OVERCOMING FEAR THROUGH HYPNOSIS

Fear and anxiety are very common phenomena that often present themselves in particular moments of our lives: in most cases they appear to help us, to avoid dangerous situations or to face a particularly difficult one. In some cases, however, they can appear without a true danger or problem. In such cases, when there is no evolutionary advantage in activating these mechanisms, we are dealing with anxiety disorders or panic attacks. The terms “fear” and “anxiety” are quite generic and they refer to general conditions of agitation. When we refer to the condition that generates fear or anxiety, we are dealing with specific anxieties or fears: for instance, we are referring to agoraphobia when we talk about the fear of open spaces, we are referring to claustrophobia when we are talking about the fear of narrow spaces. A “panic attack” is a period of sudden fear, variable in duration, that manifests itself with several physical symptoms (such as tremors, shallow breathing, sweating, nausea, dizziness, hyperventilation, tachycardia, breathing problems) and an intense fear of dying, becoming crazy or losing control. The neural bases of these disorders are still not fully understood, however the fact that several brain areas, such as the temporal and frontal cortices, the insula and the anterior cingulate cortex, are involved in the appearance of such phenomena was demonstrated.
In the last 30 years several researches have investigated the efficacy of hypnosis in treating anxiety and disorders such as panic attacks, fear of flying and agoraphobia. In a recent review (that is an article describing the state of the art of a specific topic), it was demonstrated that the inclusion of hypnosis in traditional therapies, such as cognitive-behavioral ones, drastically increases the success rate in the treatment of anxiety disorders1. Especially interesting is the idea of using hypnosis to treat the anxiety caused by surgical and dental operations (such as biopsies, radiological procedures, oral surgery). In a meta-analysis (a specific kind of analysis that involves several studies and that merges and compares their results) that included 18 studies on different kinds of pain, anxiety disorders and phobias, the authors demonstrated that, approximately, patients who received a hypnotic treatment showed a 70% greater improvement than patients who received “standard” treatment without any hypnotic induction2.
Regarding claustrophobia and agoraphobia, the difficulty of conducting controlled experiments is high, especially because of the variability between single cases: that’s why much data comes from descriptive studies on single patients. In a study that involved two patients who had cancer at the beginning of a radiotherapy protocol, hypnosis has been used, together with a traditional therapy, to treat radiotherapy-related claustrophobia  (in this treatment, in fact, patients are left in an hermetically sealed room and often need to be immobilized on a bed). This combined approach has led both patients to complete, without any further interruption, all radiotherapy sessions3. Hypnosis was effectively used on a young patient to treat agoraphobia caused by panic attacks. After the first session in which a specific relaxation technique was used, the patient has been “trained” to use desensitizing hypnotic techniques. The adoption of hypnotic treatment allowed the young lady to overcome her agoraphobic symptoms and panic attacks. Therapy was successful also in the period following the end of the treatment4.
A common phobia involves the idea of being on a plane: also in this case hypnosis can represent an effective technique to help people overcome the fear of flying. In a recent study hypnosis was used in a case of flight related panic attacks. After a 12-sessions treatment, during which a constant improvement of the willingness to fly was observed, the patient was finally able to take a plane5. Similar results in the treatment of the fear of flying, seem to be achievable with faster forms of hypnosis6.
The above cited studies confirm the importance of using hypnosis to treat disorders such as panic attacks, agoraphobia and fear of flying. Hypnosis, in fact, by itself or combined to standard treatments for these disorders, leads to a more significant improvement of the symptoms. However, it must not be forgotten that these studies need confirmation because they are mainly represented by single case studies.
 
[1] Corydon Hammond D. Hypnosis in the treatment of anxiety- and stress-related disorders. Expert Review of Neurotherapeutics; 10(2), 263–273 (2010).                                                                                                           
[2] Kirsch I, Montgomery G, Sapirstein G. Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis. Journal of Consulting and Clincal Psychology; 63(2), 214–220 (1995).
[3] Steggles S. The use of cognitive-behavioral treatment including hypnosis for claustrophobia in cancer patients. American Journal of Clinical Hypnosis; 41:4 (1999).
[4] Harris GM. Hypnotherapy for agoraphobia: a case study. Internetional journal of psychosomatics; 38(1-4):92-4 (1991).
[5] Volpe EG, Nash MR. The Use of Hypnosis for Airplane Phobia With an Obsessive Character. A Case Study. Clinical Case Studies; 11(2): 89-103 (2012).