Using Hypnosis to treat Agoraphobia

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Permalink Reply by Scott Sandland, C.Ht. on July 3, 2008 at 11:16am

I have worked with a few people over the years with either agoraphobia or severe social anxiety. The simple advice I can give is this: condition with success.

Have them keep doing things that are intentionally too easy. People have been telling them to "just go as far as you can until it is uncomfortable." This is a bad idea, in my opinion, because it conditions them with the negative feeling at the end of whatever they do. have them go until it feels good. Have them keep doing what is easy.

You can also have them practice the next step in hypnosis, so it's a consequence free environment. If they don't feel ready they just mentally halt the process and emotion. Mental rehearsal will be, in general, a great tool. Giving them tools to relax themselves and feel in control could be another big piece.

-Scott Sandland

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Permalink Reply by Brian David Phillips on July 3, 2008 at 5:28pm

Scott has some excellent advice. As far as processes . . . I would also use Hypnoanalysis (regression to cause with gestalt work). If you're not trained in this approach then go with something else. This is not a person you want to practice unfamiliar techniques with. Core Transformation (in hypnosis, not as a waking suggestion) or Parts Process would be helpful to some degree (once again, the latter only if you've the training and experience). This is not something you pop 'em into trance once and read off a couple affirmations for. This is someone who needs a therapeutic relationship based upon moving forward and success.

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Permalink Reply by Roy Hunter on July 8, 2008 at 5:49pm

I concur with Brian's comments. However, be prepared for a higher probability of a "no show" for the scheduled appointment, as the client often has to deal with his/her phobia just to leave home and go to your office.

When the core cause is in the past, regression with Gestalt work is best. However, if the problem has an ongoing cause (such as being in an abusive relationship), the client needs to be referred to a professional who experienced in helping abuse victims.

Roy Hunter, M.S., FAPHP
www.royhunter.com

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Permalink Reply by Jason Gordon on July 8, 2008 at 4:00pm

Awesome! Thanks for the help! I will let you know how it goes!

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Permalink Reply by James Hazlerig on July 8, 2008 at 9:10pm

When I work with a phobia, I have the client lay out a scale of -10 (worst possible scenario) to 10 (totally enjoying the situation) and then place various hypothetical situations on it.

Next, I ask the client to imagine a situation in which they feel happy and confident. We really revivify that experience, and then I anchor the state.

The third step is taking them through imagining each of the situations, starting with the least difficult. As the client imagines each situation, I fire the anchor for the happy, confident state. We might do one, two, or three such difficult (now innocuous) situations before breaking state, usually by imagining something the client likes to do. Eventually we work our way to the negative 10 situation.

I've used this for arachnaphobia, and it works great! Good luck with your client, btw.

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Permalink Reply by John Bittner - Ocotillo Hypnosis on July 9, 2008 at 10:18am

For fear and anxiety, I like employing a Swish pattern in the first session. As this is something the client can continue to do outside of the session, it empowers the client with control of their own emotions. I'll follow this with a formal induction and a reinforcing metaphor.

If the problem persists after this, I'll use regression to cause in a followup session to get at the heart of the matter.

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Permalink Reply by Jason Gordon on August 10, 2008 at 3:08pm

Thank-you all so much! I am having huge success with one of my two clients, while the other is dealing with some secondary gains!

JG

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Permalink Reply by Richard Nongard - HypnosisGurus.com on August 10, 2008 at 5:28pm

I would probaly do an initial PMR with visual relaxation as a deepener. Produce a deep relaxation state, have them create a feeling of "comfort, safety and security" and then anchor that to the action of touching the index finger and thumb together, with the suggestion they can bring themselves back to this state they have creates, a state of comfort, safety and scurity, at anytime, by just touching those fingers together... then on with therapy. My clients really respond to anchors that they can use apart from hypnotherapy to bring that state back in times of anxiety or panic or fear....
Anxiety disorders (and specific-phobias) have VERY physical manifestations (the DSM-4 is full of physical symptoms for these issues) and so somatic interventions are very useful.

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Permalink Reply by Jason Gordon on August 11, 2008 at 3:59am

Thanks Richard! I've actually been taking that approach with my very successful client however due to a physical disability I had to change the Anchor just a bit. I have been very successful with him. My second client however is simply not ready to make the changes in her life, she is a secondary gainer and doesn't want to let go of that gain in anyway, so I am working on some different approaches with her.

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Permalink Reply by Jason Gordon on August 11, 2008 at 6:04pm

I just had to post this update... I just came from a session with my one client, he has been agoraphobic for 8 years (since he was 22), this was also combined with OCD and several other Anxieties. Up until I started working with him the longest he had been out of the house in the last 8 years was for 2 hours to go to a friends place and even that was 3 years ago.

We have been having several great breakthroughs and continue to always work on the next level... Tonight was his 4th week with me and he announced that after last weeks session he was able to go to Wal-Mart and shop for 45 minutes. He has also been making regular trips to his family cottage and spending up to 5 hours out in the boat fishing!

Needless to say I am extremely proud of him and his accomplishments!

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Permalink Reply by Gerry on October 16, 2008 at 11:10am

Great work Jason.
I use CBT, NLP, Hypnotherapy with my clients suffering anxiety
If the client is having panic attacks with the agraphobia my first step is always explaining to the client that when the panic attacks recur and the person develops an intense apprehension of having another attack. This fear—called anticipatory anxiety or fear of fear—can be present most of the time and seriously interfere with the person's life even when a panic attack is not in progress.
Re-educate the unconscious mind so that it understands that the situations that currently trigger your panic attacks are not actually dangerous. Put a stop to the thoughts that lead to anxiety, and to replace those thoughts with realistic, rational thoughts.
A panic attack cannot cause heart failure or a heart attack.
- A panic attack cannot cause you to stop breathing.
- A panic attack cannot cause you to faint.
- A panic attack cannot cause you to "go crazy."
- A panic attack cannot cause you to lose control of yourself.
I go through exercises with my clients so they can understand the symptoms of panic will not harm them
Spinning around on the spot with their arms out stretched for 10 spins (most can only mange about 4 on the first attempt.
Sitting with head between their legs for 30secs then getting up very quickly
And panting as to hyperventilate.
So the associations such as oh Im dizzy I’m going to faint can be revaluated
Explain to the person cannot hurt you, anxiety is felt by everyone and its important because it’s there to protect you, the purpose of anxiety is to give you energy to get away from danger.
People that suffer from panic attacks focus on their symptoms; these symptoms are there for protection.
Heart pounding...helps pump blood around the body to run away from danger
Breathless...may feel freighting but it’s useful it helps get more oxygen to where it is needed.
Pins and needles....happens because the circulation changes... the blood gets re-directed to where it thinks it is needed, such as thighs, and big muscles.
Dizzy....A little less blood going to the head, as the body doesn’t need to think clearly while running away. all it thinks of is I’m out of here.
When they notice their heart pounding in a panic attack...get them to say to their self ...that’s a good thing my hearts pounding, it helps my body for flight, it may be happening at the wrong time; it’s a normal thing just simply happening at the wrong time.
Panic is an amazing paradox. It’s the scariest experience we are capable of, and yet it is completely harmless

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Permalink Reply by Michael Ellner on October 16, 2008 at 1:30pm

Hi Jason,

Although, I am usually against cookie cutter approaches to helping our clients help themselves - I'm going share one here that seems to be very effective in helping clients over-come "phobias"


The key word to focus on is "reaction." A phobic reaction is a learned behavior and our job is to help our clients find a way to give new meanings to the signals and sensations associated with the reaction... In my experience, as soon as we help our clients do that the unwanted reactions immediately fade away all by themselves...

The set-up in your pre-talk:
"What if the "phobia" is based on misunderstanding the sensations that you are experiencing? Excitation and Anxiety use the very same neurological pathways and what determines our experiences-- Is our opinion -- Example:
Two people are wired up and put in the front car of a Roller Coaster and their reactions to the ride are recorded in real time as they happen - Both riders experience their eyes tearing, a tightening in their throats and chests and shallow breathing just about the same time and they begin to feel slightly nauseous and sweaty at about the same time too. As soon as the ride ends Rider A gets out of the car and kisses the ground and swears that he will never do that again! Meanwhile, Rider B is buying another ticket and is going to do it again - right now, because Rider B loved every minute of the ride...

For the ritual part of your session, I recommend anchoring her fears and associations with the "phobia" and collapsing the anchor. Then give her a new calm and excited resource state and post-hypnotic signal for triggering her resource state... It never hurts to add future pacing. "I wonder how quickly you will notice just how liberating and great it feels to discover just how exciting being out and about can be!" Blah, blah, blah...

Before closing - You wrote: "Just wondering if anyone has experience and tips for using Hypnosis to treat Agoraphobia (fear of large spaces/crowds). I am currently treating one client and have just made contact with a second, so I am interested to hear how others are treating this."

If you are NOT a licensed mental health or health care provider it is not a good idea to get in the habit of "treating" your clients. I suggest "assisting your clients"

You wrote:
A) "Thank-you all so much! I am having huge success with one of my two clients, while the other is dealing with some secondary gains!"
B) "My second client however is simply not ready to make the changes in her life, she is a secondary gainer and doesn't want to let go of that gain in anyway, so I am working on some different approaches with her."

In my opinion, if a client is paying you to help her make changes -- she is ready and acting in good faith.

I realize that I am offering you an alternative view here, but it is based on my helping 1000s of clients who were told that the only reason that the remedy, technique, diet and/or what-ever didn't work prior to our working together was because they must be getting "secondary gains"

Blaming the client by viewing them as "getting secondary gain" from their issues is giving them a reason to justify their failures -- My goal as a hypnosis practitioner is to help my clients change their minds and give them a reason to believe that they can succeed -- And when you do - they do!

Warmest regards,

Michael

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