Discuss the relationship between stress, anxiety, habits and phobias and describe how you would treat these issues with hypnotherapy. In order to understand the relationship between stress, anxiety, habits and phobias, it is necessary to first define what each one is and how it affects us. Stress is a condition that most of us have experienced throughout our lives and in the main it is a positive emotion and it can help us to become motivated reaching our potential positively and productively. However, stress can also manifest itself in a negative and weakening way whereby the individual becomes overwhelmed and the balance that would normally achieve positive behaviours and actions becomes skewed - the very opposite can happen - where we are affected in a debilitating way, unable to cope with day to day actions and demands. (Module 5 notes) Feelings of stress come from any situation in which we feel frustrated, angry or anxious and where there is a fear or a change that will take place. Stress is the result of changes that take place in your body when you are faced with a threat. This is the body's built in survival method also know as Fight or Flight. The subconscious is responsible for our survival and is does this by creating the fight or flight mechanism in us in situations where we feel threatened or when we feel threatened. In situations of fear or change we have to decide if we run away or fight. (Module 5 notes) There are 6 different types of stress:

Hypostress – when the person is bored or unchallenged and lacking in motivation. An example of when this can manifest is if the person is doing a repetitive job and finds it difficult to be motivated in other areas of their lives. Eustress – short term positive stress that gives us the strength and motivation we need to complete a task. It occurs when we have increased our physical activity and creativity and it is positive

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Acute Stress – negative stress. It is felt through tension and physical disturbances and can be treated by various relaxation and coping strategies.

Episodic Acute Stress - a more damaging form of stress and has symptoms such as hypertension, migraines , strokes and heart attacks and often is treated through medical intervention to be brought under control.

Chronic Stress – a serious state that seems to have no end. It is characterised by serious disease and although it is treatable can take years to be brought under control.

Traumatic Stress - result of a massive acute stress which is often cumulative . Post traumatic stress falls under this category and should be treated by qualified people within a multi disciplinary team. (Module 5 notes) Anxiety is commonly linked to stress and it is the set of feelings we get when we feel apprehension or fear. We can feel anxiety when we are subjected to long term stress or when we feel threatened by something or someone. It can affect our whole being and it creates a feeling of fear and forboding, making us want to avoid situations and persistently think negative thoughts that are often unfounded and unwarranted. Due to the feelings that anxiety creates in us it is a cyclical process whereby the more anxious we feel then the greater the need to avoid the things that make us feel anxious thus having severe debilitating effects on everyday life. It can be accompanied by physical symptoms and reactions including trembling, nausea, tense muscles, sweating, and headaches. “Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying. These disorders affect how we feel and behave, and they can manifest real physical symptoms. Mild anxiety is vague and unsettling, while severe anxiety can be extremely debilitating, having a serious impact on daily life”.Often anxiety is inherited or results from something that has happened in the past and it is such instances that act as triggers for feelings of anxiety. As Karle and Boyes point out the symptom of anxiety often has its roots in traumatic experiences, most often in childhood and the recovery into consciousness of a previously repressed memory of such an event may produce relief.

For example a person may begin to feel anxiety at the thought of going to a specific place as some years previously they had a fall there and they have avoided going back for fear of falling again. Negative thoughts caused the anxiety which caused the lack of confidence in going to that place again. “A phobia is an obsessive and irrational fear and avoidance of people, places, objects or situations” (Hadley and Staudacher p98). Phobias are different from generalized anxiety disorders. A phobia has a fear response identified with a specific cause. The fear may be acknowledged as irrational or unnecessary, but the person is still unable to control the anxiety that results. Stimuli for phobia may be as varied as situations, animals, or everyday objects. For example, agoraphobia occurs when one avoids a place or situation to avoid an anxiety or panic attack.

The physical reactions vary in severity from mild to intense and typical symptoms can include sweaty palms, erratic heartbeat, nausea, muscle tension, shortness of breath, blurred vision and fainting. Not all fears are harmful, however and they can in fact be useful eg being aware of traffic and a fear of harm is more likely to keep you safe. Useless fears include excessive heights or fear of spiders or snakes but this is dependent on the persons environment (if a person lived in an enviroment where there was poisonous sneks or spiders this fear would be perfectly valid!) “ A person with a useless fear that is magnified into a simple phobia can most often function quite well by avoiding the one object/place/ situation that stimulates fear”.

Karle and Boyes highlight the technique of Systematic Desensitization for treatment of phobias. It works on the principle that anxiety and tension cannot co exist with relaxation and peace of mind. If an individual is rendered anxious spontaneously and then relaxation is induced the anxiety will diminish and even cease. If this method is repeated frequently enough the anxiety from the original reaction will be extinguished. This technique is met with some degree of scepticism from phobic patients looking for treatment. This is because as phobic patients either force themselves to endure the situation and their own reaction in the hope that repeated exposure will extinguish their response and experience relief from their anxiety only when they finally escape from. They find that in practice that their condition is made no better by this and their phobia may increase in severity. Some avoid the situation completely as soon as their anxiety rises and thereby gain relief through avoidance perpetuate their condition.

There are times when a phobia happens due to a past trauma. It can either be subconscious or conscious. You can be aware of the trauma or have buried it deep so you have no conscious recollection. Not all phobias are seen in the same way to everyone. If a person has a phobia with spiders, another person may not understand or appreciate their reaction. All forms of phobia should be taken seriously as the person sees their phobia as very true and real, although a phobia may be used for attention. Some people may even enjoy having a strange phobia, if that’s what it is. A habit is something that we do without thinking about it. For instance we could bite our nails or get ready for work in a certain order, sucking our thumb, twirl our rings around or play with our hair. These habits do not cause us any harm or are not detrimental but there are others that can be, affecting our health and well being and our self image such as smoking, comfort eating or hair pulling. The brain relies on habits either to solve a problem quickly or to use the habit to bring pleasure or relieve anxiety. The pleasurable ones are often the hardest to stop such as overeating and drinking alcohol. (Module 5 notes) Some habits are perceived as positive but due to a change in environment of time they become inappropriate and we have to stop for example having a dummy as a child is comforting but there is a point when this is not socially appropriate as an adult and we have to re programme our behaviour and take responsibility to change it.

Other habits can become obsessions and addictions and the therapist must be conscious of any other underlying issues that the client may have and it would be better to check during the first consultation and therapy that the client has no secondary gains. This could cause them to overcome one thing but only to have another ready to step in its shoes. Hypnotherapy can be used to treat all of these conditions to a certain degree and all treatment methods will include an initial consultation with the client where a full and comprehensive assessment will be undertaken using a notation. Within the intitial consultation the therapist must consider the full history of the patients habit and its role in their life including its influence on significant others. Their motives for change and the likely consequence of change should be explored along with the factors that trigger the anxiety, stress, phobia or habit. The patient must be made fully aware that hypnotherapy will relieve them of their habit but not without the effort being made on the part of the patient to want to stop and to want to make lifestyle changes limiting and extinguishing the need to continue to feed their habit and this would be discussed at their initial consultation.

I would also advise the patient to look for support and encouragement additional to hypnotherapeutic treatment and this may include counselling. As an ethical therapist I would ensure that any medications being taken by the client would be discussed. If the patient was currently receiving any prescribed drugs for any mental health diagnosis such as depression, psychiatric condition or any condition resulting from severe stress or anxiety such as heart problems I would refer them to get permission from their doctor before any treatment could be given. I would also refer the patient on to more appropriate professionals as appropriate if I felt that I was unqualified to treat or if another or additional treatment such as counselling or psychotherapy was suitable. I would encourage relaxation techniques for the patient to use at home between sessions and that an individual and personalised screed was written for them, addressing and incorporating particular characteristics/modality and preferences of the client and taking into account specifics that were pertinent and appropriate for their treatment. I would use a permissive from of screed for such conditions. In later sessions this screed would be broken down to concentrate on the main underlying condition with a more generalised focus on lesser or consequential outcomes. However, an authoritarian script could also be used for people with detrimental habits or phobias such as smoking or nail biting, agoraphobia or fear of spiders as it might be a more effective method which still contains imagery, but more directly logical and to the point, such as “close your eyes” and “you will always be in control”.

Their subconscious will pick up on this and help relieve the stress quicker. Anxiety/stress/phobias and habits can all be treated with hypnotherapy and relaxation would be promoted once the client has given the reason for such feelings, if they can recognise it. Explaining hypnosis is a form of relaxation, once they are relaxed the subconscious mind is opened, allowing the changes needed to be made in assisting them to relax and develop coping strategies to become more at ease. Any induction for these conditions would include relaxation, self image therapy and positive suggestions boosting confidence and self esteem such as saying “you are not anxious anymore, as you are confident and in control“. I would try to include trigger words to give confidence and empowerment. I would using permissive method which includes words such as “you could” or “you may like to”. Or as another example, the There should be no advice but remind them of how they want to feel once they are in the relaxed state such as “you are nice and relaxed and at ease with yourself, you feel totally calm and relaxed, your mind and body are totally relaxed”. This will be included in the suggestive therapy, before reorientation. As Heap and Dryden point out, it may be necessary to deliberately provoke a certain degree of anxiety in later sessions as the patient will need to practice how to cope in situations where feelings of anxiety or stress are triggered. One method hypnotherapists have used in their sessions relating to anxiety and stress is that of regression – taking the client back to a time when such incidents causing anxiety began. (Heap and Dryden p35) As part of the hypnotherapeutic treatment I would require as much time as possible to explore the client’s issues and as I would be recommending that the patient would need to undergo a series of sessions in order to effectively explore the possibility of more deep rooted issues relating to the cause of stress, anxiety, phobia or habit.

It would therefore be useful to induce a rapid induction in future sessions and to induce hypnosis more quickly. I would ensure that the patient felt comfortable at each session and I would ask them to focus on an object in the room whilst relaxing in a specified chair. I would then attempt to install a trigger into the induction by way of a key word that the patient could identify with when they had feelings relating to anxiety or stress. In conclusion it can be seen that although each condition has its own identifying features, stress, anxiety, habits and phobias are interrelated and their treatment under hypnotherapy is interlinked. Relaxation techniques should be encouraged throughout treatment and a number of sessions should be agreed with the client according to their condition and the subsequent treatment.