A typical case of anxiety and the stages of treating this issue.
The man that could not eat in public.
This case study explains in detail the treatment stages we use in helping someone to resolve their anxiety issues using Hypnotherapy.
An explanation of how with the use of Hypnotherapy I helped a young man overcome fears and anxieties that he had experienced for many years.
Imagine not being able to eat in public for fear of being sick. It is surprisingly common but to most of us it seems very alien.
Simon came to see me with a presenting issue of anxiety and panic attacks. He said he was unable to eat in front of anybody but his family. He was unable to go out with his mates anymore, even to the pub for a drink. The anxiety increased ten fold if any women were in the group. He had been unable to have a relationship with women for the past 5 years. He noticed anxiety in situations with women from around the age of 11. He also had to start presenting a course in the near future, as part of his job, and it was this that had filled him with dread and prompted him to seek help.
Simon was a 23-year old man who, although a little withdrawn, seemed very friendly and likeable. He works at a local company as a computer technician. In his job he did not have to interact with too many people and used to feel safe, until these new responsibilities had been laid at his door. He had created all the usual avoidance techniques.
His anxiety manifested itself by making him physically sick or at the very least retching. Understandably this had proved very embarrassing in passed times, and now the fight or flight response in many situations had been installed.
The client’s goal of therapy – expectation
He said that he wanted to be mentally stronger, to be able to enjoy other people’s company in unfamiliar places, and to stop his irrational thinking.
My aims as the Therapist
My aim was obviously to find and remove any underlying fears that were causing the anxiety, and then to move the client forward to have a few convincers those things were changing; then to build on those successes and allow the client to realise that its okay to feel comfortable in all situations, where appropriate.
I used rapid and progressive relaxation inductions, and during the therapy I used hypno-analysis, gestalt, suggestion, metaphor, timeline and NLP.
Treatment: session 1
During the initial interview we established that he had a very good and stable home life. He has two sisters, one 4 years older and one 6 years older than him. He has a very loving relationship with all his family.
We established that he became very anxious in new situations, especially where he would be required to eat. For example, if he were invited to the pub for lunch he would decline because he was afraid that he might be sick in front of his work colleagues.
During these feelings of panic, he would get a wave of anxiety rushing up from his stomach to his throat. Using an NLP technique, I anchored the feeling of a wave travelling in the opposite direction to him, by pressing his thumb and finger together. In future anytime he felt this feeling of panic, he could destroy the wave using this “finger tool”. We future paced this and he found it to be very effective.
As the session was drawing to an end I simply induced hypnosis using a modified Elman technique. I then used a metaphor about feeling really good in public and how it was possible for him to be calm and relaxed any time he needed to be, reinforcing the “finger tool”.
During the pre-hypnosis interview, we discovered that he had an overwhelming fear of loss of control and a fear of criticism. He also reported that the “finger tool” was working very well, and he had quelled several panic attacks that week. He felt as though he had a greater measure of control.
During the hypnosis I regressed Simon back to the first time he felt these feelings of panic and loss of control. He went straight back to a time aged 11, when he joined a new school. He had felt very overwhelmed and scared as it was very formal and he felt lost. During this time he had tried to make himself as small and insignificant as possible in the hope that nobody would notice him. Unfortunately this did not work and he was bullied for quite a time when he first started at this school. He always tried to make sure everything was perfect so as not to draw attention to himself. After doing integration and allowing him to realise that this could well be the reason for his fear of criticism, I went on to do some direct suggestion work on his perfectionism.
During this session Simon explained he felt that his control was still increasing, and he had not had a panic attack all week. In fact he reported that he had felt increasingly calm.
Simon asked me if we could concentrate on his anxiety over eating in front of people as he had a function coming up at work soon. I did some direct suggestion work based on his anxiety regarding eating, as well as future pacing him out with some friends, eating calmly and really enjoying himself. Upon termination of the hypnosis Simon reported that he felt really excited when he had seen himself eating calmly in front of his friends. However there was a certain amount of doubt as to whether he would really feel that way. I asked him to try it and to give me feedback on how it went the following week, which he said he would.
At the start of this session Simon explained that he had had limited success with regards to the eating. He had been able to eat in front of his mates i.e. male friends, but still felt extremely self-conscious in front of women.
In the hypnosis session I instigated a regression back to the first time he really felt self-conscious in front of women. Again it was when he was 11. His sisters and their friends were there taking the micky out of him because his voice was breaking. I had him review this event and did the integration work.
The second event was much more recent. It was a failed relationship that occurred when he was 18. It transpired that he had really trusted her but she had an affair and they had split up. It would appear that this event really seemed to knock his self-confidence with regard to women. We did some gestalt work with this woman and he told her how he really felt about the affair, and the consequential breakdown of the relationship. There seemed to be some very intense feelings still in evidence. After doing the integration work I terminated the trance.
Session 5 (Final Session)
In this session Simon reported that he had thought long and hard about the relationship we had worked on last week, and had come to the conclusion that this was part of his reticence with regard to being around women. He explained that during this week he had been out to the pub for lunch with two of the girls at work, where he had had a sandwich and a pint. Although he thought this was only a small step, he was really pleased as his anxiety levels, although somewhat high at the start, dropped to zero after about 10 minutes. He felt confident that he would be fine the next time.
I did some suggestion work for rebuilding trust in relationships and brought the session to a close. Simon felt that he had come a long way since the start so I suggested a break where he could try out these new patterns of behaviour.
Simon called me four weeks later to report on his successes. He told me that he felt so much better about himself since his sessions. He could now go out in a social environment in a calm and confident way. He had also started a relationship with a girl he had known for sometime but always kept at arm’s length. His fear of criticism had reduced and in fact he has now taken on the job of doing in-house IT training for the staff in his company. This filled him with dread before our sessions.
Conclusions and Recommendations
Simon was a very good hypnotic subject. He was very easy to work with, given his abilities to visualise. He seemed willing to take things on board very quickly and he was always willing to work to make things right for himself.
During our sessions I could almost watch him grow. The changes were so profound that it almost seemed to make his head spin.
After we had finished working together, I saw Simon 3 months later in a local pub. He was with a group of friends and he seemed to be having a good time. He was interacting well with both the men and the women. Although I didn’t make my presence known to him he did notice me later in the evening – and sent a huge smile my way!
Paul Howard is an anxiety specialist and has been helping clients with anxiety for nearly ten years. He has trained many hypnotherapists around the country to treat in particular agoraphobia and social phobia effectively. He works at The Surrey Institute of Clinical Hypnotherapy in Wallington, Surrey, UK. He can be contacted ve the website at www.sich.co.uk. He is also director for The National Council for Hypnotherapy.