Anxiety is a common term used to describe general feelings of nervousness or apprehension. It can vary from a simple fleeting worry or temporary uneasy mood, to a chronic incapacitating condition with distressing physical symptoms.Anxiety can affect your thinking, feelings and behavior when dealing with change or coping with demanding situations like exams. Anxiety becomes problematic when expectations become irrational and unrealistic, where even minor situations are met with a feeling of dread. Your general handling of life becomes overwhelming, affecting basic functioning like sleeping and eating patterns.
Anxiety: What causes it?
There are various causes of anxiety. They can be attributed to environmental and biological issues:Environmental: Lifestyle and lifestyle changes Certain lifestyles are considered to generate higher levels of anxiety. These include when using or withdrawing from addictive substances, being in a long-term job that you dislike or being in an abusive relationship.There are recognized lifestyle changes that are considered to be stressful. These can include developing certain medical conditions (e.g. heart conditions), moving house, changing jobs, getting a divorce, suffering abuse and grieving the death of a loved one. The recency and number of lifestyle changes that you are dealing with at one time would increase your anxiety levels.Environmental: Life experiencesThere are many experiences that can shape your anxious thinking such as suffering traumas, abuse and neglect. These experiences can create a template of anxiety that is re-triggered when suffering similar situations later in life.In addition to this, learning to cope from anxious parents is likely to influence your own anxious disposition. When you are younger, authority figures can act as role models for creating your own anxious belief system.Biological: Genetics A family history of anxiety will increase your likelihood that you will suffer anxiety. This considers the view that you are born a ‘worrier’ with catastrophic thinking.Biological: Brain chemistryAn imbalance in the brain’s neurotransmitters (chemicals that transmit messages between the brain cells) can cause anxiety and affect brain functioning. It’s unclear whether anxious traumas cause this dysfunction or it is something that you inherit.In my hypnotherapy consultation, I may seek to identify events that have “caused” you to deal with events in a self-limiting way. This can help reduce your internal conflict or “why” your mind has adopted this negative approach to handle problems.
Anxiety: What are the common symptoms?
Each person is individual in the way you experience anxiety. Some symptoms are more prominent than others and in some cases, symptoms can be the reverse e.g. bladder shyness (difficulty urinating) instead of frequent urination when feeling anxious.Anxiety sufferers find that their condition can exaggerate other natural symptoms. This is because of the “anxious” way you tend to tune into your symptoms. For example, sweating is a common anxiety symptom and a natural response when you are hot. Socially anxious people become more nervous and self-conscious when you show common anxiety symptoms in public. In the summer, sweating in public can be made worse by sufferers of social anxiety.Many of the anxiety symptoms are common to other more serious health conditions. It is important to have these symptoms checked by your doctor just to be certain that your symptom is anxiety-related.Symptoms tend to fall into two categories: emotional and physical symptoms:Emotional symptoms
Constant state of worry and irritability
Feeling detached and ‘spaced out’
Being forgetful and accident-prone
Over-reacting to a hint of danger, predicting negative outcomes
Difficulty relaxing and falling asleep/persistent waking
Irritable and moody
Problems concentrating
Physical symptoms
Tension headaches is a common anxiety-related symptom
Anxiety is diagnosed in consultation with your GP. You doctor will also want to establish that there are no underlying medical problems that are being masked by your anxiety. Personal questions are asked about the nature of your worries and fears, family history and any recent lifestyle changes. Your doctor will also enquire about how you are coping with your anxiety, your sleeping and eating patterns and any excessive habits which have developed.Your doctor may prescribe some medication or refer you to a psychiatrist or psychologist. Further assessment tools will be used to help diagnose the severity of your condition. A diagnosis can then be made if you have a particular type of anxiety disorder. General anxiety disorder is diagnosed when you have persistently struggled with your symptoms for about six months.
Anxiety: Living with anxiety
Just admitting that you have anxiety can be a problem for those suffering with the condition. Many people wrongly see anxiety as a condition for the weak-willed. The phrase that you are unable to “pull yourself together” assumes that you can just “snap” out of it. Although this is a rational recourse, it barely connects with the emotions felt when you are suffering with anxiety. There is an amount of helplessness within anxiety and it can take time for family and friends to accept this.Even if the diagnosis of anxiety is accepted by the sufferer, it can be met with denial. You may not want to take the medication because it can also be used to treat depression. Symptoms that can accompany anxiety are also easily rejected. The sufferer wants to believe that tension headaches or anxiety related IBS must have an organic cause. You endlessly pursue tests and further tests, rejecting the negative result as an error. A relative who has had an organic condition diagnosed e.g. heart problems might generate a further medical anxiety (hypochondria). In this state, you panic about your own anxiety symptoms, making the symptoms worse (panic about panic).
Anxiety: Approaches to treatment
MedicationDepending on how your anxiety affects you, your GP will prescribe suitable medication. It is usually in the form of benzodiazepines for short-term severe anxiety, antidepressants for chronic anxiety or beta blockers for physical anxiety symptoms.Self-helpSelf-help methods can include making changes to your lifestyle to moderate your feelings of anxiety. This can include exercise, changes to your diet and talking to people in self-help groups for further support.CBT and CounsellingYour doctor can refer you to a therapist to help you cope with your anxiety. There can be a waiting list for treatment depending on your location.
Anxiety: Treating anxiety with hypnotherapy
There is evidence-based research to show that “hypnosis is an efficacious treatment for state anxiety...and anxiety related disorders”. In my hypnotherapy practice, the majority of my patients will be suffering with some form of anxiety. Quite often it is the main therapeutic goal.Hypnotherapy can: Teach you how to relaxA key benefit of hypnotherapy is that each consultation involves deep relaxation, reducing immediate levels of stress and anxiety. In this relaxed state, you are more receptive to suggestions that I will use for your treatment. Hypnotherapy can then be used to enhance your learning of new approaches to problems that are causing you anxiety.Hypnotherapy also teaches you to how to relax for yourself. Self hypnosis involves using breathing techniques to lower your anxiety levels and gain more control over your own anxious thinking processes.Hypnotherapy can: Identify and reframe sensitising eventsHypnotherapy can be used to uncover and reframe sensitising events that have taught you to think in an anxious way. The effect of these past traumas can create negative fixed ideas that continue to fuel your anxiety.Here is an example of how it can be used:A patient who had a recent promotion was experiencing extreme anxiety during meetings. She was becoming progressively more self-conscious and dreaded the self-introduction usually required at the start of each meeting. Formal presentations however did not generate the same intensity of anxiety, nor did they create the same anticipatory anxiety. The treatment started with helping her to control her anxiety-response. Since some of the symptoms remained however, her past experiences were investigated further. Using regression, a suppressed past experience was identified when, as a teenager, she chose to give a talk to her class about a very personal issue. The delicate subject-matter caused her to feel exposed however and the risk was met by her peers taunting her. Her suppressed embarrassment was surfacing during her present meetings when she was sometimes asked to “speak from the heart.” Her colleagues were oblivious to her sensitivity. The anxiety had diminished once this causal link had been made and reframed into peer group trust. She unconsciously believed that her present work colleagues were going to taunt her in the same way the teenagers did. The treatment was complete by helping her to portray a confident character even though she was speaking about herself.
Nail biting is a common unwanted habit when feeling anxious
Hypnotherapy can: Dissociate anxiety-related symptomsNegative habits or anxiety-related symptoms can be deeply associated with higher levels of anxiety. For example nail biting can be an unwanted learnt response to comfort anxiety and stammering can triggered when the patient feels extremely anxious. Hypnotherapy can help dissociate these behavioural responses from the patient’s anxious coping strategies using direct suggestion and reframing techniques.Hypnotherapy can: Replace self-doubts with self-confidenceHypnotherapy can build a perspective of confidence into the coping of new situations. Positive and realistic thought processes can be suggested during hypnosis to strengthen your handling of lifestyle issues.
For further information on treating anxiety in Cardiff with hypnotherapy, contact Hypnotherapy Cardiff
IBS (Irritable bowel syndrome) is a common functional gut disorder. It is diagnosed after doctors have excluded other serious organic diseases. More common amongst women, IBS can develop from young teenage and adulthood.IBS: stomach cramps are common symptoms of IBS
What causes it?
The exact causes of IBS are unknown. Following a food-related illness, the sensitivity of the gut canbe increased. This can affect your body’s ability to digest food and can increase your awareness of pain in the digestive tract. Stress and anxiety create chemical (adrenaline) changes that interfere with digestive functioning increasing some of the symptoms.
What are the common symptoms?
Irritable bowel syndrome is characterised by bloating, constipation, diarrhoea, flatulence and pain/cramps. Some of these symptoms can be made worse after eating food or eating certain foods that the IBS sufferer believes is exacerbating the condition.
IBS: Living with IBS symptoms
Having treated many Irritable bowel syndrome patients using hypnotherapy, IBS sufferers have a lifestyle that is preoccupied with the need to go to the toilet. It can undermine their self-confidence.At home:In the home, Irritable bowel syndrome sufferers can feel more relaxed because you have access to your own toilet and your family are (usually) sympathetic to your condition. The number of flare-ups can be greatly reduced because there is general acceptance in the home. However, you can still be preoccupied with the urgent need to go to the toilet during “peak times” especially if the house has guests.Having gone to the toilet, you constantly feel that your bowels are not completely empty and that you have to go to the toilet again. You can also pass mucus when emptying your bowels.In your desperation, you can mistakenly blame the food as a cause of your IBS symptoms particularly when under stress. The IBS diet can then be severely restricted, depriving you of essential nutrients. This may cause other health issues when dealt with subjectively.Leaving the house:Stress and anxiety can make the IBS symptoms worse particularly when leaving the house. The proximity of the toilet is a constant worry, “toilet watching” for reassurance. Certain modes of transport e.g. public transport are usually avoided if possible. Suitable toilets are landmarked on a known journey, in case the toilet is needed. Unknown journeys or journeys where stopping the vehicle when required can be problematic e.g. motorways. There can be a feeling of claustrophobia.Having arrived at a destination, social anxiety can add to the agony. “What will they think?” is a question that you would rather not consider. If visiting somebody’s house there is the embarrassment of “messing up” their toilet. The time that you might be absent and smell of the faeces (with nervous diarrhoea) further adds to IBS sufferer’s predicament. An air freshener is an essential item when flying.Some Irritable bowel syndrome sufferers prefer to meet in a public place to disguise these issues. There is some relief from being able to hide in larger public toilets. It’s no wonder that IBS sufferers can feel housebound (agoraphobic) in an attempt to control your feeling of embarrassment associated with your condition.Formal situations:The constant preoccupation with one’s bowel movements can make certain formal situations unbearable to manage. Even a family occasion with a fixed schedule can be a worry e.g. a wedding, not wanting to disturb the procession.Work meetings can keep the IBS sufferer distracted about when the meeting will finish in case the toilet is needed. Claustrophobia can develop in these situations, feeling trapped within your own anxiety. Interviews and exams tend to be stressful events in themselves. Anticipatory anxiety can keep the Irritable bowel syndrome sufferer “toilet bound” leading up to the big events.Claustrophobia is again an issue in venues with formal seating e.g. cinema. An aisle seat is needed in case of the need to leave the cinema. When the cinema is full and a centre seat allocated, it can be difficult to concentrate on the film.IBS: If you're not on the toilet, you're worrying about needing to go!Accidents and near-misses:Some IBS sufferers have had an “accident” whilst away from home and fear repeating the situation. It can be traumatising, effecting how you handle future events to prevent a reoccurrence. Even if you have had a “near-miss”, you can develop a series of coping rituals similar to that encountered by OCD (obsessive compulsive disorder) sufferers. You become preoccupied with prevention and “control”. Inevitably, depression can be linked to long-term IBS.Toilet phobia:Some IBS patients have OCD issues with “contamination” when using public toilets. This may have been the initial trigger for the Irritable bowel syndrome. These anxiety conflicts can mean that the sufferer rarely leaves the house. Not surprisingly, when I have treated hypnotherapy patients with these anxieties, I have treated them at their home.
IBS: Approaches to treatment
Most Irritable bowel syndrome patients will have explored a number of treatment options with various health professionals. These can include the use of prescribed medication to counter your type of IBS symptoms. Antispasmodics and antidepressants are used to alleviate cramping or pain, laxatives for constipation or anti-diarrhoeal medication is used for diarrhoea.Dietary changes can involve an objective assessment of your diet to ease related symptoms. This can mean eliminating certain problem foods where there is intolerance. Or it can involve increasing or reducing the amount of fibre in the diet. Eating habits are also reviewed to ensure you are eating at regular intervals.Lifestyle issues can also be explored where a change can influence a benefit. Light cardio-vascular exercise for example is considered helpful for the digestive system.
IBS: Research shows that Hypnotherapy can help to treat IBS symptoms
Hypnotherapy has been used to treat Irritable bowel syndrome within the National Health Service. Professor Peter Whorwell, a consultant gastroenterologist from Manchester has been researching the use of hypnotherapy in the treatment of IBS for over 20 years. In his research using 12 sessions of Skype hypnotherapy, 40% fewer subjects had severe IBS symptoms following their Skype hypnotherapy treatment. Skype hypnotherapy was used instead of face to face hypnotherapy where travelling to the hospital was deemed as traumatic for the IBS sufferer.In other research in the use of hypnosis in the treatment of IBS, MJ Ford and A Dobbin conclude that “Hypnotherapy reduces patient anxiety and improves symptom control in the majority of patients with refractory IBS...Benefits extend well beyond symptom control and include improvements in quality of life and reduction in emotional distress.” (p. 297)In February 2008, the National Institute of Clinical Excellence, who advise the NHS on effective treatments suggested to doctors that "Referral for psychological interventions (cognitive behavioural therapy [CBT], hypnotherapy and/or psychological therapy) should be considered for people with IBS who do not respond to pharmacological treatments after 12 months" (See 1.2.3.1).
IBS: How can hypnotherapy treat IBS?
The causes of Irritable bowel syndrome remain unknown. However, stress and anxiety are considered to exacerbate symptoms of IBS. Following your doctor or consultant’s diagnosis of stress-related IBS symptoms, hypnotherapy can then be used to treat your IBS symptoms.
Reduction of stress
When under stress, adrenaline is released and effects the functioning of the gut. Blood is diverted away from the digestive system to essential “fight or flight” responses. By combining relaxation breathing techniques that you can use for yourself, the stress responses can be reduced, allowing the gut to function in a relaxed state.Some of your lifestyle issues will also be explored to help you manage your stress in a more effective way.
Reduction of anxiety
Living with Irritable bowel syndrome symptoms (see above) can create an anxious lifestyle dominated by “toilet” worry and panic behaviour. Hypnotherapy helps you to be more receptive to suggestions. It can be used to reframe past anxious experiences that are creating your avoidance. Hypnotherapy can also help you to visualise dealing with new situations with confidence.
Reduction of pain, discomfort and bloating
The reduction of pain, discomfort and bloating symptoms can be related to your levels of stress and anxiety. Hypnotherapy can also use specific pain management techniques to lower your awareness of pain and cramping.Bloating and distension can be eased by relaxing muscles of the digestive tract, making it easier to expel excess gas.
IBS: IBS gut-directed hypnotherapy
Gut-directed hypnotherapy or gut focused hypnosis is a treatment that is incorporated into the general hypnotherapy treatment. Gut-directed hypnotherapy focuses specifically on visualisation techniques targeted at the gut’s own nervous system (Enteric nervous system). Suggestions are aimed specifically at this neural pathway which can become disrupted or overactive following acute IBS. The aim is to positively influence communication between the brain to the gut and from the gut back to the brain. In Professor Whorwell’s words, with gut directed hypnotherapy “you are controlling your gut, rather than your gut controlling you.”I have been trained to use gut-directed hypnotherapy techniques.
For further information on treating IBS with hypnotherapy and gut-directed hypnotherapy, contact Hypnotherapy Cardiff
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Tension headaches is a common anxiety-related symptom
Nail biting is a common unwanted habit when feeling anxious
