Category: Anxiety

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? 

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 irrelevant. 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.