1. Hypnosis Application for Anxiety Shelly Johnson Gottsegen, MSW, LICSW Hypnovations, April 11, 2010

2. What is Anxiety? A natural response to perceived threats of danger. Anxiety arrives from a complex interaction of genetic, biological, behavioral and social environmental risk factors.

3. DSM IV: : a future oriented state, with "apprehensive anticipation of future danger or misfortune accompanied by a feeling of dysphoria or somatic symptoms of tension".

4. Different Types of Anxiety Disorders: Generalized Anxiety Disorder (GAD); excessive, unrealistic worry that lasts 6 months or more. Specific Phobias: Intense fear reaction to a specific object or situation. Social Phobia/Social Anxiety (SAD): characterized by extreme anxiety about being judged by others or behaving in a way that might cause embarrassment or ridicule.

5. Anxiety Anxiety involves a biological response to a perceived threat – a physical flow involving hormones adrenalin and insulin, causing a variety of physical symptoms such as the heart to race, perspiration, stomach pains, headaches, muscle tension etc.

6. Perception Anxiety involves perception; “Eye of the Beholder” - anything that one perceives as dangerous can be a trigger for anxiety symptoms.

7. “Eye of the Beholder” Not everyone reacts to the same experience in the same way.

8. Perception Influences Feelings Anxious people imagine danger. They are focused on what could go wrong in the future. Hypnosis is a superior treatment for hypnosis because it involves the use of the imagination to cope with anxiety.

10. Why Hypnosis? Hypnosis goes beyond logic and addresses the deeper self, the unconscious, where perceptions are created. Hypnosis offers a way for anxious people to develop an awareness of the here and now, and a way for them to become aware of their innate abilities to handle life.

11. Accessing Anxiety: R/O physical disorders, side effects of medicines and allergies. Identify dysfunctional behaviors and anxiety symptoms including negative thought patterns, physical sensations and disturbed sleep patterns.

12. Anxiety symptoms Agitation, excessive worries, intense fears, panic, sense of dread, rumination, perfectionism, resistance to change or the unfamiliar, social phobia, fear of rejection, panic attacks, somatic symptoms, negative thought patterns.

13. Treatment Goals (Adapt and individualize goals depending on each client’s needs.) Develop skills to interrupt negative, irrational, obsessive thoughts Increase ability to produce calming responses Diminish worries Regulate emotional reactions Eliminate fear of future anxiety attacks Increase competency to face life stress

14. Treatment Goals Decrease symptoms of insomnia, irritability, restlessness and somatic anxiety symptoms (racing heart, tummy aches, sweaty palms, headaches etc). Increase hopefulness about recovery.

15. Treatment: Develop Rapport. Educate patients about their anxiety. Psycho education conveys to the client the three major components of anxiety: genetics, temperament and environmental stressors. Validate their feelings and give them a sense of hope and confidence in their ability to heal.

17. Use of Hypnosis/teach self- hypnosis: Induction and deepening techniques: Use breathing methods as a means to elicit relaxation and a sense of self soothing. Use a focus on releasing physical sensations and tension while increasing a sense of comfort to teach calming the body and the mind.

18. Teach Hypnosis Self soothing Imagery – a safe place: Visual imagery to distract from worries, self sooth, and a context to create a sense of safety, This is also a venue for various techniques like the dialing down reactivity tool or floating in a bubble etc…

19. Use of Hypnosis Scripts focus on competency in handling life stresses age progression linking past successes to future ability to manage anxious feeling ego – strengthening suggestions post hypnotic suggestion for real life situations Teach anxious people to rethink, reframe, and to redefine. Help them answer “what if “ questions with a sensible well planned answer that allows them to feel prepared and confident that they can handle life stress.

20. Specific Hypnotic Techniques Concentrate on the Breath. Visualization: of favorite (safe) place Dissociation: view the situation without discomfort, mental rehearsing Positive or negative visualization: to increase comfort, decrease the recognition of uncomfortable stimuli.

21. Specific Hypnotic Techniques Time Distortion (increase time spent in comfort and the reverse) Pseudo-orientation in time: Experience success in the future. Age Regression: Experience a time you were not anxious, learning skills Hypermnesia: e.g. Test anxiety Amnesias: "Remember to forget" old fears.