She was on mild antidepressants for most of her adult life, her mood problems worsening whenever she tried to move way from home. H decided do come off the medication two years ago, when she met her partner and found a new job. 2. Introduction and Initial consultation H is now in a steady relationship and staying off the medication. In her new job she has taken on more responsibilities as she has learnt about the role, and is now in charge of sales unit, which means she often has to present new products in front of colleagues and clients.
H has noticed that the more responsibilities she has taken on the less adequate she felt, as she was not formally trained or supported by her boss. The first presentation to new linens didn’t go very well and ever since H has experienced strong anxiety during occasions Of public speaking. Some Of the physical symptoms H experiences few day prior to a public speaking events include: trembling knees, dry mouth and feeling light headed. Recently H started phoning in sick at work on days when she was due to give a presentation.
A friend recommended that H should seek help to deal with this issue. After some research H decided that she would like to try hypnotherapy. Although feel that I could help H, there were few ethical issues that needed to be considered prior to starting the treatment: Medication: H had not been taking antidepressants for over two years, I felt that she should have GAP consent before starting hypnotherapies treatment. H advised that upon consultation with her GAP it was recommended that some blood tests are carried out to check her hormone levels.
The results were negative and He’s GAP had no objection to H starting hypnotherapy treatment for public speaking anxiety. Possible attachment issues/co – dependence: During the initial consultation it has become apparent that H feels very strongly attached to her family (mother, father and 3 siblings). Being the eldest of four, H feels very close to re parents and somewhat responsible for younger siblings. H was unable to stay away from her family home until she met her partner.
She is now happy in her relationship, but is unable to imagine what would happen if the relationship doesn’t work out. I recommended that H may benefit from counseling to help her establish how she perceives relationships with her family and her partner 3. Diagnosis Having discussed He’s anxiety prior to and during a public speaking with her I asked her to visualize herself delivering a presentation and think about what it is exactly that she is worried about when she experiences the anxiety.
H was not sure at first, but then she told me that she fears being perceived as stupid and inadequate, that she is not good enough for the job and her boss and the clients will ‘see through he” during moments when she has to present. I believe H suffers from low confidence and lack of self-belief. She is overly critical of herself and the origin of her low self-esteem can probably be traced back to her childhood (she often feels inadequate in relationship to her mother, whom H perceives as ‘perfect in everything she does’).
When I discussed this case with my tutor, was advised to focus on He’s current taxation and given her history, to refrain from any form of regression. I have advised H that I can probably help her temporarily with the anxiety issue, but that felt she may benefit from counseling achieve for long term results. As the physical symptoms H experience prior to any public speaking event are quite severe, recommended 7 to 8 sessions. In the first two sessions I would like to concentrate on deep relaxation skills as well as target confidence and self-esteem.
Session 3 and 4 would be focused on helping H with anxiety immediately prior to and during public speaking given the charity event she loud like to speak at. Sessions 4 to 8 will be designate to improve He’s self- image as an individual and as a professional and focus further on any physical symptoms H may experience during periods of increased anxiety Session 1 During our first session after the case history I discovered that He’s goal was to be able to go to deliver a presentation at work and generally feel relaxed whilst presenting to clients, and to stop the excessive sweating and shaking that often accompanies this condition.
There was also a more immediate goal – H was organizing a charity event for 50 people in four weeks’ time and have remised to introduce the charity to the guest. H admitted that this was a big event as her boyfriend is attached to this charity and she would like to make him proud by making the initial announcement during the event. Given the timescale I suggested small goal that H could work towards and perhaps do something a week after the first hypnotherapy session to get out of her comfort zone.
He suggested speaking up at a company meeting and explaining her sales targets in front of her colleagues and her boss. This is something h usually distributes via email prior to the meeting, so she doesn’t eave to talk in front of her colleagues. H was slightly apprehensive to start with, but explained to her how, with the help of hypnosis, she can learn to control her breathing and other physical symptoms. Started with a basic MR. and then moved onto a deepened with a deep relaxation suggestions. I have recorded this session and given it to H to listen at home for a week.
H proved to be very responsive to hypnosis and at the end of the session she told me she felt much more relaxed already and that she enjoyed the hypnotic State. Session 2 The second session started with H telling me about her attempt to present re sales targets to her colleagues. This didn’t go well and H felt that she ‘made an idiot of herself’ but that one of the colleagues had told her afterwards that its quite normal. This made her feel better. She was still feeling positive about the hypnotherapy, she felt that after the first session she cared less about being perfect all the time.
H entered the hypnotic state even more easily this time and I had to bring her out a couple of times to ensure that she was not asleep. This time after the deepened I suggested to H that all people have weaknesses and this makes us human and more likeable. Also suggested that some people strive for perfection and that’s K, yet at the same time it is also K to make mistakes, because mistakes is what we learn from and what makes us better at what we do. After the session I gave H a tape with visualization exercise.
Session 3 In this session we worked on replacing a feeling of anxiety or nervousness with the counterbalancing feeling of relaxation while in hypnosis. Since relaxation and anxiety cannot coexist, it was important for H to feel the state of deep relaxation so that when she felt anxious he would be able to replace it with a feeling of relaxation. Session 4 Sessions 4 took place three day s before the charity event H was organizing. H felt that she put a lot of pressure on herself trying to organism the event and deliver the speech.
She wanted to ask someone else to do the speech on her behalf but was worried that she would disappoint her boyfriend. I asked H to imagine the reverse situation when her boyfriend was planning on doing something that caused him a certain amount of anxiety to please H. I asked H how she would feel about that. She said she wouldn’t want to put anyone she loves in this king of position. I then asked H to relax and to enter the hypnotic Tate (l used Eye Fixation induction). Once I was sure that H was hypnotized, suggested that she is loved by people close to her and that they would want her to be happy and relaxed.
H was asked to bring up the positive feelings associated with the information he would be presenting to his group during a public speech. She was asked to get in touch with his knowing he was smart and prepared. Once in touch with her preparedness, H was asked to visualize step by step the process of waking the morning of the talk, feeling prepared, excited, and relaxed. While watching David his body was extremely calm until moments before getting onto the stage in his visualization. Two days after session 4 H phoned me and told me she decided not to do the charity speech and that her boyfriend was happy to do it on her behalf.
She felt a little disappointed in herself, but decided that this was better than the feeling of anxiety. Session 5 H asked me to review her goals. She felt that the fear of public speaking is only a symptom Of a much bigger issue. We discussed it at length and H felt that she worried very much how she is perceived by others and that this affected her life more than anything else. Although she enjoyed hypnotherapy very much, she contacted her GAP and decided to ask to be put on the waiting list for counseling with Talking Therapies.
H wanted this session to be the final one for the time being and asked if could do the MR. I used during the first session and a confidence enhancing script. Asked H for an honest feedback, she said felt much more relaxed after each hypnotherapy session but didn’t have the time to do her homework. She also felt that those sessions made her realize that her issues are quite deep rooted. I thanked her for her feedback and agreed that an experienced unsolder will be able to offer more effective treatment. H expressed an interest in coming back for Weight Loss treatment 6.
End of Treatment and Results H contacted me after our final session and advised that she spoke to her boss about presenting to clients and asked to be sent on a course for public speaking. He’s boss has agreed and offered that H could also come to his meetings and observe him during sales presentations. H is currently on the waiting list for counseling and feels a little apprehensive, but determined to deal with her issues. She also stated that the hypnotherapy sessions made re realize that majority of the pressure she felt came from within. . Limits and Flaws My main mistake was perhaps to give H the impression that could help her to get emotionally ready for the charity event speech. I have failed to deliver the result and perhaps misguided the client. H has not achieved this goal; in fact she decided to avoid the activity all together. The second mistake was the way I have scheduled the sessions -? H would benefit from the treatment much more had I concentrated on the lack of confidence and low self-esteem problem rather than try to deal with the physical symptoms of anxiety.