What types of treatment are effective for Anxiety and how does Hypnosis fit in? Dr. Liz gives an overview of Cognitive Behavioral Therapy (CBT), Exposure Therapy, Acceptance and Commitment Therapy (ACT) and Hypnosis. What combination is the most effective for which types of Anxiety? And what happens during Hypnosis for Anxiety?
Tips are given for reducing anxiety.
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Transcript & Additional Thoughts
This is Dr. Liz and I’m so happy to be here today recording this episode of Hypnotize Me, the podcast about hypnosis, transformation, and healing. It’s a gorgeous day here in Florida. It’s October and it’s about a week after hurricane Matthew passed us by. Woohoo. I actually recorded an episode about anxiety the day before the hurricane was going to hit and had some technical problems and so I couldn’t use that episode. Talk about anxiety. Anxiety is completely appropriate when a hurricane is headed your way. Hey so I just want to say that that’s like that episode in one sentence. Anxiety is appropriate when a hurricane is headed your way. You can control it and you need skills to get the things that you need to do done. But everybody is going to have some anxiety there. So just know that that’s normal.
So that is the topic today – anxiety and how hypnosis can be effective for it. So when we talk about hypnosis and anxiety, it is a mixed approach. We’re going to talk about a traditional treatment approach first and then we’ll talk about how it differs in hypnosis when you when someone comes in for anxiety.
Cognitive Behavior Therapy (CBT) for Anxiety
Traditional anxiety treatment mainly uses cognitive behavior therapy, CBT. Or exposure therapy which is a form of cognitive behavior therapy, CBT for short. And that also uses Acceptance and Commitment therapy which is ACT for short. So let’s talk about CBT first. CBT involves identifying and understanding and changing thinking and behavior patterns. So that is the essence of therapy in terms of your thoughts. So a lot of anxiety starts with thoughts. I’m going to translate some of this stuff for you.
When you have a thought . . .
When you have a thought about “oh my god this is going to happen.” You’re thinking about the future and you start to get anxious. So even like someone who has a phobia of, let’s say, Heights. And the they’re picturing themselves up there. They’re not actually up there. They’re just thinking in the future. “Oh my god I’m going to be up there and I’m going to get panicky,” and you know all the panic starts. CBT really talks and focuses on this. Let’s change that self-talk. Let’s change those thoughts. Let’s figure out if we can have some better language go on in your head.
The patients I have in my psychotherapy practice in Broward County, Florida, are actively involved in that. They’re gaining a sense of control with that. They’re armed with tools. We often do worksheets when someone comes in for CBT. I’m big on worksheets. I love worksheets and handouts and I just think they’re wonderful. So we do a lot of that in my practice. We there’s also homework assignments that you do outside of practice. So you learn some skills in the actual therapy session. But then you need to go home and practice the skills. And that’s CBT and you start to catch what you are thinking.
- What are your thoughts saying?
- What is your head saying to you?
- What’s going on in there?
- What kind of self-talk are you doing?
- Are you putting yourself down a lot?
So we start to look at that stuff then.
Exposure therapy, which is a form of CBT, is a process for managing fear and anxiety and that is when someone is gradually exposed to a feared situation or an object. And you learn to become less sensitive to those over time. So it’s particularly effective for obsessive compulsive disorders (OCD), phobias. But it’s also can be used to manage all the anxiety disorders. In CBT if you’re talking about like an anxiety disorder or panic disorder then it’s becoming more and more comfortable with that thing that’s causing you anxiety; that thought that’s causing your anxiety. Exposure therapy is very effective for specific phobias
But I’m too anxious to handle my anxiety!
But some patients feel too anxious to even tolerate it. So it is not like you come in and we throw you to the wolves. No, that’s not what happens. It is like, “Let’s talk about it and get the idea of what’s going on here. Talk about the thoughts that are coming up; talk about the fears. But even then sometimes the thought of it is too anxious to even tolerate any kind of exposure to the thought or the thing that’s making you anxious. So hypnosis can come in here.
The Relaxation Response and anxiety
The relaxation response, which is you get into hypnosis (you’re in a very relaxed state) it is completely opposite to anxiety. You can’t be anxious when you’re in relaxation basically. So hypnosis can come in and say hey OK let’s do some hypnotic desensitisation. Let’s do some hypnosis around this anxiety so that you can experience what it’s like to be relaxed when you’re thinking about this thing that triggers you. And that is really useful for people. And then they may be able to go out and actually be exposed to whatever it is they fear. So that’s a little bit about exposure therapy and how hypnosis operates with it.
Now let’s talk about acceptance and commitment therapy. That’s strategies of mindfulness, living in the moment experiencing feelings, thoughts without judgment, along with commitment to valued life goals. And that is a lot of different exercises we do to increase your sense of mindfulness A very basic one is if you’re driving along in the car and you want to be really mindful about it you would turn off the radio, notice your hands on the steering wheel, notice how that steering wheel feels what is the texture of that steering wheel. Notice where you are in the world.
So often when we drive we tune out. We actually go into a semi hypnotic state. Have you ever been driving along and you find yourself at a different place? Like I remember one time . . . this is way back. I was dating someone who turned out to be my husband later. And he had an automatic pattern that he had done for 10 years. If he’s going from . . . We were living in Miami. So if he’s going from south beach and he’s driving towards 95 his automatic pattern was to drive to Hialeah, which is where he grew up. Instead of driving up to Fort Lauderdale, which is where I lived. And he did that several times. We would leave and we were coming home from being out and we’d end up in Hialeah He was just driving. That’s a perfect example of it.
So when you’re going to be mindful in the car, that’s the opposite. That is like . . . I’m right here . . . my hands are here . . . where am I going and what’s noticed . . . what’s around me . . . notice where I am. That’s an example of mindfulness.
How hypnosis fits into CBT and ACT for Anxiety
We talked to a little bit about it with exposure therapy. You know people often picture hypnosis as coming in. And you lie down on the couch and go in hypnosis and you’re fixed. It doesn’t generally work that way at all. I have to get to know you and know what’s going on so that I can customize the hypnosis to you. So I’ll know what will be most effective for you. So we do talking before I do hypnosis for anxiety and use a mixed approach. We’re doing both worksheets and looking at the patient’s cognitions going on and the thoughts and the fears around it and the automatic thoughts. And the future oriented thoughts. And then we’re doing hypnosis to help you distinguish those. We can look at like cognitions as if they’re captions on a TV screen.
And then when you do that, the client can see those captions. You can take the captions and say, “Oh my god! I need to take a break. I know that a time out is indicated here! I welcome those messages and see them as trying to avert the anxiety trying to turn the storm away before it gets to me!”
So we work on that level as well. And then your body is really learning the relaxation response as you’re in the session. So again you really can’t be in hypnosis and be anxious. You know sometimes your thoughts will start going just like in meditation. You can talk to me during the night and say OK this is what’s happening. And then we can work with that and see. Let’s see if we can go into a relaxation here and that takes some practice for some people particularly for anxiety. It often takes practice. But we’re looking at bodily cues also.
- What setting you off?
- When does it start?
- What’s your first sign in your body that you’re anxious?
Start to notice that because it usually starts somewhere. And then a sudden it’s like oh my god I’m breathing really heavy or my heart’s racing or whatever. It is sometimes that that comes afterwards versus before. And you’re learning images and skills to bring down that anxiety; to bring it down before it escalates, before it gets to where it turns into a hurricane. You’re doing all of that.
Another thing that I always notice is that any therapist doing CBT or ACT is teaching breathing to reduce anxiety. And I actually teach it in my first session and then several different types of breathing as we go along. Breathing is one step that can help you be more mindful and slow down the emotions and the anxiety. Hypnosis takes that a little further. It’s a slowing down process but it also is helping you learn skills and tools that you can help dial down the anxiety and your reactions to it and images. So it gives you concrete things to do.
Learn to Breath to Reduce Anxiety right now
But anybody can learn to breathe. So even if you take a deep inhale right now you inhale to five. You go inhale Two Three Four Five and exhale two three four five. The slowing down, the breathing is going to help soothe your nervous system and helps you decrease that anxiety. And so you know we’re doing those type of things as well but that’s something you can do at home. You can listen to this be like OK. First thing I need to do is really tune into my bodily s
ensations and then let’s work on my breathing here. You know let’s breathe from the belly and any kind of mindfulness program will teach you that. Any kind of meditation program, yoga, but also Cognitive behavior therapy and certainly ACT is going to teach you that. And it’s something you learn. So that is a little bit of that anxiety in hypnosis today. Hope you enjoyed the podcast and I always always welcome your comments and your questions. Absolutely would love to get those.
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