Anxiety And Cognitive Hypnotherapy

 

Anxiety And Automatic Thoughts :

The human brain has developed, to save unnecessary mental work, to learn to carry out many activities so well that they become automatic. Examples include, for instance, tying our ties or shoelaces, or more complicated procedures like driving a car. When we first undertook such activities, we had to concentrate hard on them and give them our full attention.

But once we have performed them sufficiently often, we can carry them out without much conscious thought at all; on ‘automatic pilot’, as it were. This is a very good thing for many activities; however, when it comes to our thinking processes, many irrational beliefs and ideas we have picked up throughout our lives we can mentally repeat to ourselves so often that they, too, become automatic and we accept them as representing ‘that’s how things are’ unquestioningly.

In this way, irrational beliefs can become habitual and ingrained, affecting our view of the world, ourselves, the future and others in most unhelpful ways. Such irrational and habitual negative thinking is often a major cause of feelings of anxiety.

 

Automatic thought processes which often contribute to anxiety include:

a – our internal ‘self-talk’ or ‘internal monologue’

b – past events and memories which perpetually recur in our minds (these can be extremely selective and are also strongly influenced by mood; so, if we are depressed, we will selectively recall our failures rather than our successes, for example. Or we might dwell on our bad characteristics, rather than our good ones. Unsurprisingly, this perpetuates the depression).

c – explanations we provide ourselves with for how our lives have turned out (e.g I am not in a relationship because I am intrinsically unlovable)

d – key stories we tell ourselves about our lives, which we believe are crucial to them (e.g in relation to our work or our childhoods etc)

e – our reflections on our daily living experience (again, this can be very selective; for example, if we are depressed we may focus solely on our errors and failings whilst, at the same time, ignoring or devaluing our successes).

All of these thinking processes are underpinned by OUR CORE BELIEFS WHICH WERE LARGELY LAID DOWN IN CHILDHOOD. Core beliefs relate to 3 main areas:

1) BELIEFS ABOUT OURSELVES
2) BELIEFS ABOUT OTHERS
3) BELIEFS ABOUT THE WORLD

COGNITIVE THERAPY HELPS US TO CHANGE OUR HABITUAL, UNHELPFUL THOUGHT PROCESSES (a-e above) and our CORE BELIEFS for the better. By changing how we think (eg by challenging our irrational, negative, automatic thoughts) and reassessing our belief system we can change the way we interpret events and very significantly and positively alter how we experience our lives.

Neuroplasticity

 

It is a relatively new discovery within psychology that the brain physically changes throughout our lives (not just during childhood and adolescence as many previously supposed).

Just as the brain’s physical development can be harmed (e.g certain types of severe childhood trauma can interfere with the development of the amygdala, which, in turn, is related to the development of borderline personality disorder (BPD)click here to read my article on this), so, too, can its structure and functionality be repaired and enhanced by therapeutic interventions; the harnessing of the power of such  beneficial interventions has come to be known as  SELF-DIRECTED NEUROPLASTICITY.

Self-directed neuro-plasticity essentially involves us teaching ourselves to think and act in new ways that can positively shape and control the functioning of our physical brain, altering its structure to our advantage and ‘re-wiring’ it in helpful ways (click here to read my article about how the brain can ‘re-wire’ itself).

 

 How this relates to the treatment of anxiety :

A recent research study, conducted by the psychologist Schwartz, involved patients suffering from an anxiety disorder being treated with a cognitive behavioural therapy (CBT) technique (called ‘mindfulness‘). CBT, to explain it in very basic terms, is a form of therapy based on the premise that by changing how we think, we can change how we act and feel, and, furthermore, that many psychological disorders have at their heart a faulty thinking style that causes distress. CBT seeks to correct this faulty thinking style.

But back to Schwartz’s study. He found that those treated with CBT improved to about the same degree as would be expected had they been treated with medication. This having been established, Schwartz then arranged for these improved patients to be given a brain scan (specifically, for those interested, a PET scan, or positron emission tomography scan).

This revealed that certain NEURAL PATHWAYS in the brains of the patients had undergone significant change. Specifically, there was seen to be, after the CBT therapy had been completed, significantly greater activity in the patients’ ORBITAL FRONTAL CORTEX.

Future implications :

As research into neuroplasticity continues and more experiments, such as the one outlined above, are conducted, it is likely that more and more psychological disorders will be amenable to interventions that exploit the phenomenon of neuroplasticity, providing us all, even those with conditions  thought to be deeply entrenched, a good deal of hope that we can get very significantly better.

 

Hypnosis And The Amygdala :

We have seen from many other articles that I have published on this site that significant and protracted childhood trauma can lead to physical damage being done to the development of a brain region known as the amygdala, locking it into a state of over-activity.

This damage can lead to severe psychological and behavioral problems in our adult live, such as:

– an inability to control our emotions

easily triggered outbursts of aggression/rage

– severe, debilitating anxiety

– intense feelings of fear/terror without obvious cause

This over-activity of the amygdala also frequently produces physiological symptoms of anxiety such as racing heart, hyperventilation, sweating, trembling etc. In other words, we get ‘stuck’ in fight or flight mode.

The amygdala evolved to increase our survival chances and reacts to fear-inducing stimuli at lightning speed.

Indeed, the amygdala responds to frightening stimuli before we are even consciously aware of why we are afraid – the response is automatic and NOT consciously willed.

This is because if our distant, primitive ancestors encountered dangers such as hungry tigers they needed to run away immediately rather than sit around deliberating whether or not it was completely necessary to do so.

The other way that the brain produces a response to fear is as follows:

The threatening stimuli in the form of sensory input is registered in the thalamus and this information is then relayed to the cortex.

 

However, this process is slower than the process involving the amygdala described in the above paragraph.

 

Harnessing The Power Of The Prefrontal Cortex :

Over-activity of the amygdala can be dampened down by another region of the brain known as the prefrontal cortex. Amongst other functions, the prefrontal cortex is involved in:

–    reappraising problems and generating new solutions

–    visualization

–   planning

By the use of hypnosis, we are able to harness the power of the prefrontal cortex so that it, in effect, ‘turns down’ activity in the amygdala and thus reduces feelings of fear and anxiety.

One technique which may achieve this goal is repeated self-hypnosis that induces visualization (remember, the prefrontal cortex is intimately involved in the mental process of visualization) of a ‘safe place’ in which one is completely protected from danger.

A second technique is that hypnosis can be used to help us reappraise our problems (again, the prefrontal cortex is closely involved in the process of reappraisal, as we saw above); for example, if we lose our job we may initially feel very disheartened; however, hypnosis can help us to positively reframe what has happened and to start viewing it from a positive perspective (e.g. focusing on the fact that by no longer having to do our previous job we now have the opportunity to retrain for something better, start our own business, or undertake studies as a nature student, perhaps in something we’ve always wanted to do).

So we have looked at how both CBT and hypnosis can help alleviate anxiety. However, I now wish to turn to how hypnotherapy and CBT can be combined in a way that the whole is greater than the sum of its parts.

Cognitive Hypnotherapy :

 

The practice of cognitive hypnotherapy derives from recent discoveries in psychology and studies of the workings of the physical brain (neuroscience).

As can be inferred from the name of the therapy, it is a hybrid of cognitive behavioral therapy.

The use of hypnotherapy is becoming increasingly mainstream. For example, many dentists now use hypnotherapy in order to reduce the anxiety of their patients. Also, it is used by some doctors in connection with certain medical procedures. Likewise, cognitive hypnotherapy is becoming more and more widely used as evidence for the effectiveness of hypnotherapy continues to build up.

Scientific Studies

One study has shown that some individuals, when under hypnosis and told the back of their hand is being rubbed with poison ivy (when, in fact, unknown to the hypnotized individual, this is not true – the back of their hand is, in fact, only rubbed with a completely harmless plant), the hypnotized individual develops a rash anyway.

Another study involved showing hypnotized individuals black and white photographs. However, whilst in the hypnotic state, they were instructed to imagine that the black and white photographs they were looking at were in colour. Brain scans made during this procedure revealed that the brain was indeed responding by processing the visual information as if the photographs really were in color – I outline this study below :

 

Kosslyn, a researcher from Harvard University, USA, carried out an experiment on colour perception which involved eight participants.

Each participant was shown brightly coloured rectangles and, under hypnosis, instructed to imagine the colour ‘draining’ from them. This resulted in brain activity that caused them to perceive the brightly coloured blocks as gray.

Color changes hypnosis

The reverse was also true; when instructed, under hypnosis, to ‘see’ gray blocks as brightly colored, they did indeed, due to the change in brain activity caused by hypnosis, perceive the (in reality, gray) blocks as colored.

(For those who are interested, the brain activity of the participants was measured by employing the use of PET [positron emission tomography] scans.

It is also highly important to note that when the participants were asked to perceive these color changes taking place but were NOT under hypnosis, the same changes in brain activity and color perception did NOT occur: this demonstrates that hypnosis used in the experiment was having a very real, measurable and observable (via brain scanning) effect.

This effect is thought to work, Kosslyn explains, because under hypnosis the brain’s right hemisphere, which deals with, amongst other imagination and expectations, is ACTIVATED (whereas the left hemisphere of the brain, dominant when the individual is not under hypnosis, operates more according to logic).

Kosslyn suggests that it might very well be the ability of hypnosis to activate the right hemisphere of the brain that also lies behind the success that hypnotherapy can have when it is used to treat problems such as insomnia, anxiety, pain management and other difficulties in which a person’s psychology plays a pivotal role.

 

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

About David Hosier BSc Hons; MSc; PGDE(FAHE)

Psychologist, researcher and educationalist.

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