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Using the Case Study of Mr. X

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    In this essay I will explain the issues Mr X has expressed as I understand them. I will also explore the ethical considerations that should be considered before devising a relevant course of treatment. Mr X stated that he has been employed as an estate agent in the same company for 18 years. During this time he has regularly demonstrated that he is capable of successfully executing the role of manager by “standing in” when the manager is absent. Despite this he is apprehensive to put himself forward as a candidate for the managerial position now that the role has been made available.

    The phrase, “he does not want to upset the apple cart if he is not successful. ” immediately suggests that he has a fear of rejection because he will not put himself in a position where rejection is a possible outcome. Mr X also demonstrates hesitation to socialise with his colleagues because he believes they find him boring; but he is afraid to ask them to meet on another evening for fear of rejection. He is unable to socialise with them as they do so on Friday evenings which is when he visits his mother. He indicates that he does not feel comfortable suggesting any change to his mother because, “…. he would pick on him even more than usual. ” This suggests that his mother is a controlling, critical parent and that Mr X will do anything to avoid displeasing her. Mr X wants his mother’s approval but fears her rejection if he fails. He indicates he is capable of emotional attachment however he cannot express them. This is shown in his description of his girlfriend as a “sort of” girlfriend but he say he would like to marry her. This suggests that he has not discussed his feelings nor has he established the nature of the relationship with his girlfriend because he is scared of her rejection.

    In my evaluation Mr X is presenting with self-confidence and self-esteem issues in addition to having a great fear of rejection and failure. Before pursuing any potential course of treatment I must, as an ethical and responsible therapist, ensure that hypnotherapy is truly suitable for his issues. I would make certain at this stage that he is not suffering from depression, as it would be out of my remit to treat him were this the case, and I would also enquire from him about any medication he may be on that could cause changes in his mental state, thus interfering with the proposed herapy. I would not agree to conduct any treatment until I had satisfied myself that he is not suffering from any psychosis, that he is not taking any psychotherapeutic medication or dependent on alcohol or drugs, Mr X has demonstrated that he is very capable in his job and is valued by his manager; however Mr X does not recognise or value his own achievements. In addition his colleagues are also obviously eager to socialise with him but his lack of self esteem prevents him from seeing how his colleagues really perceive him.

    It is Mr X who has labelled himself as boring. Hadley and Staudacher state that, ‘The major cause of poor self-esteem is past negative programming that is the product of judgemental parents. ’ This is most certainly going to be true in Mr X’s case, as he has spoken of his mother’s critical nature towards him, and even now feels unable to ask her to adjust the day for his visits to her in order that he could facilitate the social night with his colleagues.

    Self criticism manifests itself as a disabling critical voice in the mind that in time can become self-defeating and cause the person to formulate beliefs about themselves that are inaccurate and false. It is important that the therapist accepts the client’s belief about themselves in order for the treatment to be effective. ‘Self-esteem is one of the fundamental influences on nearly everything you do. When your self-esteem is low, almost all areas of your life – working, socializing and loving – are made more difficult. (Hadley and Staudacher) In this case it would be necessary to reframe the situation so that Mr X becomes aware and accepting of his competencies, so that his self-esteem is allowed to surface and he is then encouraged to take the steps to achieve his goals. I would also ask Mr X to consider that he may need to seek counselling to address the issues he has with his mother. As a hypnotherapist I am not qualified to delve deeply into these issues but it is my belief that Mr X would benefit greatly from counselling I would therefore recommend that he seeks an appropriately qualified counsellor as well as seeking hypnotherapy.

    Mr X’s issues will not be resolved in one session therefore I would advise him of that during the initial consultation. It is important and ethical to ensure that before any treatment starts that Mr X understands what exactly hypnotherapy is, what it can achieve and how we shall be using it. This is so that he and I may both be clear on what the objective of the sessions are and what can and cannot be accomplished so that we can both make an informed decision on whether we wish to continue.

    I would stress that hypnosis is a natural state of awareness and that he will still be in control at all times and can address any fears.. I would inform him that confidentiality respects the personal information disclosed and protects that information from disclosure to others as it is an important ethical requirement and without it, therapy may be frustrated by a lack of trust and safety. I would suggest that 4 sessions would be effective but always ensuring that he is aware it might not be definitive as sometimes other issues can come to light.

    He will then understand financial implications of his treatment. I would also explain that efficacy of hypnotherapy would be improved if Mr X was prepared to work outside of the sessions by daily using a recording of the script at home. At the end of the consultation it would be good to discuss his goals and ensure they were feasible. It is also important that Mr X has the chance to ask any questions regarding the treatment. Encouraging Mr X to daily use the recording will help his subconscious mind absorb the message.

    This is essential when realising that the Conscious Critical Faculty (CCF) constantly monitors our experiences of the world and aligns those experiences with our deeply embedded beliefs. Daily use would help Mr X rebuild his CCF in the way he perceives himself. As previously stated, Mr X appears to care deeply for his girlfriend because he has considered marriage, however he claims that he cannot propose to his girlfriend because ‘he does not have much to offer her at present’. I would consider the possibility that Mr X is scared of the prospect of marriage; did his mother also have a controlling influence on Mr X’s father?

    Consequently does Mr X feel incapable of being a good husband, of building a family and becoming a father himself? Does he think that all women in relationships will act like his mother and he is therefore scared of discussing his feelings with his girlfriend in case she turns into his mother? Does remaining in his position at work allow him to excuse himself from a range of other experiences? In order to counter the negative adjustments made by the CCF, it is necessary to countermand it via regular hypnotic suggestion, until the CCF has been altered.

    I would explain to Mr X at this point that the changes in his behaviour will affect the relationships he has with other people, particularly his mother because she would have laid the foundations of Mr X’s belief system. I would not discuss any of my speculations with him as it may make him angry or upset. However I would strongly recommend that he seek additional therapy so that he can be fully equipped to deal with the changes which will inevitably occur due to the changes in his own belief system.

    I would add into our contract that at the end of the third and fourth sessions we would review and evaluate the therapy to analyse how he is feeling; how he feels hypnotherapy has benefited him and whether or not he feels he may need further sessions. However it is my opinion that composing a self-esteem/self-confidence script for him coupled with affirmations to encourage him to boost his motivation, will support him on his journey to resolve to face and overcome his issues.

    Mr X constantly displays an unwillingness to act upon any positive feelings or thoughts; instead he habitually latches on to negative thoughts which underpin his fear of change and of potential failure. As part of treatment it would be worth discussing why he feels more comfortable with the negative beliefs than the positive ones. Mr X chooses not to recognise his own talents and capabilities. His abilities in the workplace are well regarded otherwise he would not be asked to stand in as the manager. However he appears not to want to see his own successes.

    It appears that quite a few of his beliefs are not grounded in reality and based more on emotion than fact “He says that all his office peers see him as a bit boring. ” It would be worth exploring his ideas about himself. Does he see himself as boring? If so getting him to realise that he is in control of both his behaviour and his thoughts about himself. This would be getting him to take responsibility for himself and his own life. By choosing to place an emphasis on what others think, he is avoiding facing up to what he thinks and so can effectively blame outcomes of his actions upon others.

    The “something that seems to be holding him back” is undoubtedly himself. Mr X will need to recognise this before he can move forward. The way in which he claims he would “love” to do things differently but blames others for the fact he has refused to change. However by remaining in these situations he avoids potential failure, rejection, and the responsibility, expectation and change that would come with throwing himself fully into his life. Before any hypnotherapy begins it will be important to discuss these possible secondary gains with him as they may act as a barrier to successful treatment.

    A hypnotherapy screed which focused upon feeling relaxed and confident when dealing with other people would be useful for him. I would begin with a general self esteem screed in order to help Mr X recognise and accept his strengths, so that he values himself and his abilities. This would enable him to build the confidence to, apply for the managerial position; to actively suggest an alternative time to socialise with his colleagues; to confront his mother without fear of her responses and to discuss his feelings with his girlfriend despite the possibility she may reject him.

    I would also allow for some specific work to help build his confidence in the workplace. It is not too late for Mr X to make a new start, to make changes become the person he wants to be, to value and accept himself. By coming for hypnotherapy he has taken the first step on the ladder. If Mr X is willing to take things on board and work to make changes in his life then he should start to feel much more positive. Once he has these in place he can continue to confidently face change and move forward, replacing his negative concepts with a positive ones.

    I would recommend that he continues to practice self hypnosis and utilise any affirmations which have proven to be successful, also continue to use the recording until his new confidence to becomes second nature. Bibliography Hadley, J. Staudacher, C. (1996) Hypnosis for Change. USA: New Harbinger Publications. Chrysalis Diploma in Psychotherapeutic Counselling. Year One – Hypnotherapy and Counselling skills- Module 4. Alternative induction Techniques, Deepeners, Ideomotor response, Understanding Hidden Agendas, Working with Self Esteem, Useful NLP Techniques.

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