Resolving hypnosis in cases of anxieties, phobias and panic attacks – Resolving unprocessed feelings with hypnotherapy

The cause-oriented hypnosis is THE MEANS OF CHOICE for treating many anxieties and other blockages. In case of an isolated phobia one or two sessions are often sufficient for a sustainable treatment.

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Overview: Hypnosis to treat anxieties – How to heal old emotional injuries and thus successfully treat anxieties, phobias and panic attacks

Introduction

Simple anxieties

Stage fright and exam anxiety

Asthma and shortness of breath – Mortal fear because of the feeling that one cannot breath

Anxiety disorders

Generalized anxiety disorders

Panic disorders and agoraphobia

Hypnosis and physical psychotherapy in the events of anxieties, phobias and panic attacks

Pillar 1. Resolving hypnotherapy (hypnoanalysis)

Pillar 2. Physical psychotherapeutic therapy

Pillar 3. Psychotherapeutic methods and combination with an ongoing psychotherapy

Introduction and fundamentals in the events of various anxieties, phobias und panic attacks

Simple anxieties

Simple anxieties are always learnt. The term in learning theory describing this condition is classical conditioning. This means the following: Normally, there is a concrete triggering situation for the anxiety. The situation is neutral at the beginning and is not evaluated with being fearful, for instance when you are playing with your neighbour’s dog. The dog is a neutral or even positively perceived stimulus as long as he bites you accidentally – while playing or because you touched the dog’s feeding bowl. The painful event is now connected to the formerly “neutral stimulus dog” in your brain. From now own you will always be frightened when you meet dogs. Because you have learnt that these dogs may also present a risk.

The affected person will thus evaluate situations involving dogs as being dangerous from now on. This situation is memorized by such person’s nervous system as potentially menacing and will be evaluated accordingly in the future. The next time that you experience such a situation or whenever your brain perceives a situation as being similar to the one described, your nervous system will trigger the typical physical and mental conditions that arise in situations triggering anxiety (situations of distress). These include:

- Sweating
- Hypertension
- Accelerated pulse
- Muscle hypertonia
- Increased circulation of the limbs
- Weakening of memory performance and power of concentration (reduced activation of the responsible brain areas)
- Increased activation of brain areas that are responsible for the physical escape.

If you experience such a situation repeatedly, an increased sensitivity will developed in your nervous system. This means that on each such occasion you will react with more dread. It often suffices that you only think of such an event (trained expectations), so that the respective physical and mental symptoms are triggered. Through this learning mechanism both the specific fear (a special possible level of activation in the brain) as well as the general basic fear (generalisation including other situations, which, taken separately, do not trigger fear). An actually specific fear can thus step by step have a negative and limiting effect for other areas of life – by way of learning.

Exam anxiety and stage fright

So far you have passed all bachelor or master exams or your journeyman’s examination blindfolded. However, in only one case the examiner makes you look like a fool and you do not pass the exam. Although you know that all other examiners are much nicer and fairer, there are generalisations all over the place (generalisations of other persons and situations). From that moment on you will always be afraid of tests, although you are very well prepared. If there is another incident, e.g. in the last exam of the studies, which you are thus not able to terminate, it might happen that in the future you will be more distrustful with respect to others. This happens out of the permanent anxiety that these people wish to do evil.

In a normal conversational therapy it is almost impossible to reach the feelings memorized in the brain (more precisely in the so-called limbic system) because of the work involving reason associated therewith. Things are different with hypnosis:

By way of the so-called cognitive inhibition in hypnosis (in the state of trance), reason is scaled back. The patient gets access to his emotional memory (in particular to the limbic areas of the brain). This means that in trance the patient can be put back to the situation stored in the brain, which was originally triggering the respective feeling. In this manner, the unprocessed feelings can be worked off and be resolved. This has both positive effects on specific fears (fears of dogs or exams) as well as a lowering effect on the level of basic anxiety (e.g. anxiety in social interactions). The scientific term for that is extinction (specific and general extinction). Learned fears can thus be resolved again by means of hypnosis and “unlearned” in this manner.

In my experience, however, many exam fears are based on deeper-seated lack of self-esteem. The persons concerned fear that they “are of no value”, if they do not bring any good or even excellent marks. These people are accustomed to earn appreciation and often also the love (of a friend or of one’s parents) through performance. In their early childhoods they were threatened with withdrawal of love or even beating, if they did not listen or if they failed to bring the corresponding performance (be that in school or in sports clubs). This is why they were not able to develop a feeling of basic security and an absolute, unconditional “acceptance”. In these cases, the resolving hypnosis has to be applied to work with old emotional injuries and heal them, so that the affected persons are able to build up a normal, stable self-esteem. Only then is it recommended to put a focus on exam fear – except that a specific examination is imminent.

Asthma and shortness of breath – Mortal fear because of the feeling that one cannot breath

A typical body posture for asthmatics, in which the abdominal muscles, amongst others, are cramped. This is how shortness of breath arises.

Stress Verspannungen Schmerzen Rückenschmerzen

Together with back pain, asthma (and respiratory problems in general) are among the most widely spread common illnesses in many countries world-wide. In fact, both back pain, asthma and also the anxiety disorders comprehensively explained hereunder all have the same cause:

Muscles that are permanently tensed – mostly because of psychological stress – and thus prevent the diaphragm (the most important respiratory muscle) and the respiratory accessory muscles from working easily.

The lungs cannot be pulled down – as it is provided for from the anatomically-functional viewpoint – and opened in order to produce the negative pressure in the lungs that is necessary for breathing in.
In the same way an exhaling habit is developed under stress – which decisively supports the maintenance of the aforementioned mechanism – which can rather be described as a “squeezing out of air” (by tensing the abdominal muscles) than a relaxed breathing out (loosening the tension in the respiratory musculature).

Both: Tedious intake of breath and overexerted exhaling are mutually dependent. Both phenomena significantly contribute to it that the spinal column loses its natural stability and flexibility, which, in turn, may lead to other consequential symptoms, such as postural defects and disorders or illnesses of the musculoskeletal system.

In other words: Everything is becoming more and more exhausting.

As with all other psychosomatic diseases, the solution for treating asthma is the resolving hypnotherapy (resolving unprocessed feelings that cause permanent stress and muscular tension by way of hypnoanalysis) and the practicing of different breathing techniques (change from “gasping or deep breathing” to full breathing) by way of Sensomotoric physical psychotherapy. Both therapeutic techniques are described further below.

Anxiety disorders – Fear that became pathological

Pathological fear is a disorder that is becoming more and more frequent in Germany; one out of ten people suffers from it. As many do not know that such fears constitute a serious disease and are not aware of the fact that there are corresponding ways of treatment, not all anxiety disorders are diagnosed and treated. The real number of affected persons is therefore probably much higher.

It can be assumed that specific fears and in particular a higher level of basic fear contribute to the development of other diseases, such as burnout, depression, other mental diseases or physical illnesses (cf. emergence of pain here).

Normally, these anxiety states have severe consequences for the lives of those who fell ill. However, these anxieties are also an indicator of the problems hidden behind them. Only in this manner is it possible for affected persons to become aware of them and reflect them and have them treated – e.g. together with a therapist.

Therapy with drugs vs. other methods such as hypnosis

Drugs are only suitable for suppressing anxieties (and not for resolving the conflict behind them) and are additionally frequently associated with specific side effects. Some drugs may also weaken the experience of positive emotions. By way of hypnosis, however, anxieties can be specifically tackled and resolved (see further below).

Generalised anxiety disorders – Generalised fear

In cases of generalised anxiety disorders, many stimuluses and thus situations, which healthy people evaluate as being neutral (or positive) are experienced as fear-triggering. The affected persons are often tormented by anxiety states appearing over a longer time period that correlate with an increased physical and mental excitation. The typical symptoms arise, such as increased vigilance, tension, sweating, partially also uncontrolled defaecation, problems to fall asleep and sleeping problems and more.

Phobias (e.g. fear of flying, dental fear, fear of spiders, syringes, and other isolated fears)

Phobias are very concrete fears that are exclusively triggered with the occurrence of a specific stimulus. Triggering environmental stimuluses can be specific persons (e.g. the dentist), animals, or situations. The fear triggers tension of the flexor muscles in the body, and many people hold their breaths. At the same time, the heart starts racing (cf. further below: “physical psychotherapeutic therapy in cases of anxieties”), or the heart shortly comes to a halt, as many affected persons report about experiencing extreme fears. In addition, outbreaks of sweat and abdominal pain occur when the respective person is directly confronted with the stimulus, or when the affected persons only think of being confronted with such stimulus, respectively (developing expectations). The affected persons try to avoid such stimuli, but they get involved in new problematic situations, because they get socially isolated, for instance.

Phobias can be simple or complex. In cases of simple phobias, hypnotherapy should be used to directly work on the symptom. In case of more complex fears – which in most cases arise through experiences in the early childhood – it is recommended to work regressively as well: In the state of trance, events from the early childhood that are the cause for developing the present anxieties should be addressed in order to work off and resolve the negative emotions stored in the emotional memory (cf. resolving hypnosis vs. suggestive hypnosis).

Social phobias

In cases of social phobias, people are mostly extremely frightened of social assessments, often caused by low self-esteem. In order to avoid being negatively assessed – which would lead to a reactivation of negative emotions during early childhood – the social phobic has to “represent something” and “always do things a little better” to feel good or not to feel bad, respectively. Healthy people, however, are able to deal with it better, if others do not approve everything that they do and say or how they look.

Because of the described problems, the interaction with others and the stay in social rooms is either aggravated – being exposed to stimuli leads to the known mental or physical symptoms (sweating, breathlessness, anxieties, etc.) – or the stay in the respective places immediately triggers anxiety states that the affected persons are unable to endure. This is why they avoid such and similar situations whenever possible.

For treating social phobias, it is usually necessary to tackle the low self-esteem that has to do with the reactivation of emotions from early childhood, first and foremost the anxiety stored in the emotional memory (mostly the fear of being rejected by one’s parents). The learned anxiety mechanisms that were acquired in the respective social situations have to be treated in the same way. On the one hand, it is necessary to work on the self-esteem, so that one’s own experience of feeling is less dependent or no longer dependent from any external factors. Once this was achieved, the patient does mostly no longer act out from such fear, but is rather able to address what he really wants (away from the “get away from” goals towards the “get to” goals). In addition, in trance the situations that are typical for the occurrence of fear have to be lived through again in order to achieve an extinction of the unprocessed negative feelings in the emotional memory here as well.

Fear of commitment

Fear of commitment is a fear like many other fears, whereby this is no specific fear (like the one felt with respect to isolated phobias, e.g. spider phobia), but rather a more complex type of fear. As a rule, it involves problems with one’s self-esteem. People with fear of commitment mostly feel blocked internally by two things:

The fear to be left (again). This fear has its basis in experiences from early childhood, in which children were left alone (physically) or felt left alone (emotionally). This leads to a permanent basic fear, in particular also in dealing with others and especially with sexual partners that can massively impair one’s self-esteem as well. The therapeutic strategy now is to enter these early “emotional injuries” in the state of trance with the patients, so that the patient can free himself from the feeling associated with the situation and that the emotional injury can heal. With that, the self-esteem does not necessarily increase automatically; however, from my point of view the letting go of old emotional injuries is the fundament for the (further) development of one’s self-esteem.
Another core topic is the self-esteem problem, because of which many of my patients do not really succumb to their partners in their former relationships (see above) or in which they were not able to distance themselves and/or assert themselves (“they want to please in order not to be left or devaluated by the partner”, cf. also social phobia). If the self-esteem increases and the (permanent) fear of being left diminishes or completely disappears, it is normally also possible to succumb to one another in a close relationship in a more constructive way, but also to distance and assert oneself in the right moment. In such a manner, potential conflicts are addressed earlier in such partnerships, so that a constructive dealing with such conflicts is possible, while these were previously rather ignored and/or bottled up because of the fear of disputes and devaluation, which would have eventually led to an escalation.

The picture of the dam – Why some people are emotionally more balanced than others

The picture of the dam is a very accurate picture for the stability and resilience of one’s own personality and for the capability of a person to handle appropriately social assessments and the emotions associated therewith and process them:

A good dam has to be big enough to hold all of the rainwater away from the civilisation whenever it is raining. However, a dam also needs hatches that gradually drain the water into the river during the rest phases, but without flooding the whole city. People who had a happy childhood – as the saying goes – have it both, because there was somebody there for them almost every time that they did not feel well, they were not depreciated when they felt bad or when they got some bad marks at school. In this way they were able to learn to handle negative social assessments appropriately and also with their own associated emotions. They have learnt to express these emotions, show them and thus work them off in order to reach a better balance again. This means: They have strong walls (self-esteem) and at the same time many smaller hatches (regulation mechanisms), by means of which they can get rid of all accumulated negative emotions consciously or unconsciously whenever there is the need or opportunity to do so.

Those who were not lucky enough to have a happy childhood have not build up such strong walls, which is why even a soft wind hits them like a storm – without any resistance. Even with the slightest negative social assessment these people experience the same physical and psychological symptoms that are typical for anxiety disorders. In addition, these people have fewer of these (dam) hatches through which the negative emotions can gradually disappear, just like the water controlled by the dam that sinks back on a normal level. A permanent strong feeling of pressure (in this case social pressure) occurs, which leads to energy blockades and often also to overreactions – be it to the inside (auto-aggression, i.e. aggression against oneself) or to the outside (foreign aggression, i.e. aggression against others, often only in one’s mind).

The weaker the fundament and regulatory capacity of the dam (a person’s self-worth and self-regulation skills), the more probably can emotions spill out and the whole surroundings are flooded, which in some situations also leads to breakdowns.

Emotional injuries and deficits from childhood are unfortunately harmful in two ways.

On the one hand, because they have a negative impact on the (positive) vital energy as they are stored in the emotional memory and distress a person perpetually and painfully (physically and mentally). On the other hand, this unprocessed information entails behavioural patterns that cause further emotional imbalance to all persons concerned. It can happen that some people get in the same situations or the same relationship patterns again and again, without knowing how they are actively (yet unconsciously) participating in searching for these or similar situations or produce them by themselves.

If, for instance, a child is neglected and receives recognition only through performance, this child regularly has the feeling of not being good enough. This can be compensated to some extent through recognition from the outside, e.g. by extremely good school grades or professional achievements, which are motivated from the fear of not being worth anything. For many top students it is habitual to bring home good grades, and if there is one single bad grade for them – and often for their parents as well – the whole world is coming apart.

This leads to a dependence of one’s own internal experience (emotional self-worth) on external factors and thus makes these people even more vulnerable than they are anyway. For people with social phobia the interaction with others is aggravated, because the bases of these phobias are underlying hurt feelings. Physical and mental fear reactions are activated in these people every time that they get in contact with others. This triggers perspiration, flushing and other reactions.

The good news is: Social phobias can be successfully treated, just like all other learned fears. The treatment consists of a mixture of the resolving and the confrontational hypnotherapy.

The great thing about hypnosis is that on the one hand it is possible to access the basic fears that cannot be accurately accessed in conversational psychotherapy (because the reason pushes back the emotional memory).

Contrary to the behavioural exposure therapy, in hypnotherapy it is not necessary to be confronted with the situation at issue (in behaviour therapy the therapists accompanies his patient in crowds of people, for instance, namely for such a long time until the social fear is worked off). In fact, it rather suffices to do that in one’s imagination, because in the state of trance the direct access to the emotional memory is possible because of the cognitive inhibition, and thus the same emotions are triggered.

Once the respective fears are resolved, the patient is finally able to develop a healthy and adequate self-esteem with the corresponding experiences. This is the prerequisite for healthy social relationships and also for an emotionally balanced way of treating oneself. It certainly cost some effort, but it is surely worth it.

Panic disorders and agoraphobia

Approximately 3% to 4% of the German population suffers from panic disorders. The start of the disease can mostly be seen in people aged 20-30, where this panic disorder often occurs in combination with agoraphobia, the fear of having to stay in public places. In most cases, panic attacks occur unpredictably. A feeling of panic occurs (mostly in the chest area or in the abdomen, cf. physical psychotherapeutic treatment below), tachycardia, perspiration and fear of death. Some people are also afraid of going mad, most probably because their perception of the own body in the brain is distorted and the sensomotoric amnesia occurs, once the defensive reflexes in the body are activated.

The affected persons have only little control of their attacks, if any. For this reason as well panic attacks are perceived as extremely burdening psychologically and physically, in particular if these panic attacks come from the inside (in cases, in which they come from the outside, i.e. when they are triggered by particular stimuluses, the patients may reduce the occurrence of such attacks in that they avoid specific situations). Based on the development of specific expectations, there is also likelihood that a person is afraid of occurring fears, the so-called phobophobia.

A frequent consequence of panic disorders is social withdrawal in order to avoid the occurrence of attacks, which in most cases has correspondingly negative impacts on family, partnerships and social relationships.

Hypnosis and physical psychotherapy in the events of anxieties, phobias and panic attacks

Pillar 1. Resolving hypnotherapy (hypnoanalysis)

Anxiety can thus occur in many different forms, sometimes as a specific fear, often with tendencies to generalize (generalisation to include other situations or persons), whereby the reason for the occurrence of fear can differ significantly.

A therapist therefore has to precisely define the type of the anxiety disorder together with the patient within the framework of a comprehensive anamnesis. To this end, the therapist familiarizes himself with the patient’s personal living conditions and history of development. In the hypnosis session often feelings, situations and experiences turn up again, which the patient was not able to remember during the (first) anamnesis.

The advantage of hypnosis as compared to conversational psychotherapy is that during the state of hypnosis reason is pushed to the background and thus the patient gets access to his emotional memory. In this sense hypnosis is an ingenious method for resolving anxieties. The hypnoanalysis necessary in this respect is something in which only few therapists are proficient, while suggestive hypnosis is more prevalent, but is not suitable to work on the real causes of most anxieties.

In hypnosis the patient is able to move back to the fearful situation – in a protected environment and accompanied by the therapists – in order to access the unprocessed emotional memory matters, which the patient can then work off and resolve. The underlying principle is thus very simple and absolutely harmless.

If after a couple of treatments the feeling of anxiety cannot be triggered in the hypnosis session (all excessive fears are resolved), it is possible to work future-oriented with suggestive hypnosis, so that the patient can face a situation that he typically associates with a situation of fear not only with a neutral feeling, but even with a positive one (and also with the corresponding expectations).

After this treatment the patients often notice positive impacts in other areas of life as well, e.g. less fear in dark rooms, no fear in a lift, a more relaxed interpersonal interaction, less or no fear of commitment, etc.

Pillar 2: Physical psychotherapeutic therapy to treat anxieties

The fact that anxieties, phobias and panic disorders also trigger physical symptoms (the neuromuscular basic setting of the locomotor system is changed, i.e. the body posture and movement organisation) is another important factor for accessing the emotional memory in the brain that is difficult to reach in conversational psychotherapy. Where does this correlation come from?

This correlation is because of the old defensive reflexes that are deeply rooted in the human nervous system. Due to these reflexes we tense the flexor muscles in our bodies and hold our breaths in situations, in which we feel physically or psychologically threatened in our position. The stress researcher Lazarus referred to such situations as situations of distress, i.e. the negative form of stress. If this physical – and at the same time emotional – pattern becomes an unconscious habit, negative emotions accumulate in the emotional memory (in particular in the limbic system) and are not adequately worked off, neither psychologically nor physically. The corresponding body pattern is illustrated in the following graph.

1 2

If you are experiencing at least one of the symptoms listed below, we should at least talk about including physical psychotherapeutic elements in the therapy:

A sunken body posture (cf. graph above)
pain (often in the shoulder-neck area, back pain, abdominal pain or hip pain)
anxieties that you are able to feel in your body in the chest and the abdominal area (around the diaphragm or the heart)
a changed, mostly reduced body perception because of muscular tensions

If you want to know more details about how unconscious processes contribute to the development of the mentioned body pattern over time, you can cast a glance at the following illustration. This picture visualizes in a way comprehensible for laymen as well the vicious circle of situations of (di)stress, the resulting muscle tensions (as emotional protective reaction) and the development of the sensomotoric amnesia in the brain.

The role of sensomotoric amnesia (SMA) and muscular tensions in the development of anxieties and panic attacks

If one so wishes, the body postures (that is visible to the outside) is a mirror of one’s inner experience. This inner experience, in turn, is decisively influenced by the body posture, by the permanently tensed muscles that were forgotten because of permanent stress, and first and foremost by a narrowed diaphragm. The diaphragm has to fight against the permanently tensed (flexor) muscles (people with anxiety disorders and panic attacks always have tensions in the chest area and the abdomen), which is why it gradually blocks. This is why panic feelings and many anxieties are associated with the feeling of not being able to breath. They are thus correlated to the aforementioned (unconscious) holding of one’s breath through the central nervous system (brain).

People with anxiety and panic disorders thus have problems breathing and the breathing is very shallow. This means that the chest does not lift up or lifts up only weakly, or it lifts up, but because of the wrong aid of the back flexor muscles. By the way, even Paracelsus knew that our feelings are located in the chest area and the abdomen and are closely connected to breathing. This is why he once wrote that Breathing is the key to healing.

Physical psychotherapeutic therapy methods

As in psychotherapy, in physical psychotherapy there are many ways leading to the goal. There are numerous physical psychotherapeutic methods that, among other things, lead to a deeper breathing and to less muscle tensions. However, some of them are faster and more efficient, because they do not fight against resistance (the defensive reflexes), but rather go with them and set learning impulses in the central nervous system with small movements.

The most important methods that I usually apply when treating pain patients are the following:

Pandiculations according to Professor Thomas Hanna
Active trigger point or myogelosis treatment of the musculature
Kinetic mirroring according to Feldenkrais
Sensomotoric learning according to Feldenkrais and body awareness training

These methods are discussed in detail on the following page (here), whereby the trigger point treatment can be very painful, because it directly works against the defensive reflexes. This is why I prefer treating patients suffering from anxieties and/or panic attacks with the integrative respiratory therapy.

Contrary to treating pain patients, with whom the biggest relief can mostly be achieved by resolving individual tensions, when working with patients suffering from anxieties and panic disorders I prefer using the integrative respiratory therapy. As outlined in the graph above and exemplified in the text, there are muscles that are permanently tensed (because of the flexor muscles that are tensed because of the defensive reflex) and thus obstruct the breathing. The tensed muscles prevent (unconsciously) that the diaphragm can unfold its entire functionality and thus open the lungs, so that air can flow into the lungs.

Integrative respiratory therapy

In the integrative respiratory therapy I then try to find out – together with the patient – where the muscles are that narrow breathing by means of soft touches and small cautious movements. As soon as the patient feels again, where he unconsciously generates tension and learns how this tension correlates with his breathing, this protection patterns gradually opens up and “the dam is broken”. Therapy is thus a playful process of research that all patients that I have worked with really enjoyed. In fact, this therapy uses our innate childish curiosity and does not have an “educational” effect.

Pillar 3: Psychotherapeutic methods and combination with an ongoing psychotherapy (e.g. behavioural therapy)

In order to make physical and psychological change processes more understandable and easier to reflect, I apply some methods of psychotherapy also in the treatment of anxieties and panic disorders. The physical psychotherapeutic methods or the hypnosis therapy can of course be a good supplement for a psychotherapeutic treatments, such as behavioural therapy, if you are already undergoing psychotherapeutic treatment. However, this should be discussed and agreed with the therapist.

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