What are the symptoms of anxiety?

Anxiety disorders are amongst the most prevalent mental illnesses in most populations that have been studied (Sadock & Sadock, 2003).

While everyone experiences some level of anxiety for healthy functioning, an anxiety disorder is usually when those feelings and symptoms associated with anxiety become so overwhelming that the negatively impact on the person’s social and occupational functioning.

Anxiety is generally understood as a general unpleasant and vague sense of apprehension and nervousness that is normally accompanied by one or more physical symptoms (Saddok & Sadock, 2003).

There are a range of anxiety disorders, but in order to understand any of them, it is important to first understand what anxiety is and the symptoms thereof. Sadock & Sadock (2003) explain that there are two components to anxiety; namely the awareness of the physical sensations and the awareness of feeling nervous. In this sense, the physical symptoms of anxiety include the following:

Racing heart
Heart palpitations
Shortness of breath
Excessive sweating
Dizziness / lightheaded
Restlessness (pacing)
Tremours or trembling
Upset stomach including diarrhea
Frequent urination
(Sadock & Sadock, 2003).

These peripheral manifestations of anxiety are coupled with a feeling of nervousness, butterflies in the stomach and, possibly fear.

Another way of understanding anxiety is as a pervasive and excessive worry about some future event or instance (Penney, Mazmanian & Rudanycz, 2013).

The act of worrying is further defined as a repetitive thought activity that deals with negative future events – in other words, thinking repetitively about possible negative events or outcomes in the future. Anxiety is, in many cases, a self-fulfilling prophecy so to speak.

Often it creates a vicious cycle that exacerbates itself. For instance, someone who is acutely aware of themselves as in the state of anxiety, may become anxious about the way other people are perceiving them. In so doing they worry about the symptoms they are showing, such as the trembling hands and excessive sweating.

They become more anxious about their physical symptoms, which increases the anxiety and, therefore, increases the physical symptoms.

In the same manner, those that feel anxious due to excessive worry, begin to exacerbate and maintain their own state of anxiety by viewing the worry as a negative thing and believing that they do not have control over their worrying.

They may go as far as to believe that the worrying itself may lead to a mental breakdown and that the anxiety that accompanies the worrying is clear evidence for the fact that it is dangerous (Wells & Carter, 2001).

This is the start of a negative cycle where worrying causes anxiety, which leads to more worrying and, therefore, greater levels of anxiety and so forth.

In short, anxiety is a condition that manifests psychologically, emotionally and physically. People struggling with anxiety usually also struggle with excessive worry about negative events, a generalized and vague feeling of dis-ease and apprehension as well as very clear somatic symptoms such as heart palpitations, shortness of breath and trembling.

The state of anxiety can often be self-perpetuating and anxiety about anxiety becomes a maintaining factor in the disorder.

Penney, A. M., Mazmanian, D., & Rudanycz, C. (2013). Comparing positive and negative beliefs about worry in predicting generalized anxiety disorder symptoms. Canadian Journal Of Behavioural Science/Revue Canadienne Des Sciences Du Comportement, 45(1), 34-4

Sadock, B. J. & Sadock, V. A. (2003): Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry. Philedelphia Lippincott Williams & Wilkins

Wells, A., & Carter, K. (2001). Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and worry in GAD, panic disorder, social phobia, depression, and nonpatients. Behavior Therapy, 32, 85–102

Social anxiety perth hypnotherapy

Social anxiety is a type of anxiety disorder that is typically characterised by a fear of negative scrutiny by other people (Hedman, Strom, Stunkel & Mortberg, 2013). Most people have some level of anxiety when entering new and unfamiliar social situations. To some extent, most people fear negative judgement by others. Social anxiety disorder is when this anxiety becomes debilitating and results in impairment in social and occupational functioning.

Those struggling with social anxiety disorder experience an exaggerated and inappropriate fear of being negatively evaluated by those around them in both social and performance situations (Seedat, 2013) to the point at which their performance and functioning in social situations is impaired or they avoid them altogether by withdrawing completely from social situations. In these situations people may experience the usual symptoms of anxiety; namely racing heart or heart palpitations, sweating, trembling, stuttering, and feeling dizzy, nervous butterflies in the stomach, upset stomach such as diarrhoea, dry mouth and shortness of breath.

This intense anxiety is situation specific, unlike generalised anxiety disorder, and the person tends to experience anxiety only when in social or performance situations, or when anticipating such events. Due to the fact that a primary characteristic of social anxiety is a heightened sensitivity to a perceived threat of negative evaluation, it has further been suggested that people struggling with social anxiety also tend to have a general hypersensitivity to threats in their environment (Kimbrel, 2008).

As such, people with social anxiety disorder tend to be hypersensitive to any evaluation from those in their social and occupational situations. Perceiving risk of negative evaluation and a fear of being excluded is a common anxiety to most people. Social anxiety, however, is more debilitating and those struggling with it find it very difficult to cope in those situations. Due to the fact that this form of anxiety is so common, some have even theorised that social anxiety is an evolutionary way of preventing an individual from behaving in ways which may exclude them from the general community or society (Hedman et al., 2013).

Social anxiety disorder, along with specific phobias, have an earlier onset than other anxiety disorder and typically start at around 13 years of age with an onset age of 25 or later being rare (Seedat, 2013). It is typically an adult disorder and there are more females that struggle with social anxiety disorder than males (Seedat, 2013).
The most studied and effective treatment for social anxiety disorder is cognitive behaviour and behaviour therapy where important factors for success include the individual’s motivation and commitment to treatment and having available alternate coping strategies and support structures (Sadock & Sadock, 2003).

The cognitive behaviour therapy techniques involve psycho-education around the disorder – the symptoms and presentation as well as education around the factors that maintain it. In this sense, the individual is shown how his anxiety behaviours (such as withdrawing from conversation) actually exacerbate and feed into the social anxiety.

People struggling with social anxiety tend to have a heightened awareness of self and often negatively evaluate their own behaviours in social situations, leading to anxiety attacks and anxiety behaviours, which then feed back into negative self-perceptions and fuel the belief that others are also evaluating them negatively. Cognitive behaviour therapy looks at these irrational beliefs and self-perceptions and attempts to challenge the negative thought patterns that result in anxious behaviours.

Relaxation training and other coping skills are also taught alongside the therapy (Seedat, 2013). Hypnotherapy can be a very useful tool in therapy to reinforce relaxation and coping skills and to adjust self-perceptions in social situations.

Overcoming social anxiety disorder is no easy task, but is certainly achievable through committed treatment with a psychiatrist or psychologist and the use of cognitive behaviour techniques.

Hedman, E., Ström, P., Stünkel, A., & Mörtberg, E. (2013). Shame and Guilt in Social Anxiety Disorder: Effects of Cognitive Behavior Therapy and Association with Social Anxiety and Depressive Symptoms. Plos ONE, 8(4), 1-8.
Kimbrel, N. A. (2008). A model of the development and maintenance of generalised social phobia. Clinical Psychology Review. 28, 592-612
Sadock, B. J. & Sadock, V. A. (2003): Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry. Philedelphia Lippincott Williams & Wilkins
Seedat, S. S. (2013). Social anxiety disorder (social phobia). South African Journal Of Psychiatry, 192-196

hypnotherapy weight loss

Most people, at one point or another in their lives, find themselves in a position where they feel pressured to lose weight, whether it’s external pressures from the media, friends or family, or internal dissatisfaction with body weight and/or shape. However, most people also find that losing weight is more difficult than expected. While for some, changes in diet and exercise routines lead to quick results, for most these changes are slow, barely noticeable and the process is often very difficult and frustrating. For these reasons, people who want to lose weight find themselves relapsing especially if their hard work seems to fail to deliver the desired results.

 The commercial programs available to the general public have also yielded suboptimal results. For example, the largest randomized, controlled trial of the Weight Watchers intervention only yielded a loss of 3.2% of initial weight after 2 years. On the other hand, medically supervised very-low-calorie diet programs resulted in approximately 15% to 25% weight loss, but also incurred high costs and resulted in high attrition rates, and a high probability of regaining 50% or more of lost weight in 1 to 2 years. Furthermore, other commercial interventions available over the internet and organized self-help programs have been shown to produce minimal weight loss (Tsai 2005).

One possibility for why these interventions continue to fail is the fact that weight gain, and an unhealthy relationship with food is not merely behavioral in nature: important psychological processes are at play whose role it is to guide behavior. Food is not used just as nourishment, but it is often a direct and immediate way to regulate emotional experiences that may feel overwhelming or distressing. It is therefore important to begin exploring this aspect of weight gain and weight loss, as eating habits are frequently related to emotional states.

For example, feeling anxious, or lonely, or upset, or sad can trigger cravings and eating behavior that is unhealthy and results in weight gain. These emotional states can further discourage someone from engaging in physical exercise, further increasing the risk for weight gain.

Food, especially high calorie and sugary foods activate the reward centers in the brain, resulting in a reinforcing effect that has an immediate effect of soothing unpleasant emotions, distracting attention from them, and a long-term effect of learning that eating unhealthy foods, when stressed or upset, is an effective immediate emotion regulation strategy. This way, eating as an emotion regulation strategy becomes a habit and a behavioral pattern that is difficult to break.

Therefore, in order to be successful, weight loss strategies must break these behavioral patterns and habits, and must also effectively address psychological distress and provide alternative emotion regulation strategies. A healthy eating and exercise plan may be important, but addressing the psychological factors that allow one to stick to the plan and overcome its challenges is even more important. In this sense, hypnotherapy for weight loss can be a fantastic adjunct to a healthy diet program.

Hypnotherapy helps an individual transition into an altered state of consciousness for a brief period of time, through techniques involving relaxation and visualization. Therapeutic suggestions are used to reinforce the benefits of an active and healthy lifestyle, providing a boost in motivation to maintain focus on the plan and the weight loss goal, rather than give up when challenges arise.

Through these suggestions, the therapist further encourages the patient to want healthier foods, to learn to enjoy them and find reward in them, while at the same time providing coping mechanisms for emotional stressors that can replace food and strengthen the patient’s commitment to a healthy lifestyle. When the craving for unhealthy foods seems unconscious and in conflict with a person’s conscious desire to lose weight, hypnotherapy can target those desires more directly.

It is often easier to learn new things and address stressful or overwhelming situations when you are in a relaxed state. When deeper work is needed to address past trauma or psychological difficulties, hypnotherapy can help relieve some of the emotional tension and allow the patient to safely explore these aspects of their experience. In addition, hypnotherapy can help shift a person’s general outlook and attitude to facilitate a more positive emotional experience.

It is important to note though that while hypnotherapy can effectively help or add to a person’s motivation and commitment to weight loss treatment, it cannot be viewed as a replacement for these internal experiences. In other words, a person needs to be motivated to change and ready to commit to life style changes before hypnotherapy can enhance these factors and strengthen them.

How successful is hypnosis for weight loss?

Hypnotherapeutic suggestions about the benefits of a healthy lifestyle and healthy eating behaviors have a positive effect on weight loss. They can help people shift their perceptions about food and eating, become more mindful of their behaviors (e.g., eating too fast, eating unhealthy food for stress relief, etc.), and change these behaviors for more effective strategies.

Therefore, successful weight loss requires a program that takes into account not only behaviors, but also a person’s internal experiences and emotions, and stresses healthy eating, exercise, and emotion processing and regulation strategies. Hypnotherapy for weight loss not only assists in increasing and maintaining positive motivation and behavior change, but also assists the person in exploring deeper psychological issues.

It is important to keep in mind, though, that hypnosis is not a therapy. It is a technique to be used as an adjunct to therapy. It has had positive results in combination with therapies such as rational emotive therapy, cognitive behavior therapy, and other forms of empirically supported treatments. Studies have shown repeatedly that when hypnosis was used as an adjunct to cognitive-behavioral therapy, including therapy for obesity, it has increased the positive impact of the treatment and helped patients continue to lose weight long after therapy had ended (Everly, and Lating 2013).

Hypnosis can help cognitive-behavioral interventions in multiple ways. For example, many such interventions for weight loss rely on imagery to effect change. Hypnosis is a particularly effective strategy for enhancing the effects of imagery methods, reducing disturbing imagery and helping patients cultivate self-compassion and unconditional self-acceptance. These aspects have received increasing attention in the scientific and psychotherapeutic community as important factors for behavioral change (Milburn 2011).

Individuals who struggle with psychological problems, as well as individuals who struggle with obesity and weight loss, experience stigma on a daily basis. This begins very early on in development and occurs in every context of life, from school and work to stores, restaurants and even doctors’ offices. There is a pervasive stigma of overweight, and this stigma is frequently internalized by the individual who struggles to control their weight and their eating behaviors. This means that very often, individuals who are overweight and want to lose weight have a deep, long-lasting feeling of non-acceptance of their own person, behaviors, thoughts and decisions.

They feel judged by others and by themselves, which may leave them feeling more emotionally distressed, anxious, and hopeless about their chances of overcoming the current situation. Hypnotherapy for weight loss can help in these instances, as it does not require rationally arguing against deeply held negative beliefs, but rather creates a safe setting in which the patient can experience acceptance and nonjudgmental focus on valued goals.

Hypnotherapy for weight loss can be used as an adjunctive means for promoting unconditional self acceptance, and thereby pave the way for increasing the patient’s receptiveness to more conscious cognitive restructuring and behavioral interventions.

In addition to countering self-condemnation, genuinely unconditional self-acceptance seems essential to acceptance of others. It is intimately associated with self-compassion and can counter self-deprecating beliefs that may hinder therapy. Unconditionally accepting oneself further reduces perfectionism and the need for achievement, as well as the need for approval. Because unconditional self-acceptance reduces self-labeling and self-condemnation, it diminishes a significant obstacle to therapeutic change without creating another. It renders emotional activation less threatening and allows for therapeutic interventions to change the way the patient interacts with his or her emotions (Milburn 2011).

Two forms of hypnotherapy in particular (stress reduction, energy intake reduction) have been tested in recent scientific trials, and found to have a lasting positive effect compared to dietary advice alone, even more than a year after treatment ended. However, it is important to bear in mind that when not conducted by a trained professional, hypnotherapy can have side effects, especially in vulnerable groups (e.g., obese adolescents), including anxiety, depersonalization, and dissociative states (Allison et al. 2001).

Allison, David B., Kevin R. Fontaine, Stanley Heshka, Janet L. Mentore, and Steven B. Heymsfield

2001 Alternative Treatments for Weight Loss: A Critical Review. Critical Reviews in Food Science and Nutrition 41(1): 1–28.

Everly,, George S., and Jeffrey M. Lating
2013 A Clinical Guide to the Treatment of the Human Stress Response. New York, NY: Springer New York. http://link.springer.com/10.1007/978-1-4614-5538-7, accessed June 23, 2014.

Milburn, Milo C.
2011 Cognitive-Behavior Therapy and Change: Unconditional Self Acceptance and Hypnosis in CBT. Journal of Rational-Emotive & Cognitive-Behavior Therapy 29(3): 177–191.

Tsai, Adam Gilden
2005 Systematic Review: An Evaluation of Major Commercial Weight Loss Programs in the United States. Annals of Internal Medicine 142(1): 56.

Binge eating perth

What is a eating disorder

An eating disorder is a serious condition in which preoccupation with food and weight leads to significant impairments in health, psychological well-being and daily living. The three main types of eating disorder are anorexia nervosa, bulimia nervosa and binge-eating disorder. Two of these disorders, bulimia nervosa and binge-eating disorders, have as their core characteristic the presence of eating binges (American Psychiatric Association, 2013).

Compulsive eating disorder

Known by its official name as binge-eating disorder, this disorder is characterized by frequent episodes of compulsive eating. It has also often been conceptualized as a food addiction, because during these episodes, the individual feels a loss of control over eating and a marked distress about these eating behaviors. In addition, individuals affected by binge eating disorder also have dysfunctional body shape and weight concerns, psychiatric comorbidity (e.g., depression), obesity, as well as other significant health and psychosocial impairments (Wilson, Wilfley, Agras, & Bryson, 2010).

Established treatments for binge eating disorder include interpersonal psychotherapy, cognitive behavior therapy and behavioral weight loss techniques aimed to help patients learn how to stop eating excessively and monitor and control their food addiction.

Interpersonal Psychotherapy: Patients first focus on a detailed analysis of the interpersonal context within which the binge eating disorder developed and was maintained. Using this analysis, current interpersonal problem areas are formulated, which then form the focus of the second stage of therapy. The final 3 sessions review the patient’s progress in terms of compulsive eating and an explore ways to handle future interpersonal difficulties and challenge related to food addiction.

Guided Self-Help Cognitive Behavior Therapy:

This treatment is manualized and performed under the guidance of a therapist. Patients are given a book for how to overcome binge eating, which also includes a step-by-step self-help program. The primary focus of this intervention is to develop a regular pattern of moderate eating using self-monitoring strategies, techniques for self-control, and problem-solving approaches.

The treatment stresses relapse prevention in order to promote behavior change maintenance. The therapist’s main role is to explain the use of the self-help manual, help the patient develop reasonable expectations for success, and to motivate the patient throughout therapy.
Behavioral Weight Loss:

This approach to treating compulsive eating and food addiction addresses the patient’s concerns for how to stop eating excessively by including both moderate caloric restriction and exercise. The treatment initially focuses on dietary change toward a weight loss goal of 7% of one’s starting weight, by reducing fat intake to 25% of calories from fat. The exercise goal is 2.5 hours of moderate exercise each week.

Hypnosis can help in the treatment of binge eating, bulimia and compulsive eating, because individuals suffering from binge eating appear to be more hypnotizable than patients with anorexia nervosa or more restrictive types of eating disorders, which suggests that hypnosis could work as potentially effective adjunct to therapy. In hypnosis treatments that include several 60-minute sessions, hypnosis interventions have been shown to be as effective as more established cognitive-behavior therapy for some patients (Brewerton & Baker Dennis, 2014).

 

 

American Psychiatric Association, American Psychiatric Association, & DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, Va.: American Psychiatric Association.

Brewerton, T. D., & Baker Dennis, A. (Eds.). (2014). Eating Disorders, Addictions and Substance Use Disorders. Berlin, Heidelberg: Springer Berlin Heidelberg. Retrieved from http://link.springer.com/10.1007/978-3-642-45378-6
Wilson, G. T., Wilfley, D. E., Agras, W. S., & Bryson, S. W. (2010). Psychological Treatments of Binge Eating Disorder. Archives of General Psychiatry, 67(1), 94. doi:10.1001/archgenpsychiatry.2009.170

quit smoking perth

Quit Smoking

Compared to individuals who have never smoked, smokers lose at least one decade of life expectancy. Most of the excess mortality among smokers is due to neoplastic (e.g., tumors), respiratory, and vascular diseases. Furthermore, cessation before the age of 40 years reduces the risk of death associated with continued smoking by about 90%.

Specifically, adults who quit smoking at 25-34 years of age gain about 10 years of life, those who quit between the ages of 35 and 44 gain 9 years of life, and those who quit between the ages of 45 and 54 can gain on average 6 years of life, as compared with those who continue to smoke (Jha et al., 2013).

Tips to Quit Smoking

Quitting smoking can be challenging, but researchers have found several behavioral approaches that can help smokers overcome their addiction. For example, engaging in treatment groups where participants use name tags, encourage group members to introduce themselves and to talk about themselves and their experiences, have shown to be effective (West, Evans, & Michie, 2011). Other effective strategies include:

  • Betting games: giving the option to group buddies to place bets; each pair bet together that they won’t smoke for the next week. If one of the buddies smoke, then both buddies have to forfeit their money (West et al., 2011).

  • Group tasks that promote interaction/bonding: any tasks which group members perform together in the therapy session that may make the clients more attached to the group and each other or encourage group interaction (West et al., 2011).

Hypnotherapy has been suggested as an alternative treatment to help people quit smoking, and techniques may involve weakening people’s desire to smoke, strengthening their will to quit, or helping them concentrate on a ‘quit program’. Although it is possible that hypnotherapy could be as effective as counseling treatment, there is not enough evidence to be certain of this (The Cochrane Collaboration, 1996).

What are the effects of quitting smoking?

There is substantial evidence that quitting smoking benefits psychological well-being. For example, health-related quality of life improves following cessation, but decreases with continued smoking. This effect occurs relatively quickly, i.e., within the first year after a quit attempt. In addition, over 3 years, research findings show that continuing smokers report increased negative affect and decreased positive affect, while successful quitters report decreased negative affect and increased positive affect. Thus, negative mood might constitute a barrier to smoking cessation treatment, but long-term cessation can help improve mood. This also suggests that continued smoking may play a role in maintaining and possibly exacerbating a range of psychological problems (Piper, Kenford, Fiore, & Baker, 2012).

Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R. N., … Peto, R. (2013). 21st-Century Hazards of Smoking and Benefits of Cessation in the United States. New England Journal of Medicine, 368(4), 341–350. doi:10.1056/NEJMsa1211128

Piper, M. E., Kenford, S., Fiore, M. C., & Baker, T. B. (2012). Smoking Cessation and Quality of Life: Changes in Life Satisfaction Over 3 Years Following a Quit Attempt. Annals of Behavioral Medicine, 43(2), 262–270. doi:10.1007/s12160-011-9329-2

The Cochrane Collaboration (Ed.). (1996). Cochrane Database of Systematic Reviews: Reviews. Chichester, UK: John Wiley & Sons, Ltd.

West, R., Evans, A., & Michie, S. (2011). Behavior Change Techniques Used in Group-Based Behavioral Support by the English Stop-Smoking Services and Preliminary Assessment of Association with Short-term Quit Outcomes. Nicotine & Tobacco Research, 13(12), 1316–1320. doi:10.1093/ntr/ntr120