Overcoming anxieties, panic, and phobia: Social anxiety, fear of animals, flying, heights, or public places; exam, driving test and performance anxiety.

What is anxiety?

Anxiety serves to prepare us physiologically and psychologically for the challenges of daily life (Barlow 2002) and to respond to a life-threatening situation (alarm reaction or „fight-or-flight“ response; Cannon 1929). More recent research with non-human primates has identified four distinct responses to threat: freeze response, flight, fight, and tonic immobility (Bracha 2004).

Anxiety is expressed at different levels (Heap and Aravind 2002):

  • Physiological: Faster heart beat, breathing, sweating
  • Cognitive: Unhelpful thoughts about the future, “What happens if…”, “I won’t cope”
  • Behavioural: How the person responds behaviorally to the anxiety-provoking situation by avoidance, escape, protective actions, posture, gestures, vocalizations

The correlation between these three levels is low. This means that patients can perceive a high level of anxiety but if we measure objectively, the physiological response might show low values: They might say that they are very frightened but heart and respiratory rates are relatively slow.

The concept of the „here and now“ is of great importance in Gestalt therapy, and its founder Fritz Perls (1992) explained that experiencing anxiety is caused by not being in the now:

‘Anxiety is the gap between the now and the then. If you are in the now, you can’t be anxious, because the excitement flows immediately into ongoing spontaneous activity. If you are in the now, you are creative, you are inventive. If you have your senses ready, if you have your eyes and ears open, like every small child, you find a solution.’

What are examples for anxiety disorders?

Specific Phobia

The main feature of specific phobias is a marked anxiety about a specific object or situation. There are five subtypes of specific phobias:

  • animal
  • natural environment
  • blood-injection-injury
  • situational
  • other

Have you ever wondered what phobias are the commonest? Check out our blog post “What are the 11 most commonest phobias”

Anxiety and stress associated with medical, dental and surgical procedures

Medical procedures

Hypnosis and self-hypnosis have been found effective in the reduction of anxiety, distress and pain in medical procedures (e.g. bone marrow aspiration, lumbar puncture), and in decreasing the need for intravenous sedation in radiological procedures.

Dental and surgical procedures

Hypnosis has many advantages when applied before or during a dental or surgical intervention.

Scientific research has shown that patients who have undergone a preparation with medical hypnosis benefit in the following ways:

  • reduced anxiety, depressed mood, and pain during and after the operation
  • less requirements of intravenous sedatives and narcotics
  • less postoperative nausea and vomiting
  • greater patient satisfaction

When hypnosis was applied prior to an intervention at the dentist’s, the patients showed the following benefits:

  • a significant decrease in dental anxiety
  • a significant reduction in analgesic medication

(Hammond 2010)

Social Anxiety Disorder or Social Phobia

Social anxiety disorder is defined by a marked anxiety of social situations, in which others may scrutinize the subject. The anxiety, fear and avoidance interferes with the patient’s life, social, academic and occupational functioning or causes significant distress.

Panic Disorder

Panic disorder is defined by recurrent abrupt surges of intense fear or discomfort associated with various somatic (e.g. palpitations, sweating, trembling, chest pain, sensations of shortness of breath, nausea etc.) and mental symptoms (e.g. derealization, depersonalization, fear of losing control or dying) without cue or trigger.

Agoraphobia

The diagnosis of agoraphobia is defined by marked anxiety in two of the following situations:

  • using public transportation
  • being in enclosed spaces
  • being in open spaces
  • being in a crowd or standing in line
  • being outside of the home alone

Generalized Anxiety Disorder

The main feature of general anxiety disorder is excessive worry or anxiety about various activities or events, associated with three out of six symptoms such as:

  • restlessness
  • being easily fatigued
  • concentration difficulties
  • irritability
  • muscle tensions
  • sleep disturbance.

Other anxiety-related disorders

Tension headaches and migraines

Several studies showed that the usage of hypnosis, self-hypnosis and autogenic training can effectively reduce headaches and anxiety, and that self-hypnosis is as effective or superior to pharmacological treatment.

Obstetrics and gynecology

Hypnosis can effectively reduce pain, anxiety, and hyperemesis gravidarum associated with pregnancy and childbirth.

Irritable Bowel Syndrome

Teaching patients self-hypnosis can effectively reduce gastrointestinal symptoms (such as pain, flatulence and constipation) in irritable bowel syndrome but in addition to this, it appears to be beneficial in improving anxiety in the same patients as well.

Learn more about irritable bowel syndrome.

Anxiety in cancer patients

Training in self-hypnosis is effective in reducing anxiety, coping and improving sleep in patients diagnosed with cancer.

Psychotherapy for Anxiety Disorders

Scientific research has revealed that there is evidence that the therapeutic methods listed below are effective in the treatment of anxiety disorders:

Literature:

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders 5th edition American Psychiatric Association

Barlow DH (2002) Anxiety and its disorders. The nature and treatment of anxiety and panic 2nd edition The Guilford Press

Bracha HS, Tyler CR, Matsukawa JM, Williams AE, and Bracha AS (2004) Does “Fight or Flight” Need Updating? Psychosomatics 45(5), 448-449

Cannon WB (1929) Bodily Changes in Pain, Hunger, Fear and Rage. D. Appleton and Company

Hammond DC (2010) Hypnosis in the treatment of anxiety- and stress-related disorders. Expert Review of Neurotherapeutics 10 (2): 263-273

Heap M and Aravind KK (2002) Hartland’s Medical and Dental Hypnosis 4th edition Churchill Livingston

Perls FS (1992) Gestalt Therapy Verbatim The Gestalt Journal Press