in metaphor, her mind would figure out what the real issue was.

I then did some direct suggestion and counted her back to full awareness.

Fear of flying origin

She said she remembered after the infidelity came out, a scene with her mother pretending to read the paper and her father trying to find something to say and them not communicating. They spend the rest of their marriage not communicating. She realized she would have to fix both of them and that was the day she grew up before her time.

The whole atmosphere was one of immovable tension and for her a suffocating feeling of not being able to get away. Of course, the "not communicating" suggested an interesting link between 'not listening' and the tinnitus.

She thought that she had already dealt with it because she had gone over the memory many times, but obviously she had not because that was the root of her problem.

The human mind is endlessly fascinating.

Your experience

I felt that this case was quite significant. It got me thinking about the whole fear of flying hypnotherapy approach. I wonder what your experience of dealing with fear of flying is?

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mind goes black hypnotherapy

Mind goes blank hypnotherapy

Mind goes blank hypnotherapy

A reader emailed me and said: Sometimes when people ask me questions that I do know the answer for, my mind goes blank, for no reason. I know I know the answer, but I just cannot get the words out.

This is quite common of course, most people suffer from it from time to time. But if it happens a lot, or in specific situations then you need some therapy. What is happening is that you are being asked a question, you know the answer, but before you say it, a bit of doubt creeps in, either that you might be wrong, or that the answer will not please the other person. This sets off a mini panic attack, in which your mind goes into fight-or-flight mode and everything else is cleared away so that you can make a break for safety. That is why you get the feeling of 'blank' - your conscious mind has been pushed away and you are operating directly in your unconscious mind.

Fight or flight response

Of course another part of your mind knows that there is no need to run away. So you end stuck, you have no access to your conscious mind that knows what to say, and you are ready to run but rooted to the spot. The result is you end up tongue tied, unable to speak and feeling stupid. Exactly the situation you feared.

The basic problem is low esteem or low self confidence. The recommended treatment is to provide therapy to increase the person's self confidence.

Mind goes blank hypnotherapy

This can be done in several ways:

a) Regression to cause. Find the first time that the client felt really unsure of what to say, some situation that made them doubt what to do, and clear that by inner child work

b) Scripts. Use an 'ego strengthening' script to make the client feel confident about their abilities in all situations.

c) Self Hypnosis. Teach the client how to relax, and how to access their own resources. Applied relaxation techniques will stop the panic attacks as they start. By squishing them right away the person can stay in control of the situation.

What do you think?

Do you suffer from going blank? What works for you? How do you fix it for other people?

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Controlling Clients

Hypnotizing Controlling Clients

Hypnotizing Controlling Clients

Controlling Clients are always difficult. Today I saw what was perhaps the most difficult client I have ever had. She was not being deliberately difficult, but every techniques I tried just didn't seem to work. I first saw her last August. At that time I could not hypnotize her. She was constantly internally challenging everything I said. She analysed every word, doing everything except doing what I wanted her to. My policy in those cases is to send her home with some hypnotic CDs to listen to. Then come back when she has learned to let go enough to go into trance reliably.

Today she said the CDs annoyed her. The imagery did not suit her. She was constantly analyzing why I used certain words, and frankly the whole recording irritated her. The recordings might have made her a little more physically relaxed. But she was never hypnotized.

Anxiety and the need for control

She clearly has anxiety and hypervigilance but she was still unable to tell me what trauma she had. She said that there is nothing there to find. Her problem was a fear of earthquakes in high buildings. The obvious approach is to use regression. I thought that she might have had some effect from the CDs. So I again tried to hypnotize her, going very slowly and carefully. But as I approached the feeling the fear part she smugly told me that she wasn't feeling anything.

However,  I saw clear signs of trance. It seemed to me that she actually was going into trance, but as soon as she felt herself losing control she popped right out again. She could not reduce the rate of her breathing during the induction. She was breathing very shallow. This  was to me another indicator that she has some sort of chronic anxiety.

Controlling Clients means giving them control

So decided to approach hypnosis indirectly. We talked about our options and how I didn't have any. I told her I really didn't know what else to do. I explained the theory of hypnosis. The best I could do was to teach her self hypnosis, but  I warned her there was a danger of an abreaction.

She asked me how she would do that . So I proceeded to show her. I told her that I was going to take her through the steps of self hypnosis.  She should pay close attention because she needed to control the stages. That way she would be able to do it herself when she gets home.

I therefore started on physical relaxation, then breathing focus, then finding a safe place. Then told her to empty her mind, stack any stray thoughts over to one side, treat them like puppies and shoo them out the door. Then I suggested that now her body was relaxed and her mind was empty, she need to practice controlling her mind. I did a long series of suggestions about finding a color and shrinking it down to a point of light. Then I suggested she might find herself floating inside that light. Her head started to nod, and her eyes were moving under hey eyelids in response to my suggestions. She was clearly in trance.

Getting a Controlling Client into trance

I then led on a metaphoric journey with lots of symbolic interactions as a form of therapy. Then I got her to count herself out. The moment I suggested that she opened eyes she told me she hadn't been in trance!

Now she obviously had been, so I asked her to tell me what I had talked about. At that point she realized that in fact large chunks were missing. What she had done was to go deep into trance in some parts, and then start to come out of trance before I deepened her again. She was remembering only the times when she was in light trance. The times when she was in deep trance she had no memory of. She finally agreed that she had indeed been in trance.

The technique for hypnotizing controlling clients is to let them think that they are in control. Telling her that I was going to teach her self hypnosis by-passed all her defences. As she followed along with my instructions she naturally led herself  down into trance. All the same, I was very relieved when she finally did succumb. 

What do you think?

I wonder what other hypnotists do to deal with clients who won't give up control? What do you think is the best technique?

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Stress from childhood

Is your Stress from childhood memories?

Stress from childhood

My client was a senior manager in a construction company. He came to me because he was getting more and more stressed. It was affecting his work, and it was beginning to show. He could nut understand why he was getting stressed so badly. His job was high powered, he had been doing it for many years, he was successful and had a great future. He was a big tough guy in an industry full of big tough guys. And yet, something was really getting to him. He not only had stress, he was getting distressed. 

I started trying to find out exactly what he meant by "stress". He told me there was only one thing worrying him.  He had personally championed bid for a big government contract, and had got it. That contract was going to make the company truckloads of money. If they could pull it off. It was going OK, but as it ramped up, he could see shortages of key components, and of the skilled labour needed. He worried he might not be able to source these. Somehow, this was really winding him up.

Stress from childhood feelings

He was not able to identify any specific thing about this contract that was different from any other contract. He had thought about it himself, but could find no explanation. I asked him, "How do you feel about the problems with that contact? How it make you feel inside?" I encouraged him to go inside, to allow the feelings to come out. 

This immediately brought out a whole lot of unhappy memories. He was not close to his stepfather. His mother left his father and married his father's best friend, my client's stepfather. My client was distressed that he in fact had been named for this other man. The memories caused him to get more distressed and he started crying. His emotions were clearly right at the surface so I decided to go for a metaphor replacement therapy.

Exploring his feelings with Metaphor Therapy

I asked him "what are you feeling right now? What is it like?" He said it was like a ball about the size of a fist. A  heavy weight. Black, cold, not smooth. He said it was all screwed up and smashed. It was dark and solid. I got him to think about how he could change that thing. He said that when he could get rid of it he could forget all that stuff.

I got into think about that ball. He said that he was carrying it around with him. And got him to make it bigger and smaller and to get it to change. It became full of colours and green. Eventually I got it to go away. But he was still upset.

I explored this remaining feeling. He told me that when he was a child his parents broke up. His mother left his father. She broke off all communication with him. The complete break meant that he was not allowed to see his nana anymore. He loved his grandma, and she was taken away from him. This was what it was all about.

Being unable to have his nana. This was the source of the feelings of unfairness, of the unhappiness, of the feeling of being cheated and deprived. This was what the uncertainty and loss of control of the contract was about. The feelings about the contract were triggering memories of the same helplessness. Every time he thought about the contract going wrong, it brought up those ancient feelings of despair and loss. The current stress was actually rooted in childhood. 

Healing his inner child

So I did inner child work on his feeling about being taken away from his nana. I got him to go back to that little boy. He comforted the boy. I told him to tell that little boy that it was not his fault. "Tell him he did nothing wrong." He changed the boy's feelings and led him out of that place. Then I got him to watch  over the boy as he grew up, and finally reintegrated and reconciled the adult and child.

I think this is the first time I've done inner child work with a man. But the results were spectacular.  He said "I felt a great weight  lifting off me. That feeling just isn't there anymore."

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fear of everything

Fear of Everything

Fear of Everything

I had a really interesting client today. A young woman came in complaining of being anxious all the time, of worrying about things that might go wrong, of distrusting everyone, of never feeling safe except in a group of friends.

Her symptoms were getting worse, she was finding more and more things made her uneasy, and she was getting anxious about whether this would ever stop or if she was slowly going mad. She had started losing all her friends and could see no future if this continued. Her anxiety itself was making her more anxious. She was beginning to think that her life was closing down, and that she was losing her mind.

Sudden violence

She said that she used be the most easy going person around, but that changed about three years ago. I asked her what happened at that time and she described a home invasion by some criminals. They had gone to the wrong house and started to demand things with violence. The client was punched, thrown around, and her father terrorized by these men.

She said it was not a problem as she had seen a psychotherapist and although they did not talk about it directly the psychotherapist said that it did not matter and the anxiety come from something else in her childhood.

I started talking about the home invasion and immediately she looked distressed and tearful. I told her that is was obvious that she had not gotten over it, and that I thought that was the cause of all her problems.

Embodied fear of everything

I explained that what she was experiencing was the body's natural reaction to a sudden unexpected trauma. She had never resolved the fear of the home invasion and that fear was now generalizing to more and more aspects of her life. The fear was made worse because it was totally unexpected. Far from having a bad childhood, as the psychotherapist had said, she actually had a lovely childhood, and felt safe and secure and loved right up to the time that the home invasion occurred. The contrast between her life up to that point and the sudden out of control situation made it even worse. She had no personal experience of violence up to that point, and it made her terrified.

I believe that PTSD is the result of a situation where the person feels that they have had the rug pulled from under their feet; that everything they ever believed in is no longer true; nothing can be relied on; that the world is suddenly seen as a dangerous place. This woman had all of these things and had not been properly counselled as to how to deal with it.

Relieving the fear of everything

I got her to relax, and to think back to the home invasion. She immediately got the feeling of anxiety. I asked her to locate it in her body. Then I got her to turn the feeling into an object, to describe that object in ever increasing detail. Eventually I had her move the object out into her hand and asked her how it seemed now. She replied that it was smaller and not important now. She said she wanted to throw it far away so it couldn't come back.

I got her to do that. Then I brought her back to the present and asked how she felt now. She that all the anxiety had gone, and she was quite looking forward to going out with her friends that night instead of dreading it. As far as I could tell all the problems had disappeared completely.

I thought this case was particularly interesting because it showed clearly how one incident can then expand to dominate the client's life. It also shows that the theories about the mammalian response to life threatening events is correct. 

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sexual dysfunction

Sexual Dysfunction is not always about sex

Sexual Dysfunction is not always about sex

My client came to see me because of sexual dysfunction. He is a fit young man living with a woman he loves. She is keen on sex and so is he, but he keeps losing his erection during the process. She is understandably annoyed and is threatening to end the relationship.

My client told of a disastrous first attempt at sex that left both of them unhappy. He had been at a Christian camp and the object of his desire was also inexperienced. When the two of them met at night in an empty room it was in secrecy and under constant danger of being discovered. He said the whole thing was an embarrassment, nobody got anything out of it. He blamed it on inexperience and the threat of exposure. It was a classic case of a first attempt at sex that goes wrong, and plants the seed of worry that expands and ruins the rest of his life.

Sexual Dysfunction and Regression

Before he came to me he had been to see a different hypnotherapist three times. That therapist asked the usual questions and tried regression, but it did not have the right effect. He is now in a relationship with a woman who he thinks could be 'the one' so he is putting extra pressure on himself and his girlfriend is putting on even more pressure. I couldn't see what I could do that would be different from the regression and general NLP advice that he already got.

And then I got to thinking about that first encounter. A young man, a teenager, should have no problem getting it up. That's what young men are designed for. So I asked a bit more deeply about what went on that night, and particularly about what went on just before his assignation. He revealed that he was worried about what might happen before he even got there, and that everything turned out wrong just as he feared it would.

So I started thinking about why a young lover would be fearful even before the attempt. There must have been some reason why it even crossed his mind that it could go wrong. I tested for anxiety/depression. He has a bit of Introversion and a bit of anxiety thinking, but not full depression. His father had depression. He told of a childhood where his parents divorced when he was ten and he heard them arguing all the time. I concluded that he has hyper vigilance.

Sexual Dysfunction anxiety

I think that he had childhood anxiety and that it was the existing anxiety that made the first sex go wrong, not the bad sex that caused the sexual anxiety. He has underlying anxiety that is making him catastrophize over his past sexual failure. And because he sees this particular woman as his chance at a life partner, he is putting intense pressure on himself because this one must work, or he will miss out for life. This is causing more catastrophizing thoughts, more anxiety, and she is putting more pressure on him to perform, which causes more anxiety and so on.

The interesting thing about this case is that it is not the first sexual encounter that was the Initial Sensitizing Event (ISE) and therefore regression is the wrong treatment. There was no ISE. What was there was chronic anxiety from childhood, that happens to be expressing itself as sexual performance problems.

The solution therefore is to treat the anxiety. And that's what I did.

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