Can Hypnosis Help as a Treatment for Anxiety Disorders?

Anxiety Disorder depiction for woman

In this article you’ll discover:

  1. Different forms and types of Anxiety Disorders, and what this means for you.
  2. Common treatments for the disorders and details about the medications and therapies used in providing relief of symptoms.
  3. How hypnosis can help with the treatment for anxiety disorders to provide quick relief of symptoms as an alternative to other therapies or as an adjunct.
  4. Further reading, medical studies and resource links around the disorders and various treatments.

It’s estimated at least one quarter or more of the U.S. population suffers from anxiety or some anxiety-related disorder at any given time in their lives. According to the National Institute of Mental Health (NIMH), about 40 million American adults in any given year are affected by anxiety disorders [1].

The fact is, Anxiety Disorders are a recognized mental illness [2] and not a disorder that’ll naturally cure itself with time, but rather a persistent illness that if left untreated will likely worsen and impact an individual’s quality of life. There are a number of treatments medical professionals use to help affected individuals, which often includes combinations of both prescribed medication and therapies.

This article has been written for sufferers of anxiety disorders. In it, I’ll provide information and other resources for you on different forms and treatments, including the use of hypnosis as a therapy gaining traction in providing both quick and long-term relief for patients. I’ll reference studies [16] conducted using hypnosis as a treatment and offer my own experience on what to expect from using it for my clients.

Let’s get going though by describing what is included in the Anxiety Disorder grouping…

 

DIFFERENT FORMS OF ANXIETY DISORDERS:

Woman feeling anxiousWe hear the terms anxiety and stress used often these days – people in conversations use the words interchangeably – but from a diagnosis and life impact perspective the conditions are significantly different.

Feeling anxious and under stress is a normal part of life. Stress particularly is persistent but normally the levels come and go in specific situations, and we find ways of coping or reducing it. However, stress can cause short-term physical symptoms similar to anxiety such as rapid heart rate, muscle tension and headaches.

Stress is your body’s reaction to a trigger and is generally a short-term experience. Stress can be positive or negative. When stress kicks in and helps you pull off that deadline you thought was a lost cause, it’s positive.

When stress results in insomnia, poor concentration, and impaired ability to do the things you normally do, it’s negative. Stress is a response to a threat in any given situation” [3-4].

Anxiety, on the other hand, is a sustained mental health disorder that can be triggered by stress. Anxiety doesn’t fade into the distance once the threat is mediated. Anxiety hangs around for the long haul, and can cause significant impairment in social, occupational, and other important areas of functioning” [3].

Anxiety disorders are the most common mental health concern in the United States. Let’s look at these identified in the DSM-5 Handbook used by professionals and published by APA [2].

Panic Disorder (including Agoraphobia):

Panic Disorder is marked by sudden feelings of terror leading to panic attacks which can strike repeatedly and without warning. These attacks can cause physical symptoms such as shortness of breath, heart palpitations, dizziness, and chest pains. People with this disorder will go to great measures to avoid having an attack, including avoidance of places and situations (agoraphobia) where attacks have occurred in the past.

Phobias:

Phobias are a persistent and irrational fear of a specific situation such as flying, driving, and heights. To avoid a panic sensation people with a phobia, avoid triggers, and this attempt to control the triggers can seem to take over a person’s life. There can be many types of phobias and the DSM-5 APA [2] lists 5 subtypes: animal, natural environment, situational, blood-injection-injury, and other.

In my hypnosis practice I have seen and worked with a number of phobias the most common ones being fear of heights, driving, public speaking, performance anxiety, and flying. Hypnosis as a sole treatment for specific phobias can be effective or used as an adjunct to another therapy such as Cognitive Behavioral Therapy (CBT).

Generalized Anxiety Disorder (GAD):

Those who suffer from Generalized Anxiety Disorder (GAD) experience chronic anxiety and difficulty controlling their worry most of the time about different situations and activities. Symptoms include restlessness and being easily fatigued, headaches, muscle tension, nausea, sleep problems and sweating. People with GAD can find it hard to concentrate or complete routine daily tasks.

Social Anxiety Disorder:

Social Anxiety Disorder or SAD is a persistent fear or worry about social and performance situations”, from DSM-5 APA [2]. SAD can impact people in a specific situation, such as eating in front of people, or generalized where people fear most social situations and interactions with others. Unlike shyness and social awkwardness, this disorder causes irrational worries about conversations or participating in class discussions, causing isolation. People with Social Anxiety Disorder have a hard time making and keeping friends, blush and sweat a lot around people, and are afraid they’re being judged all the time.

Obsessive Compulsive Disorder (OCD):

I’ve covered Obsessive Compulsive Disorder and use of hypnosis for this condition in an earlier article “Can Hypnosis Really Help with Obsessive-Compulsive Disorder – OCD?” here [5].

Post-Traumatic Stress Disorder (PTSD):

Post-Traumatic Stress Disorder is a reaction to traumatic stress and gained substantial recognition in recent times due to men and women in military service experiencing combat and assault events suffering from this disorder. Known as “shell-shock” when recognized in the World Wars of earlier generations, it can also be diagnosed in survivors of sexual or physical assault or those subjected to natural disasters or accidents. Information on Hypnosis use for PTSD can be found in Spiegel and Cardena J Clin Psychiatry. 1990 Oct;51 Suppl:39-43; discussion 44-6 [18].

Causes, Risk factors, and Diagnosis:

Similar to many mental illnesses professionals are concluding genetic and environmental factors are a prevalent cause and risk factors for anxiety disorders. Some families experience higher-than-average members with anxiety issues. In addition, professionals also believe stressful or traumatic events such as abuse, death of a loved one, violence or prolonged illness is often linked to the development of an anxiety disorder. However, genetics and environmental factors are risk factors rather than they predict the disorder in somebody.

Because many of the physical symptoms of an anxiety disorder can also be found in other medical conditions, a Doctor will perform a physical examination and lab tests on you to rule out those other conditions. The physical symptoms of an anxiety disorder can be easily confused with other medical conditions like heart disease or a thyroid condition. Therefore, a Doctor will rule out a medical illness first, then recommend you see a mental health professional to make a diagnosis.

 

TREATMENTS FOR ANXIETY DISORDERS:

Psychologisy helping woman overcome fearsIf you’ve been diagnosed with an anxiety disorder then there’s good news for you, you’ll likely experience significant improvements in symptom relief and quality of life with professional treatment. The type of treatment you need will depend on your symptoms and type of disorder. There’s no one treatment fits all, so, you may need to try different, or combination of treatments, before settling on what works best for you.

Anxiety, like stress, can’t be cured, but can be reduced and controlled. I talked about the difference between anxiety and stress earlier, so, the treatments are aimed at helping you control your disorder so it doesn’t have the type of impact on your life it has at the moment. The therapies described below help build coping and relaxation skills, along with behavioral modification to help control symptoms.

Medication:

While medication is commonly used for treating patients diagnosed with an anxiety disorder, research studies suggest better outcomes are obtained by a combination of medication and therapy treatments. Medication treatment falls into two general types; antidepressants, and anti-anxiety (anxiolytics). Your Doctor may prescribe a mixture of medications and perform trials to find the right combination and/or dosage to help your symptoms.

Antidepressants [6] are used to treat depression but are also found helpful in treating anxiety disorders. Frequently the first choice of medical professionals for panic disorder or social phobias they’re not a problem for most adult people to take but require close monitoring.

Anti-anxiety medications (benzodiazepines) [6] tend to be preferred for Generalized Anxiety Disorder (GAD). Medications known as Beta-blockers [6] are also prescribed to help with the control of physical symptoms of anxiety, such as rapid heartbeat, shaking, sweating and trembling. Beta blockers work by blocking the effects of norepinephrine, a stress hormone triggered when you perceive you’re in danger or under severe stress.

Medications can have serious side effects on some individuals such as suicidal thoughts, nausea, insomnia, weight gain, dizziness, and headaches. In addition, not everybody does well on meds or benefits from them.

Psychotherapy Treatments:

Most treatments plans include a combination of medication and therapy. Up to recent times the most common form of psychotherapy to treat anxiety disorder is Cognitive Behavioral Therapy (CBT). CBT isn’t a quick fix for anxiety but it has a reputation for providing long-term relief. It can involve months of sessions before results are seen, and health insurance coverage can therefore be an issue. The sessions are aimed at identifying and changing unhealthy and harmful thought patterns you experience that can lead to your anxiety. Essentially, you’ll learn positive behavioral change techniques you can use to monitor and change your own thoughts. It takes diligent practice and homework, and these, along with time and money, are some of the criticisms leveled at this therapy, and the reasons patients drop out of treatment early [7].

Another therapy for anxiety is Exposure Therapy. Exposure therapy uses different methods of controlled exposure to fearful situations for a patient, which is intended to lead to decreased anxiety and distress in these real-life situations. The exposure is performed in a safe environment by a psychologist. The treatment is based on the premise confronting our fears helps overcome them in the long-term. While avoidance can help in the short-term, it can lead to making the fears increase over time. Various studies have concluded its effectiveness in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, PTSD, and specific phobias [8].

Exposure therapy can be done progressively over multiple sessions or “flooding” as in somebody with a spider phobic being put straight in a room full of spiders. The professional concern on exposure therapy is for specific patients it can be disturbing and lead to them dropping out of the treatment early. Additionally, care must be taken not to re-traumatize a patient.

Mindfulness Techniques:

Structured Mindfulness is a form of meditation and has become common vocabulary in the treatment of many conditions involving stress and worry. It’s based on Asian practices of meditation and brought to USA in 1992 by Jon Kabat-Zinn. Kabat-Zinn who also pioneered work in its use in Mindfulness-based Stress Reduction (MBSR) treatment programs for anxiety disorders and conducted a number of studies [9].

According to Psychology Today magazine, “mindfulness” is a state of active and open attention on the present moment. Sometimes described as “… in a state of living in the moment. When you’re able to do this, you become capable of just observing your thoughts as a viewer without judging them as being either good or bad” [10].

So, what’s the intent of mindfulness compared to other anxiety treatments? Its main focus is to help you calm yourself and to get in a relaxing and accepting state. It doesn’t focus on confronting or exposing of fears but more on controlling your thoughts in the present and importantly not struggling to control distressing thoughts which can only intensify your anxiousness.

Mindfulness isn’t necessarily about formal meditation, although this can be one aspect if meditation has helped relaxation in the past for you, but it can also be practiced as you go about your everyday activities. So, you can adopt a mindful attitude when eating, listening, walking, and working, being nonjudging, with openness and gentleness. If this sounds strange and unnatural to you, then, consider the roots of mindfulness comes from cultures where these attitudes expect this should be your natural state of mind anyway, so practicing “meditation” to achieve your default state is considered positive for your health and body.

Mindfulness isn’t the only stress-reduction management technique that can help with anxiety, but cited studies have shown, “… mindfulness has indeed proven somewhat effective in the treatment of anxiety and should therefore be considered as a viable treatment alternative” [9].

There’s no shortage of mindfulness training these days. If you’ve a local yoga or meditation studio available near you likely there will be sessions or short courses available at them. The difficulty is not in learning mindfulness but in practicing it. Controlling your thoughts around anxiety and the symptoms you experience when it happens requires learned techniques and confidence you can control then, and this will take dedicated and focused practice. For this you may need professional help from a practitioner of mindfulness with experience in helping others with anxiety disorders.

Hypnosis:

I’ve written extensively about hypnosis in previous articles and covered its use in clinical and medical issues. When people describe hypnosis they usually also include the work done under hypnosis to make changes, but hypnosis is really a state separate from the therapeutic work done when in a hypnotic trance. Hypnosis then is “… a heightened state of awareness which means your mind becomes more focused. Individuals are able to shift their focus to specific qualities of an experience and hold them there. This allows people to place their attention on things they want to change and avoid focusing on the things they don’t want to think about. Wherever your thoughts go, this is what you’re going to focus on most, and continually bring it into your personal awareness” [11].

A patient, once in hypnosis, will receive therapeutic and post-hypnotic suggestions from a hypnotist while in a trance-like state to help control thinking of thoughts triggering anxiety. Self-hypnosis is often used to aid patients in controlling issues without the need for a therapist to guide the session. Most hypnotists can provide self-hypnosis training to a client in 2-3 sessions. This helps minimize costs and also provides empowerment to the client in dealing with any anxiety that may appear later.

While on the surface mindfulness and hypnosis share common characteristics, and sometimes even techniques of achieving relaxation and focus and an attention on breathing, the approach to obtaining outcomes is different. Whereas mindfulness promotes acceptance of the way things are through focusing on your state of awareness, hypnosis uses change and goal-orientated language in its suggestions to control symptoms. Hypnosis also benefits from the ability to address specific symptoms.

Hypnosis can be used as the sole treatment for anxiety disorder or as an adjunct to other psychotherapy treatments such as Cognitive Behavioral Therapy (CBHT), or along with use of medication. I want to explore the use of hypnosis in treating anxiety disorders in more depth and so the next and final section will provide you realistic assessment of what we know today about its effectiveness, and what you can realistically expect from hypnosis as a treatment for anxiety disorders.

 

CAN HYPNOSIS REALLY HELP WITH ANXIETY?

Woman smiling after therapy sessionHypnosis offers an alternative therapy that can be used to tackle specific symptoms quickly and address anxiety over long-term.

It can also be used as an adjunct to medications and other therapies such as CBT (called CBHT), or mindfulness, to help speed up outcomes to experience relief and positive outcomes.

In my own practice, where my main focus is on providing help for people with smoking cessation, stress, weight loss and control, and phobias, I use hypnosis almost exclusively in my therapeutic sessions. While my client hypnosis sessions often include elements of neuro-linguistic programming or NLP [12], and where appropriate for client resources and homework Emotional Freedom Techniques or EFT [13], the bulk of the change work achieving outcomes are in the hypnotic suggestion session work.

In clients experiencing trouble quitting smoking or with obesity, there is often an undercurrent of anxiety and stress blocking an effective outcome for them. Where this is the case addressing the anxiety is the first step before tackling any negative habit changes. As chronic anxiety is considered a mental illness and intervention is mostly at the hands of medical doctors, then the question for you is can hypnosis help you with anxiety and what proof is available it even can?

Where’s the Proof?

You can read studies and research on the medical use of hypnosis which has proven a viable and effective solution to treat chronic pain, pre- and post-surgery stress and discomfort and emotional upset, labor, sleep problems, dentistry-related procedures, and irritable bowel syndrome [19-26]. “Of note is that in the medical environment, clinical hypnosis is provided as an adjunct to medical treatment. Intervention is often provided at bedside, or in preparation and during medical procedures away from the usual office-based psychotherapy setting” [16].

Dr. David Spiegel – Medical Director of the Center for Integrative Medicine at Stanford University School of Medicine – is an advocate of hypnosis and used it on himself for pain management after surgery. Spiegel says “Hypnosis can be an effective method for managing pain and treating anxiety and stress-related disorders” [14].

In another study on “Hypnosis in the Treatment of Patients with Anxiety Disorders”, the authors conclude, “The obtained results reflect the fact that both the intervention based on cognitive-behavioural methods and the one using specific hypnosis strategies and cognitive-behavioural techniques have led to reducing the anxiety, the level of depression and the level of negative mood into the experimental groups” [28].

But Will Hypnosis Work for Me?

Most people can be hypnotized as it happens to us naturally regularly. Being relaxed and focused is all it takes. If you’ve ever been absorbed in a book or movie to the extent of being oblivious to other people or what’s going on around you, then you’ve been in trance. A small percentage of people are poor candidates for hypnosis, and if you fit in this category, then, this will become apparent to the hypnotherapist during your first session. There are no guarantees for any therapy treatment or medications for that matter.

Whether you’re taking medications or currently in therapy, such as CBT, then hypnosis may be able to help you get to faster and better outcomes. There’s enough evidence to consider hypnosis as a serious alternative, or adjunct, to your current treatment for your anxiety disorder.

How Do I Get Started on Hypnosis Therapy for My Anxiety?

Getting started with hypnosis is about finding a local hypnotist you can work with and this will involve interviewing a few to find one who has experience in anxiety disorders. Do your research and take some time choosing. Experience and trust should be your guiding beacons in choosing somebody to work with you. You’ll find an array of people who practice hypnosis and these include licensed psychologists who also have training in hypnosis, to professional therapeutic hypnotists. Generally, professional therapists will offer you a free consultation where they can discuss your case and symptoms and you can ask them about their experience and methods, and of course timelines and costs. I’ve found confident and experienced professional hypnotists are not threatened by these questions and welcome them because it conveys you’re serious about achieving outcomes.

Finally, I want to expand further on self-hypnosis as it provides ongoing therapy for your anxiety without the need to see your therapist regularly. A professional hypnotherapist can teach self-hypnosis and/or provide custom-tailored recorded sessions for you. Learning self-hypnosis can take a few sessions but like mindfulness it provides a practical way of controlling situations that normally cause anxiety by bringing quick relief. When interviewing your hypnotists be sure to discuss this and choose one that advocates for self-hypnosis and a willingness to teach you.

I hope this article has provided you further insights into anxiety disorders and options available to you to get relief.

 

CONCLUSIONS:

While we all get anxious and stressed at various times in our life and work, having an anxiety disorder impacts your life daily and is a recognized mental illness. The disorder can range from causing panic attacks, phobias, OCD, PTSD, social anxiety where we avoid any contact with others, to Generalized Anxiety (GAD) where you worry constantly about many different situations and activities.

Treatment for these disorders includes medications and various therapies and most people are prescribed both. Typical medications include antidepressants and specific anti-anxiety prescriptions. The most common therapy used is Cognitive Behavioral Therapy (CBT), but more recently other therapies have met with success either as an alternative therapy or in combination with CBT. These include: Exposure Therapy, Mindfulness, and Hypnosis.

Whereas many of the therapies can require significant numbers of sessions before improvement is seen, hypnosis can help provide quick relief from your symptoms and also provide ongoing help by learning self-hypnosis under the guidance of a professional hypnotist.

 

ADDITIONAL RESOURCES:

[1] Anxiety Disorders: National Institute of Mental Health (NIMH) >>>

[2] DSM-5 – Diagnostic and Statistical Manual of Mental Disorders – APA >>>

[3] Stress vs Anxiety: How to Tell the Difference >>>

[4] Why is it So Darn Hard to Cope with Stress? Ways to Reduce It >>>

[5] Can Hypnosis Really Help with Obsessive-Compulsive Disorder – OCD? >>>

[6] Common Medications for Anxiety Disorders >>>

[7] The Benefits and Criticisms of Cognitive Behavioral Therapy >>>

[8] What is Exposure Therapy? – APA >>>

[9] Hypnosis and Mindfulness for the Treatment of Anxiety Disorders: Empirical and Applied Perspectives >>>

[10] Introduction to Mindfulness – 4-Part Series >>>

[11] What is Hypnosis and How Does Hypnosis Work? >>>

[12] Introducing a Primer for Neuro-Linguistic Programming (NLP) >>>

[13] 5 Emotional Freedom Technique or EFT Tapping Benefits for Stress, Pain & More >>>

[14] Transformation – David Spiegel on how hypnosis can change your brain’s perception of your body >>> 

[15] Therapy Session Case Study: Dealing with Anxiety, Stress and Poor Self-Confidence >>>

[16] Using Hypnosis in the Treatment of Anxiety Disorders: Pros and Cons >>>

[17] Overcoming Generalized Anxiety Disorder in Kids and Teenagers >>>

 

CITATIONS:

Access to the full text of these medical journal articles may require a free membership account to journal websites:

[18] New Uses of Hypnosis in the Treatment of Posttraumatic Stress Disorder. Spiegel D, Cardena E.

[19] Neron S, Stephenson R. Effectiveness of Hypnotherapy with Cancer Patients’ Trajectory: Emesis, Acute Pain, and Analgesia and Anxiolysis in Procedures. International Journal of Clinical and Experimental Hypnosis. 2007;55(3):336-54.

[20] Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, et al. A Randomized Clinical Trial of a Brief Hypnosis Intervention to Control Side Effects in Breast Surgery Patients. Journal of the National Cancer Institute. 2007;99(17):1304-12.

[21] Snow A, Dorfman D, Warbet R, Cammarata M, Eisenman S, Zilberfein F, et al. A Randomized Trial pf Hypnosis for Relief of Pain and Anxiety in Adult Cancer Patients Undergoing Bone Marrow Procedures. Journal of Psychosocial Oncology. 2012;30(3):281-93.

[22] Lang EV, Berbaum KS, Faintuch S, Hatsiopoulou O, Halsey N, Li X, et al. Adjunctive Self-Hypnotic Relaxation for Outpatient Medical Procedures: A Prospective Randomized Trial with Women Undergoing Large Core Breast Biopsy. Pain. 2006;126(1-30:155-64.

[23] Jensen, MP, Gralow JR, Braden A, Gertz KJ, Fann JR, Syrjala KL. Hypnosis for Symptom Management in Women with Breast Cancer: A Pilot Study. International Journal of Clinical and Experimental Hypnosis. 2012;60(2):135-59.

[24] Harandi AA, Esfandani A, Shakibaei F. The Effect of Hypnotherapy on Procedural Pain and State Anxiety Related to Physiotherapy in Women Hospitalized in a Burn Unit. Contemporary Hypnosis. 2004;21(1):28-34.

[25] Landolt AS, Milling LS. The Efficacy of Hypnosis as an Intervention for Labor and Delivery Pain: A Comprehensive Methodological Review. Clinical Psychology Review. 2011;316(6):1022-31.

[26] Mackey EF. Effects of Hypnosis as an Adjunct to Intravenous Sedation for Third Molar Extraction: A Randomized Blind, Controlled Study. International Journal of Clinical and Experimental Hypnosis. 2009;58(1):21-38.

[27] Lynn SJ, Green JP. The Sociocognitive and Dissociation Theories of Hypnosis: Toward a Rapprochement. International Journal of Clinical and Experimental Hypnosis. 2011;59(3):277-93.

[28] Hypnosis in the Treatment of Patients with Anxiety Disorders. Holdevici I, Craciunb B.

 
Erika Slater CH
Director
Free At Last Hypnosis
Massachusetts

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