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What is Cognitive Behavioural Hypnotherapy?
Why integrate hypnosis with cognitive behavioural therapy?
CBH and Fears and Phobias
CBH and Panic Disorder
CBH and Post Traumatic Stress Disorder
CBH and Acute Stress Disorder
CBH and Anxiety
Hypnotherapy and Generalized Anxiety Disorder
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Welcome to The Hub

The Hub is an information channel, specifically designed for health and medical centres, clinics, GP's and dental surgeries.

It offers useful information on Cognitive Behavioural Hypnotherapy, an integrated psychological therapy offered by Clinical Hypnotherapist Mark Spalek, at his city centre practice, Positive Suggestions.

FREE Workshops: Secrets of Sleeping Cats - Treating Anxiety Seriously

Mark Spalek offers Free 1 hour workshops for health centres, clinics, GP's and dental surgeries to demonstrate how he uses Cognitive Behavioural Hypnotherapy to help people overcome anxiety disorders such as Generalised Anxiety Disorder, Post Traumatic Stress Disorder, Social Anxiety Disorder, Panic Disorder, Obsessive Compulsive Disorder and Dental Anxiety Disorder.

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About Mark Spalek, Clinical Hypnotherapist
GHR (reg), Dip. Hyp, Dip. NLP, GQHP, MSc, BSc, PGCE

Mark is a Clinical Hypnotherapist and Brief Solution Focussed Therapist working in his city centre practice, Positive Suggestions.

He employs Cognitive Behavioural Hypnotherapy (CBH) within his work and offers clinical experience in helping clients overcome a range of anxiety related conditions including:

- Generalised Anxiety Disorder
- Post Traumatic Stress Disorder
- Social Anxiety Disorder
- Panic Disorder

What is Cognitive Behavioural Hypnotherapy?

CBH is an integrated psychological therapy employing hypnotherapy and cognitive behavioural therapy (CBT).
It offers a powerful combination of cognitive behaviour modification and hypnotherapeutic interventions.

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Why integrate hypnosis with cognitive behavioural therapy?

There are many benefits of integrating hypnosis with cognitive behavioural therapy. Hypnosis is highly effective in bringing about rapid profound changes that encompass behavioural, emotional, cognitive and physiological elements (De Piano & Salzberg, 1986). It fosters a strong therapeutic alliance that is focussed on helping the client utilise their own inner resources in order to overcome any issues or problems that they have.

As well as helping induce and maintain a deep feeling of relaxation, hypnosis embeds positive suggestions within the client, allowing them to think more positively about themselves and the world in general. This ego-strengthening not only enhances a client's self-confidence and self-worth (Alladin, 2008:12), it also challenges negative thoughts and depressed moods, facilitating optimism and promoting self-worth, important emotions in any therapeutic treatment plan. The use of post-hypnotic suggestions can be very effective in increasing desired behaviours while decreasing undesired ones.

Through hypnosis, systematic desensitisation (changing the way a client deals with difficult in vivo situations using their imagination), cognitive restructuring, exploration of the past and directing attention on positive feelings and experiences are all possible.

Mark incorporates an evidence-based approach within each treatment plan, and tailors interventions specific to each individual, post-assessment.

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CBH and its use in overcoming fears and phobias

CBH incorporates both hypnotherapeutic and cognitive behavioural methodologies which means that a client can be exposed to a particular conditioned fear stimulus that would otherwise prove difficult or unacceptable, for instance when treating someone who has a phobia of vomiting (Wijesinghe, 1974).

Phobias such as this can be overcome through the process of flooding, where the client, under hypnosis, is introduced to various triggers for the fear. The client visualises these triggers and together with the therapist explores the emotions around them. In this way a high state of emotional arousal can be induced and maintained and this can then be progressively reduced as the patterns of association to the fear stimulus are transformed in the hypnotic state – which is nothing more than a relaxed state - bypassing the often critical conscious mind.

Over the course of a treatment plan which may span several sessions, new ways of behaving to the old stimuli can be introduced. On a subconscious level the client embeds these healthier ways of behaving and this results in reduction and elimination of the phobic anxiety.

Nolan (2008) describes the use of a combination of CBT and hypnosis in managing anxiety over visiting medical specialists. In this case, CBT and hypnosis was used to expose the patient to both the symptoms panic and situational anxiety. After five sessions there was marked decrease in symptoms of anxiety with the patient being able to visit their doctor without undue blood pressure elevation.

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CBH and its use in overcoming Panic Disorder

Research demonstrates that hypnosis can effectively reduce symptoms of panic disorder, allowing the client to be able to prevent the development of a panic attack cycle (Iglesias & Iglesias, 2005).

One of the ways this can be achieved is through the combined utilisation of hypnosis and guided imagery; the client can be exposed to panic triggers and allowed to cognitively identify self-defeating components so that they can revise and rehearse alternative beneficial ways of thinking that prevent the panic attack cycle from manifesting. This results in an increase in the sense of control, elimination of symptoms and termination of panic attacks (Du-Fay Der & Lewington, 1990).

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CBH and its use in overcoming Post Traumatic Stress Disorder

The hypnotic state can be easily and quickly induced in PTSD individuals who are highly suggestible (Bryant, Guthrie & Moulds, 2001). This allows the production of profound mental and physical relaxation states that help the individual dissociate from upsetting memories of the traumatic event into a safety and comfort associated with the present physical environment (Alladin, 2008: 102).

Within this relaxed state the individual is taught how to become aware of symptoms and how to modulate and control these symptoms. Traumatic events can be re-scripted so that the emotions behind these events can be processed in a more healthy way.

Treatment Strategies for PTSD

Most treatment systems employing CBH for PTSD are based on a three-stage process:

Stage 1 involves several sessions that focus on:

  • Inducing relaxation
  • Demonstrating the power of the mind through simple exercises the individual performs under hypnosis, for example, eye and body catalepsies
  • Ego-strengthening to promote control and boost self-esteem
  • Expansion of awareness of internal states including emotions, feelings and thoughts
  • Modulating and controlling symptoms
  • Self hypnosis training for controlling emotional and physical symptoms outside of therapeutic sessions
  • Post hypnotic suggestions to deal with problem behaviours and negative emotions

Stage 2 involves employing cognitive interventions utilising CBT to help the PTSD individual change the meaning of their traumatic event.  

Stage 3 focuses on emotional processing of traumatic events through imaginal exposure incorporating hypnosis. Individuals are exposed to their fears in a safe environment, allowing them to re-evaluate the traumatic event and their reactions to it (Alladin, 2008: 111).

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CBH and its use in overcoming Acute Stress Disorder

Bryant et al (2006) investigated the use of CBT combined with hypnosis for trauma survivors with acute stress disorder. Patients were assessed 3 years after treatment and those patients that had received CBT and CBT integrated with hypnosis reported less re-experiencing and less avoidance symptoms than those receiving supportive counselling.

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CBH and Anxiety

Cognitive Behavioural Hypnotherapy is an example of a multi-modal psychotherapeutic approach used within the successful treatment of anxiety. A study by Schnur et al (2009) confirmed that CBH was used successfully to reduce negative affect and increase positive affect in 40 female patients undergoing radiotherapy for breast cancer. 

Hypnosis is effective in treating anxiety and anxiety disorders because it allows exposure to the reminders of anxiety in a system that promotes safety and relaxation, so the individual can feel safe in the presence of the triggers that cause the anxiety reaction. In this way, the individual learns to feel safe in situations that would previously have elicited anxiety (Bryant, 2008).

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Hypnotherapy and its use in overcoming Generalized Anxiety Disorder

Schoenberger (2000) states that as well as treating phobic anxiety, panic attacks and post-traumatic stress disorder, hypnosis can also be used in treating Generalized Anxiety Disorder. Zhao et al (2005) compared the clinical efficacy of hypnotherapy with Alprazolam in the treatment of Generalized Anxiety Disorder and concluded that hypnotherapy was effective in treating GAD.

This confirms that hypnosis has a powerful role to play within alleviating anxiety, as suggested by Smith (1990) who provides several clinical examples illustrating the use of hypnotherapy in treatment of generalized anxiety, phobias and post-traumatic stress disorder.

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Alladin, A. (2001). Cognitive Hypnotherapy. An Integrated Approach to the Treatment of Emotional Disorders.

Bryant, Richard A. (2008). Hypnosis and Anxiety: Early Interventions. In Nash, Michael R. (Ed); Barnier, Amanda J. (Ed). The Oxford Handbook of Hypnosis: Theory, Research, and Practice. (pp. 535-547). New York, NY: Oxford University Press.

Bryant, R. A., Guthrie, R. M. & Moulds, M. L. (2001). Hypnotizability in acute stress disorder. American Journal of Psychiatry, 158: 600-04.

Bryant, Richard A.; Moulds, Michelle L.; Nixon, Reginald D. V.; Mastrodomenico, Julie; Felmingham, Kim; Hopwood, Sally. (Sep 2006). Hypnotherapy and Cognitive Behaviour Therapy of Acute Stress Disorder: A 3-year Follow-up. Behaviour Research and Therapy, Vol 44(9), 1331-1335.

De Piano, F. A. & Salzberg, H. C. (eds.) (1986). Clinical Applications of Hypnossi. Norwood, NJ: Ablex.

Du-Fay Der & Philippa Lewington (1990) ‘Rational Self-Directed Hypnotherapy: A Treatment for Panic Attacks’, American Journal of Clinical Hypnosis, Vol. 32, Issue 3, pp. 160-167.

Iglesias, A. Ph.D. & Adam Iglesias (2005): Awake-Alert Hypnosis in the Treatment of Panic Disorder: A Case Report, American Journal of Clinical Hypnosis, 47:4, 249-257.

Nolan, Maria. (2008). Hypnosis to Enhance Time Limited Cognitive-Behaviour Therapy for Anxiety. Australian Journal of Clinical & Experimental Hypnosis, Vol 36(1), 30-40.

Schnur, Julie B.; David, Daniel; Kangas, Maria; Green, Sheryl; Bovbjerg, Dana H.; Montgomery, Guy H. (Apr 2009). A Randomized Trial of a Cognitive-Behavioral Therapy and Hypnosis Intervention on Positive and Negative Affect During Breast Cancer Radiotherapy. Journal of Clinical Psychology, Vol 65(4), 443-455.

Schoenberger, Nancy E. (2000). Hypnosis in the Treatment of Women with Anxiety Disorders. In Hornyak, Lynne M. (Ed); Green, Joseph P. (Ed). Healing from Within: The Use of Hypnosis in Women’s Health Care. Dissociation, Trauma, Memory, and Hypnosis Book Series, (pp. 45-64). Washington, DC: American Psychological Association.

Smith, W. H. (1990). Hypnosis in the Treatment of Anxiety. Bulletin of the Menninger Clinic, Vol 54, 209-16.

Wijesinghe, W. (1974) ‘A vomiting phobia overcome by one session of flooding with hypnosis’, J. Behav. Ther. & Exp. Psychiat. Vol. 5, pp. 169-170.

Zhao, Yan-Hong; Shan, Yi-Hui; Ma, Lian-Hua; et al. (Aug 2005). Clinical Efficacy of Hypnotherapy in the Treatment of Generalized Anxiety Disorder. Chinese Mental Health Journal, Vol 19(8), 543- 544.

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