17 Common Reasons For Drinking Alcohol
People have various reasons for drinking alcohol without their drinking patterns being a cause for concern. An alcoholic drink or two can be part of an occasional celebration or to complement a special meal. Other people may avoid alcohol altogether if they don’t like to taste, fear being out of control, or associate alcohol with past distress.
In the early stages of drinking, you may not enjoy the taste. However, the situation surrounding your drinking behaviour e.g. feeling intimidated by peer pressure, will motivate you to push through your negative taste reaction until you accept it.
After some persistence, you find out that alcohol produces many gratifying effects on your mind and body. If you perceive this effect as rewarding, then your habits will draw you in to establish a level of alcohol dependence, however small. The associations you make with your drinking experiences will shape your values and expectations to continue drinking. But the effects of alcohol on the mind and body are so deceiving that people persevere with drinking alcohol compulsively even after it becomes a problem.
The reasons for drinking alcohol listed here include a further analysis of that reason. When you want to reduce your alcohol consumption, examining your underlying motivation or reason for drinking can help you re-evaluate your perceived reward. This can start a process of change in which you can then find better emotional and behavioural alternatives that are aligned with your new drinking goals.
Reasons for drinking alcohol: two broad categories
There are generally two broad categories that define the common reasons for drinking alcohol. One category uses alcohol as a coping mechanism to ease discomfort (or for negative reinforcement). The other category involves using alcohol to be cheerful and lively at social situations (for positive reinforcement). Both categories are vulnerable to habitual and binge drinking behaviour depending on the situation and individual beliefs. Situations can involve a mix of both categories e.g. when someone’s mood is jovial with moderate alcohol consumption, but after heavy drinking their mood becomes hostile causing them to release repressed anger from childhood experiences.
What are some common reasons for drinking alcohol?
You drink alcohol to relieve stress – Alcohol has anxiety reducing (or anxiolytic properties) and diminishes the feelings of stress. This is often acknowledged in the early stages of drinking, but as the dependency grips you, drinking continues even when the stress-relieving benefits have faded. The memory of the past benefit pushes the misconception that the feeling of relief will arrive after another drink. Ironically, for those with a high alcohol dependency, the increased alcohol consumption intensifies the feeling of stress that you were hoping to escape in the first place.
You are influenced by peer pressure (social norms) – The UK has an established drinking culture and following these social drinking norms and rituals is one of the main reasons for drinking alcohol, regardless of age. Drinking influences can come from your peers, your family, the media, the occasion etc.
In a social situation, you may not want to drink, but the fear of offending someone or standing out from the crowd if you don’t “keep up” can trigger feelings of isolation, a fear of being criticised or fear of being rejected from the social group (or activity). These fears can pressurise people into drinking because it’s socially expected particularly when it is connected to occasions like weddings and large parties.
For some people and social groups, drinking is the activity and the term “drinking buddy” can be used to form a relationship in which heavy drinking is normalised. Ironically, those with a high alcohol dependency will frequently drink alone with minimal social interaction in a social setting. Peer pressure can then be used as the hidden excuse for yet another occasion to believe you are drinking and having fun with friends.
You drink alcohol to feel grown up – Teenagers are highly curious and suggestible when they see adults doing something that they don’t do. With adulthood approaching fast, their impatience can encourage them to imitate adult behaviour. Tell your teenage children not to do something when you are doing it yourself and it’s likely to fire their curiosity when you are not around and see what all of the fuss is about. For teenagers, acting like an adult is one of the most common reasons for drinking alcohol. Ironically, when drinking excessively, it’s an excuse for many adults to act like young children!
You drink as an act of rebellion – If you are a teenager who is surrounded by rules and is constantly being told not to do things, being defiant about breaking the rules can be exciting. And when the members of your peer group haven’t “found” alcohol yet, it can seem very cool to do something excessively that they don’t do. The need to stand out as a non-conformist can continue into adulthood however, justifying the drinking behaviour as the definition of your individuality. Being the adult rebel with a high alcohol dependency, others will probably pity your behaviour rather than admire it, thinking that you have somehow lost your direction and now hide behind the “glamour” of your rebellious drinking.
You drink alcohol to take back control – If you have experienced control, manipulation or abuse from a parent or partner, you may use alcohol to “take back control” or even take revenge on your oppressor, particularly if they don’t like you drinking alcohol. Or maybe you are struggling to control a part of your life e.g. post-traumatic stress disorder, and having something that gives your mind moments of “release” can feel like you have momentarily escaped your torture and can “control” something. Drinking alcohol to cope with the despair of abuse and to take back control and is one of the most common reasons for drinking alcohol heavily. Even when you have battled your way out of your situation, the subtle reminders of your previous loss of control can be a strong trigger to drink again. It’s a long path back to heal the damage of your situation, but alcohol never really gave you the emotional resources to conquer it.
You drink alcohol to lower your inhibitions – Social phobia or (social anxiety) is a common phobia in which the individual fears embarrassment and attention. Alcohol is often used as “liquid courage” to take the edge off shyness particularly when coping with situations like a first date or a large party filled with strangers. You can feel anxious and drink alcohol to cope in anticipation of the actual event.
As your intolerance increases with a hectic social life, those spontaneous moments of awkwardness can trigger the need for another drink. Ironically, when you then become a binge drinker, your lack of inhibition can create situations that are often embarrassing, aggressive or attention-seeking. This is something that you can obviously blame on alcohol and “shrug off” the next day to hide your blushes, rather than developing skills like using affirmations, breathing techniques to control your anxiety, self hypnosis and meditation.
You drink alcohol to improve your sleep quality – When you are going through major lifestyle changes or work-related stress, your sleep quality can be affected. Introducing alcohol as a sedative to break the sleep-worry cycle can have a short term benefit, but when the effects of alcohol wear off, you are likely to wake up in the middle of the night. As your intolerance to alcohol increases, it means that you will need more alcohol to have the same sedating effect though the night. If the stressful conditions continue, those benefits can fool you into believing that alcohol is helping your long term sleeping habits. Since alcohol is a depressant, it reduces the amount of Rapid Eye Movement (REM) necessary for quality sleep. So when you have drunk alcohol, you tend to wake up feeling fatigued with poor concentration levels. Learning how to regain your natural sleep quality will help you break the sleep-worry cycle.
You drink alcohol to manage pain – It’s common to manage chronic pain with alcohol, but in order to be effective, you will need to binge drink over long periods to achieve some level of benefit. As you build up a tolerance for the quantity of alcohol, you will need more to achieve the same pain-relieving effect. There are further dangers of causing harm to other organs when mixing alcohol with painkillers.
Drinking alcohol helps you to feel better – Another term for using a substance like alcohol to feel better is called self medication. This is a broad category within the reasons for drinking alcohol that includes gaining any perceived benefit whether it’s shared by others or just personal to you.
Common reasons to self medicate (other than reasons already listed in this article) include feeling angry, lonely, depressed, bereft, worthless, frustrated, guilty, ashamed, bored etc. Using alcohol becomes the crutch to help you avoid, escape, divert, deny, suppress, repress, relieve, replace, numb, punish, block, hide, erase, stall, mask, forget etc. actively confronting or dealing with the discomfort associated with another situation.
In so many of those situations, the underlying problem doesn’t go away after you have finished drinking. Drinking alcohol just gives you a momentary release that is more bearable until you have accessed (if ever) a better way of coping with the alternative. If, for example, you drink to block feelings of guilt about something that you did wrong, your attention can be temporarily diverted from that guilty feeling that connects to the situation.
Some problems become more complex with time and latch onto additional situations causing the sufferer to feel more guilt and increase your dependency on alcohol. You don’t find an active solution to their problems; instead, drinking alcohol becomes the solution. Forming new good habits without alcohol takes time; prepare for a long road ahead.
You enjoy the taste of alcohol – Tasting ethanol for the first time as a child is rarely a pleasant experience. Evolution has hard-wired humans to dislike bitterness. But the taste can be “acquired” when it is suggested to you to “give it time” or you attach other reasons to persist with the bitter taste until you accept it e.g. because you want to fit in with your peer group.
Adding sugar to disguise the bitterness will help that acquired “liking” for you alcoholic drink and this addition also takes care of the other half of what evolution has programmed us to do (like sweetness). Flavour it with a whole range of mixers in enjoyable surrounds and your perceptions quickly convert it to the acquired taste that you enjoy.
And despite many people having drunk excessively to the point of vomiting to indicate that your body doesn’t like this, it only serves as a temporary aversion when your peers boost your drinking and vomiting achievement as “cool”.
You really want a drink – When you already perceive pleasure from something, the neurotransmitter that controls the reward centre in the brain called dopamine is playing a major part in motivating your behaviour. Drinking alcohol has an effect of increasing the release of the dopamine giving some people this temporary euphoria of enjoyment. Then add to that physiological process numerous pleasurable experiences like parties and celebrations to set up habits and your “want” and expectation to want more will be amplified.
Unfortunately, with continued alcohol use, the brain adapts to the dopamine overload by producing less of the neurotransmitter and lowering your mood. To regain your euphoria, the brain is tricked into thinking that you have to keep drinking to stay happy, meaning that you may need more alcohol to have the same effect. At this stage of alcohol dependency, your want is bordering on a “need” to feel good again. If you maintain a high level of alcohol consumption, you are on the early pathway to alcohol dependency.
You drink alcohol to warm you up – Drinking alcohol can temporarily feel warming by the receptor nerves in your skin detecting a rise in skin temperature caused by vasodilation. But this effect actually lowers the body’s core temperature as the thermoregulatory system would normally perform this function to cool your core temperature down. Natural ways to warm up include moving around and putting on warmer clothes and wrapping your hands around a hot cup of tea if your hands are cold.
You drink alcohol to quench your thirst – Drinking alcohol has a diuretic effect, helping you to eliminate water from your body by increasing the production of urine, hence you tend to feel thirsty in the night or morning after a drinking session. It’s likely that when you are thirsty and you consume one alcoholic drink, you believe that the next drink will taste better because of the false belief that it is thirst quenching. If you are thirsty, there are many non-alcoholic drinks that will quench your thirst.
You drink alcohol to improve the taste of your food – Pairing your food with alcohol can seem like a sophisticated ritual that is built into fine dining culture. Excessive alcohol consumption however can damage your sense of taste.
Moderate drinking activates the taste and smell receptors connected to the brain to generate a chemo-sensory perceptive experience along the lines of “ah, plenty of berry fruits…etc.” This response makes it an ingenious marketing opportunity to mark up the cost of a bottle of wine in a restaurant. When you then buy your “deliciously” described steak from the menu (another way to build expectation about having something better than it is), you are fully buying into the illusory benefits of wine pairing.
You drink alcohol to feel powerful – Power can mean several things to different people. It can mean feeling confident, self-assured, authentic, courageous, being assertive, funny, sexy, beautiful, sociable, impulsive, flirtatious, important or liberated as an ideal version of your “self”. For some people, it can mean an excessive “high” feeling of arrogance or aggression that can be admired by one’s peers (social confidence) and would not come to the surface without using an elixir to immortalise you in some way. The reason that you might feel powerful is again connected to the brain’s flooding of dopamine (pleasure neurotransmitter) that can have the effect of lowering one’s inhibitions. Then there’s the placebo effect – believe that that an amount of alcohol “caused” you to have a good outcome last time and you will drink alcohol again to “create” the same effect.
If you have low self belief and low self confidence, and fear being exposed as dull, unintelligent, ugly etc., you are probably using alcohol to fill your void of insecurities. You remain convinced that alcohol will give you “power” or another emotional boost and guess what, it will probably will!
You drink alcohol to improve sexual performance – Drinking alcohol to improve the quality of your sex can have variable benefits. Depending on your gender, people may drink alcohol to increase your desire to be intimate, be less “fussy” with your choice of partner, lower the level of performance anxiety, increase or decrease arousal levels depending on your underlying negative issue (e.g. premature ejaculation), sustain an erection and delay orgasm. But there is an optimal amount of alcohol to achieve the desired result. Excessive alcohol can have a detrimental effect on the quality of your sex, decreasing sensitivity (common with erectile dysfunction), reducing arousal and your ability to achieve orgasm. As with using any substance excessively, achieving natural sexual satisfaction can become more difficult to achieve as you drink heavily. Many people who binge drink often regret their sexual experiences whilst being drunk.
You drink to get drunk – Drinking with the intention of getting drunk can be motivated by a number of underlying reasons. People usually get drunk to cope with negative experiences, to be more sociable, to conform to ritualised behaviour and to feel more excitable. The physical effects of alcohol include reducing stress by acting like a common tranquilliser in parts of the brain, dimming your judgement abilities so that you “don’t care”, releasing dopamine to increase pleasure and releasing endorphins (opiates) to help you “feel good”. With alcohol being legal, it’s not surprising that people want to get drunk in the short term with all of these physiological effects. Continue to binge drink over an extensive period of time and the changes in your brain chemistry steer you towards high alcohol dependency.
Common reasons for drinking alcohol: Summary
The reasons for drinking alcohol are numerous and personal but can be generalised into drinking for positive and negative reinforcement. Any behaviour associated with a substance can become habit-forming. A behaviour that is part of cultural norms and values can quickly accumulate positive beliefs as you multiply those experiences.
If you are seeking to reduce your alcohol consumption, interacting with your underlying needs will help you to focus on positive changes.
- Relying on any substance like alcohol to cope deceives you that you are really dealing with it.
- The perceived rewards can become a habitual.
- Your initial rewards can be redundant, but you continue to believe that you are still benefitting even though your lifestyle has changed.
- You can be convinced that things would be worse if you didn’t drink.
- As your tolerance to alcohol increases, you need more alcohol to have the same effect.
- When you drink heavily, the rewiring of your brain chemistry makes it harder to cope with those situations naturally.
- Heavy drinking patterns can creep up on you.
- You increase the number of health risks as your drink heavily, including risking alcoholism.
Reasons for drinking alcohol: for more information on hypnotherapy to lower your alcohol consumption contact Richard J D’Souza Hypnotherapy Cardiff
Break a bad habit with Hypnotherapy
Do you want to break a bad habit? Well, here’s a new notes on habits first to help you understand how you have arrived here…
Break a bad habit: What is a habit?
A habit is an automated mental and behavioural activity that enables you to shape aspects of your daily life. Habits give you structure, stability and security so that you can focus on the more important tasks. Without habits, you would need to regenerate creative and complex thinking into every part of your day. Compare the current effort needed to type on your “qwerty” keyboard with typing on one that has been randomly rearranged. Typing up a project on the latter would be a frustrating process until you have learned the new keyboard format and formed the new habits needed to type proficiently again.
Habit formation is a mind-management tool. When you form a habit, it enables you to save mental energy and to take short cuts on certain activities. Automated behaviour demands less effort from you than activities that demand your complex and creative thinking. Habits thus act as one of the brain’s power-saving mechanisms, “chunking” the routine behaviours to free up energy for those other “essential” tasks.
Habits are important to understand because they contain specific aspects of your thinking, your emotions and your beliefs, which in turn, can also become automated. In many ways, a habit is a reflection of your direction, who you are, and what you believe. When you achieve your goals, it is a result of your well-nurtured habits.
Habits are also important to understand because when a habit has been formed, it creates a huge influence in how you expect to behave, think and feel. This can be ideal if the habit is serving a good purpose. If the habit is (or has become) a bad habit however, then it can have a negative impact on many aspects of your life, how you feel about yourself and your confidence. Ingrained bad habits will conflict with what you want to do, displacing your rationality and what you might consider to be your “free will”.
Habits are more challenging to adjust when you are experiencing a number of major lifestyle changes e.g. a change of job, a relationship break-up, a bereavement etc. When you are under pressure, letting go of the old habits and establishing new ones can be frustrating. It can seem easier to continue with the bad habit particularly when you are under stress, even though you can appreciate that it’s not working for you and that it’s conflicting with underlying beliefs (cognitive dissonance).
If you want to break a bad habit, layers of repetition that you have formed in one direction will now need to be undone and replaced with a new positive process. If this habit has taken many years to develop, it can be particularly challenging to work against the tide of expectation, break down the bad habit and install a new self-affirming behaviour. When you want to break a bad habit it’s not surprising that you get stuck in a recurrent loop.
Have you reached a dead end with your bad habit? Then maybe professional help would benefit you.
Break a bad habit: how are habits formed?
Approximately 40% of your daily behaviour is determined, not by conscious decisions, but by habit. Have you ever tried to be conscious of some of your basic routines? Take your morning routine for example. It can be exhausting analysing every action, the methods available, the pros and cons, assessing and evaluating if the behaviour was good enough etc. Like most people, you slip into subconscious mode and prepare for your day ahead.
Let’s consider one part in that morning routine, like brushing your teeth. For many of you, rewinding back to the day when it all started will have connections with your parents or relevant authority figures. The cue (or trigger for the behaviour) will have originated from a suggestion, demonstration or assistance from them. The reward or perceived benefit is the reason for your brain to store the pattern of behaviour. This may have come from your parent’s praise, your own reward for “looking very grown up” imitating what they did, enjoying the feel of the toothbrush on your gums or taste of the toothpaste etc. With the repetition of daily teeth brushing, the routine or habit was created.
Now let’s consider another habit that is not so fundamental for the general population, but is essential to those who do it – the habit of nail biting (onychophagia). Again, the cue for nail biting can derive from observation and imitation of an authority figure or a peer. For some, having the irritation of an uneven nail that was torn or split was the cue. Biting off the torn nail reduced the irritation and became the reward. And with the repetition of biting more nails, the habit was formed.
As a nail biting habit becomes ingrained over a period of years, it integrates additional needs (emotions and beliefs) and incorporates more rewards. This intensifies its effect on the individual, as if it’s part of your identity. By now, the nail biting habit has numerous triggers and is taking over many situations in your lifestyle. You may even be biting your nails in your sleep.
Some of the underlying needs that can develop over the years for nail biting can include personal grooming, perfectionism, problem-solving, achievement, emotional comfort (from stress, anxiety etc.), alleviation of boredom, control, self punishment, time-efficiency (using your teeth is easier than fetching nail clippers), defiance, loneliness, a thumb-sucking replacement, hunger satisfaction, appetite suppression etc.
With such a complicated needs-reward pathway, wanting to break a bad habit like nail biting as an adult can be a challenging process.
Habits, compulsions and addictions
What are the similarities and differences between habits, compulsions and addictions?
As discussed, habits (whether good or bad) are routine behaviours that are consolidated through repetition. You may or may not notice that you are performing the behaviour, but when it is brought to your conscious attention, you can usually temporarily stop the behaviour. With time, the original reward that integrated the good habit during formation can separate from the current behaviour. Hence you can be in possession of habits that are no longer useful. If it conflicts with current needs, the good habit has become a bad habit.
Compulsions are repetitive behaviours driven by anxiety and are often defined within obsessive compulsive disorder. There is hope of a reward, but once the compulsion is performed, there is no relief from the underlying anxiety connected to it.
Whilst there is pressure to act with both habits and compulsions, the pressure to perform the compulsion is usually more intense than with habits, and will continue even if consciously noticed. The “good habit” of washing your hands before eating has a definite sense of completion. With compulsive hand washing however, the ritual can have a specific sequence, is time-consuming and anxiety continues even after completion of the hand washing routine.
Addictions involve biological connections with substances that are consumed or used, such as drugs, alcohol and nicotine. There are many compulsions that are considered to be addictions, where no substances are consumed or used e.g. when gambling or shopping as a “shopaholic”. Addictive behaviour is characterised by intense cravings, loss of control and behavioural persistence often to the neglect on one’s health, relationships and work. An addiction can be referred to as a disease with many triggers because of the brain’s involvement in the development of the condition.
Addictions start as habits but the behaviour can remain as habits e.g. when habitually drinking alcohol every evening. As the habitual patterns intensify however, they can become compulsive and addictive. What defines it can depend on the individual and your motivation, your negative emotions connected to the behaviour (e.g. to manage anxiety) and its affect that these patterns are having on your neurology. All behavioural patterns can be difficult to stop.
Generally, an OCD compulsion has does not have any pleasurable attachments; it originates from a need to relieve an obsessive urge. Addictive behaviour starts with the desire for pleasure, but there is usually a point where enjoyment is lost and you are just seeking relief from the urge to continue the behaviour. This is intensified during withdrawal and can look like an OCD compulsion at this stage because the pleasure has ceased.
Another major distinction is related to the awareness of reality. Those with an OCD compulsion are aware that the obsession is not real and you are distressed by the need to carry out the irrational compulsion. People with addictions however are in a state of denial and are disconnected from the long term consequences of your actions. Instead you are in pursuit of short term gratification, ignoring how your behaviour might be linked to an underlying problem.
Why is this distinction between habits, compulsions and addictions important? From the above discussion, it is evident that these types of repetitive behaviour can overlap in one person, yet can remain distinct in another person. Consider an example like exercising every day. Is this someone who is passionate about their hobby, health and fitness, and wants to maintain a good exercise habit? Or has the exercise routine become more of a bad habit or a compulsion, masking an underlying health anxiety or insecurity about their physique? If the individual is spending hours each evening at the gym and neglecting family relationships, does this mean that it has become an addiction? It would need a closer analysis to define it accurately.
When you want to break a bad habit, understanding the category of your automated behaviour (habit, compulsion or addiction) can help you appreciate what may be necessary in your treatment plan. Treatment to quit smoking for example can involve treatment for the addiction and habit to convert the smoker into a non-smoker.
Has your repetitive behaviour been diagnosed? Many clients arrive with deeply entrenched bad habits that have become compulsions. It’s often necessary to treat the connecting beliefs and emotions to release the subconscious mind’s need to maintain the bad habit.
Break a bad habit: Most common bad habits
Bad habits come in all shapes and sizes and varying degrees of severity. Placing them into “categories” inevitably involves a degree of overlap depending on how you view the habit e.g. is watching too much television a bad health habit, or a procrastination habit, or both? Certain bad habits can also vary in the specific situation e.g. procrastination can be determined by what distractions are available at the time such as access to television, your phone, snacks etc. and whether you are at home or at work.
And not all bad habits are behavioural; some bad habits can be identified as cognitive and emotional e.g. when dwelling on lost opportunities or worrying about the future.
Bad habits that increase your weight
It’s not just identifying where the calories exist; it’s important to make the connection with how you approach your eating and drinking patterns. Bad habits that increase your weight can include:
- Overeating, binge eating
- Drinking high calorie drinks
- Emotional eating (aka comfort eating)
- Snacking late in the evening
- Eating a diet that is high in salt, sugar and fat
- Eating too quickly
- Always needing to finish everything on your plate
- Not eating consciously (snacking whilst watching television),
- Not planning your meals
Bad habits that can harm your health
Ignore some of these bad habits and they can apparently take years off your life. Bad habits that can harm your health include:
- Many of the habits that increase your weight (see above)
- Drinking too much caffeine
- Being inactive (lack of exercise)
- Slouching, crossing your legs
- Not having enough or quality sleep
- Habitual drinking and binge drinking (alcohol)
- Using phones and other devices late at night
- Taking drugs
- Overmedicating (pain killers, sedatives etc.)
- Ignoring how stress is affecting you
- Skipping medical appointments
- Not drinking enough fluids
- Not flossing
- Wearing high heels
- Skipping meals
- Ignoring the value of your health
- Living beyond your financial means
Bad habits that damage your productivity
Being productive can involve a number of issues including effective time management skills and balancing obligations with work and home life. Activities that can be defined as “time out” or escapism to some can be a time-wasting activity (procrastination) to others. In the balance of managing stress however, it is important to have some relaxation time; too much “chill” time and it can add to your stress. Bad habits that can damage your productivity include:
- Watching too much television
- Overusing your phone
- Playing video games
- Over-using social media
- Saying yes to everything
- Lack of delegation
- Being indecisive
- Not having breaks
- Poor punctuality
- Watching too much porn
- Sleeping in
- Leaving keys/wallet/purse in random places
- Leaving things until last minute
Bad habits that hurt your finances
Some people say that money isn’t everything, but it’s important to achieve a level of financial comfort where you don’t have a daily financial struggle just to survive. Ignore poor financial management habits and it can lead to health problems. Bad habits that can hurt your finances include:
- Emotional impulsive shopping
- Ignoring credit card limits
- Not economising/budgeting
- Stealing (kleptomania)
- Not saving money
- Neglecting your bills/expenses
- Not saving towards a pension
- Spending to compete with others
- Hoping to get lucky
Personal bad habits
Personal grooming patterns can become destructive habits, even though they start with the intention of comforting the individual. Some of these behaviours can annoy, offend and disgust others when done in public. Personal bad habits can include:
- Nail biting or biting/chewing on other objects
- Thumb sucking
- Twiddling hair
- Hair pulling (Trichotillomania)
- Biting your lips, biting the inside of your cheeks
- Picking your skin, scabs or spots
- Clearing your throat excessively
- Grinding your teeth (bruxism), clenching your jaw
- Not washing your hands
- Picking you nose
- Cracking knuckles
- Excessive scratching
- Over grooming
- Using your phone when driving
Bad habits that harm your relationships
Communication, trust and respect are just some of the common relationship goals. Certain bad habits can hinder those goals from flourishing. Bad habits that can harm your relationship include:
- Trying to change your partner
- Provoking jealous reactions from your partner
- Being too critical
- Staying in toxic relationships
- Being abusive
- Not standing up to abuse
- Being aggressive
- Not acknowledging your partner
- Not actively listening
- Competing with your partner
- Keeping score
- Failing to respect each other’s space
- Engaging in passive-aggression
- Avoiding conflict
Bad habits that harm your emotional wellbeing
It can be a slow process, but giving daily attention to some of the behavioural patterns that are contributing to your low mood can gradually pull you out of your unhappiness. Bad habits that can harm you emotional well-being include:
- Being self critical
- Associating with negative people
- Being unassertiveness
- Fearing failure
- Struggling to take criticism or praise
- Failing to take responsibility
- Isolating yourself from others
- Comparing yourself to others
- Worrying excessively
- Not making time for yourself
- Self hatred
- Not practising meditation/mindfulness/self hypnosis
- Obsessing about things out of your control
- Undervaluing self awareness
- Not using correct breathing techniques
- Failing to use affirmations
- Dwelling on your negative past
- Not wanting to break a bad habit
The impact of ignoring bad habits in a certain category can obviously have a direct impact on that part of your life e.g. obesity can be the result of ignoring bad habits that contribute to weight gain.
Other negative effects include anxiety, depression, stress, sleep problems, panic attacks, fatigue etc. Long terms bad habits can also contribute to family problems, dental problems, social problems and unemployment.
How are bad habits justified?
Bad habits start as “good” habits. At the time of their formation, you make the connection with a perceived benefit (or reward) regardless of how negative it may seem to others. What you connect with can be based on the resources that are conveniently available at that time.
Young children can develop habits such as twiddling hair, nail biting, thumb sucking and skin picking to manage stress, to comfort insecurity and loneliness, and calm anxiety. When there is a lack of activity for children, the bad habit can combine with the management of these negative emotions to become a new daydreaming “activity” to feel comforted and ease boredom.
Depending on your family situation and your interaction with adult authority figures, the developing bad habits can be reinforced to balance emotions from negative conditioning e.g. where there is control, manipulation, abuse or neglect from adults (or other school children). By employing the habit, the child will seek to gain attention or regain a level of emotional control. Some habits can be used as self-punishment (self-harm) to divert feelings of guilt, shame or worthlessness.
Whilst the bad habit of comfort eating can develop from young childhood, teenage curiosity can be a period where bad habits are connected to other substances. Alcohol, tobacco and recreational drugs are common ways that young people self-medicate to escape problems and manage stress and social anxiety.
Beyond the use of substances, emotional and behavioural bad habits can also become ritualised at this young age to manage anxiety, a fear of failure, guilt and shame. Negative self-talk, obsessive compulsive behaviour (e.g. gaming or gambling) and procrastination (e.g. watching television, using social media) are common bad habits that leak into adulthood, often damaging efficiency, self confidence and self esteem.
The needs that justify bad habits can be complex. They start as a functional good habit. With repetition, changing needs and new situations, they evolve and attach new rewards that can make the original need for performing the habit redundant. When you are struggling to break a bad habit, you are attempting to confront theses conflicts in your emotional history.
How can hypnotherapy help you to break a bad habit?
Stubborn bad habits leave a deep imprint in how you manage your life. Bad habits can persist despite them being detrimental to your health, harmful to your relationships and a contributor to your stress. A desire to change isn’t always enough to break a bad habit cycle.
When you are battling to break a bad habit and you have reached a dead end, hypnotherapy can give you the tools that you need to eliminate it. That’s why many people seek professional help from a hypnotherapist. How can hypnotherapy help you break a bad habit?
Hypnotherapy can identify and remove the cause of your bad habit
Many habits were installed within a particular belief system or state of mind that met your needs at that time. You have now moved on from these needs but the cause of the habit is still influencing you to continue the behaviour. Regression techniques can be used to take you back to when you set up the behaviour and reframe the needs-habit (causal) pathway. The emotional roots can then be disconnected freeing to access new habitual patterns that suit your current lifestyle.
Hypnotherapy can break the triggers that surround your bad habit
Bad habits start as a conscious process and with repetition they become unconscious. You may not even notice that you are performing your bad habit in certain situations until a negative trigger prompts you e.g. your bitten nail is sore, or there are no more biscuits in the pack, or the bottle of wine is now empty, or your skin is bleeding, or you have just “lost” another 2 hours to procrastination etc.
Throughout your treatment, you will become more mindful of your bad habit, helping you to identify “where” and “when” the triggers are intense. Suggestions can then be used to remove the negative patterns that are associated with these triggers.
Hypnotherapy can reprogram your negative thought patterns
Your bad habit is paired with negative thoughts, beliefs and emotions that justify its continuity in a part of the mind called the ‘critical factor’. Negative thoughts like…
- “I can’t do that assignment” (so you procrastinate with a few more round of Candy Crush).
- “I’ve lapsed so many times now; I may as well keep smoking” (so you light up another cigarette!)
- “I can’t win with this diet” (so you grab a few biscuits in frustration).
…help maintain the bad habit.
In hypnosis, the critical factor is overridden enabling you to absorb positive suggestions or affirmations that have a more profound effect on your old bad habits. It’s as if your mind is given accelerated conditioning experiences to optimise and embed new positive thoughts, beliefs, emotions and behaviour that are aligned to your treatment goals.
Hypnotherapy can replace your bad habit with new positive habit
How many times have you heard people tell you to “just stop” doing your bad habit? How many times have you said that to yourself in vain? Ingrained bad habits rarely respond to suggestions “to stop” when they ignore deeper unmet needs. This is because your mind’s system becomes unbalanced, registers that something is “missing” and demands that the need is met (usually with what it expects to have, based on past behaviour).
The main therapeutic aim when you want to break a bad habit is to give your mind a brand new habit that is functionally more acceptable than the bad habit, and then install the new habit with repetition. If the underlying needs (e.g. stress and anxiety) are stable during the transitional period, the connection with the good habit can be achieved relatively easily. This approach is effective with “simple” bad habits.
Intense repetition is important for conditioned learning; to create the switch from the old bad habit to the new good habit. When the repetition is too slow and it lacks emotional intensity however, your mind can revert back to using the old bad habit. This is where hypnotherapy can step in and be so beneficial with visualisation techniques.
Visualisation in hypnosis can give your mind the positive experiences with emotion intensity, as if you have actually had those experiences in reality. This treatment approach accelerates the conditioning process. Visualisation can serve useful when it’s difficult to continuously simulate the emotions and behaviour in a particular situation e.g. when installing a performance skill in open field sports situations.
Hypnotherapy can treat the underlying needs of the bad habit
When you want to break a bad habit, the above process (i.e. habit replacement) is the most common and direct treatment aim with simple bad habits. The conversion can be relatively quick, particularly with highly suggestible clients. Try this hypnosis test to assess your level of suggestibility.
Some bad habits are more complex and might be defined as compulsive behaviour. This is because there are numerous underlying needs (emotions and beliefs) that have connected to the bad habit over a long period of time. This causes the structure between your needs and the bad habit to become very rigid.
Your goal in therapy remains: to break a bad habit. In this situation however, the underlying needs (or core issues) are very strong and demand treatment in the context of your bad habit. If the bad habit is eliminated without dealing with the underlying needs, the exposed needs will draw you back into the bad habit. Regression techniques may be used to identify and treat the cause, and reappraise any issues that were impacting on the habit during its formation.
Let’s take for example someone who wants to quit the habit of smoking cigarettes. You have tried and failed several times using “willpower”. Direct suggestions in hypnotherapy are only having a partial effect and you relapse in certain situations. The background to the habit of smoking is identified and reappraised using regression hypnotherapy. As a teenager, the origin of the habit of smoking was connected to control and manipulation from an abusive father. Smoking was used as defiance, to “take back control” from your abuser (i.e. your reward). Smoking was something that your father despised and was unable to control in your absence. As the adult, you now live independently from your abusive father, but he criticises you each time that you have a telephone conversation with him. After the conversation you feel tense and worthless and this is a recurring trigger for you to smoke. Your “abuse-tension-worthlessness-smoking” connection (or your underlying need) is treated and this helps you to quit smoking completely. Your treatment helps you install new, more functional habits and deal with the stress of your father’s criticism of you in a positive and constructive way.
Hypnotherapy can teach you self hypnosis for future habit maintenance
Habit formation is an ongoing process; as your needs change habits need adjustment to be effective. Developing good habits that can be adapted to your changing needs and situations in the future is a skill that can help you manage your lifestyle independently. Having achieved your goal in my hypnotherapy treatment, you will take with you some of the skills of breathing techniques and self hypnosis to maintain the independent “mind-work” that can be so useful for future habit management.
For more information on hypnotherapy treatment to break a bad habit contact Richard J D’Souza Hypnotherapy Cardiff
Agoraphobia Treatment in Cardiff
Agoraphobia treatment: Agoraphobia is an anxiety disorder and complex phobia in which the sufferer fears being in various situations that are considered difficult to leave. Having a panic attack in a situation and feeling trapped, embarrassed or isolated from help starts a sequence of fearful reactions that exacerbates the condition.
Agoraphobia can also develop when you have experienced a trauma usually away from your home. You now live in fear of experiencing another trauma when you leave your home.
With mild agoraphobia, you may be able to travel short distances to deal with “essential” matters. In the extreme progression of agoraphobia, you will struggle to leave your home.
Agoraphobia treatment: What situation does an agoraphobic fear?
Someone suffering with agoraphobia will fear returning to any situations where you have previously experienced a panic attack or a trauma, typically open spaces and public places. This can include:
- Being in open spaces where help may not be readily available such as in open fields and countryside, around and at the top of hilly and mountainous landscapes.
- Being away from home in extreme weather conditions.
- Travelling in vehicles or on public transport where you are unable to control the journey e.g. when travelling on a train, bus, coach, ship, underground tube, airplane and even a taxi. Or travelling in a car with unfamiliar people whom you fear would be unsupportive if you had a panic attack.
- Social situations or crowded locations where you cannot see your “exit” or where your help may not be able to find you easily.
- Being in confined spaces that are difficult to escape or where the location has limited access points such as in forests, on bridges, in tunnels, walking amongst tall buildings and being stuck in traffic jams. It can also include inaccessible situations at a relative height or altitude e.g. being in a lift at the top of a multi-storey building, parking at the top of a multi-storey car park or using a cable car to travel between locations.
- Visiting a large shop or supermarket that has: narrow aisles, is very crowded, has queues at the service tills, has electronically operated doors or where the shop is so enormous that you may not be able to vacate it easily.
- Being left alone and feeling isolated (either at home or away from home), particularly from those whom you trust or whom you believe can help you.
- Travelling over or being close to other potential areas of danger such as bridges, heights, deep water etc.
- Progressively being further away from your safe place, (this is usually your home) and being away from people who are important to you.
- Having driving anxiety (or fear of losing control and having a panic attack whilst driving) and endangering yourself, your passengers, other drivers, pedestrians and damaging the vehicle. This can be experienced in numerous situations detailed in this section. For example when driving over bridges (heights) and deep water. The feeling of anxiety is also intensified with certain road types such as motorways with increased speed, motion, shorter reaction time, relative open/closed spaces, exposure to sudden gusts of wind, distance away from home, being stranded if the vehicle broke down etc.
- Having experienced a previous trauma or near-trauma, you believe that you may experience an actual trauma or another trauma when you leave your home. Traumas can include being attacked, doing something that may cause extreme humiliation such as having a severe attack of IBS or being (re) infected by a serious illness. Fear of contracting a serious illness is also known as health anxiety.
You can appreciate from the above information that when you fear more situations, it increases the complexity of your agoraphobia with the likelihood that you could encounter any one of these “panic stricken” situations when you leave home.
Some locations will include several of these feared situations in one area and are likely to cause high anxiety if obligated to confront it without help e.g. when using the motorway to drive over a national boundary bridge (like the Severn bridge that spans the River Severn between England and Wales).
Agoraphobia treatment: What causes agoraphobia?
Agoraphobia is caused by a number of biological and psychological factors, more notably as a complication of panic disorder. Panic disorder is an anxiety disorder characterised by panic attacks that are assumed to be spontaneous and a possible symptom of a more serious condition e.g. a heart attack.
During the early development of panic attacks, you are in a state of high alert trying to look for causes of and solutions to your distress. You ignore the importance of your internal beliefs and the physiological meaning of these panic symptoms i.e. you are in a fearful state, but at this time, you just don’t know how you can end up feeling this way are why you feel this way.
You (mistakenly) focus externally on your situation, location or activity and (incorrectly) give excessive importance to when these symptoms are alleviated (i.e. when you escape the situation and arrive home). The situation you were in when you felt anxious becomes the “cause” of your distress and your rapid escape home becomes the solution.
Then, in order to control the frequency of panic attacks, you will avoid these situations in the future. The combination of your rapid retreat and avoidance convinces you that you are dealing with the situation in an effective way to minimise your immediate discomfort. However, these avoidant solutions are quick-fixes that make the long term situation worse as there are a diminishing number of situations in which you can feel safe from panic attacks.
In addition to this, your hasty escape becomes automated and a “necessary” method of coping even when you anticipate feeling anxious. Progressively, as the condition grips you, you feel high anxiety when you are at home just imagining confronting the outside situations.
Experiencing panic attacks in your “safe place” causes confusion as your remedial escape plan is now meaningless. Effectively, you are running away from your “own mind” and have exhausted your options to comfort it. At this advanced stage of the agoraphobia, you are probably housebound and experiencing a higher frequency of panic attacks.
Other causes of agoraphobia can include:
- Experiencing trauma (e.g. violence) whilst away from your home. You live in fear of experiencing another similar trauma if you were to leave your home.
- Suffering major lifestyle traumas like bereavement, divorce and unemployment. These external events can cause a significant loss of confidence, feelings of guilt, worthlessness, embarrassment and shame. Some people feel vulnerable and exposed to judgement from others when you go through a major lifestyle event and are exposed to social situations.
- Having other anxiety disorders and phobias such as depression, generalised anxiety disorder, obsessive compulsive disorder (OCD), social phobia and claustrophobia.
- Suffering a history of abuse and control.
- Conditioned responses from a family background of agoraphobia. In some cases the background can include a “dependency culture” that stifles self-confidence.
- Problems with substance abuse.
- You have certain medical conditions such as suffering problems with balance (vertigo) and spatial awareness distortion issues. This affects how you perceive the proximity of people and objects. You feel disoriented and vertiginous when environmental features “look busy”, are too close, too far away or have a “descending” perspective when viewed from a height.
Click this link for more information on the general causes of a phobia.
Agoraphobia treatment: What are the symptoms of agoraphobia?
Physical symptoms: Since avoidance is the common strategy to minimise discomfort, the agoraphobic will rarely confront those situations that cause distress. When it is necessary to confront those situations however, the anxiety symptoms experienced are common to those when having a panic attack. Symptoms will include hyperventilation, rapid heartbeat, nausea, excessive sweating etc.
Cognitive symptoms: The cognitive symptoms reflect the underlying belief system. For example, the agoraphobic with health anxiety will be convinced that your physical symptoms are connected to a serious illness. Whereas the agoraphobic with social anxiety will be believe that appearing out of control with a panic attack will draw attention and will feel humiliating. In addition to this, the agoraphobic with claustrophobia will judge that you will not be able to escape the situation particularly when experiencing a panic attack.
Behavioural symptoms: The behavioural symptoms have been detailed in the section above entitled “Agoraphobia treatment: What situation does an agoraphobic fear?” and includes being in open spaces where help may not be readily available.
How is agoraphobia diagnosed?
Agoraphobia is usually diagnosed by your doctor who will ask questions about your signs and symptoms, and your medical and family history. It is common to do some blood tests to dismiss any physical causes for your condition e.g. hyperthyroidism.
How is agoraphobia treated?
Agoraphobia treatment can involve a specific or a combination of different interventions including:
- Self help techniques that help you understand agoraphobia and panic attacks. When you learn about these conditions, it may help you have more control over your symptoms. Lifestyle changes such as taking up regular exercise (initially performed in your home) can help you reduce symptoms of everyday-anxiety.
- Prescribed medication from your doctor such as SSRI’s (selective serotonin reuptake inhibitors), antidepressants or anti-anxiety medications can relieve some of your agoraphobia or panic attack symptoms.
- Therapy such as psychotherapy, Cognitive Behavioural Therapy (CBT), and Exposure therapy can be used to discuss your fears, change your thoughts and progressively challenge your behavioural symptoms.
How can hypnotherapy treat your agoraphobia?
Agoraphobia is considered to be a complex phobia since it can integrate various anxiety disorders e.g. panic disorder, and a number of advanced individual fears and phobias that now dominate the sufferer’s self-limiting experience. Unless the symptoms are being caused by a specific issue, agoraphobia treatment is rarely a quick-fix since many of the symptoms have developed over an extended period of time. But when the agoraphobia treatment allows for a structured approach, it can be invaluable in returning the sufferer to emotional wellbeing and lifestyle confidence.
Is hypnotherapy a viable treatment for agoraphobia then? There is some case study research to demonstrate hypnotherapy’s effectiveness. For example, hypnotherapy has been used when treating IBS-induced agoraphobia and in another case study where the application of hypnotherapy was psychodynamic in its approach. Hypnotherapy has the advantage over other treatment modes since it can utilise the subconscious mind with some impressive outcomes.
Furthermore, studies from Stanford University state that phobia sufferers “tend to score high on hypnotic susceptibility scales and… respond favourably to hypnotic intervention.” You can assess your level of suggestibility using this hypnosis test.
To be successful in agoraphobia treatment however, hypnotherapy still needs to incorporate other tried and tested methods. My agoraphobia treatment approach includes various treatment strategies using these tried and tested methods.
This is how you can benefit from hypnotherapy:
Your core issues will be identified and treated
When you live inside your agoraphobia symptoms, you will be responding to a negative programme that is now established and automated. Your behavioural reactions are not the problem, but act as a further symptom of your condition. In the early stages of your treatment your agoraphobia “map” will be traced to identify core issues that may have been forgotten and repressed. In many cases an issue like a height phobia is not being confronted, yet is still playing an active part in the avoidance programme. When these issues have been identified, either through discussion or using hypnotic techniques, your treatment goal will become clearer and can be broken down into progressive stages.
Hypnotherapy will help reduce your anxiety
Advanced anxiety states benefit from an interruption from the pathways that maintain it. By introducing relaxation into these pathways, it allows you to see out of the habitual patterns of avoidance and prepare to accept new patterns. My hypnotherapy incorporates anxiety reduction as part of the induction, a process that may not be included in other therapies. This is helpful in your goal to overcome your agoraphobia, but it is not the complete treatment. The post-hypnotic suggestions that are targeting aspects of your agoraphobia are the main part of the treatment and will accelerate you towards therapeutic change.
Hypnotherapy can help you control your panic attacks
The ability to use breathing techniques to control your anxiety is an essential part of feeling in control of your internal state. You may have previously tried breathing techniques, struggled to benefit from them and then dismissed them as being helpful following another panic attack. Your treatment will revise these techniques and anchor them in hypnosis so that they become a natural effective intervention in your anxiety management.
Hypnotherapy suggestions can target your agoraphobia symptoms
In a hypnotic state, you are more receptive to positive suggestions. Hypnotic suggestions can target your physical, cognitive and behavioural symptoms interrupting the current pathways that are overwhelming you. When you have intense positive visualisations without conscious interference, it can transform your current negative state into your desired state. The suggested visualisations act as positive rehearsals for your practises enabling you to confront the situations that you are avoiding. As you embrace these new patterns of behaviour, essential feature that maintains your agoraphobia like your automated “escape” reaction will be modified.
Hypnotherapy can reframe your past emotional traumas
Regression techniques often get a slating from solution focused hypnotherapists and other therapies that consider “revisiting the past” as a waste of time. Painstakingly combing through every part of your life is the common misconception with age regression techniques, but this is not necessary unless treating deeper issues like extensive abuse. With agoraphobia, reframing the negative emotional learning from past events can be completed in a relatively short period of time. By examining the (i) origin (also known as the “cause” of your condition), (ii) the most emotionally significant past event, and/or (iii) the most recent event is, in many cases, sufficient for emotional release. Regression hypnotherapy adopts the view that it’s your state of mind when you learned your agoraphobia that is continuing to cause you problems, not the reactions that have ensued.
Hypnotherapy can assist your desensitisation programme
Doing the “in vivo” exposure or “mind work” to treat the emotional blocks connected to your agoraphobia in the clinic is an important part of the treatment process. It will prepare you for the “in vitro” or behavioural exposure to confront the “outside of clinic” situations that you are currently avoiding. As you systematically achieve the objectives in stages, it completes the circle of belief that you are building confidence and can overcome your condition.
Can hypnotherapy be combined with desensitisation (or graduated exposure) techniques effectively? Hypnotherapy can be mistakenly identified as a “one trick pony” in which you are “made” to change in one session or the treatment has failed. Would you seek this same expectation from a cognitive behavioural therapy programme? Probably not; you would expect a course of therapy particularly if it includes systematic desensitisation. In the treatment of phobias, research has shown that hypnotherapy can be effective in the application of desensitisation therapy where the treatment is tailor-made to the individual. Hypnotherapy can offer a “rapid and cost-effective form of treatment for these conditions” (p. 107).
Follow this link for more information on general phobia hypnotherapy treatment.
Hypnotherapy: how can you access your agoraphobia treatment?
Agoraphobia treatment at the clinic: If your agoraphobia severity is low to moderate and you can travel short distances or travel accompanied to the practice, then your hypnotherapy treatment can take place at the clinic.
If your agoraphobia is moderate to high then consider:
Agoraphobia treatment at home: Initially, you can be treated in the safety of your own home with hypnotherapy home visit treatments to get your therapy moving. (N.B. an additional travel fee applies.) Or…
Agoraphobia treatment online: You can access your agoraphobia treatment using online hypnotherapy without the need for travel or additional travel fees.
For more information on agoraphobia treatment & hypnotherapy in Cardiff, contact Richard J D’Souza Hypnotherapy Cardiff
Health Anxiety Treatment Cardiff
Health anxiety treatment: Health anxiety is the irrational and excessive preoccupation with having (or developing) a serious mental or physical medical condition. The condition is also known as illness anxiety disorder, (psycho) somatic symptom disorder and illness phobia (nosophobia). Health anxiety can be considered a category of OCD due to the obsessive nature of your health fears and ritualised compulsions to alleviate those fears.
In psychiatry, the terms hypochondria and hypochondriasis are also used to identify health anxiety. Unfortunately these terms have developed negative connotations. Being labelled a “hypochondriac” can be wrongly misconceived as being someone who is always ill or who has a tendency to “moan about everything that is wrong with them”.
In reality, health anxiety is a serious mental health disorder in which you can feel like a prisoner inside your own body. In a UK study, nearly 20% of those in hospital clinics met the criteria for having health anxiety. Accepting health anxiety can involve many challenges in your health anxiety treatment.
Health anxiety treatment: Types of health anxiety
There are two main categories of health anxiety. Each one tries to manage the discomfort of their symptoms. Some sufferers have traits in both categories however.
Health anxiety with avoidance behaviour: This type avoids attention, new information, diagnoses, and anything else that you have (mistakenly) connected as triggers for your symptoms e.g. exercise, drinking caffeine, television dramas, media articles etc. By playing silent or suppressing your thoughts, you believe that “not knowing” is a better way of coping with bad news. You don’t want to have your fears confirmed and go through the agony of major treatment. Instead, you deceive yourself that “it’s probably nothing”, hope that the symptoms will go away and potentially neglect your health for extensive periods. Some avoidant sufferers believe that your condition is (or that you are) not important enough to warrant treatment. You may be convinced that you are beyond help.
Health anxiety with reassurance behaviour: The category of health anxiety seeks attention, new information and diagnoses in order to be reassured, but the depth of reassurance is superficial. You hope that endless searching on the internet will give you the information that you want, but it rarely satisfies your need. Craving a certain kind of reassurance, this health anxiety sufferer is more vocal about signs and symptoms and this can be frustrating for your family members and friends to keep hearing about your ailments. Depending on your level of insecurity, you might complain to people close to you hoping that they can make an emotional connection or even open up to complete strangers in search of that novel reassuring response. They may have little or no medical knowledge, but their lack of medical authority is irrelevant. Those who have medical expertise could give you the release from your health anxiety but only if meets your specific emotional need in that moment. Frequent visits to the doctor complete the circle of help that is available to you. Yet the medical opinion you are offered is not convincing enough to give you long term reassurance, despite the tests showing negative results.
Is Munchausen Syndrome the same as health anxiety?
Munchausen syndrome (also called Factitious disorder) is a rare psychological condition in which the sufferer feigns or causes their illness in order to gain special attention or sympathy. You might impose it on yourself or somebody that you are caring for (also called Munchausen syndrome by proxy). Munchausen syndrome is characterised by manipulation of test results, lying about symptoms, harming yourself to create symptoms and seeing different medical staff who might believe that your symptoms are genuine. Health anxiety is different to Munchausen Syndrome because with health anxiety, you believe that you are ill but you do not manipulate your test results.
What is Malingering?
Malingering is similar to Munchausen syndrome in the way that the symptoms of illness are manipulated. Whereas Munchausen syndrome has no clear cause, malingering is motivated by personal gain. It might be financial gain from insurance claims, time off work, a reduction in work obligations, prescriptions for controlled medication or avoiding military duty and prison time.
Health anxiety treatment: What causes health anxiety?
There is no single cause of health anxiety. A combination of background factors, traumas and coping mechanisms are likely to contribute to developing this condition.
There are some factors that can make you more vulnerable to experience health anxiety. These include:
Genetic factors – Your genes may predispose you to develop generalised anxiety. This can influence the development of certain mental health conditions. This does not mean that you are destined to develop health anxiety however.
Personality factors – You may be a “born worrier” or develop traits to worry from parental conditioning. The tendency to worry or struggle with uncertainty will increase your potential to develop health anxiety.
Life experiences – Many beliefs, attitudes and behaviours are learned from your parents and other significant authority figures. You will learn their values from what they say, how they say it, what they do and how they react to situations, particularly with reference to medical situations. This may then influence how you react to your own (or their) medical experiences.
As a child, these experiences can include:
- Personally being ill or other family members being ill.
- People close to you dying suddenly from an illness. Being made aware of your family member’s illness-signs and symptoms (that was the cause of their death).
- Being overly protected from illness as a child which can then influence you to be more fearful and insecure if you then suffer illness as an adult.
- Developing negative definitions of your personal health and the general wellbeing of your body. This can be formed by the amount of illness you have previously suffered and comparisons that you make to other people’s health.
- The timing of when you have sought medical attention after being concerned about possible signs and symptoms and the outcome of that medical diagnosis. For example, health anxiety can be formed when you have initially suppressed your health concerns, believing your condition to be benign. Then some time after, you are diagnosed with a serious illness and attribute your delay to seek medical help as the cause of your serious illness. As a reaction to this situation, you may then consider the trauma as “proof” that a premonition or physical sensation in the future must be more serious than it actually is.
Adulthood vulnerability factors
As you move into adulthood, your life experiences may involve having a career in which the performance of your body is essential to your success. Musicians, singers, dancers, sportspeople, surgeons etc. are all involved in perfecting skills with the precise functioning of body organs and muscle groups to the level of professional peak performance. Your peak performance state of awareness can be instinctive. But the effect of injury, illness, stress, periods of under-performance and performance anxiety can cause you to become hypervigilant to bodily changes when performances aren’t perfect.
As you work on the solutions to your performance, you can be convinced that psychosomatic sensations or tightness in the body are more serious health conditions and problematic causes of your under-performance. The bodily sensations become the new focus of your attention during your performances. This distracts you even more from the demands of the immediate task and becomes another issue that takes you further away from your peak performance level.
In addition to vulnerability factors listed above, certain triggering events can also reinforce the development of your health anxiety. Again, experiencing further personal illnesses and grieving illness-related deaths to someone close to you are important reinforcing events.
Other triggering events can include external stressful and anxious traumas like a relationship breakup that coincide with periods of illness. During this period of hypervigilance, both of these events can become subconsciously connected so that when there is say a future illness, it generates subconscious anxiety or stress symptoms. Or when you have future period of stress or anxiety, you feel emotionally “unwell” without being able to formally diagnose your illness.
Learning experiences can also act as triggering events in the development of health anxiety. Sensationalised or dramatised portrayal of illness in the media can influence certain viewers to believe that these traumas are factual. Without filtering your understanding of the content, you may be traumatised by the media viewing.
Traumatic learning experiences can also triggered during medical training. When studying medicine, you may not have anticipated the near-fatal consequences of certain signs and symptoms that you have personally experienced (and possibly ignored) before your medical studies.
Health anxiety treatment: What causes health anxiety to persist?
The health anxiety causes already discussed can lay the foundations of a negative belief system that is highly sensitive and receptive to bodily sensations. You are likely to (mis) interpret and (over) react to these bodily signs and symptoms thereby maintaining your health anxiety beliefs.
Some of the negative beliefs that become established and maintain your health anxiety include:
You overreact to your body sensations. This is a continuous cycle in which your hyper attention to your symptoms is amplifying your experience of the symptom. As you keep noticing it and give it more importance, the sensation is intensified.
You obsess over exaggerated health issues. Your health anxiety is now distorting your perception of your signs and symptoms. Your thoughts are illogical and your irrational handling of medical issues extends the uncertainty of a serious illness.
You have developed suppressive coping mechanisms. It’s normal to dismiss some issues that cause feelings of discomfort. Thought suppression is generally ineffective and can backfire with long term issues however. “Burying” important thoughts by trying to forget them can have the opposite effect and make them persist because the emotion pushes the issue back into your awareness. This ends up making the issue more pronounced in your mind when you aren’t busy focusing on anything particular.
You are compulsive in your checking and reassurance seeking. Objectively checking your body for potential problems and health changes can be a useful self help health tool. When you have health anxiety you are desperate to know that what you have is benign however. You will check your body because this method is easily available to you. But this can cause “false positives” with your feedback because you are already convinced that the situation is malevolent. The act of checking can also irritate the area creating sensations that you now believe must be serious. Stuck in this cycle of doubt and insecurity, you then seek external reassurance with a medical opinion, but this tends to only reassure you at the surface level. Checking your body and seeking medical opinion thus acts as a temporary release from your anxiety until the next issue surfaces. The reassurance-seeking process can be more harmful to your health anxiety if you become dependent on the reassurance to function.
You overuse avoidance and safety behaviours, and are convinced that they help you. Avoiding discomfort and finding a suitable “safety” distraction is a common defence mechanism to get you through your day. But these behavioural patterns are a short-term fix to overcoming health anxiety. Some behaviour can be superstitious without ever connecting with your return to good health.
Overusing these avoidance and safety behaviour can reduce your confidence to deal with the “real” anxiety issue in the long term. For example, drinking a moderate amount of coffee is not considered harmful. If you have health anxiety and are convinced that caffeine is the cause of your palpitations, you may avoid caffeine altogether yet still find that the palpitations persist. In this situation, avoiding caffeine is a type of “safety behaviour” because it gives you a feeling of control that you are acting on the issue. The actual issue of confronting the anxiety related to your symptoms still remains however.
Health anxiety treatment: Signs and symptoms of health anxiety
When you have health anxiety you may not have any physical symptoms yet you still worry about becoming seriously ill. Alternatively, you may be convinced that normal bodily sensations or minor physical symptoms (like a “gurgling” stomach, dull aches, a minor rash or feelings of weakness etc.) are signs of a serious medical condition. With or without a formal diagnosis your hyper-attention to these symptoms can persist.
Sometimes the stress and anxiety caused by your excessive worry can create additional sensations in your body e.g. twitching sensations or feelings of fatigue. These sensations can then become the new health anxiety focus as something more serious.
Signs and symptoms of health anxiety can include:
- Worrying that you have or will develop a serious illness.
- Feeling anxious about developing the same medical condition that a member of your family has previously had.
- Being preoccupied with bodily sensations or minor symptoms developing into an acute medical condition.
- Overreacting to anyone’s analysis of your health.
- Struggling to function in your day e.g. to concentrate, relax or sleep because of your health worries. This can then impact negatively on your work, family and social life.
- Being immersed in self-examination for signs of a serious illness.
- Being overly cautious and avoiding certain people, activities or situations due to your fear of illness.
- Seeking reassurance from family and friends by frequently talking about health issues and your fear of developing an illness.
- Frequently consulting with medical professionals for reassurance about a potential illness, or…
- (Ironically), neglecting your own health and avoiding medical consultations and tests in case it confirms your worst fears of having a serious medical illness. You may even avoid medical television dramas since you struggle to separate fact from fiction.
- Giving minimal confidence to a medical diagnosis or being unconvinced about a negative test result in case something was missed. Worrying that a new symptom has developed since the test was taken and that it will need retesting.
- Constantly consulting with Dr Google by researching online for a medical diagnosis and confirming your fearful beliefs that what you have is a serious illness. This condition is known as cyberchondria and compuchondria.
Health anxiety treatment: How is Health anxiety treated?
Following a diagnosis from your doctor, treatment for health anxiety usually involves Cognitive Behavioural Therapy (CBT) to explore how your thoughts, beliefs and emotions are affecting your behaviour. In addition to therapy, anti depressant medication may also be prescribed to stabilise your condition.
How can hypnotherapy treat health anxiety?
Hypnotherapy is a viable and effective health anxiety treatment. This is how hypnotherapy can help:
Hypnotherapy can treat the anxiety behind your condition
When your physical sensations seem so real, it can be challenging to accept that this is being caused not from a serious “physical” medical illness, but from how you are worrying about your health. This shift in your perspective is fundamental to your treatment success. “Parts” hypnotherapy is an effective tool that can assist this change of perspective and deal with the subconscious emotional blocks hindering your progression.
Hypnotherapy can help you to confront your avoidance behaviour
Your avoidance behaviour is a temporary fix for your health anxiety. When you avoid something that reminds you of your illness like hospitals or medical television dramas, you feel better in the short-term. Avoidance has the long-term effect of prolonging your health anxiety however. An important part of your treatment is to build the confidence to face these situations. By confronting them, you will appreciate what coping skills are needed in those situations and acknowledge the accuracy of your imagined danger. Hypnotherapy can help you challenge your avoidance behaviour by visualising your confidence in those situations. Hypnotic techniques will enable you to break down the emotional structures that are keeping you in fear.
Hypnotherapy can reduce your reaction to bodily sensations
Your health anxiety is causing you to overreact to psychosomatic sensations. The attention that you are giving these sensations is a source of more distress. These sensations are benign, but the smallest change in feeling causes you to become more anxious about what this could be. Hypnotherapy can help you concentrate your attention into these sensations, changing how you perceive them. During hypnosis, you will appreciate that you have control over these bodily sensations. Visualisation work can be done to calm the alertness from these sensations and fade into the background of your mind.
Hypnotherapy can help you reframe the emotion from past traumas
Using regression techniques selectively, hypnotherapy can help you release the fear learned from the past traumas that are still influencing your negative emotions and behaviour. You will not be constantly dwelling on these past traumas but they act as stored “causes” in your subconscious mind. Contrary to other critiques of this approach, it is not necessary to trudge through every year of your life. Only the most relevant traumas are reframed for you to feel the emotional benefit from this approach.
Hypnotherapy can help you challenge your cognitive distortions
One of the many benefits of using hypnotherapy to treat your health anxiety is that it can be used in conjunction with other therapeutic approaches. Cognitive behavioural therapy (CBT) aims to help the client recognise and challenge the cognitive distortions that make health anxiety so distressing. They can include catastrophising events, struggling with uncertainty, being inflexible with beliefs and being convinced that your thoughts will cause future actions and situations. CBT hypnotherapy focuses on these cognitive distortions, retraining your mind to appreciate how these unhelpful styles of thinking are perpetuating your condition. Your mind can then embrace calmer and more rational ways of thinking about your health.
Hypnotherapy can help you reframe your beliefs about uncertainty
A major feature of health anxiety is your inability to cope with the uncertainty of your future health. When you believe that you are unable to control it, you adopt checking rituals and seek reassurance from others to alleviate your anxiety. These compulsions only give short-term relief however and rarely help you to tolerate uncertainty. When you can tolerate it, the compulsions can be abandoned. Hypnotherapy can help you increase your tolerance of uncertainty by helping you rehearse resisting your compulsive urges. You can learn to be comfortable “in uncertainty” without trying to excessively control it.
Hypnotherapy can help you to reduce your safety behaviour
Like avoidance behaviour, safety behaviours are (overt or covert) diversions that are carried out in order to prevent feared outcomes. They are useful when connected to an actual danger, but with a perceived danger, safety behaviours tend to prolong the anxiety; you do something else that helps you to feel better in the short term. An example can be casually asking non-medical friends (instead of speaking to a doctor) for their medical diagnosis, knowing that their opinion holds no authority and can be easily dismissed if their opinion causes you anxiety. Hypnotherapy can help you to identify and reduce your safety behaviours so that you can confront the fear behind your health anxiety.
Hypnotherapy can assist your graded exposure to health anxiety
Overcoming your health anxiety ultimately means confronting the fear that you have or will develop a serious health condition. Graded exposure is an approach that involves structured and repeated exposure to your fear. By getting acquainted with your fear you get used to the situations, bodily sensations or worries that are keeping you anxious. In the short term, it’s not unusual for your anxiety to elevate when taking a change in direction and confronting your fear. With persistence, your confidence will grow and you will be more in control of your health anxiety in the long term. Hypnotherapy is an excellent method for using your imagination to confront your worries and alter how you perceive your bodily sensations. Exposure to the situations that you are currently avoiding can be discussed and built into your treatment programme.
For more information on health anxiety treatment contact Richard J D’Souza Hypnotherapy Cardiff
Accepting Health Anxiety
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?
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.
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.
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
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.
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 with the 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?
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.
Reassurance 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.
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
An important part of managing OCD is about reducing your level of your anxiety. 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 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.
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
Types Of Obsessive Compulsive Disorder
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.
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
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.
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 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.
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 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 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 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.
Types of obsessive compulsive disorder: for more details on treatment for OCD please contact Richard J D’Souza Hypnotherapy Cardiff
Claustrophobia Treatment 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”.
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 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 people inhibit 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:
- 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.
- “Butterflies” in the abdomen.
- Feeling light-headed or faint.
- Nausea or vomiting.
- Nervous diarrhoea.
- Numbness and tingling.
Living with claustrophobia
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.
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.
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:
- 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?
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 During The Coronavirus Pandemic
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
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.
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.
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.
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.
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.
- 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…”
- Learn to relax – There are various forms of relaxation techniques. Self hypnosis could be your chosen activity and try simple breathing techniques to reduce anxiety and feelings of panic.
- 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
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.
Click this link for more information about online hypnotherapy.
For more information about online therapy during the coronavirus pandemic, contact Richard J D’Souza Hypnotherapy Cardiff
Restrictive Eating Behaviour
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 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.
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.
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.
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.
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.