Should all Cognitive Behavioural Therapy include Hypnosis for better results?

Some may consider it a big question, but should cognitive behavioural therapy be making use of hypnosis as a means to increase the likelihood of positive therapeutic outcomes?  

Perhaps we should start with this from Kirsch, in his meta-analysis of 'Hypnosis as an Adjunct to Cognitive-Behavioral Psychotherapy', in which he analysed existing studies in which cognitive behavioural therapy was compared with the same therapy supplemented by hypnosis. He wrote:

"The results indicated that the addition of hypnosis substantially enhanced treatment outcome, so that the average client receiving cognitive behavioral hypnotherapy showed greater improvement than at least 70% of clients receiving non-hypnotic treatment."

Pretty impressive stuff there in his analysis across a range of issues including weight loss, anxiety and insomnia.

So why isn't hypnosis part of the mainstream CBT therapy process if the evidence suggests that it is likely to help people get better results?

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Weight Loss and the Impact of Self-Hypnosis:

I remember way back being overweight well into my teens. In those days, it seemed much less common of a thing to find people who were overweight or obese. I'm sure they were about but all the evidence suggests not in as great numbers as they are today. Weight loss is now an industry, a problem and still a challenge.

Back in those days I remember standing out like a sore thumb at school because of my size. I ate too much junk, paid no attention to healthy eating and had beyond little interest in exercise (I hated P.E. with a passion and did all I could to get out of it!). Maybe people were slimmer because (like my mum) they were doing the Jane Fonda aerobics video or the Callenetics one.  

Anyway, I started to lose weight when I got so sick of being fat and the limitations that went with it (including wearing trousers with an elasticated waist!), that I decided to do something about it. I cut down on the junk, I moved more and I even went through many months of sweating it out every night on an exercise bike in my room.

These days obesity is often described as an epidemic despite all the knowledge we have about healthy eating and the benefits of exercise. And although many people start out with the motivation and determination to lose weight, for most, after a few months they find that unhealthy habits creep back in, along with overeating and the tailing off of physical activity. Those bad habits and overeating, often along with a sense of being out of control over eating, often mean that any weight loss achieved soon evaporates. 

And in many weight loss programmes and systems, the psychological aspects of eating, such as emotional eating to suppress unwanted thoughts and feelings, and using food as a form of reward, are often overlooked.

A recently published randomized control trial has now reported their findings. They set out with this objective: "Obesity is a worldwide epidemic; most obese individuals who lose weight after lifestyle educative treatments, soon regain it. Our aim is to evaluate the effectiveness of a training to teach self-conditioning technique (self-hypnosis) added to standard care in determining weight loss compared with standard care in patients with obesity.

The results of their trial (discussed below) would assess whether a self-conditioning approach, based on self-hypnosis, is able to help people to modulate unhealthy patterns of eating and sustain weight loss in the long term.

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Binge Drinking - the next day impact of heavy alcohol drinking:

Next month marks the annual 'Go Sober For October' campaign where thousands of people quit alcohol for the entire month to raise money for MacMillan cancer support (an awesome charity by the way).

And let's be honest, it really should be relatively straight forward to not need alcohol for a few weeks shouldn't it? Whether you are taking part in 'Go Sober For October' or have just made the decision to cut down your alcohol consumption, you are likely to benefit from sleeping better, feeling more energised and just feeling healthier (as well as saving a fortune that you would have spent on booze). And there's the added benefit of no hangovers (along with those hangover promises you make to yourself about how you'll never drink excessively again....).  

Some recent research has looked at the impact on the next day effects of heavy drinking and how it impacts on your thoughts and performance. 

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Health Anxiety - Is it Cancer?

When I'm working with someone with health anxiety, perhaps the biggest concern is that any physical symptom being experienced could be a sign of having cancer. And with so many references to cancer around us, it's perhaps no surprise that the anxiety heads in the direction of what is perceived to be the worst possible case.

In the last 24 hours alone, I've heard a cancer charity advert on the radio, seen a similar, watched a programme where a character had been diagnosed and heard about a relative receiving treatment. It can seem like it is all around us, impacting everywhere, and that is the fuel that anxiety needs to start imagining the worst.

And of course, 'Doctor Google' doesn't help here because just about any symptom 'could' be a sign of cancer. Of course, it could be a sign of something else or even nothing at all, yet those nagging thoughts continue to grow stronger and ramp up the panic. The internet just isn't that great at helping you to self-diagnose effectively. 

Once you calm the anxiety down (and ditch trying to be an online doctor), your thoughts become clearer, more logical and more reasoned. You can make better decisions about what you should do next.

Just recently I've had my own reasons to be thinking about cancer and my own future health.

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Are Mental Health Apps Helpful For Anxiety?

There has been an immense level of excitement in the Regan household over the last 48 hours, with levels not far off those experienced at Christmas. And it's all been because my daughter saved up and ordered herself a fitbit. From the moment the online order was placed she has was asking when it would arrive and whether it would come while she was at school the next day or whether it would be the evening. I reckon we were getting a dozen mentions, questions and references about it every hour!

The following evening, when it hadn't arrived by the evening, she could be seen going and standing by the door to look out for the delivery driver, and then things moved into the realm of questioning whether the order had actually gone through ok. Perhaps it had been lost? Maybe the company had delivered it to the wrong house? Would it arrive? Would it ever arrive?!!!! (By this point I think we were all just hoping it would arrive soon!).

The no sooner had it been delivered than she was sprinting down the stairs to unbox it and get started (those running steps obviously wasted because they weren't counted by the fitbit).

And the excitement didn't stop because no sooner was she awake than she was wanting to look at the app to find out how she had slept (no more relying on guesswork about sleep from now on!). And then the joy of updates every ten minutes on the number of steps she had taken. I say every ten minutes but it seemed like a lot more!

Now I don't mind all this excitement about walking and moving because it can only have a healthy goal of having her being more active. That can only be a good thing in the age of screen after screen.

And I think this is an example of technology and an app that serves people well if they want to improve their health and wellbeing.

But what about the ever growing multitude of mental health apps? Are they good for anxiety and other mental health issues?

A recently published study took a look at mental health apps to identify how they frame mental health, including who has problems and how they should be managed.

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Anxiety in the workplace - More Action Needed!

Over two years ago I was published in the Ely Standard newspaper calling for more action to be taken to be taken to combat anxiety and stress in the workplace ('Ely hypnotherapy expert calls for more effective action on stress and anxiety levels').

Sadly, a new survey published by mental health charity, Mind, suggests that poor mental health affects about half of all employees. Their survey of 44,000 employees revealed that poor mental health at work is widespread and only half of those who had experienced problems with anxiety, stress and low mood had talked to their employer about it. 

I remember when I struggled with anxiety in the workplace. When it was bad it would impact on my performance and there were times I was too anxious to even go to work. Back then, mental health was much less understood and recognised so there was no way on this planet I would ever have discussed it with my employer. Indeed, I was certain back then that it would have a detrimental impact on my career and I was very aware of cases of colleagues off work with anxiety or depression and how it quickly became common office news.

I really would like to hope that times have changed with mental health having been elevated as an issue that can affect anyone and with more understanding about it than ever.

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Sports Psychology: Trauma, Abuse and Injury:

I work with lots of sports people who are seeking to improve their performance or to bounce back after a setback. At the professional level, the benefits of sports psychology are well understood, and that recognition of the importance of mind-set and mental attitude is something that anyone who wants to improve and perform should be incorporating into their training programme.

Sports psychology can take many forms and will depend on the particular individual. For example, recently I worked with a triathlete who wanted to stop the negative internal dialogue that impacted on his performances. It was those pesky thoughts that can make us hold back and become lost in thoughts of potential injury or things going wrong, rather than focussing on what is actually happening.

I've helped footballers who wanted to get their motivation, confidence and self-belief back, horse riders who had become anxious and fearful after a fall, fighters nervous about competing, cyclists too anxious to ride and many others who knew that they would benefit from effective sports psychology help to engage in and enjoy the sport they love. Many of these have kindly gone on to give feedback on how their sessions helped and there are many, many more who preferred to just get on and deliver in their sporting arena.

And recently new research has again highlighted the importance of effective psychological help in sport. This research looked at the impact of lifetime sexual and physical abuse and trauma and its association with sports and non-sports injury.

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Anxiety and Dreaming - How Your Anxiety Impacts While You Sleep:

If you are currently struggling with anxiety then one thing you may have noticed is how it even seems to filter into your dreams while you are sleeping.

It's something that people with anxiety often describe to me - that they seem to experience vivid, negative dreams at night. Those dreams can be filled with unpleasant scenarios that lead to them waking filled with sensations of dread and fear.  Those anxiety filled dreams can create very real unpleasant emotions and feelings that may linger into the day.

Only yesterday, an anxiety client described how he had woken the night before during a dream, drenched in sweat, with his heart pounding and filled with fear and panic. Many other clients experience this or just find that those vivid images from their dreams upset them and make them feel low. 

When I was a teenager I remember buying a book in a bargain bookstore all about dream interpretation. It would say things like if you dream of a cat you will come into money or lose money, if you dream of flying you are destined to soon travel and if you dream of being killed you will not awake! Seriously, it did say that sort of stuff (I often wondered about the last example there because how would anyone know?!).   

Anyway, the world of understanding the role of dreams has moved on a lot since then! And there's some recent research about how your anxiety while awake impacts on the content of your dreams.

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Eight Years of Hypnotherapy in Ely - Thank You!

This month (September 2018) marks the eighth year that I have been running my business of hypnotherapy in Ely. Time has flown!

I'm very proud to have reached this milestone where I've helped so many people to overcome anxiety, increase confidence, let go of old limitations and achieve their goals. And I wanted to say thank you to all of you who have trusted in me, worked with me and supported me over these years - thank you!

I've had the opportunity to meet and help so many wonderful people, many of whom have kindly left feedback on our work together and I'm excited about continuing to grow, improve and help many thousands more people in future years.

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Migraine Treatment: Hypnotherapy, Acupuncture or Medication?

In my last blog I wrote about research into the effectiveness of hypnosis for the management of  headache and migraine. The researcher in that report concluded their systematic review by saying, "This study has demonstrated that hypnosis has a significant impact on the pain activity of individuals suffering with migraines and supports the findings of several double-blind, placebo controlled studies that have demonstrated hypnosis to be statistically superior or equivalent to commonly used treatments."

Which is, of course, great news and evidence for those with migraine who are seeking help and treatment or who are finding their current treatment programme isn't as effective as they would wish.

In August 2018, another study that discussed migraine and hypnotherapy was also published in addition to the one I discussed in the previous blog article.

This report compared the efficacy of acupuncture, hypnotherapy and pharmacotherapy in patients with migraine. The study divided 90 patients into three groups: one group was treated with acupuncture, another with hypnotherapy and the third with medication. 

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