Accepting health anxiety: You often hear that you should “trust your gut instincts”. It’s probably true for most of the time. But what if those instincts are rooted in fear? Does it then mean that those fearful instincts are distorted and will cause havoc if you follow those gut instincts?
How fear is affecting your reactions?
You can appreciate that sending for the emergency fire services each time that someone lights a match because of what might happen to that small isolated fire would be a blatant over-reaction. But when suffer you have excessive fear, your reality is dominated by your emotion; the situation will be catastrophic. With excessive fear, this reaction feels right and the fearful person is unable to “normalise” how less fearful people might dismiss it.
Health anxiety (also known as hypochondriasis) is a condition in which you are preoccupied with the fearful belief that you have or will contract a serious illness. You struggle to enjoy life because you are convinced that all of those bodily “noises” (sensations, feelings and discomforts etc.) that normal healthy people learn to live with is something far more serious. With health anxiety, you are convinced that this small match fire is attached to something highly flammable and needs the fire service to extinguish it. In addition to this, when it has been extinguished, you’re convinced that it will keep relighting and cause another major fire.
Accepting health anxiety: Feared illness or actual illness
The internal systems of the body are constantly making normal “noises” that can affect heart rate, breathing patterns, changes muscle tone etc. Many of those sensations that you feel can alter according to your emotional state. Heart rate slows when relaxed, but increases when you are anxious. Your digestion rate can change with emotions and create many noises along the way! Some of the bodily sensation changes can be uncomfortable, startling and even undesirable, but they are not dangerous. When you are convinced that they are symptoms of a serious illness, your anxiety can exaggerate those sensations, and trigger more of them. When you feel these changes, they are not fabricated. The sensations you feel are real but the fearful beliefs and emotions that underpin them are false. The sensations deceive you because you or people close to you usually have suffered a retrospective medical trauma.
Confronting this internal deception is an important part of your return to health. It means acknowledging that the medical illness you fear is not the medical illness that you have; instead, the fear is the illness.
Accepting health anxiety: From denial to acceptance
Accepting that you have a mental health disorder can be a difficult path. Denial, embarrassment, guilt, shame, frustration, anger and self blame are likely to be just some of your emotional obstacles en route. As you continue your journey, you can then understand what your health anxiety means for you and the options available to cope with it.
Your survival mechanisms can include rituals of exercise, dieting, self care programmes all of which are generally good for your long term health. Some of those rituals can become compulsive and indicate that you are avoiding or struggling to deal with the core issue. This is not your fault as you are driven by your emotions, trying your best to minimise that moment of discomfort.
Your journey of change may initially involve looking back on how it originated. Did you make the retrospective link to childhood values that “taught” you to be fearful of your health? This is not about blaming others, more about understanding your foundation layers of belief. Understanding how you “did it” can relieve some of your mind’s confusion. Some of those learning situations were traumatic and in the same way certain phobias are formed, you were hyper-reactive to the “object” of your fear. Typically, with health anxiety, it involves a close member of your family suddenly falling ill. A massive heart attack can give no warning for you to prepare your grief.
You are convinced that your symptoms are a serious illness
When you are a young child it’s difficult to understand what has happened and how your emotions are affecting you. The mark it leaves on your emotional development won’t show itself for some years to come. It’s likely that authority figures who were coping with their own grief may have shielded you from this trauma without involving you in discussions of your grief. What they may not have realised is that you had already made your own (misplaced and often illogical) associations of health anxiety-learning and this is now taking its hold on you.
So the heart attack trauma and all that you then learn about heart functioning becomes a focus of your attention. Before you understand what stress and anxiety is, you are already convinced that this rapid heartbeat (caused by a panic attack) is a major cause for alarm. Will you also have a heart attack like your close relation? If something does happen to you, will it be your fault if your family go through yet more suffering?
What about other types of family traumas that can exacerbate health anxiety? It is well known that when parents go through acrimonious separations, this creates deep insecurity in children who may struggle with anxiety in the future. This can reinforce the health anxiety “seeds” from a family bereavement or be the start a deep feeling of helplessness when symptoms of anxiety (like a racing heart beat) present themselves. If the excessive attention given to a sick child diverts the family rows, the “emotion gain” can be a trigger for health-related attention-seeking behaviour when the child feels unwell in the future (Munchausen Syndrome).
When you bring health anxiety symptoms into teenage hood, the shift towards a socially-oriented value system brings additional pressure to appear “normal” to one’s peers. Feelings of embarrassment when you get attention are likely to heighten your struggle with excessive anxiety symptoms. You want to remain invisible but the tightness in your chest will surely be noticed and be judged by your peers. You fear looking as if you are having a heart attack and the irreversible damage this will have on your frail social esteem. So you avoid presentations, you suffer panic attacks with exams and your school attendance may suffer as a consequence of your anxiety.
You are still convinced that your palpitations are more than just anxiety. Then there’s the dilemma about admitting these issues to your peers. Will they mock you? Will it make the symptoms worse if they know about it? Afraid to speak out about it, you go through a period of silence, stifling your social confidence and avoiding situations that might trigger your anxiety.
When you are tired of running away from it, you finally speak to your family and they offer their reassurance that it will probably just disappear with time. But how do they know? They aren’t doctors so maybe they’re just trying to distract you. You pluck up the courage to see your doctor who wants to refer you to a cardiologist just to make sure that there is no underlying medical issue. This is helpful that someone has heard you but the appointment is months away. During that period of anticipation, it seems like an eternity. You are convinced that it must be serious to have to see a consultant. Your imagination creates any number of catastrophic scenarios of needing major heart surgery, or that you are untreatable or even worse.
Is it a betrayal when the diagnosis is not what you expected?
When you finally have your medical consultation, you are told by the consultant that all is clear and it’s probably anxiety. Momentarily, you feel reassured; then you feel betrayed. What if they have missed something? The symptoms are still there and you are not ready to fully accept the diagnosis. “What I am feeling can’t just be anxiety!” The symptoms are too real.
Determined to prove the reality of your chest sensations, you research your symptoms with Dr Google. This is a bit risky because during your research, you are likely to only accept what you already believe. You feel tense during your research and it causes your symptoms to become active just reading about the traumas of heart conditions.
Feeling desperate, you let down your guard and go back to your GP who prescribes some medication for your anxiety. You are not elated about taking medication; you have never had to take medication before. Is it safe to introduce something unnatural into your body? Will it have any side effects? When you research the possible side effects, you read that it could actually cause palpitations. Why was this medication prescribed if it can cause the very problem that you want to resolve?
Feeling betrayed by your doctor, you take matters back into your own hands. The next line of attack is trying untested natural remedies by people who seem to be going through the same situation as you. If it works for them, it could help you too! And when you read the reviews, they are fantastic! You haven’t considered the placebo effect just yet.
Sometimes by coincidence, those natural health remedies help, but the racing heart beat still has its moments. Then, a friend opens up and tells you about their anxiety symptoms. They mention that they have had a similar traumatic background with a relation dying suddenly of a medical condition. You are ready to confide in them and the conversation moves to the topic of health anxiety. In that moment, everything adds up. It takes a while to sink in but when you research “accepting health anxiety”, more of it makes sense.
Now you can get the help that you need. You are not seeking treatment for a medically-based condition; you are seeking treatment for a mental health condition.
Click here for more information on health anxiety treatment.
Accepting health anxiety: For more information on treatment for health anxiety contact Richard J D’Souza Hypnotherapy Cardiff
OCD Treatment Cardiff: Obsessive Compulsive Disorder (OCD) is a mental health condition that is characterised by having uncontrollable obsessions and compulsions. Obsessions are unwanted, persistent and sometimes intrusive thoughts, images or impulses that cause emotional distress. Obsessions can cause the individual to act out certain repetitive behaviours or additional mental acts (called compulsions) in order to immediately reduce the distress of the obsession.
OCD is characterised by uncontrollable obsessions and compulsions
It is estimated that about three quarters of a million people in UK suffer with obsessive compulsive disorder, with about half of those being affected severely. It tends to interfere with the majority of people’s lives around early adulthood, but can be problematic at any age.
OCD Treatment Cardiff: OCD in everyday language and OCD in reality
There are many medical terms that cross-over into everyday language. Being “addicted”, “paranoid” or “agoraphobic” are common labels that can be used respectively to describe how a person can exaggerate the enjoyment of something, fear that something terrible is going to happen or have a lack of enthusiasm for social events. But the real conditions are far more distressing than those applied in everyday language.
Similarly, being “obsessed” or “obsessing” are common terms used to give casual reference to say, being preoccupied with a person, a new hobby or with a specific goal. Used in this context, your “obsession” will absorb your time and attention in some momentary way, particularly if the event is recent. You may listen to a new song repetitively and keep singing it when you are doing something routine. Or you may persistently think about a new love interest so intensely that it can distract some moments of your concentration, but it will be placed in the context of your other responsibilities that will help your day to function.
Undoubtedly, the nature of the “obsession” can be related to negative situations like illness or death, but the preoccupation lessens when the situation has ended or when it gradually fades with the passing of time. Generally, you will still get to work at the time required, eat meals regularly, attend social events and ensure that you have a reasonable night’s sleep.
With OCD, the obsessions and compulsions have more permanence. The time spent (usually more than one hour per day) replaying thoughts or perfecting rituals will interfere withthe other important parts of your life such as your health, your relationships and your occupation. There is extensive loss of control over your repetitive thoughts or behaviours. Additionally, there is little or no satisfaction when carrying out your compulsions; any relief from the anxiety is usually brief.
OCD Treatment Cardiff: Types of OCD
Your obsessive compulsive disorder can attach onto any specific issue depending on your belief system, history of traumas and reactions to those traumas. There are some common categories of obsessions and compulsions however.
Categories of obsessions can include contamination fears, orderliness and symmetry, fear of danger (and harm), and taboo thoughts.
Categories of compulsions can include rituals of decontamination, rearranging, checking, and reassurance-seeking.
You can access more information here on the common types of obsessive compulsive disorder.
OCD Treatment Cardiff: What causes OCD?
There are various possible causes of OCD
Despite extensive research into the causes of obsessive compulsive disorder, no definitive cause of OCD has been identified. Instead there are various theories that relate to possible causes:
Biological factors – Varied blood flow in parts of the brain and chemical deficiencies of serotonin (and other neurotransmitters) are indicated with OCD brain chemistry. These differences do not confirm whether this is a cause or an effect of having OCD however.
Genetic factors – Those with close relatives who have OCD can increase the likelihood that you will also develop OCD. There have been attempts to identify a specific gene with OCD, but no research has been conclusive. Where OCD is limited to only some members of the family, it may still suggest that the condition could be a learned behaviour from authority figures, rather than a genetically-linked condition.
Environmental factors – The effect of past abuse, traumas and stressful events play a significant role in the development of OCD. They are likely to accelerate its development where there are biological or genetic connections. OCD can also develop in children following streptococcal infection.
OCD Treatment Cardiff: Signs and symptoms of OCD
The severity of your mental or behavioural rituals is the major factor in determining whether you have OCD. In the early stages, you may live inside the condition and not realise its development. For some people, it may take a partner or close relative to point out that your rituals are excessive.
When OCD is suspected, it’s important to have the condition formally diagnosed by your doctor.
What are some of the common signs and symptoms?
Checking – Checking rituals are used to prevent harm, danger and avoid feelings of irresponsibility. It becomes more troublesome when the checking rituals cause you to miss deadlines (e.g. being late for work) and when the rituals have a fixed numerical routine that cannot be compromised e.g. you must check it five times or you have to start the ritual over again.
Hand-washing – Hand-washing becomes an OCD problem when you are in possession of elaborate hand-washing routines that focus more on the comfort of the ritual than the cleanliness of your hands. Hand-washing can also be problematic when you still feel anxious about contamination even after you have thoroughly washed your hands.
Cleaning – Cleaning rituals can become an OCD problem when you experience no relief from your contamination fears, despite you having spent an extensive amount of time on cleaning.
Ruminating on relationships – It’s common to obsess when a relationship has broken down; it’s part of the grieving process. With non-intimate partners, obsessing over the intricacies of what was meant by someone or whether your comment was likely to offend someone can mean more than just issues of social anxiety. It could be a sign of OCD when those conversations keep replaying in your mind and you struggle to turn them off.
Counting – Counting becomes problematic when the ritual of repetitive counting distracts you from being able to function in important situations. Or it could be a sign of OCD when you assign excessive superstitious value on to your behaviour e.g. will only take action with “lucky” numbers, and will avoid participation with “unlucky” numbers.
Despising your looks – Disliking some physical features of your appearance is common. Extensively avoiding social situations or spending hours in front of the mirror fixating on a body part that you perceive as abnormal can be linked to body dysmorphic disorder (BDD). OCD is indicated when you place too much importance to your physical features.
Meticulous aligning and rearranging is a sign of OCDReassurance seeking – It’s ok to have moments of doubt and seek reassurance from people that you trust. Continually asking for reassurance on the same issues and being told you are doing this by someone close to you could be a warning sign for OCD.
Symmetry – Organisation issues are troublesome when they exceed perfectionism. Tidying the sock draw is occasionally helpful, but OCD can be indicated when you may not really want to do the task in the first place, but need to “order it and re-arrange it” to relieve anxiety.
Fear of violence – It’s common to have fleeting thoughts about harming yourself, harming others or being harmed by others. But it could be a sign of OCD when these (sometimes intrusive) thoughts are persistent, you continually seek reassurance about these negative thoughts, or you avoid the situations that could cause this harm.
Hoarding – Most people are guilty of collecting things for that “just in case I need it in the future” moment. When those collections pile up and prevent you from routine functions because they are taking over your sleeping space or the ability to use the bathroom, then it’s time to accept that you have an OCD (related) condition.
Forbidden thoughts – Most people have fleeting taboo thoughts that you can dismiss easily. Struggling to reject forbidden thoughts, believing that they are part of your identity and avoiding those people who are connected with your forbidden thoughts can be a sign of OCD.
You can access many more of the common signs and symptoms of OCD in this article detailing the various types of obsessive compulsive disorder.
OCD Treatment Cardiff: Common Treatment Methods
Accepting that you have OCD is an early common obstacle because most sufferers can feel embarrassed and ashamed of the condition. This denial can cause more avoidance and negative, suppressive coping strategies. Like with so many mental health conditions, you will have done your best to prevent the development of your condition. But once the condition is in full swing, it can be very challenging to treat it without external help.
Depending on the severity of your condition, your GP will offer some of the following methods to treat OCD:
Medication – You may be prescribed SSRI (selective serotonin reuptake inhibitor) antidepressant medication from your doctor.
CBT – Cognitive Behavioural Therapy is a talking therapy that explores how your thoughts, beliefs and emotions are influencing your behaviour.
ERP – Exposure and Response Prevention (ERP) is similar to systematic desensitisation where you are gradually exposed to situations whilst changing how you react to them. With ERP, you are assisted by your therapist to confront the situations that cause you anxiety. Instead of carrying out the compulsion, you are encouraged to tolerate the anxiety and resist your compulsive urge.
OCD Treatment Cardiff: How Can Hypnotherapy Treat Your OCD?
The research for treating OCD with hypnotherapy may not be as comprehensive as treating it with CBT and medication, but there are smaller isolated studies that demonstrate its effectiveness. For example, hypnotherapy has been used when treating two OCD patients with contamination fears, with another OCD patient who had an AIDS-related contamination fear and again as an OCD dissociative tool.
How can you benefit from hypnotherapy?
Hypnotic states of awareness are similar to OCD states of awareness
Hypnosis can be an effective tool for treating OCD because the two states of awareness are so alike. In both hypnosis and OCD, your attention is highly concentrated; your mind will “zone out” and become inwardly absorbed into the intense “reality” of what you are imagining.
OCD and hypnosis are similar states of awareness
There is also a similarity with temporal distortion. When you are in hypnosis, it’s common to lose track of time whilst in deep visualisation. In the same way, during the performance of your OCD rituals, hours can pass you by without noticing how much time you have spent inside your ritual or what is happening in the outside world.
With these common features, it’s logical to treat what can be considered as a “hypnotic” condition using a treatment mode that is so similar. You won’t be surprised to know that previous OCD clients that I have treated have been highly responsive to hypnosis.
You can test your level of suggestibility here with this hypnosis test.
Hypnotherapy can help with anxiety reduction
Reducing your level of your anxiety is an important part of coping with OCD. Hypnotherapy has an advantage over other therapies because anxiety reduction is incorporated into the hypnotic induction. But anxiety reduction by itself is not the complete treatment for OCD; being able to confront the emotions that dominate your obsessions so that you can resist the urge of your compulsions is also a necessary part of your treatment. When you are in a relaxed hypnotic state, you will be more receptive to suggestions that will target this treatment goal.
Hypnotherapy can help you interrupt the patterns from past traumas
Using regression techniques selectively, hypnosis can be used to change the negative emotional learning from past traumas. Interrupting the past patterns of thoughts, emotions and behaviour that have consolidated your OCD rituals will help you to break recurrent ritualistic habits that now define your OCD. But this doesn’t mean ploughing through every year of your life as is commonly considered with age regression techniques. Only the most pertinent traumas are selected and reframed for you to benefit from this treatment technique.
Hypnosis can treat the problem part of your OCD mind
Obsessions and compulsions can be intensified when you have recurrent traumas. Your feared reactions then serve to reinforce the impact of these past traumas. Over time, this habitual functioning becomes automated and gets pushed down into your subconscious mind. This process can create (what can be considered as) OCD “parts” of your mind (or ego states) that replay your OCD “programme”. Traditional counselling methods attempt to work on these issues at the conscious level, but this can be a challenging process when this OCD “programme” now resides in your subconscious mind.
In hypnosis, your subconscious mind is accessed. The subconscious OCD “programme” can be treated, adding insight into the sensitising emotional causes of your OCD “programme”. By treating the emotional parts of your OCD mind, you can relearn to cope with these negative emotions, to resist the urge to perform the compulsions and relearn that nothing bad happens when you don’t give in to your compulsions.
Hypnotherapy can be integrated with ERP (Exposure and Response Prevention) Techniques
It’s a common misconception that hypnosis will be the magic wand and will simply turn off your OCD in one session. Is a hypnotherapist actively promoting this belief? If you see any hypnosis being advertised in this way, you will know not to bother giving it a second thought as quite simply, it will fail. When you enter your treatment with this expectation, not surprisingly, you will leave saying “hypnosis didn’t work for me”. ERP techniques are the effective way to treat OCD, but these techniques are not a quick fix either. ERP takes commitment and persistence to go through what can be a short-term increase in anxiety, before your condition gradually improves.
ERP: Confront the emotions that drive your obsessions
What happens in a typical ERP treatment? Under the guidance of your ERP therapist, you learn to confront the anxiety of the obsessions whilst resisting the urge to perform your compulsions. Over time, as you resist your compulsions, the anxiety fades. You progressively learn to challenge the fear that drives your compulsion and accept that nothing catastrophic follows. In other words, rather than taking the short-term “compulsion fix” that has dominated your OCD ritual, you learn to ride out the anxiety as the structure of your OCD “programme” changes.
Another misconception by the other therapies considers that hypnosis is not suitable for ERP techniques because when you are “put under”, you will not be exposed to the anxiety sufficiently to change what drives the urge to perform the compulsion. This depends on how hypnosis is being used. There is some previous research with a war veteran that demonstrates how hypnosis can be integrated with ERP techniques successfully.
Hypnotherapy offers a multitude of therapeutic interventions to treat OCD. It is only limited by the skill of the hypnotherapist employing these techniques. Other therapists may not be able to appreciate this enough if they don’t have the experience of using hypnosis. Hypnotherapy can thus be mistakenly classified as a single-approach modality in which you are “made” to change in one session or it doesn’t work. There are many reasons why other therapies outside of hypnotherapy would fail to treat OCD too, particularly if you only had one treatment session.
Hypnotherapy can treat the emotions that are manipulating your feared reality
Contained within your deceptive OCD programme of “fictional outcomes” is a mix of unwanted (and sometimes intrusive) thoughts, images, sensations, urges, emotions and behaviour. The biggest driver that formulates your OCD “programme” and convinces you that your OCD story is real are the emotions and feelings of guilt, shame, disgust, blame, fear, responsibility etc. Without these strong emotions and feelings underpinning your condition, you would be able to dismiss the thoughts and triggers as nonsense. Instead, you fear them, avoid them, seek reassurance from them and have the strong urge to immediately perform the compulsions as safety behaviour.
Hypnotherapy can help you access, welcome and embrace the emotions and feelings that overwhelm your OCD programme. As part of your integrated ERP hypnotherapy treatment, you can learn to tolerate these negative emotions and feelings that are out of control. This process of emotional desensitisation will give you the confidence to believe that the intrusive thoughts are irrational, overestimated and undeserving of those needless and time-consuming compulsive rituals. Hypnotherapy can convince you that you are strong enough to deal with the deceit behind the OCD programme, to confront the painful emotions and feelings until they pass. With hypnotherapy, what awaits you is emotional freedom from your OCD programme.
OCD Treatment Cardiff: For more information on how hypnotherapy can treat your OCD contact Richard J D’Souza Hypnotherapy Cardiff
After defining obsessive compulsive disorder, this article will explore the various types of obsessive compulsive disorder.
Obsessive compulsive disorder (OCD) is a type of anxiety disorder. The condition can be firstly characterised by having an obsession in which you have repetitive, unwanted, uncontrollable or intrusive thoughts, images or urges that cause emotional distress.
The obsession may then drive the need to perform certain compulsions which form the second part of the condition. Compulsions are repetitive behaviours, rituals or acts that you perform in order to alleviate the emotional distress caused by the obsession. The benefit is usually temporary however.
A way of life for many people; an excessive compulsion for those with OCD
Sometimes the compulsion remains as a “pure obsession”, where the individual uses an additional internal thought-based ritual to alleviate the emotional distress of the primary obsession e.g. you silently repeat a word ten times to “close” the cycle of anxiety. The additional connected “safety” thought is not usually observable by another person.
Common Types Of Obsessive Compulsive Disorder
Common obsessions include (1) fear of contamination; (2) arranging; (3) fear of harm; and (4) forbidden thoughts.
Common compulsions include (1) decontamination; (2) rearranging and repeating; (3) checking; and (4) cleansing and reassuring.
Whilst there is a common connected compulsion that alleviates the distress of a specific obsession, an individual suffering with OCD may incorporate several different compulsions to alleviate the emotional distress depending on your specific history.
Obsessive thoughts can originate from (or be reinforced by) strong emotional experiences or traumas. Common emotions can include disgust, guilt, fear, blame and shame learned from authority figures in childhood or generated by the individual. These emotions can be connected to the following types of Obsessive Compulsive Disorder:
Obsession: Fear of contamination
A fear of contamination can focus on how your own acts or omissions can contaminate you or how your acts can affect other people. They can also include how other’s acts or omissions can contaminate you.
The most common form of contamination is by direct physical contact. But contamination can also be spread through your senses e.g. how it looks, smells, sounds, tastes and feels. The memory trace of something contaminating can persist for some time after, demanding specific rituals to alleviate the distress of the obsession.
The list of objects that you fear as contaminants can be specific and quite extensive, more than what is commonly considered as a preoccupation with germs, dirt, illness and viruses. For example, contact with animals, bodily fluids and excretions, chemicals and spoiled food may also be feared as a potential source of contamination.
But the fear of contamination can also involve a type of mental contamination where there is no direct physical contact with harmful substances. The mind becomes infected by a certain thought, word, image or memory that connects you with something “contaminating” and this causes an internal feeling of dirtiness and can’t be cleansed with a physical compulsion. An example might be seeing a possession adored by a previous abuser. This mental contamination needs a specific thought-based compulsion to cleanse it and lift you out of the association, like an image of being free from your abuser.
Even more disconnected to physical contamination is a type of “magical contamination” in which the individual feels contaminated by an “unclean” word or unlucky number for example and has gradually become associated with contamination. Magical associations make very little sense to another person who does not share the same belief, but are “real” enough for the individual with magical OCD.
Connected compulsion: Decontamination
Hours can be spent on decontamination cleaning rituals
Common compulsive strategies to alleviate contamination fear distress can include avoidance of the object, person or situation. Avoidance can be constructive in the short term but will cause high anxiety when there is an obligation to interact with the object.
If avoidance is not an option, then other strategies will be used to limit contamination including using protection. Gloves, masks and other protective equipment suitable for the situation or task may ease the level of anxiety of direct contact.
Confidence in the protective equipment may be complemented by excessive washing, cleaning and hygiene rituals. These rituals can be time-consuming and can adopt a specific ordering of the routine to feel decontaminated. If doubt is triggered by any part of the ritual then the ritual will need revising and until it feels cleansed.
Sometimes the confidence in the ritual is not enough and someone believes that the contamination has developed a new medical condition. This then needs external verification by a doctor or a medical test to reassure the contamination fears.
Someone who uses internal thought-based compulsions and magical thinking may try to cleanse the contamination by repeating “clean” words or counting to a “clean” number to alleviate the distress of contamination.
Obsession: Arranging, organising and sequencing
People with an orderliness, symmetry, completeness or “just right” OCD have an obsession with the way that objects or the features of something are arranged and how they feel. Based on specific criteria, there is extreme discomfort and tension when there is a perceived misalignment and something “does not fit”. The perceived misalignment can be registered through any of your senses; how it looks, sounds, smells, tastes or feels when the object is being touched. Common situations can include attending to features of your own appearance such as how you dress, wear make-up or set your hair, the precise position of furniture, the alignment of personal items, the sound of a note being played on an instrument or the way that written content has been completed.
Arrangement obsessions can also combine with the other types of obsessive compulsive disorder where it necessary to structure the sequence of a cleaning ritual (with contamination OCD) or maintain the exact routine of checking securely (with checking OCD discussed below) for the distress to be alleviated.
Magical OCD associations can indirectly connect the perceived misalignment of an object with the fear of harm to someone or the fear of a catastrophic event.
Connected compulsion: Rearranging, reorganising and repeating
Doubting that the arrangement is “just right” drives the compulsion to rearrange and repeat the ritual as many times as it is needed to achieve a deeper feeling of comfort. The process can be time-consuming, often with nocturnal hours being spent on the ritual. The result is usually mental and physical exhaustion.
It is not uncommon to arrive late or miss deadlines for appointments as doubts creep in with “just not right”-thoughts. Without getting it right, it would disturb the next situation like being able to concentrate on an important meeting. Or it can cause high anxiety with fear of failure if say an academic assignment has been submitted with errors.
Realigning objects to alleviate “just right” symmetry obsessions
This type of OCD, like the other types of obsessive compulsive disorder, can impact on relationships with time-consuming rituals being prioritised over quality time with family and friends. Social interaction at the individual’s house may be avoided in case another person disturbs the symmetry of objects. Even outside the home, meeting new people can involve a degree of social anxiety when you fear judgement from others. Will they notice your personal appearance imperfections?
When you feel that something is not right, magical OCD compulsions might be used to break the misalignment anxiety. Irrelevant objects might need to be touched in a certain way or over a certain number of times to feel comforted again.
Obsession: Fear of harm or damage
With a fear of harm or damage OCD, you have an obsession that through your acts or omissions, you could accidentally, unknowingly, negligently or impulsively harm yourself, harm somebody else or cause damage. These thoughts and urges are repetitive, unwanted and often intrusive with no actual intention of harming anyone or causing damage to anything. When having these intrusive thoughts, you fear losing control over your acts or omissions and this loss of control could then result in subsequent physical harm or damage.
OCD harm fears can generate other shameful fears that there is something desperately wrong with you to be having these intrusive thoughts. You may fear being a secret sociopath and that people or the media will confirm your fears and expose you to the world. With this obsessive insecurity and distrust, you seek constant reassurance from other people or the media that these fears are not true. Ironically, if they give you reassurance, you then question their motives for being honest with you and wonder if there is a conspiracy against you.
Even though it is illogical, OCD harm and danger obsessions might connect the “power” of your thought or mental activity to the actual physical cause of harm or a disaster. When someone is harmed or damage has been done, you then feel an overwhelming sense of responsibility that you are the instigator through your thoughts.
Connected compulsion: Checking
Being in fear of harm or damage by losing control pushes your compulsion to ritually check and recheck that all is safe. You may also seek constant reassurance from other people by continuously asking them, texting them or by thoroughly researching if your danger fears are true.
Other reassuring compulsions including hiding objects that could harm people or avoiding situations in which you consider you could lose control and then act on your obsessions.
Checking locks is a common fear of harm compulsion
Checking compulsions aim to ease the distress associated with the uncertainty or doubt that a situation is safe. For example, that you really have locked the doors to prevent an intruder from entering your house or turned off the appliances in case there is an electrical problem that starts a fire.
When going through your checking ritual, doubts can creep into the process and you wonder if you missed something that could then result in harm. As with the other types of obsessive compulsive disorder, these checking rituals develop a sense of being “just right”, but the feeling can be misplaced with general feelings of anxiety. On generally anxious days, the checking ritual can be confusing and exhausting, wondering if your senses are failing you.
Other compulsions can include returning to the location several times to check that nothing harmful has happened. For example, as a driver, you may retrace your last journey to ensure that the road hump you drove over was not a pedestrian. You may want to take numerous photographs or videos of a situation to be confident that no harm was caused. With bigger disasters, you might ritualistically check the newspapers or research on Google that a catastrophe has not happened.
If you fear self harming you may constantly check yourself in case you have inadvertently hurt yourself. These self harming fears can cause psychosomatic sensations in various parts of your body like tingling or tension, as prompting you to believe that you may have harmed that part of your body and not realised it. These false alarms then cause you to feel constantly on edge, disconnected from your body wondering if a sensation is real or not, checking constantly for reassurance that you have not self harmed.
With an obsessive fear of sexual harm, you could fear that your arousal may trigger an impulsive sexual attack on someone. To alleviate this distress you may be concerned about sensations of sexual arousal. But your sexual thoughts could inadvertently influence you to feel sexually aroused when seeing someone that you don’t want to be attracted to. By triggering sexual arousal, you may then fear that your arousal is out of control and must be connected to real sexual desires towards that person. If you cannot control these desires, you may then impulsively act on them and sexually attack them.
With magical OCD checking compulsions, you might use a specific number of times that you need to check for the situation to feel “just right”. Or you may have “unlucky” checking numbers that you avoid because they have been connected to previous disasters. If the unlucky number is presented in any way, internal mental rituals might then need to be used again to neutralise the fear of harm.
Obsession: Forbidden or taboo thoughts
People who don’t have OCD are usually able to dismiss fleeting taboo thoughts that go against your individual nature or your cultural or religious values. Sufferers of OCD however are unable to separate the intensity, frequency and internal judgement of these thoughts or images. Having these forbidden thoughts convinces you that they must be part of your identity.
Forbidden or taboo OCD obsessions include thoughts or images that are physically violent, sexual and/or blasphemous towards people or subjects that are adored or valued.
Intrusive thoughts of violence can include strangling, stabbing and mutilating someone with any variety of dangerous objects. Examples of taboo sexual obsessions include intrusive thoughts about your (or your partner’s) infidelity, paedophilia, rape, incest, bestiality or thoughts against your sexual identity. Forbidden religious obsessions can include thoughts that might question the strength of your religious beliefs or thoughts that break religious laws (also known as scrupulosity). They can also include intrusive thoughts that involve shouting blasphemous words in a religious location or involve intrusive sinful or sexual thoughts about your deity.
As with other types of obsessive compulsive disorder, those with taboo or forbidden obsessions have no intention of acting upon these intrusive thoughts. This is what distinguishes you from more malicious psychological personality disorders. Instead, you worry that in the future you may lose control and then act on your taboo obsessions. You are convinced that by having these thoughts, there must be something wrong with you.
Another important point is that whereas sexual fantasies involve some form of potential pleasure, sexual obsessions are distressing and involve guilt, shame and self hatred. The responsibility you feel for having these thoughts causes you to over-control them, suppress them and seek reassurance from them.
Magical OCD forbidden or taboo obsessions might exaggerate the power of these thoughts being able to actually cause these events to happen. Magical connections may also be made with what you define as “unlucky” events e.g. by attending a funeral it will cause more death, or believing that something bad might happen on a certain day of the week.
Connected compulsion: Cleansing, reassuring, purifying and undoing
Compulsions related to having forbidden or taboo obsessions aim to alleviate the emotional distress of your intrusive thoughts. Your compulsive acts can include many of the other types of obsessive compulsive disorder behaviours. Objects that could be used to inflict harm on someone may be ritually hidden and then repeatedly checked that the object has stayed in its safe place. Avoidance of the associated situations, people or objects is another common short-term strategy.
Reassurance that you are not the bad character that you define yourself to be will be sought from various sources. Those people that you trust, or consider an authority, and are likely to maintain confidentiality over your sensitive issues will be constantly approached like close family members, doctors or clergy members.
Due to the sensitivity of the obsessions, you rarely feel confident enough to talk to other people about your taboo thoughts in case they misunderstand your condition and label you as malicious or as a potential criminal. This suppression maintains the internal suffering of these disturbing thoughts and your desperate need to alleviate your distress. Reassurance may also be repeatedly sought from online sources by checking the content of relevant topics.
Praying to neutralise intrusive religious obsessions
Intrusive thoughts can feel internally contaminating and may be comforted by indirect compulsions. For example, washing compulsions may be used to “cleanse and purify” your intrusive thoughts from your body into your mind. Other arranging compulsions may also be used to help you feel “clean” by maintaining order and alignment in your personal life. Internal mental and magical compulsions may be used like repeating “good” words or excessively praying to undo and cancel out the intrusive negativity of your religious intrusive obsessions. Counting may also be used as a strategy to block intrusive thoughts from entering your mind.
Some compulsions can also serve as an outlet to release the potential urges in your intrusive obsessions. Excessive use of porn may be used with intrusive sexual obsessions to manage the build up of your sexual arousal. Drugs that have a sedating effect may also be over-used to reduce the potential urge to be aggressive.
Other Types Of Obsessive Compulsive Disorder
Compulsive hoarding
Compulsive hoarding has been previously listed as one of the types of obsessive compulsive disorder. It has been re-classified as a condition in its own right because many hoarders refuse to accept that they have a problem. In some cases however, the individual’s hoarding issues can be related to OCD.
Hoarding disorder is the excessive retention and collection of objects. Your (and other people’s) living space is swamped by these objects causing potential burdens on your day-to-day functioning, your health, finances, work spaces and social ability. Common living and mobility around the home is obstructed and becomes hazardous or potentially hazardous.
Compulsive hoarding is connected to many issues including the exaggerated importance and emotional attachment of material possessions. Hoarders feel guilty and wasteful about throwing items away and so will retain it in case it has a future use. You continue to make excessive purchases of these treasured items in an attempt to increase the collection, often sacrificing other functional spaces like shower cubicles or ovens.
These collectable items can have connections with one’s history and identity and thus you would feel grief if these items were interfered with or thrown away. Items can also develop personalities and can act as replacements for anticipated memory loss; “I’ll keep hold of this just in case I forget...” is the common response.
Hoarders may have lived in poverty during childhood, experienced trauma following a major lifestyle change like a bereavement or house move. There may be other mental health issues too. Hoarders are also known to suffer with perfectionism and behavioural avoidance. You can have problems with decision-making, organisational skills and procrastination.
Rumination
Rumination is the repetitive and excessive thinking about the same event. It can involve reflecting on issues which is more analytical in nature. Another type of rumination is brooding which is more negative, repetitive and continual. Hours can be spent being self absorbed in deep thought on topics of morality that may not have satisfactory conclusions or on depressive issues in which the individual is unable to create closure.
Trichotillomania (hair pulling)
Sufferers of Trichotillomania have strong urges to pull hair from any part of the body. It is considered an impulse-control problem often in response to certain (often unconscious) emotional cues such as stress, anxiety, boredom, loneliness and worthlessness.
Body dysmorphia
Body dysmorphic disorder is the excessive preoccupation with a perceived defect in one’s appearance. The sufferer is usually convinced about the defect’s negative qualities. The condition can relate to issues of low self esteem, anxiety and perfectionism. It can involve numerous repetitive behaviours like, checking in mirrors, skin picking and reassurance seeking.
Other specific obsessions
Other obsessions may not fit precisely into the above types of obsessive compulsive disorder but can still be classified as OCD. Obsessions can include specific superstitious fears like not walking on the cracks on pavement, luck or bad luck related obsessions, inquisitive obsessions (needing to know all the details of something), speech-related obsessions (speaking perfectly) and fears of losing things. Some obsessions can focus on the hyperawareness of bodily functions like blinking or swallowing.
Other specific compulsions
Other compulsions can be specific to each individual and may not fit the common types of obsessive compulsive disorder listed above. They can include list-making in which the sufferer believes that they will forget something important and this will then lead to a catastrophe. People who fear making mistakes can have the compulsive urge to tell people absolutely everything but in doing so can make a minor issue into a bigger problem e.g. telling your partner every time you notice someone else who is attractive, or feeling the need to elaborate on or confess every detail of a specific issue. Other compulsions can include, skin picking (excoriation), nail-biting, ritualised eating patterns, superstitious behaviours, blinking or staring rituals, and specific touch-related compulsions.
Summary of types of obsessive compulsive disorder
OCD is a serious medical condition that can cause significant dysfunction and emotional distress. With any type of therapy treatment, the therapist will initially explore the make-up of your obsessions and compulsions. They can then devise a treatment plan to help to address the specific features of your condition. Self help coping with OCD methods will also complement your therapy.
Types of obsessive compulsive disorder: for more details on treatment for OCD please contact Richard J D’Souza Hypnotherapy Cardiff
Claustrophobia is known as the fear of confined spaces. It is categorised as a type of anxiety disorder and as a specific (rather than a complex) phobia. The term is derived from the Latin word claustrum which translates as a “closed space" and from the Greek word phobos meaning "fear".
A lift is a common claustrophobic situation to avoid
Sufferers of claustrophobia have an illogical fear of being trapped in a confined space. Once trapped, you are convinced that you will have no means of escape.
Natural to the development of claustrophobic traumas is the anticipation that the catastrophic outcome is certain. The mere thought of entering this confinement is enough to cause strained breathing as if your chest walls are threatening to close in on your lungs until complete suffocation.
Breathlessness is a common feature of high anxiety or a panic attack. A panic attack is typical symptom of all phobias. With claustrophobia, breathlessness is one of the most prominent features of the panic attack.
Where possible, avoidance is commonly sought to alleviate your anxiety symptoms. But as most claustrophobic sufferers are aware however, avoidance of these confined situations just intensifies your sensitivity to the relative confinement. It also increases your desperation to evacuate when you perceive that you are trapped or about to be confined in a situation.
Claustrophobia Statistics
Claustrophobia is an extremely common phobia. It is estimated that around 10% of the population in UK are affected by the condition in their lifetime.
Types of claustrophobia
Claustrophobic sufferers fear being trapped, fear being restricted and/or fear being breathless. The history of your personal traumas will influence your perception and ability to cope with either of these situations listed below.
Fear of confined spaces
You fear the relative closeness of the walls/objects that constrain you and/or obscure your view. Without seeing “space” immediately around you, you fear entrapment. You struggle to place trust in what operates (controls) the constraint e.g. an electronic door. The sound or visible operation of the exit is a strong trigger for your panic reaction.
Your fear of these situations can be generalised or specific to one situation. They can include:
Mechanical situations – lifts (elevators); public transport including airplanes, trains, coaches, ships; yachts and submarines; the underground and subway trains, particularly those that enter extended tunnels; carwashes; MRI or CT scans; fairground rides with limited visibility; small cars or taxis that are centrally locked.
Structural situations – Toilet cubicles; wardrobes and closets; cellars and basements; store dressing rooms with lockable doors; any confined spaces or rooms that are dark; tight stairwells; mazes or labyrinths; mines or underground sites; tombs and coffins; shower cubicles; trailers.
Natural situations – tunnels; caves or caverns.
Fear of being immobile
Claustrophobic sufferers also trigger anxiety when you perceive that your movement is restricted. In these scenarios, you can appreciate that there is there is significant space in the distance, but you, the situation or other peopleinhibit or control your movement, or demand that you “stay put”. Feeling obstructed (as you would in a physically confined space), your panic prepares your limbs for “flight” mode, in readiness to run away to safety. Without actually using up this anxious energy, this can be felt as muscular tremors in your legs (feeling “jelly-like”). Being around people and displaying your panic symptoms (tremors or desperation to leave) can then cause you to feel embarrassed, further adding to your fear cycle.
The fear of mobility situations can include those listed above (in fear of confined spaces) and the following:
Fear of being restrained in a crowded situation
Mechanical situations – traffic jams, driving on motorways or roads with high surrounds e.g. high bushes or trees; sitting in the back seat of a two door car or taxi; using an escalator; a ride at the fairground/amusement park; revolving doors.
Structural situations - hotels with sealed windows; being in the higher levels of a high rise building.
Treatment situations – having a injection; needing a hospital medical procedure; being treated at the dentist/optician, or hairdresser/barber/beautician.
Social situations – as a young child, losing sight of your family particularly amongst crowds; being in the middle of large crowds; bars and nightclubs; public speaking situations; work meetings; interviews; some social situations, some performance anxiety situations e.g. driving test; supermarket queue/line; other situations where you need to line up.
Venue situations – inner/centre seating position (not close to aisles or windows) or crowd potential at cinemas, theatres, concert and sports venues; prisons.
Natural situations – forests.
Fear of suffocation
The panic response which triggers breathlessness influences the claustrophobe to fear suffocation. You become hypersensitive to anything constrictive or partially constrictive touching your body, particularly over your head and respiratory organs. Environmental conditions where breathing is strained (because of heat or humidity) can also trigger anxiety with the urgent need to remove clothing to cool down and catch your breath.
Since feeling hot, sweaty and itchy are common anxiety symptoms, this fear of constriction can extend to other parts of the body when they are also constricted in some way e.g. a cast around a limb. It’s as if the immobilised limb is being “choked” of air when it senses increased temperature changes and cannot move. The reflexive need to “evacuate” your whole body from the situation causes general anxiety which can only be eased when you have “ripped off” the constriction at the source.
Fear of suffocation situations can include any of those listed above in close proximity to your body and the following:
Clothing situations - Wearing tight-necked or tight fitting clothing over your body e.g. ties, polo neck sweaters, girdles etc.; fancy dress suits and masks.
Apparatus/equipment situations – wearing apparatus over your face or head e.g. crash helmets, masks, breathing apparatus, medical apparatus; immobilising casts over your body; sleeping with your head under the bed clothing.
Environmental situations – swimming under water with or without breathing equipment; hot and humid climates, being at high altitude.
What causes claustrophobia?
A combination of childhood direct traumas and indirect traumas from your authority figures (usually your parents) will have the most impact on the development your claustrophobia.
Some of the most traumatising childhood experiences include being accidentally (or purposefully as a game or as a punishment) locked in a box, cupboard or small room; being trapped in darkness; getting lost in a relatively confined space e.g. a series of tunnels; being separated and losing your parents in a crowd of people; being left for a period of time or abandoned in a confined space (e.g. the car) by your parents; near drowning in deep water; getting your body, particularly your head stuck or trapped somewhere.
Your biology can also be connected to your claustrophobic fears. Previous childhood bullying involving near-suffocation (being strangled) can also contribute to adult claustrophobia.
Spatial distortion is often identified as a cause of claustrophobia where you underestimate the horizontal distances of objects. However, it is unknown whether this distorted spatial perception is biologically linked at birth or is over-developed through trauma. Someone with a spider phobia is similarly likely to give an exaggerated account of their last spider trauma and the apparent size of the arachnid. Has this size distortion come from birth or learned from traumatic experiences?
Most people can recall where they were and give precise details of their location at the time of an emotional experience. These experiences can be good or bad. Some people are extremely location-sensitive; usually those who are visually or spatially-oriented learners. With this learning style you can prioritise making an intense association with the physical features of your location (e.g. the size of the room) and your emotional experience, over what you were doing in the situation. With a visual learning style you may be more vulnerable to developing spatially-oriented fear, typical of the beliefs held with claustrophobia.
Click this link for detailed information on the general causes of a phobia.
Major Common Symptoms
There are numerous claustrophobic symptoms that vary in severity including:
Breathlessness, strained & rapid breathing (hyperventilation). A history of asthma attacks may complicate this symptom.
Choking sensations.
Body tremors, particularly in the legs. The legs feeling “restless”.
Increased heart rate.
Changes in temperature in the form of sweating, hot flashes or chills.
As a child, regardless of how you have acquired your claustrophobia, you will continue to avoid these confined spaces to alleviate your anxiety. If your family understand your condition and treat it sensitively, it will limit the frequency of your panic attacks.
Local family holidays can avoid the need to fly abroad
Most situations have alternatives. Lifts can be avoided where stairs are available. The learning value of a school trip and the trauma of using a school bus/coach for transport can be assessed by all parties involved. If the family situation allows, the parents may provide their own transport. With family holidays, where there is a fear of flying, the family can agree to stay in UK or use an acceptable alternative method of travelling.
As a growing child, you begin to understand the physiology of your condition. This helps you to anticipate and avoid many confined situations. But the need to confront them becomes a more of a challenge during teenage years, when there is growing pressure of social conformity. Fear of embarrassment (katagelophobia) connected to a social display of your panic attack adds another layer of anxiety to the fear of confined spaces. Teenagers with social anxiety want to avoid any behaviour that draws attention and is likely to cause humiliation in front of your peers. Amusement parks, large crowds in bars and nightclubs, and centre seating arrangements in concert or cinema venues are just some of the popular youth culture situations that could trigger panic attacks. Having the confidence to admit the condition can be a dilemma because it could be a source of ridicule by less sensitive members of the peer group.
Some of these confined situations can affect the teenage pupil on a daily basis during school, affecting formal and informal public speaking situations. They can disrupt academic performance with the added stress during tests and exams. Excessive anticipatory anxiety may be detrimental to school attendance levels causing the teenager to suffer panic attacks each morning.
If the claustrophobia and social phobia is mismanaged, the teenager or young adult will continually associate feeling safer when you are outside of the confined social situation. With each hurried evacuation, the urge to suddenly dash out of the situation becomes more impulsive. This can impact on infrequent but necessary situations like being stuck in traffic, having injections, medical procedures, MRI and CT scans, dental visits and other treatment situations like the barbers/hairdressers. The need to avoid the embarrassment of this panic response can even affect the development of relationships causing the abandoning of first dates, only to regret the cancellation after. If you have overcome this initial hurdle and the relationship flourishes, meeting the partner’s best friends and family can be traumatising.
Work life can have its claustrophobic moments too, affecting participation in meetings and when speaking in public. Inevitably career progression can be hindered, avoiding interview situations and assessed presentations that are necessary for promotion.
As more situations are avoided and opportunities are lost, the young adult may then be ready to assess the need to seek help. The subconscious layers of fear are well-formed at this stage however. To overcome it will demand a strong, determined desire and a reasonable period of behavioural adjustment.
Professional help is still beneficial at this stage. The therapist will objectively evaluate the significance of the background traumas and identify the specific treatment criteria that will progressively alleviate your claustrophobia.
Treatment
Phobias are not usually formally diagnosed by your doctor. Observations by close family and friends may be met with a period of denial before fully accepting the condition and how it continues to affect you.
Self-help – Where possible, constructive avoidance is the most common self help treatment method. But avoidance is usually a short-term fix without developing any skills and techniques to overcome the phobia.
When you are ready to confront it, effective self-help methods however can include the use of breathing techniques to manage the general anxiety symptoms, particularly the fear of suffocation.
Progressive self-help methods will consider your subjective criteria that exacerbate the fear, combined with repetitive, graduated exposure to those confined situations. Using this method, breathing techniques are used to keep the anxiety at moderate levels before gradually increasing the confinement of the physical environment. This will prevent high levels of anxiety or “flooding” which can have an adverse effect on overcoming the phobia.
Choose criteria in which you feel comfortable first, and then add to the intensity in gradual stages. The criteria can include:
Build trust with the people you are working with to reduce anxiety
Defining each situation as one where you can choose to calmly vacate (where possible).
Assessing the relative physical confinement of the room or situation. Evaluating the notable design features and their position e.g. opening windows to “give air” and to permit a view, and sitting towards the aisle etc. (For many claustrophobic sufferers, how far you can see out into the distance is a significant feature of your anxiety management. You may be physically confined in the similar dimensions of a situation e.g. in an airplane or glass lift, but just because you can see out of a window, it will make a huge difference to your anxiety and drastically reduce your fear.)
Establishing the number and proximity of the exits.
Gradually extending the duration of the confinement. Aim for the anxiety to subside before changing the confinement of the situation or leaving the situation if possible.
Aiming to access personal control of the exits if possible, rather than mechanical control or indirect control by another person.
Establishing how many people are present in the situation and your relationship with them. Are they sensitive to your anxiety?
If you are having a professional treatment, learning more about the treatment process and what you are likely to experience.
Assessing how much you trust the professional directing the situation. Is there any benefit by admitting your fear to them? Can this trust be developed before the treatment situation?
Identifying a helpful purpose for yourself in the confined situation e.g. practising breathing techniques, meditation, or mindfulness, cooperating with the treatment process, managing your time with activities if there is extended periods of boredom, learning presentation skills if giving a presentation etc.
Practising using any “suffocating” or confining apparatus/equipment outside of “real” situation e.g. learning to spend time with a face mask on, relaxing in your own company or with someone you trust who can give you assistance if your anxiety is excessive.
Other treatment methods include:
Medication - Your doctor may prescribe antidepressants or an anti-anxiety medication in order to help you treat your anxiety symptoms. Prescribed medication can be combined with therapy.
Cognitive Behavioural Therapy (CBT) – CBT is a talking therapy that focuses on the negative thoughts that drive your fear. The treatment may combine exposure therapy to help you overcome your phobia.
How can hypnotherapy help you overcome your condition?
People with phobias are considered highly responsive to hypnosis. This hypnosis test will help you assess your level of suggestibility.
Your hypnotherapy treatment will use a combined approach to help you overcome your claustrophobia including regression techniques to remove the cause of your phobia, controlled exposure (systematic desensitisation) and panic control methods. Visualisation techniques, similar to those used with virtual reality computer simulations will be integrated into your treatment to realign your spatial distortion.
There is more information in this link on how hypnotherapy can treat your phobia.
For more information on treatment for your claustrophobia in Cardiff, contact Richard J D’Souza Hypnotherapy Cardiff
Online Therapy: As the coronavirus outbreak restrictions grip the nation, its effect is undoubtedly having an impact on the way we live, work and spend our leisure time. It is important to follow the government guidelines to minimise the spread of infection. Wash your hands, keep surfaces clean and cover your sneezes and coughs. Self-isolation and social distancing has been advised to contain the coronavirus.
Online Therapy: Pre-existing health conditions
Self isolation has been advised to contain the coronavirus
Changing your lifestyle to protect yourself from the coronavirus can have a negative effect on your emotional health. Your may have had emotional issues that caused you distress before the coronavirus outbreak. Now with the need to self-isolate, many of these emotional issues will be intensified, increasing feelings of fear, anxiety and loneliness.
Anxiety
Coupled with anxiety is the inability to manage uncertainty. Your mind will dwell on catastrophic outcomes, anticipating the worst case scenarios if you (or someone you know) has underlying medical conditions. If you have pre-existing health anxiety, you may be convinced that minor benign symptoms are a sign that you are infected. If a medical test proves negative, you might dismiss it and fear that any new symptoms will need a retest. During calmer moments of rationality, you will feel guilty that you are wasting the very limited resources available at your GP surgery during the pandemic. Panic disorder, characterised by random panic attacks, will also be more distressing with the current level of communal fear.
OCD
Obsessive compulsive disorder is another pre-existing condition that can be intensified during the coronavirus outbreak. OCD can include a number of repetitive thoughts and behaviours such as counting, checking, arranging items in a specific order and hand washing. With a fear of contamination, compulsive hand washing can be excessive. You are convinced that your hand washing is not thorough enough. You then start the hand washing routine over again until you feel comforted.
Prior to the coronavirus outbreak, some OCD sufferers may have self-isolated as a “safety” behaviour, unconvinced that in normal conditions there was sufficient protection against infection from others. With the government advising self-isolation, the OCD sufferer will be “proven right” to be in fear and may become near-agoraphobic even after the coronavirus pandemic is over.
Phobias
There are similarities with OCD hand washing and certain phobias, such as a mysophobia (fear of germs). With both conditions, you spend an excessive amount of time washing hands but rather than being a comforting ritual, mysophobia stems from a fear of contamination. A fear of contamination sufferer can have both conditions.
Other phobias will generate more anxiety during the coronavirus crisis including monophobia (fear of being alone), thanatophobia (fear of death), xenophobia (fear of the unknown) and nosocomephobia (fear of hospitals). Those with social phobia (fear of embarrassment) and agoraphobia (fear of open spaces) may ironically experience a reduction in anxiety with the current self-isolation and social distancing advice, compared to your gregarious and extrovert counterparts.
The coronavirus pandemic will activate many fears, obsessions and compulsions
Looking ahead beyond the coronavirus pandemic, the situation will have an impact on those who have a predisposition towards health anxiety, OCD and certain related phobias. The crisis can act as a “traumatising” event, activating fearful, obsessive or compulsive behaviours. It will undoubtedly act as a reinforcing event that will exacerbate many of these pre-existing conditions.
Online Therapy: Lifestyle changes
With the major change in your lifestyle during the coronavirus pandemic, the need to self-isolate and social distance throws the usual demands, routines and ways to relax into chaos. For example:
For some people, work can normally act like a distraction giving you something to focus on when there is anxiety.
People will feel loneliness without the comfort of face to face human contact.
Stress will be higher with the closure of many resources. Families with small children may find it difficult to entertain their children for what could be months (?), especially with their usual physical activity outlets closed e.g. parks. Bad weather will also deter peoples from wanting to go outside.
An absence of goals and increased boredom can heighten feelings of depression.
There are a number of other lifestyle issues that can be worsened during the coronavirus pandemic.
Increased anxiety can affect sleep
Family home life can be more stressful particularly for teenagers with their usual social venues closed (e.g. pubs, nightclubs, wine bars etc.)
Normal eating patterns can be affected without an established routine. Snacking can become an activity to fill time causing people to gain weight.
Boredom and isolation can be a trigger for intensifying negative habits and addictions.
With boredom, people can self-medicate more than usual, drinking more alcohol at home and smoking more cigarettes.
People who are socially motivated to exercise may find it difficult to motivate themselves to exercise during the coronavirus pandemic.
Online Therapy: Finding a way through
It can take time to settle into positive lifestyle patterns and accept the emotional impact of the coronavirus pandemic. But there can be effective ways to cope:
Wash your hands but... – If you have contamination OCD or health anxiety, it’s likely that your rituals will be excessive. Keep to the advised guidelines of 20 seconds. Consider if you are washing hands as a ritual for it to feel comforting or for the purpose minimising the spread of infection.
Work and study from home – Working from home where it is possible will minimise exposure to the coronavirus. Check on government websites if you are entitled to any financial assistance (benefits or loans). As with home studying for many pupils and students now completing their study courses, working from home demands self motivation to assign quality time to your work/studies.
Limit media exposure – Look at reputable media sources no more than once or twice a day. Ignore social media gossip as these often unreliable sources are likely to increase your fear about the coronavirus; they usually lack evidence to back up their claims. Appreciate that just because you think or read about something on social media, it doesn’t make it right or always mean that it will always come true.
Plan ahead for routine medication – With many medical services feeling the strain, ensuring that that you request repeat prescriptions early will minimise the fear that you may be without important medication.
Online communication can help feelings of isolation
Use phone/video calls to communicate – Where you have access to electronic forms of communication, devote some part of your day to social interaction, keeping in touch with close family and friends.
Other ways to exercise – Find other ways to exercise safely to reduce stress and physical tension. Uninterrupted walking is a good form of exercise. If you have no medical conditions, running or circuit-based activities on YouTube can motivate you to exercise a variety of different muscle groups. Just getting some fresh air by stepping outside your door and connecting with nature (if it is in easy reach of your home) can help clear your mind.
Devise an effective home routine – Working from home with small children can be challenging. How and where you each spend your time in each part of the house will need a discussion to accommodate everyone’s needs. Spend time with your children helping them to understand the facts about the coronavirus pandemic and how it has changed your lifestyle. Consider any hobbies that you can (re) start, especially the ones that you keep saying “if only I had more time...”
Allocate some time to worry – Using some of the relaxation techniques above, devoting some “active worrying time” can help you appreciate the difference between the present and being in fear of the future. It’s ok to feel anxious during a pandemic, but the feelings need to be placed into perspective with hopeful feelings too. By acknowledging worries as wasteful thoughts you can work on disposing them during your “mindful” exercises. This will also help you to...
Focus on what you can control – Focusing on what you can influence in your life will help you feel like you have more control over it. This approach is very different to focusing on concerns which tends to be worry-based and has very little impact on outcomes.
Take care of your lifestyle issues – Set home based goals that are realistic under the present conditions, take moderate exercise, eat healthily, learn how to sleep well, quit destructive habits like smoking and reduce your alcohol intake. By taking care of your health and wellbeing, it may prepare you to fight the coronavirus should you become infected.
Help your community – Where it’s safe to do so, helping others will lift your mood. Even small acts of altruism, like taking an elderly neighbour’s rubbish can make you feel virtuous.
Grieving during the crisis – Whether you (and your family) are grieving the death of someone caused by the coronavirus or due to other circumstances, it may be a useful time to seek professional online help with social distancing measures in place and the ability to hold large funerals is restricted.
Pace your days, weeks and months – Long term goals need to be placed to one side until the coronavirus pandemic is over. By focusing your energy on short to mid-term goals, it help to you feel that you are achieving something tangible. Your normal life experience will be different for some time to come.
Seeking Online Therapy: Coronavirus anxiety and related disorders
During the coronavirus pandemic you may feel an overwhelming sense of worry due to health anxiety and related disorders. With the current uncertainty about when it will end, some people can lapse into feelings of depression and anxiety. Persistent anxiety can trigger the release of stress hormones that keep you in “high alert” also known as the “fight of flight” survival state. Being stuck in this mode for long periods can lower your immune response and cause persistent panic attacks. This continuous state can have a negative impact on your personal wellbeing, ability to work or study, maintain close relationships and your ability to take care of others.
If you tend to struggle with anxiety, online therapy could be a great solution to help you cope during the coronavirus crisis. With online hypnotherapy you will access the same level of professional care that would receive with face to face therapy. Online therapy ensures that you can access help in the safety and comfort of your own home without any of the health risks to you or your hypnotherapist.
How suggestible are you to hypnosis? Try this hypnosis test to assess your level of suggestibility.
The benefits of online hypnotherapy
Online hypnotherapy has many benefits
The benefits of online hypnotherapy include:
Deep relaxation to alter the affects of continuous anxiety.
Suggestions designed to accelerate the achievement of your specific goals.
Regression therapy to treat the “cause” of your condition.
Immune system-directed suggestions which could improve its efficiency.
Treating lifestyle issues that are also being affected by stress, anxiety and depression.
Restrictive eating behaviour goes beyond what is commonly termed “fussy eating” or “being picky” with food. Restrictive eating can start in young childhood as displaying a preference for a limited diet. As the child grows up, the repertoire of food choices remain small and may even become narrower in response to a various individual and social experiences.
Meal times can be challenging with restrictive eating behaviour
Meal preparation for a young child with restrictive eating disorder can be challenging for the food preparer. The child may prefer to remain hungry when encouraging them to try new food and offering no suitable replacement. As a parent of that child you can then feel that you are neglecting them and failing to give them nutritious meals. The tension at meal times can increase when the food preparer is enthusiastic about cooking and finds that the time spent on your gastronomic delight does little to inspire the child’s appetite to eat it.
As a disorder, restrictive eating has changed from Selective Eating Disorder (SED) to the group term Avoidant Restrictive Food Intake Disorders (ARFID). It can also be termed as a Food Neophobia.
Do you have restrictive eating problems?
With restrictive eating habits, there is usually a sensory aversion to the unwanted food. The appearance of the food, the colour, the presentation, the taste, the texture, the temperature and/or the smell of the food causes disgust or an anxiety response (panic attack). Seeing the food nearby or talking about the food is enough to provoke the negative response.
Generalised avoidance patterns can usually be identified e.g. the fibrous, crunchy or varying textures found in raw fruit, vegetables or meat; the smooth or lumpy textures found in sauces, or the acidic or spicy tastes found in certain fruits or Asian foods.
But the restrictive eater can also have specific and random aversion issues too, usually caused by an individual direct or indirect bad experience. The bad experience is often forgotten, but it continues to direct the aversion. The problem food appearance, flavour or sensation is then difficult to rationalise; it just looks, tastes or smells horrible, feels unpleasant in the mouth, or is difficult to chew or swallow.
Apathy towards food and mealtimes is a natural consequence of these negative reactions. Pressure to eat can trigger anxiety responses which can then become the focus of the aversion.
Can restrictive eating be connected to other eating disorders and phobias?
Parents of children with restrictive eating patterns may become concerned about their potential anorexia, bulimia or binge eating behaviour. However, a child with restrictive eating disorder does not have the same weight and body image issues connected with these other eating disorders. Instead, the lack of nutrition becomes the concern, threatening to affect the physical development of the growing child, and the future health implications for the adult.
Restrictive eating behaviour, however, can be part of a general neophobia (or fear of anything new) and even connected to OCD (obsessive compulsive disorder). Those with a neophobia feel insecure about trying new things and tend to rigidly stick to their already-formed habits or routines. Avoiding the risk of new food with unknown flavours and textures can be just one aspect of a general neophobia.
The term food phobia is sometimes used to describe restrictive eating behaviour since there are common avoidance patterns and the similar negative emotional responses of fear and disgust. But a food phobic person tends to be preoccupied with contamination and hygiene issues. They worry about the hygienic contents of the food, the way the food is prepared, how it is stored or if it is still safe enough (within its use-by date) to be consumed. They believe that if they eat the food, it will cause a bacteria-related illness or food poisoning (sickness and diarrhoea etc.) If an illness has been associated with a problem food, the food type will then be temporarily or permanently avoided in case of further contamination.
Over-generalisations are common with traumatic experiences. When you connect a “cause” to an illness with symptoms of say, diarrhoea, you can be forgiven for wanting to avoid that “cause” ever again to prevent another bout of diarrhoea. If it’s chicken that did the damage, chicken only needs to be “off” once to be convinced that it will always be “off” in the future.
Diarrhoea: Is it anxiety or contaminated food?
These illogical and mistaken over-generalised connections can be easily made with “bad” food, however. With food digestion being closely related to your emotional state, anxiety can be the real “cause” of symptoms like diarrhoea and not the food that you happened to eat around the time of experiencing your diarrhoea symptoms. When you believe that food is the culprit, it’s difficult to separate cause and effect. You may just blame the food without realising the impact of your anxiety, because food is an easier object to target. You expect to be unwell, and your anxiety makes you unwell.
Your anxiety symptoms can also affect other aspects of digestion, not only diarrhoea. When you forcibly eat food that is “bad” or that you dislike, it can cause muscle tension (spasm) in the upper oesophageal tract (and diaphragm). The result of this spasm is difficulty swallowing the food. The body can react by gagging (retching), choking or feeling nauseas (vomiting). In more severe cases it can even cause persistent vomiting (rumination syndrome). Whilst these symptoms are “normal” reactions under the tense conditions triggering them, nobody wants to react in this way. If you persistently react to a particular food by retching, you will naturally want to eliminate that food from your diet.
Restrictive eating and social anxiety
Without parental and family pressure, a young child with restrictive eating behaviour will focus on their own food choices and accept their own boundaries until they are ready to change. But the growing child will inevitably make comparisons with themselves and how others eat. At around the time of teenagehood, the value system typically shifts towards social standards of acceptance. “Fitting in” during social eating occasions has increasing importance and peer judgement gradually leaks into what you should and shouldn’t eat. Just having “different” eating habits might draw attention and embarrassment, which a teenager with restrictive eating behaviour and social anxiety will want to avoid. It could be a high risk situation adversely reacting to new food with everybody watching you. With social anxiety, it’s as if you are constantly on show, but without wanting to give a performance.
School dinners, the increasing number of friend’s parties and formal dining events become a continuous source of anxiety. There is pressure to eat what everyone else is eating in case you stand out. But the anticipation can start days before the event, not knowing what is on the menu, not liking what is on the menu, being in fear of offending the host if you don’t eat everything served on your plate, or feeling guilty about wasting the money of the person buying the set menu food at a fancy restaurant.
It would seem logical and helpful to communicate your restrictive dietary needs, but the inability to assertively communicate your needs is often part of the (social anxiety) dilemma. Just mentioning the issue is likely to bring you attention. It doesn’t matter if you have praise, encouragement or criticism; you just don’t want to be the focus of any attention.
These internal conflicts in being able to handle the situation will build up your anxiety. Your appetite is usually lost by the time the event arrives. Cancelling with notice or not showing up at all increases the guilt of letting people down and losing friends, and acts as a deeper trauma likely to cause the avoidance of all future social dining experiences.
For those who feel under pressure to attend and try new food that you dislike, a panic attack is likely to trigger the digestive muscular spasm symptoms (gagging, choking etc.) described above. It’s distressing enough being at home and provoking these tension-related symptoms. For the socially anxious person who fears embarrassment, displaying these tension-related symptoms at a formal dining occasion like a family wedding, would cause complete humiliation.
Social anxiety then adds another problematic layer to the restrictive eating behaviour. Having a social trauma with that food (or a different food that has similar properties) will associate a deeper avoidance of future social dining experiences.
What causes restrictive eating behaviour?
The causes of restrictive eating behaviour can be linked to physical, emotional/psychological and socio-cultural factors most influential during childhood.
Some developmental disorders and temperamental traits can be inherited from your parents, predisposing you to develop similar patterns of restrictive eating behaviour in childhood. Research by Schreck at Pennsylvania State University found a higher percentage of children with obsessive compulsive disorder and autism are more likely to have selective eating problems.
Children with acute sensory processing abilities (sensory processing disorder) are likely to overreact to “normal” sensory stimuli. The condition causes certain sights, smells, tastes and sensations to overload how their brain handles sensory inputs. Other research suggests that a small percentage of the population are “super tasters”, possessing a gene that heightens their taste response. Super tasters are overwhelmed by certain taste sensations that “non” or “normal” tasters can manage comfortably.
Children can imitate a parent’s restrictive eating behaviour
Some children will acquire their selective eating behaviour by imitating parents (or significant authority figures) that also eat a small repertoire of food. Parents can have a selective eating disorder themselves or may be influenced by hectic lifestyle choices. Convenience food like takeaways tends to be high in saturated fat, sugar and salt with many of the ingredients being overcooked. Children can become conditioned to eat only these flavours and textures. This can then set up an expectation for these flavours and textures that are rejected with healthier home cooking food choices. The pressured parent who wants to feed their child quickly (without meal time conflict) will give children what they know that they will eat, rather than spending time extending their curiosity for new food types.
Some (non food-related) learned experiences can be emotionally destructive to the growing child’s eating patterns. Family traumas like parental rowing and abuse can cause constant fear and insecurity. Since appetites are affected by emotions, a child who feels anxious and insecure during meal times may struggle to eat certain flavours and textures. These foods can then be associated with trauma and avoided because they symbolise family trauma.
Other indirect traumas can be caused by seeing a parent or family member choke on a certain type of food. Without an explanation about why the parent has reacted in this way, the young child might identify the food as the cause of this trauma to their parent and avoid it in the future to be safe from danger.
Direct trauma with food is often the major influence of restricted eating behaviour, where the child concludes that the food is associated with the trauma. If the child has a physical or emotional condition (mentioned above) that initially restricts their eating behaviour, then trying food that is outside the “norm” can overwhelm their sensations and prevent them from wanting to eat that food again. If the food causes an illness (food poisoning) or a physical tension-related symptom (when alone or in public), then this food type will again be avoided.
Parents who possess overly strict eating patterns, are controlling and abusive with food will cause lasting damage to a child’s restrictive eating behaviour. The majority of clients who have sought hypnotherapy treatment from me often recall agonising memories of battles with food involving their parents or other significant authority figures. Being force fed certain food, having to stay at the table for hours until the plate is cleared and being punished for not eating the food are common childhood traumas.
The parents may have been subjected to abuse themselves and continue to inflict these abusive and manipulative patterns on their children. Other parents are just overly enthusiastic about their (lack of) “parenting skills” when it comes to eating methods and stimulating a child’s appetite. By forcing the child to eat at just one meal time, they are unaware of the damage that it is doing in the long term. Insisting that the food is “healthy and good for you!” won’t make the food taste or feel any better. Yes, it’s common for some children to avoid the main course when they know that a dessert awaits them, but the child’s manipulation is usually innocent at a young age. It’s up to the parent to tactfully work around this.
Food traumas can have a lasting effect on restrictive eating behaviour
Either way, the emotional conflict that these food wars create becomes the association that the child wants to avoid in the future. Eating this food type again as an adult would “bring the horror story back into their lives”. And a child who is defiant then feels that eating this food as an adult would be a victory for the parent because they historically connect “healthy food” with control and manipulation. It’s not surprising that the defiant growing child then opts to stay “unhealthy” to spite the controlling parent.
Treatment for restrictive eating behaviour
Most restrictive eaters would like to broaden their limited food choices. There can be numerous personal and lifestyle changes that can motivate a desire to overcome the restrictive eating behaviour. For example, reaching teenagehood or young adulthood, being in a new relationship and being a new parent are common situations to encourage a dietary change.
Motives to change restrictive eating often include: the limitations it places on your lifestyle, new healthier eating values, feeling embarrassed about how the restrictive eating appears in public and how the restrictive diet is affecting significant others e.g. your partner or your children. A successful treatment will confront the variety of issues that cause your food aversion and identify progressive realistic and achievable goals.
A combination of cognitive behavioural therapy and systematic desensitisation are conventional approaches used to treat restrictive eating behaviour. The strategies will vary for adults and children. The teenager or adult who chooses to start therapy will arrive with a motive for change. Young children are still responsive to the conditioning patterns offered by their parents. Both the young children and parents will discuss the child’s current restrictive eating behaviour and how it is conditioned by the parents. A treatment plan is discussed and new conditioning strategies can be suggested. For example, the emphasis with young children can focus on offering non-food related rewards (e.g. a sticker) for being curious about tasting food that is new or disliked. It’s important to avoid giving food-related rewards like sweets. The experience should be fun with the parents similarly being involved in the new taster sessions.
Exposure to the new food needs to be repetitive (with trials completed at least once a day) and thus keeping a stock of that food item is essential for continuity. It can take ten attempts with the new food to convert it from a “dislike” to “acceptance”. A parent typically surrenders to a child’s refusal after two attempts and will then give the child what they know they will eat. This prevents “failure” on both parts and reduces food wastage, but the submission is premature for long term gains. When persevering with the food trials, the food doesn’t have to be “loved”, more that the anxiety and tension-related symptoms are alleviated. The new food item can then be “accepted” and can be included into the general meal.
Some parents try to disguise food to reduce the anticipation of rejection. This can have the benefit of minimising strong flavours or rough textures when they are liquidised into a soup for example. The child has already eaten the food that they “dislike” (albeit in a disguised form) and this can be used as a reference to reduce the fearful reaction when they say “I don’t like carrots!” The parent then (smugly) replies “you didn’t object to the carrots in my homemade soup that you’ve been eating on the last ten occasions!” If applied carefully, it can enable the child to separate the “danger” that a disliked food might cause them. There is a risk however. When outsmarting the child too frequently or too obviously (when the carrot isn’t disguised enough), the child can feel betrayed and will distrust not only the parent’s future cooking, but other’s attempts to control what they want to eat. It’s far better to gain their approval with trials, praising being curious with new food and ignoring their refusal of a food. Criticising the refusal will hinder their progress.
Getting children involved with food can help their curiosity
Another useful way to encourage children’s curiosity with food is to involve them in the preparation, cooking and serving of food. This can still be done with some of the food that they dislike e.g. using a selection of liked and disliked food to top a pizza. This helps children be creative with food, learn about textures, and how food changes in flavour and appearance when it is being cooked. Again, they should not be forced to eat the disliked food, more that they gradually get used to it being present. When they are involved in family meal preparation, it gives them a sense of responsibility and ownership with the food that can transfer into curiosity and acceptance in the long term.
How can hypnotherapy help restrictive eating behaviour?
My hypnotherapy treatment for selective eating behaviour incorporates cognitive behavioural therapy approach to challenge negative attitudes and systematic desensitisation to encourage graduated exposure to disliked foods.
Hypnotherapy is used to reduce anticipatory anxiety and control the anxiety reactions when sampling the food. Positive visualisation of food eaten can accelerate the food trials, acting as pleasurable experiences that have already been practised in reality. Regression is also used to remove past negative “causes” of an aversion, releasing the beliefs that are contributing to an emotional block with disliked food.
For more information on treatment for your restrictive eating behaviour in Cardiff, contact Richard J D’Souza Hypnotherapy Cardiff
One of the most common and oldest recorded phobias is a spider phobia (or arachnophobia). The term is derived from the Greek terms “arachne” meaning spider and “phobos” meaning fear. Whilst the term is usually associated with spiders, it also includes other arachnids including daddy long legs and scorpions.
Arachnophobia in UK
In UK, about 45% of the populationadmit to being terrified of spiders. However, the research doesn’t say what percentage of the sample is too embarrassed to admit that they have a spider phobia!
Are UK spiders dangerous? Some UK spiders are known to bite, but their venom is considered harmless.
Spider phobia symptoms and reactions
A panic attack is common with all phobias including a spider phobia
The fearful reaction that is common with all phobias (including an intense fear of spiders) is a panic attack. Your panic reaction can seem disproportionate to the actual danger that confronts you, but “knowing” that the actual harm you face is minimal doesn’t ease your severe emotional response.
The panic response can include, but is not specific to:
A racing heart rate and stress induced chest pains
Breathlessness (rapid and shallow breaths)
Sweating and hot/cold flashes
Trembling and Dizziness
Confusion and hysteria
Nausea and other gastrointestinal tension
The role of anticipation with your spider phobia
The panic reaction is generally acute when actually confronting your phobic object (a spider). Where you see the spider and experience the panic attack can then become a fearful location in which you anticipate seeing the spider again. Your fearful mind is trying to protect you from yet another “trauma” by generating anxiety symptoms, so you feel the breathlessness and the rapid heart rate etc. as you approach the (previous traumatic) location. You now distrust the location and avoid it, whether there is a spider there or not. Your anxiety symptoms predispose you to believe that you will see another spider because your “instincts” are being emotionally influenced by fear. At this advanced stage of your spider phobia management, others might say that you are becoming paranoid! You are just responding to how your brain has become wired to deal with spider fear.
In addition to location traumas, there are other associations that you will instinctively make. The season in the year can be a significant trigger for anxiety. Feelings of apprehension can creep up on you, leaving you confused about having Seasonal Affective Disorder or some background virus and then you remember that “spider season” in UK is around autumn (early September until mid October). This is when the outdoor temperatures drop and male spiders seek their mates in warmer indoor locations.
With advanced spider phobias, generalised anxiety (to unrelated issues) can raise your irritability and expectations that you will confront a spider. It’s as if the more anxious you are, the more spider-paranoid you become. You may even have “arachne”-related dreams that are part of your unconscious mind symbolising your anxious connection with spiders.
Spider Phobia: Home used to be a safe place
Progressively, as you are traumatised by seeing spiders, you become more alert to their whereabouts. You want to stay ahead of yourself, so you ask others where they have come across them and label their account as a potential danger. Google is a great place to traumatise yourself further because, still in avoidance mode, you are drawn towards topics that confirm that spiders are a threat to your emotional wellbeing. Your mind is filtering “in” the content that confirms your beliefs about spiders.
With your hyper vigilant action plan, you then compulsively cleanse popular spider assembly areas before you can relax. You might approach the location armed with a long vacuum cleaner and frantically suck up cobwebs as you go. Or you send your “spiderphiliac” loved ones to thoroughly investigate and purify the location first.
Here are some of the popular spider assembly danger areas:
Under and behind furniture including sofas and under your bed
Confined spaces with limited exit points such as cupboards, attics or basements
Outdoor areas such as the shed or garage
In the ceiling corners of a room
Various places in the bathroom or toilet
Near holes, crevices and cracks in walls (all of which need to be sealed)
Outdoor areas of clutter, debris or vegetation
If you believe that harming a spider is cruel, this may compromise your ability to take assertive action over the spider. You may have access to a “spider catcher”, but you struggle to maintain the dexterity to use it when you are trembling with fear.
For many people, home is the safe place where you close the door and recover from a stressful day, but with a spider phobia, home becomes a restless and insecure place which needs your constant hyper vigilance to feel safe.
Spider pranks, social anxiety and other phobias
Arachnophobics can be traumatised by spider pranks
Even though your own spider phobia panic reaction can seem illogical, your panic attack can also seem highly irrational to those around who do not have a spider phobia. Unfortunately, their lack of compassion can make you a victim of their practical jokes. I have treated many arachnophobes who have retold their accounts of friends (I use the term “friends” loosely here!) who have placed a toy spider (and worse!) down the spider phobia sufferer’s back just to get a kick out of their startle response. Don’t ask me what their enemies have previously done to them!
These experiences can be traumatic for the spider phobic sufferer. When you have social anxiety (social phobia), you generally struggle to cope with embarrassment, humiliation, negative attention and judgement. The effect of these social traumas (or when having social anxiety as a separate issue) can elevate the spider phobia from a simple phobia into a complex phobia. A complex phobia combines additional layers of distress and avoidance where one established phobia can overlap with the anxiety from another established phobia or fear. In this case, it’s the additional embarrassment of displaying your spider phobia panic reaction to others, which makes the situation even more difficult to manage; even more traumatising.
New phobias can also develop from the reactions of an untreated already-established spider phobia. With a spider phobia, you can become progressively claustrophobic, particularly if you have been in rooms, seen spiders near the exit points and then struggled to leave the room quickly enough to feel safe. These traumatic situations build up the “withdrawal urgency” typically experienced in a (claustrophobic) panic attack when someone hastily flees the source of the fear. Over time, this learned response becomes automated; you see a spider and then dash away from the area knocking down people as you go, just to feel calm again!
Progressively, with these automated reactions, when you feel generally anxious or feel confined in a location, it’s as if your subconscious mind is telling you to “move from your location to feel relaxed” as you have done previously with confined spider traumas. This process can start to link to new confined situations which previously had only low levels of anxiety e.g. when having a dental procedure. When you now have dental treatment and need to stay put to have a filling, you feel tenser than ever before. You associate into your “rapid withdrawal response” and feel claustrophobic, desperate to get out of the dentist’s chair to feel calm again. The untreated spider phobia is entrapping more situations, more triggers and more avoidance reactions that will reinforce your need to run away from danger, but the list of dangerous situations is growing.
Fear and disgust with spiders
Although the fear reaction is considered illogical, people may not appreciate that there can also be a disgust response mixed in with the panic reaction. The internal disgust reaction associated with spiders can be so hideously repulsive, that you can then fear it being triggered. The mix of fear and disgust can vary between spider phobia sufferers, but it adds another layer of distress to the panic reaction. Disgust can be associated with anything, but in this case, it’s the sight of spiders and what you imagine that they could do to you that overwhelms you.
Most spider phobias are started in childhood. The imagination is so vivid at this young age, that a child will traumatise themselves with ghoulish images of spiders doing ghastly things. As a child, these “horror movies” then leak into your dreams giving you nightmares about it. It’s common to be awoken in a panic imagining the object of fear near you. Even worse is a nightmare where you are in contact with this fearful object, something that is likely to make your skin shiver with disgust. It's a dream that was terrifying as a young child and remains terrifying as an adult, even though you can appreciate that the dream is just a dream.
Children’s imaginations can amplify fear and disgust with spiders
At this young age, the child’s conscious mind is not able to contain these fearful and disgusting boundaries. They become installed as “video nasties” that will have a huge emotional impact on your behavioural reactions to spiders as you age. By the time you are old enough and your conscious mind is ready to challenge it with irrationality, the emotional mind-set is already in place. Even when the conscious mind is ready to challenge it, the challenges tend to be inadequate because they tend to lack emotional intensity to have any effect on it. For many spider phobics, some of these images remain as the peak of emotional distress that combines both fear and disgust together.
Causes of a spider phobia
Spider phobias are generally learned by personal direct traumas and indirect traumas from authority figures. Biology may also be a cause of your arachnophobia. Click this link for more information on the causes of a phobia.
Treatment for a spider phobia
Medication from your GP may be used to alleviate the short term effect of a panic attack or general anxiety caused by long-term uncontrolled exposure to spiders. It’s common to combine medication with therapy involving relaxation techniques, visualisation and controlled exposure.
How can hypnotherapy treat your spider phobia?
Phobia sufferers are very responsive to hypnosis (you can try this hypnosis test to assess your level of suggestibility). You can benefit from a combined approach including, visualisation techniques, regression to remove the cause, controlled exposure and anxiety (panic) control to assist the removal of your fear of spiders. There is more information in this link on how hypnotherapy can treat your phobia.
For more information on treatment for your spider phobia in Cardiff, contact Richard J D’Souza Hypnotherapy Cardiff
Addiction relapse triggers: Quitting an addiction should always be understood as a process rather than an accomplished goal. If you are an addict who has overcome your addiction, the job is not finished. The effects of a long-held addiction are likely to be deeply attached to many aspects of your life, including your emotional, mental, environmental, and social levels.
Addiction creates deep attachments to many aspects of your life
One of the causes that can restart your addictive habit is termed as “addiction relapse triggers”. This can be understood as a phenomenon that occurs when an alcoholic, for example, goes back to the habit of drinking again after a period of abstinence. What makes a relapse occur is the influence of a trigger or group of triggers that drive you right back into your addiction.
These addiction relapse triggers can exist in many forms, but they are also varied enough to range from very obvious triggers to subtle triggers that escape your attention. Visiting the location that is associated strongly with habits of gambling or drinking will obviously draw you in emotionally, creating addictive cravings that lead you to try it "just one more time". Whereas seeing an advert that promotes what you drink in excess might take you by surprise, playing on your mind until you submit to frustration.
The ability to quit an addiction is achievable for most people. It is usually your surrounding emotional issues, conflicting habits and lack of self-management skills that create triggers that are difficult to resist or subdue. This is why many addicts return to their addictions; you are unaware that your life is littered with triggers and problematic situations for which you have not developed a recovery plan.
With the help of a qualified professional, you can work together to treat the many issues that surround your addiction and identify your personal addiction relapse triggers. Through this process, you can then establish which ones you are ready to confront and which ones you should avoid until you have dealt with the background issues that might destabilise you when you are outside of the rehabilitation centre.
Some of the more common addictions include alcoholism, cocaine, heroin, cannabis, gambling, video Games, sex, pornography, food, Painkillers, benzodiazepines, and tobacco. There is a growing list of obsessions and compulsions related to modern lifestyles. They are commonly, and in many cases, mistakenly referred to as addictions. This list includes eating disorders, work, television (especially celebrity gossip and reality TV), internet, exercise, mobile phone usage, teeth whitening, retail therapy (or shopping addiction/oniomania), tanning (tanorexia), plastic surgery, coffee, chocolate, Facebook, junk food, beauty products, hoarding and checking finances.
Addiction Relapse Triggers
Listed below are some of the most common addiction triggers that are likely to cause a relapse.
Good Times
Contrary to popular belief, the bad and tragic times associated with your addictions are not the strongest triggers to cause your relapse; it's the good times that deceive you best and weaken your resistance. Think back to the experiences where you achieved something special and your addictive substance symbolised your celebration. Was this when your self esteem was soaring and you had the best fun with your drinking partners? Or did the achievement inspire the gambling activities which drove your adrenaline and excitement to the highest levels as you played your riskiest bets and won the games, giving you another euphoric “high”?
When you have quit your addiction for months and restricted your sources of pleasure, these “good times” cravings can return to seduce you for one more mood lift like they did in the old days. It’s seducing because it’s during this period that it seems so unlikely that you will to go back to your addiction now.
Then consider how your brain physiology is so susceptible to the imprint of these joyful memories because it formed deep attachments to higher levels of dopamine during the long periods of your addiction. You cannot deprive yourself of good times, but caution needs to given to how you manage your mood variations, finding new ways to celebrate and new ways cope with your emotion lows.
Places
Places can make a strong imprint in your addiction pathway
Places can make incredibly strong connections to your memories, whether they are negative or positive. Even people and objects inside these places act as relevant triggers to the emotions that you have experienced there. Just seeing a single picture can create a wave of negative emotions about a tragic loss or past abuse, whilst the location of your friend's house can be linked to excitement and fun of wild parties. Even though these location-based triggers are below the level of your consciousness, your addictive behaviour can come to the surface and control your decision-making when you step through the door. It doesn’t take long for the addiction tide to pull you in, only to wake in the morning regretting that you have once again binged on several bottles of beer during the previous night, despite your strong motivation to commit to the recovery plan. And when you revisit the location that you associate with past drug use for example, the environmental trigger rapidly unsettles you. This is because the wiring between your reward centre and memory part of your brain has been welded, raising your expectation to use the drug.
For some time to come, your way out is an uncompromising avoidance to all of these places. If you are surrounded by these triggering places and people (e.g. you take drugs in your family home), continuing support with your therapist will help you maintain control until you are ready to confront your location-based addiction relapse triggers again.
Stress
Stress is a constant feature of modern living and the way that you manage it is important for you to feel emotionally balanced. When stress is managed poorly, it can lower your mood and influence anxious and depressive thinking. Additional adrenaline in your system caused by stress inhibits the production of dopamine, something that an addict’s brain has been hard-wired to expect and satisfy on demand from your addictive behaviour. Effective stress management is the key to long-term success in your addiction recovery. As your therapist establishes your emotional profile, stress management techniques will be individualised to help you develop new habits to reduce your stress.
Stress is often considered to be having excessive demands, but a lack of demands can also be stressful if you find it hard to cope with boredom. When you are bored for long periods your time becomes meaningless and you will fill it with whatever is easily available in that moment. Boredom is a major trigger for habits and addictions, and needs to be managed with setting and working towards achievable and realistic goals.
H.A.L.T. (Hungry, Angry, Lonely and Tired)
HALT is an acronym for some of the states that are considered high risk situations and can make you an easy victim to relapse. According to Ego Depletion theory, when hunger, anger, loneliness or tiredness reaches an excess, your willpower to confront your addictive urges is weakened and you will seek immediate comfort. If your comforting strategy is not rehearsed, you are more likely to find comfort in your addiction.
Understanding your own ego and when you are vulnerable to its depletion can help you to take charge of these (and other) excess negative states from overwhelming you. Giving attention to the common healthy lifestyle areas (e.g. eating healthily, managing stress, maintaining social interaction, exercising regularly and sleeping well, practising meditation etc.) are key to preventing relapse from a depleted ego.
Bad Times
Negative emotions from the bad times are at the heart of addictive behaviour and impaired dopamine production. You may have to go back further than the first day that your addictive behaviour kicked off to appreciate this connection. Anxiety, neglect, abuse, betrayal, worthlessness and insecurity are just some of your childhood influences that have created a pathway of dependency. When you found your addictive escape, it temporarily numbed the pain. It was easier than challenging authority figures or trawling back through your emotional history to resolve it. Your “high” remains the reactive mechanism to similar emotions that you feel in your life now. When confronted by negative emotions to resolve, you are tempted to reach for the quick fix because the pain still runs deep.
Gradual exposure to these emotions and their solutions are huge strides to make for someone whose “solution history” is marked by addictive retreat. Embracing the other road is effortful but with therapeutic support, it’s a journey that changes your behaviour and the past emotions that connect them.
Overconfidence
Over-confidence is one of the most dangerous addiction relapse triggers that betray you into believing that your addiction no longer exists. Just when you think that you are over it and months (or years) have gone by, you become complacent. Over-confidence deceives you that it’s fine to quit your relapse prevention plan and test the “I’m over it” hypothesis. “Just one more time...” can seem like a reward for all of your efforts and repairs that you have made. And then you realise how foolish you have been and you are back inside your addiction chains again!
Don’t confuse over-confidence with self confidence. With self confidence, you accept that your addiction is a chronic disease and your recovery is a life-long process; you choose never to want “just one” ever again. With self confidence, you embrace your commitment to this choice.
Relationships
Relationships are discouraged during early stages of recovery
The attention from a new relationship can be hard to resist, but new relationships can come loaded with emotional rebounds that are likely to jeopardise your recovery plan. Rehabilitation programs are very aware of these risks and advise staying clear of new relationships for at least a year during recovery.
So why would rehabilitation programs advise this? Any recovery plan demands commitment and your commitment to it can waiver when the honeymoon period of a relationship is in full swing and the excitement of it can be so seducing. Moreover, this relationship phase is so euphoric that it can deceive you into believing that your new partner’s special attention is a sign of your addiction treatment cure. It’s as if your addiction high has been replaced with a relationship high, without the necessary time to naturally balance these changes.
After a few months, when this honeymoon phase settles down, all of those normal things like arguing and temporary break-ups generate mood changes that need open communication to fix them. If your partner isn’t ready to communicate a solution, then anger, resentment, jealousy, loneliness and abandonment fears can drive your stability downwards. During those emotional lows, you will seek immediate relief from your addiction.
Social Settings
There are many individual and social addiction relapse triggers that can compromise your “clean” intentions. A social situation where your addictive substance is the main event is undoubtedly a risk to your recovery and needs to be avoided in the early stages due to the pressure of social compliance.
When you look back on your addictive pathway, peer pressure may have been the factor to start your addiction and it continues to be your vulnerability when you fear offending a close friend’s offer of another “hit”. Even without an offer from a friend, just being surrounded by your peers who are under the influence (when you are not participating) can cause you to feel lonely and alienated from the surrounding social mood and force your relapse.
And social unease can still be your weakness even when you are with acquaintances, colleagues or strangers who are not addicts. You may struggle to blend in with them and then feel the pressure to look as if you are having a good time. A quick hit can momentarily take the edge off your social anxiety.
If you are convinced that your addiction is the source of your “better self” or your social confidence, you may believe that you need it to be “the life and soul of the party” and without your substance, you are inadequate, dull and a “nobody”.
How you believe that your addiction defines your self esteem and social esteem is an essential part of your recovery treatment. When you have worked through these issues, a return to your social life is no longer a threat to your recovery.
Reminiscing Times of Addiction
The reason that your addiction gained power over you is because at some level you gave it a reward. It convinced you that it numbed the pain of abuse or control, gave you an escape from depression or anxiety, or relieved the stress from work. You persisted with it until the need for it became automated. Then the balance changed. It took over and became the problem that controls you. It destroyed the relationships and situations that are important to you.
In your mind it needs to stay loathed with all memory traces of the addiction’s glory completely eliminated. Only then can you be free from it. But there’s an internal danger to its security; it’s called reminiscing. Reminiscing is also known as replaying the “good old times” where you glamorise your addictive past, boasting about how much more you could “use” compared to your peers and of the power it gave you.
When your mood is low and you are searching for a way out of a problem, the frustration can put you into a daze. You are doing what is natural though, delving into the depths of your subconscious mind to access a solution. You are entering a reflective state of “self-talk” that some would call self hypnosis. When your resolve is strong, your internal voice will reject your romantic past with your substance. When you are down, reminiscing the times of addiction can seem like an attractive activity. Without developing assertive thinking however, it will be a trigger to a relapse.
Learning to stay firm with your intentions is an essential part of your treatment. When you can access an assertive and positive thinking attitude, it takes charge of how you handle those situations. It also guides your mental rehearsals and reflections when you are away from the situations. Learning to take control of your mind will help you eliminate fondly thinking about your past addiction as a glorious period in your life. You will reframe your addiction’s past as a betrayal that it deserves.
Social Isolation
Many of the social pressures that can cause your addiction to relapse are listed above in “social settings”. On the opposite end of the continuum is social isolation. Having your own space is important but the mix needs to be applied effectively to avoid loneliness, as this can be another one of the many addiction relapse triggers. Shy introverts are justified to argue a case for avoiding some social interaction, with the degree of social anxiety that you experience, but consider if your addiction has really become your substitute best friend.
You can reinforce negative beliefs when you feel isolated
Developing self confidence and self worth is an important part of your recovery and this pursuit needs to be placed in the context of welcoming enough external help to support your recovery. During times of social isolation, you can reinforce your negative state of mind. Strong feelings of shame, guilt, anxiety, blame, depression and embarrassment then drive you back into your cycle with no positive disruption from others to pull you out of it. Developing a close network of trustful friends can offer you this help, regardless of how much you might view the support of others as a reminder of controlling behaviour from previous authority figures.
Another source of loneliness assistance outside of this friendship circle is the help from your addiction support group. It allows you the opportunity to share experiences and manage situations with those who have similar backgrounds, but in a non-judgemental framework. You can also gain valuable insights into the destruction that other addicts have suffered in their journey, helping you to place your own experiences into a social context. As another benefit of support meetings, it’s natural to form acquaintances and friendships from these support meetings too.
You may personally prefer to avoid group meetings or think that you have exhausted all of the benefits from attending previous addiction support meetings. Individual therapy can still help you to challenge your own negative self limiting beliefs and moderate some feelings of social isolation.
Re-exposure
Returning to the situations where you have previously accessed your substance should be avoided during the early stages of your treatment. In these early stages, the trigger is often too strong and complex, and is likely to cause your relapse.
As your therapy progresses, your therapist will help you deal with the surrounding issues and set up a controlled exposure plan to confront those situations again. So if social situations are your vulnerability, treating your self confidence and social confidence is fundamental to the re-exposure of social situations. Your treatment will prepare you to engage with social situations in controlled stages, dealing with craving control and specific relapse issues that are contained in the situation.
Avoidance of these situations can last for a period of months because even though you may believe that you are ready, there’s usually more therapeutic and developmental work to be done before you can confidently confront those situations without feeling vulnerable.
Addiction Relapse Triggers: Summary
It takes time to disconnect your addiction relapse triggers
In summary, the achievement of quitting an addiction is already a great milestone, but it doesn't end there. Being aware of and treating the issues that surround your addiction are important stages of your continued recovery. It takes time to dissociate these triggers with the reward of using your substance and reconnect it with the new reward of abstinence.
As you embrace your therapy plan, understand that these triggers are not only diverse and complicated, but also very unique to your specific physical, mental, emotional disposition and life experiences. Your commitment to your therapy will help you identify key techniques and management tools to prevent a relapse.
There are many therapeutic approaches. Hypnotherapy can help you disconnect the triggers to your addiction and anchor new and positive responses to these triggers. Hypnotherapy can also treat the surrounding psychological issues which influence a relapse.
For more information on how to treat your Addiction Relapse Triggers with hypnotherapy, contact Richard J D’Souza Hypnotherapy Cardiff
Phobia and fear treatment Cardiff: Fear is a natural emotion that helps protect you from imminent or real danger. A phobia is an anxiety disorder that causes you to feel intense fear of an object, situation, place, or living organism. In contrast to the level of danger commonly felt with a fear, the reaction with a phobia is more severe, usually triggering a panic attack. With a fear you may cautiously interact with the object or situation but with a phobia, the intensity of your anxiety influences the way that you lead your life. When you have a phobia, you mould your lifestyle to avoid the object or situation, even though the imagined danger is usually far greater than it actually is in reality.
A panic attack is major distinguishing feature of a phobia
How common are phobias?
Some phobias that develop during childhood can be short term and can disappear within a few months. However, 80% of phobias that progress into adulthood can become chronic and need to be treated. Approximately 10 million people in the UK have a phobia, and the sufferers can be of any age, sex, and social background. You may feel embarrassed about having a phobia, but you are certainly not alone however remote your phobia might be.
Phobia and fear treatment Cardiff: Types of phobias
Phobias can be divided into 2 main types:
Specific or simple phobias
Complex phobias
Specific or Simple Phobias
Specific or simple phobias are an irrational fear caused by the thought or presence of a single specific object or situation. The phobia usually develops at a young age, and as you grow into adulthood, its intensity may become less severe. As an adult with a phobia, you can appreciate that your panic reaction is usually disproportionate to the actual danger you are in, but you are still unable to prevent your reaction from overwhelming you.
Specific or simple divided into the following types:
Animal phobias: these are the most common, and can include being afraid of anything living such as a fear of spiders (arachnophobia), fear of dogs (cynophobia), fear of snakes (ophidiophobia) or a fear of insects (entomophobia).
Situational phobias: these can occur in response to a specific situation such as a fear of flying (aerophobia), fear of visiting the dentist (dentophobia), or fear of being in enclosed spaces (claustrophobia).
Natural environment phobias: these can include examples such as a fear of water (hydrophobia), fear of heights (acrophobia), fear of storms (astraphobia), or a fear of contamination or germs (mysophobia).
Blood-injection-injury phobias: this category can include a fear of blood (haemophobia), a fear of needles or invasive medical procedures (trypnophobia) and fear of injury (traumatophobia). These are specific fears that evoke the emotion of disgust and anxiety. They can also cause a further fear of fainting.
Other phobias: these can include various fears such as a fear of falling (basophobia) or fear of costumed characters such as clowns (coulrophobia).
Complex Phobias
Meeting new people can be a challenge with a social phobia
These phobias have an overwhelming effect on an individual’s life and mostly develop during teenagehood and adulthood, although the roots of the phobia can be caused in childhood. These are commonly divided into 2 types:
Social phobia: This is also known as Social Anxiety Disorder, and is affiliated with feeling extremely shy or anxious in social situations. With a social phobia, your “danger” is focused on another person’s negative reaction. Thus, you fear embarrassment, humiliation, attention, judgement and intimidation from other people. In its generalised form, all aspects of social interaction are affected by anxiety and can also be combined with introversion where you feel even more anxious in the presence of larger groups. In its specific form, social phobia can affect individual situations such as meeting new people or eating in public. It can also be characterised by performance anxiety situations e.g. when public speaking (or performing in front of an audience), during exams, interviews, in sports performance and in sexual performance situations. When you have an individual phobia and a social phobia to cope with, the social phobia adds another layer of “embarrassment” anxiety. You fear drawing negative attention to yourself with a public display of your panic attack. With an individual phobia and social phobia, great effort is also placed on hiding your anxiety symptoms, since you don’t know who to trust with this information or whether you will be taunted or bullied by your peers.
With agoraphobia, your constant retreat can leave you feeling a like a prisoner in your own home
Agoraphobia: Agoraphobia is commonly associated with the fear of open spaces but can include numerous fears which ultimately leave the sufferer housebound. Before a complex agoraphobia develops, individual phobias and/or a social phobia may combine to gradually affect the sufferer. Other fears that can activate the agoraphobia include a fear of loneliness (monophobia), a fear of confined spaces (claustrophobia) which conditions a hurried exit from the situation to a safe place (usually your home), and health anxiety (hyperchondriasis) - the fear of that your anxiety symptom is a more harmful condition. As these fears and avoidance strategies progress, panic disorder can surface where the panic attacks can seem random and unexpected. Your home becomes the “safe place”, but journeys from home can vary from individual to individual depending on the method of travel, distance from home, the activity upon arrival, the situation, time of day, whether you can trust your company during the journey and/or upon arrival. When agoraphobia is untreated, the anticipation of leaving the house can trigger the panic attacks meaning that your home is no longer your safe place.
Phobia and fear treatment Cardiff: What causes a phobia?
There are numerous causes of a phobia ranging from direct trauma, parental influences and genetics. Follow this link more information on the causes of a phobia.
Diagnosis and prognosis of a phobia
Most specific or individual phobias are not formally diagnosed by a doctor. As the condition develops in childhood, you are often told by parents or other authority figures that you have a phobia. As a young child, you live “within” the condition, guided by your parents’ reactions and management of your phobia. Their diagnosis or lack of diagnosis could be influenced by the existence of their own phobias which biases their reaction to you e.g. if they have a social phobia they are more likely to protect you from embarrassment, advising you to avoid a social situations where you could be exposed to “embarrassment” harm.
Following their informal diagnosis and you grow older as a child, you will then research your own condition for confirmation of your behaviour, symptoms and potential coping strategies. Avoidance is the common short-term coping strategy but each retreat only serves to reinforce the power of the phobia over you.
Shock is a common reaction to the diagnosis of a condition as you begin to come to terms with the full meaning of a phobia. As a growing child, avoidance may continue to dominate your behaviour even with your progressive understanding of the phobia. Assessing possible solutions to your phobia can be met with indecision because the commitment necessary to confront it can build anticipatory anxiety when the situation beckons. The accumulation of anticipatory anxiety itself can “flood” your response to the phobic situation, overwhelm you and create yet another traumatic setback in your self help phobia treatment plan; your anticipatory anxiety feelings justify your avoidance instincts.
Fear of embarrassment may play a central role in the prognosis of a simple phobia through teenagehood as your value system shifts towards the approval of your peers. Again with a social phobia you can rationally understand how it is affecting you, yet still feel helpless to deal with the negative attention that it can generate.
Between teenagehood and adulthood, some phobia sufferers can react with denial or shame until you are able to fully accept how the condition is affecting you. To admit that you have anxiety might be considered a weakness by your peers and be a target for bullying. This adds more anxiety in those situations where your panic reaction could be visible to your peers e.g. when speaking in public.
The need to speak in public can return at many stages of your life
A fear of public speaking (glossophobia) is a demanding situation for many people. When you add social anxiety, it can expose the common social phobia symptoms like blushing and shaking to your peer audience. It can also affect the control of your speech with tension felt in the diaphragm and vocal chords, leaving you breathless when you are desperately trying to sound confident. The effort to suppress these symptoms becomes a distraction to the skills needed to speak in public, but are considered the priority for the social phobia sufferer.
A fear of public speaking is a phobic situation that can span school, undergraduate study and your adult career. Public speaking traumas from school can leave avoidance footprints throughout this period, influencing you to avoid undergraduate presentation tasks, or job applications (or promotions) that specify public speaking in the new role. Where there is the opportunity to delegate, you will justify it as being good development for the subordinate staff.
If the growing need to confront your phobia hasn’t sabotaged your career opportunities, the damage that it can do to your relationships may serve as a “wake up call” to treat certain phobias. In a new relation, the early motivation of the “honeymoon period” can easily mask a deeper social phobia, with shyness appearing as an endearing quality. During this stage of relationship bliss, the anxiety is temporarily “transferred” to your partner as you both push emotional boundaries and are being supported by the other partner to be your “best” person. As the honeymoon period fades, the social anxiety “returns” to its original owner with the declining desire to socialise if the social phobia has not been overcome. The social phobic partner hopes that their gregarious partner is accepting of these changing relationship dynamics or the relationship can be strained with a diminishing desire to socialise together.
Even a flying phobia can impact on a couple’s holiday arrangements and be a source of relationship break down for intolerant partners. Indeed, there are solutions to enjoy holidays together without the need for flying, but the pressure to overcome a phobia is again brought into the limelight with a new family. Parents are aware of how young children can easily learn and imitate phobic behaviour. In an attempt to avoid guilt and shame, this can be a time to motivate the phobic parent to confront the phobia. A phobia held for many years is still treatable, but the treatment now has a long history of conditioned avoidance to work through. The treatment also has to take into consideration the time pressures of working and a family lifestyle that limit the time necessary for graduated exposure to the phobia and its benefits to alleviate it.
During adulthood, the consolidation of personality traits and other mental health conditions can reinforce the affects of a phobia e.g. anger may be communicated as a defence strategy to mask the embarrassment of the phobia or some OCD issues can attach themselves to the phobia forming deeper ritualised patterns of avoidance.
But despite the potential restrictions that a phobia can cause you, your family and your lifestyle, the growing awareness and tolerance of a phobia as a mental health issue can mean that your phobia can still be supported. As you learn to live with your phobia and justify your avoidance, those people close to you can, where possible, change their lives so that you are protected from the distress of your panic attack.
What are the major common symptoms of a phobia?
A panic attack is the acute anxiety condition common with all phobias. You can feel specific symptoms whenever you encounter the object or situation of your phobia. In some cases, you can also experience milder symptoms just by thinking about that object or situation. The severity of your individual anxiety symptoms can vary from person to person.
Psychological anxiety symptoms can include:
Extreme feelings of fear: these will be intensified as you get closer to your specific phobia object or situation.
Irrational thoughts: you can appreciate that what you fear does not affect other people in the same way; and that the likelihood that the feared experience is going to actually happen is very remote; and that your fearful reaction is usually disproportionate to the degree of actual harm that you are in, yet this still does not alleviate the severity of your response.
Hopelessness, frustration and confusion: the conflict of these emotions tearing away at your mind can leave you feeling helpless, anxious and embarrassed.
Physical anxiety symptoms can include:
Dizziness, light headedness, and nausea when facing your phobia.
Excessive sweating and an increase in heart rate/palpitations.
Shortness of breath and shaking.
An upset stomach (nervous diarrhoea) or IBS is also a common.
Phobia and fear treatment Cardiff: Common Phobia Treatments
For many people the common self help phobia treatment is avoidance. If the phobic object or situation rarely affects your life then avoiding it (in the short term) will give you a feeling of control. Connected to avoidance is delegation with certain specific phobias. Getting someone else to remove a spider with a spider phobia (in the short term) is an effective way of minimising anxiety. Changing your lifestyle to minimise exposure can seem drastic to non-phobia sufferers but would only be done out of necessity to reduce long term suffering.
After avoidance, delegation and lifestyle changes to minimise exposure, the next level of treatment approach can include a combination of attending self-help groups and self-initiated exposure therapy. With simple phobias, creating a hierarchy of graduated exposure situations can take time to work through but with the effective use of relaxed breathing techniques or mindfulness, it can prevent the “flooding” of intense anxiety. Flooding (when the participant is not prepared) can cause traumatising setbacks in the alleviation of a phobia.
Therapy can help your controlled exposure program
Complex phobias and agoraphobia are usually more difficult for the sufferer to objectively confront and work through by yourself, unless you understand your belief system and can stage graduated exposure situations that don’t generate internal conflicts. This is where certain talking therapies like counselling or CBT can be helpful, creating an understanding of your beliefs and conflicts so that you can then progressively confront your phobia.
Medication such as tranquilisers is not usually helpful for phobias but they can reduce the short term effect of a recent traumatic exposure of anxiety. Beta-blockers can reduce the effect of panic when you know that you are about to confront a phobic situation e.g. when public speaking. Antidepressants are more beneficial with certain long terms situations found with complex phobias and agoraphobia. The use of any medication should be done in consultation with your GP.
Phobia and fear treatment Cardiff: Treating phobias using Hypnotherapy
You may tell yourself that the source of your phobia does not pose an actual threat, however, your mind and body will still react with fear because your phobic reaction exists at the subconscious level. Hypnotherapy is a technique that allows you to understand and disconnect the cause of your phobia. It can help you communicate with your subconscious mind to change how you feel towards the phobia. Under hypnosis, you will feel extremely relaxed while still being in control allowing you to confront your fears without actual exposure trauma. Follow this link for more information on how you can treat your phobia and fear with hypnotherapy.
Phobia and fear treatment Cardiff: for more information contact Richard J D’Souza Hypnotherapy Cardiff
Treat your phobia and fear in Cardiff using hypnotherapy
Are you ready to treat your phobia and fear in Cardiff using hypnotherapy?
Long term avoidance makes phobias and fears a bigger challenge to overcome
Avoidance of a fearful situation is a natural, short-term response to feel safe. In the long-term however, the avoidance behaviour can leave you helpless and stuck with a situation that is far more challenging to overcome. When you are ready to confront your phobia, you have decided at some level that avoidance is no longer the best option for you.
Your decision to overcome your phobia or fear may have been prompted from an external situation or forthcoming lifestyle change. I often ask my clients their reasons for confronting their phobia and fear. They include health changes, internal conflicts, despair, embarrassment, relationship issues, travel arrangements, study needs, conflicts within your family, fear that your children will learn your phobic response, general lifestyle changes, promotion at work or potential situations in your next job.
Whatever your motive to change, you can live your life freely with your anxiety in the distant past when you want to treat your phobia and fear in Cardiff using hypnotherapy.
How will your phobia be treated?
A previous BMJ publication by Vickers and Zollman gave a clinical review of existing research on hypnosis and relaxation therapies. It concluded that there is good evidence from randomised controlled trials that hypnosis is an effective treatment for phobias and fears.
My treatment therapy will essentially use a variety of hypnotic techniques to help you overcome your phobia and fear. Some types of phobias need a different treatment approach e.g. when treating a fear of fainting compared to a fear of spiders. In addition to this, each client also brings different core beliefs and issues into the treatment process. These need to be analysed to find the most appropriate hypnotic solution.
Hypnotherapy treatment techniques can involve strategies such as removing the emotional “cause” of your phobia or fear, anxiety control, and changing the thoughts, emotions and behaviour connected to your phobia. The treatment will also apply methods used in CBT and controlled exposure to ensure that you are benefitting from other effective processes used to alleviate phobias and fears.
Can you treat your phobia and fear in Cardiff using hypnotherapy if you have an uncommon phobia or fear?
Some of the more common phobias and fears include:
Agoraphobia – commonly considered as a fear of open spaces, but is characterised by the fear of leaving home. When you are outside, you fear having a panic attack in a confined space or around other people where you would feel extreme embarrassment. The need to rush home to your “safe” place exacerbates the agoraphobia.
Mysophobia – a fear of germs or contamination commonly associated with obsessive compulsive disorder.
Pyrophobia – a fear of fire.
Xenophobia - a fear of strangers.
Entomophobia - a fear of insects.
Speksophobia - a fear of wasps.
Cibophobia – a fear of food. Food is avoided to minimise illness (contamination) or vomiting (emetophobia). It can also be called a restrictive eating behaviour when there is a disgust/panic/choking response with certain food types. It can also be mistaken for anorexia.
Gamophobia – fear of commitment, affecting long-term relationships but can affect other lifestyle situations such as long contract work, mortgaging a house and staying in one city location.
Hydrophobia & Aquaphobia - a fear of water and drowning.
Ophidiophobia - a fear of snakes.
Panic disorder - a fear of panic attacks which can be associated with hypochodriasis, medical anxiety and health anxiety.
Hemophobia (blood phobia), trypanophobia (injections phobia) and traumatophobia (injury phobia) which can develop a fear of fainting or passing out.
Illyngophobia - a fear of vertigo (or feeling dizzy).
All phobias and fears can be treated however obscure they might seem
If your phobia or fear is obscure and is not listed as a common phobia, you can still treat your phobia and fear in Cardiff using hypnotherapy. Your phobia and fear will have a sensitising event and subsequent reactions in which you have associated your panic attack. The acute anxiety or panic attack is common with all other phobias and fears. The treatment will analyse your individual background experiences and disconnect your panic response using some of the same hypnotherapy techniques discussed in this article.
Are phobia sufferers receptive to hypnosis?
There are many intra-personal and inter-personal factors that can influence how receptive you are to hypnosis, including a strong desire and commitment to change your behaviour. When you have made the decision to seek professional help from a hypnotherapist, you are already a step closer to being open to therapeutic hypnotic suggestions. What then happens during your treatment will continue that process to its resolution.
When I look back at the profiles of my previous phobia clients, almost all of them have been highly responsive to hypnosis. Does this reliably mean that phobia sufferers can be hypnotised easily? Studies from Stanford University state that phobia sufferers “tend to score high on hypnotic susceptibility scales and... respond favourably to hypnotic intervention.”
Are phobia sufferers generally treatable? In the same article, a psychologist Joseph Barber, PhD considers that the source of a problem and its resolution can conveniently originate from the same place. “The very capacity that lends itself to developing the problem is the same that lends itself to solving it." Barber considers the learning of phobias as “environmentally suggested anxiety”; which means that the anxiety can be effectively un-learned or relearned with the use of external therapeutic suggestions. You can assess your level of suggestibility using this hypnosis test.
What happens in your first phobia and fear hypnotherapy consultation?
The first important stage in your phobia and fear treatment is to analyse your individual phobic or fearful situation. This is conducted in the early stage of the first consultation but can also continue through your treatment as new issues are uncovered. Every situation can be different and this process ensures that your treatment is individualised to your specific needs. The process includes the following:
Establish the history of your direct and indirect traumas: This usually answers the “how and why” you have arrived at your phobic or fearful situation. Sometimes this is obvious with direct traumas, but with complex situations like agoraphobia, it may involve a number of issues. By understanding this pathway, it helps you to appreciate how your sensitising events have affected you and continues to inhibit the achievement of your goal (the removal of your phobia).
Identify any conflicting beliefs and emotions: Other beliefs and emotions (outside of your specific phobic or fear) may have contributed to your phobic situation. For example, during your teenage years, defiance may have added anger into your coping strategies when people tried to control how you should deal with your insect phobia. So anger and anxiety are now triggered when you confront insects because you anticipate people interfering with how you will cope with your phobic situation. Or social anxiety during your teenage years may have added embarrassment into trying to confront your wasp phobia. So now when you have to cope with the fear from wasps, you also feel embarrassment from your anticipated peer’s judgements.
Examine your coping strategies: In most cases, the (negative) coping strategies that you have previously employed have gradually transformed your fear of a situation into the current phobic situation with panic attacks. With repetition sustained over a long time period, your reactions have now made your coping strategies automated even though you try your best to keep yourself safe from perceived danger. This build up of avoidance reactions can create a complex phobic situation especially when it involves more than one fear. Aviophobia (fear of flying) can involve direct flight-related traumas, but it can also be a complex situation that involves a number of fears e.g. a fear of heights, fear of confined spaces and social anxiety. In order for you to maximise the effective use of your new therapeutic coping strategies and prevent “flooding” of anxiety, this process is made easier when a complex phobic situation has been analysed.
Define your treatment pathway: In response to the analysis of these specific and wider issues that impact on your phobia and fear, your treatment plan can then be formulated to ensure that it is individualised and goal-oriented.
How can hypnotherapy treat your phobia and fear?
Listed below are some of the ways that you can benefit when you are ready to treat your phobia and fear in Cardiff using hypnotherapy:
Your phobia or fear can be treated in a controlled environment
Treat your phobia and fear in a controlled environment
Hypnotherapy offers you the opportunity to confront your fears in a controlled and detached environment, limiting the amount of exposure to your situation so that you are not overwhelmed (flooded) with panic. Hypnotherapy also allows you to safely deal with your fears and the removal of your panic response at an unconscious level. You can accept positive suggestions without interference of your conscious mind.
Control of your anxiety and panic response
You may not feel that you have conscious control over your phobic response but appreciate that you have ownership of your reaction; it’s yours to change. Your hypnotherapy treatment will help you to alleviate your panic symptoms that cause you to feel so traumatised when confronting your phobia and fears. For example breathlessness (hyperventilation) is a common symptom of panic. After learning relaxed breathing techniques, these techniques will be incorporated into your hypnosis treatment so that your breathing rate and breathing style can be calmer when you are ready to deal with your phobic situation. Other symptoms like palpitations, shaking, profuse sweating etc. will also be alleviated in your hypnotherapy treatment.
Treat anticipatory anxiety
With some anxious situations, the build up to the situation can be as bad (if not worse) than the actual demands needed to cope with the situation. Your anxious mind will instinctively play any number of random “what if...” scenarios where you meet your doom. Learning to cope with anticipatory anxiety is integrated into your phobia treatment so that you can disconnect the anxious build up to the phobic situation. You can then apply your positive resources when it is needed during the phobic situation.
Dissociate your disgust or nausea responseDisgust is a common phobic response
Fear and panic dominate most phobias, but your panic response may combine with (or be specific to) a disgust reaction. When your disgust response is triggered, it creates such an overwhelming, internal feeling of revulsion that you are then unable to cope with this emotional response and you fear it being activated by your phobic object or situation. Disgust reactions are common with certain phobias such as a fear of vomiting, fear of insects, fear of holes, fear of germs, fear of blood, etc. They can also contribute to a penetration phobia (vaginismus) depending on your individual background history. Dissociating your emotional disgust reaction is essential for you to overcome this type of phobia.
Treat your fear of fainting with a blood phobia, injection phobia or injury phobia
About 15% of the population have an in-built fainting response (some people sense it before fainting, whilst with others it happens spontaneously). Physiologically, fainting occurs when blood pressure spikes due to the initial anxiety and then suddenly drops, causing blood to be diverted away from the brain. There numerous physiological explanations (e.g. vasovagal response) and self protective psychological theories why a fainting response is activated. Fear and disgust are the emotions responsible for the creation of a blood, injection or injury phobia. If you have previously fainted or near fainted, it can then trigger this additional fear with the insecurity and embarrassment that can accompany it. Your hypnotherapy treatment is specific to keeping your blood pressure raised as you confront your fears and inhibit your fainting response. This particular hypnotherapy treatment technique is a method also used in The Applied Tension Technique.
Assisted desensitisation (controlled exposure)
When you research how to treat phobias, you will see the term desensitisation or controlled exposure appear time and time again. Desensitisation is an effective way of treating phobias. By itself however, this method can be cumbersome and time consuming. Hypnosis can offer you the positive mental rehearsals that act as accelerated controlled graduated exposure away from the phobic situation. So when you are ready to progressively deal with your fearful situation, you will feel as if you have already done the practise with the appropriate positive mindset. When combining hypnosis with desensitisation, you can expect a rapid progression your phobia and fear solution.
Treat the causes of your phobia and fear (sensitising event)
This technique is favoured less by solution focused hypnotherapists who tend to disregard the influence of the past on the treatment of a phobia. The sensitising event holds the repressed emotions contained in the memories that “cause” the phobia and generates the anticipatory anxiety (panic attack) when confronting similar future incidents. When the emotions contained in the sensitising event are released (as an abreaction), it can have a dramatic effect on the alleviation of your phobia. This technique uses regression to identify the experiences just before the sensitising event so that the unconscious details of the trauma (e.g. beliefs held at that time and conflicts that influenced the learning of the anxious response) can be studied and reframed. When you remove the roots, you set free everything above the ground to allow new positive resources to be planted. The Rewind Technique can sometimes be used with some clients with the same purpose of reframing the traumatic emotions contained within the sensitising event or panic attack.
Visualisation of your desired positive experienceVisualisation is a powerful tool in phobia and fear treatment
Visualisation is a powerful tool that can launch you towards the achievement of your goal. When you visualise positive change, you are creating the network of neural pathways that can be accessed more easily when you are in that situation. Hypnosis is a relaxed state where the depth of visualisation is enhanced. When you visualise in hypnosis, it’s as if you are passing those “real” imagined experiences down into your unconscious mind to help it accept that this is the new reality without actually being in the experience. Put another way, you are accessing the necessary “in-vivo” controlled exposure that can sometimes be difficult to access in real life situations. For example, when you have a wasp phobia and you want to practise your relaxation techniques with a wasp nearby without being re-traumatised with panic. It can be difficult to recreate a controlled situation involving real wasps. In hypnosis, you can do the “mind work” necessary to dissociate your panic reaction without always having to access the real life situation.
But hypnotherapy can you offer more than just visualisation when using advanced techniques. Many of the cognitive restructuring processes used in CBT can be applied during hypnosis, helping you to accelerate the change of your thought patterns towards the removal of your phobia or fear.
Contact me for more information
So when you are ready to treat your phobia and fear in Cardiff using hypnotherapy, please contact me giving a few brief details of your phobia. These details will help me understand the precise nature of your phobia or fear however obscure you think it may be. This information will be treated in the strictest confidence.
If you are ready to treat your phobia and fear in Cardiff using hypnotherapy, contact Richard J D’Souza Hypnotherapy Cardiff
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