The Issue of Management of Depression and Anxiety
The issue of management of depression and anxiety is very relevant at the current moment because numerous people all over the world suffer from these disorders. The current work will cover one of the most beneficial methods of treatment of these health issues, namely hypnotherapy. It is notable that there are some differences between treatments of anxiety and depression, and they will be discussed below. Much attention will be paid to the impact of therapists on the consciousness and unconsciousness of individuals who suffer from stated disorders. It is needed to handle numerous issues and ethical matters during the treatment of patients with depression and anxiety. This essay will discuss whether hypnotherapy is the appropriate method of treatment of depression and anxiety which provides the maximum positive effect and has the minimum threat to the patient’s condition.
General Information about Depression and Anxiety
Depression “is a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration” (Marcus et al., n.d.). The above-mentioned health issues can become chronic if the illness was not appropriately treated in due time. As it is noted in the article “Excess Risk of Chronic Physical Conditions Associated with Depression and Anxiety,” “Depression and anxiety have been reported to be associated with chronic physical conditions” (Bhattacharya, Shen, & Sambamoorthi, 2014). Depression can lead to a personal inability to perform daily responsibilities and take care of oneself (Weightman, Air, & Baune, 2014). Moreover, this disorder can trigger suicide. It is notable that the proneness to depression is not dependent on the income of the person.
A person can suffer from different variants of depression. The major defining feature of these episodes is the occurrence or non-occurrence of manic episodes; thus, “bipolar disorder is a chronic mood disorder characterized by the presence of at least one manic episode” (Cerimele et al., 2013). A depressive episode is characterized by such symptoms as loss of interest, growth of fatigability, and depressed mood. There are mild, moderate and severe depressive episodes taking into account the severity of symptoms and the ability of the individual to perform everyday tasks (Marcus et al., n.d.). Talking about bipolar affective disorder, it is characterized by the combination of depressive and manic episodes which are separated by “periods of normal mood” (Marcus et al., n.d.). During manic episodes, the person feels the raise of energy and elevated mood (Golden, 2012). As a result, this leads to over-activity and lowered the need for sleep (Leibenluft, 2011).
The major illness that coexists with depression is anxiety disorders like obsessive-compulsive disorder, post-traumatic stress disorder (also known as PTSD), generalized anxiety disorder, panic disorder, and social phobia (Devane, Chiao, Franklin, & Kruep, 2005). The general understanding of anxiety is provided in the work “What Is an Anxiety Disorder?” (Craske et al., 2009). The authors state that “anxiety is a future-oriented mood state associated with preparation for possible, upcoming negative events” (Craske et al., 2009). It may develop before the described disorder or be a consequence of it (U.S. Department of Health & Human Services, 2011). For example, the person can suffer from PTSD after undergoing a terrible ordeal like a natural disaster or accident. Thus, that means that the major reflections of depression and anxiety are usually interwoven with each other.
Treatment of Depression and Anxiety by Hypnotherapy
At the current moment, depression and anxiety are successfully treated by hypnotherapy and the use of hypnosis. It is considered to be “an animated, altered, integrated state of focused consciousness, that is, controlled imagination” (Spiegel & Greenleaf, 2006). At the same time, hypnotizability is considered to be “some change brought about hypnotic induction” (Kirsch et al., 2011). The therapist puts the patient who suffers from the described disorders into the mental state called a trance. The purpose of a trance is to enable the patient to focus on a particular topic and the therapist’s suggestions. It is notable that the individual who undergoes hypnosis does not lose self-control and free will (Airosa et al., 2011). Moreover, this person obtains the ability to take control of individual awareness (Enck et al., 2013). Hence, hypnosis is considered to be an active and directive means of intervention.
The major aim of hypnosis as the way of treatment of depression is to target the root cause of the issue and develop better-coping behaviors (Chiarioni, Pallson, & Whitehead, 2008). In the majority of cases, the causes of depression are forgotten or suppressed (Slavich & Irwin, 2014). The result of this is that the patient breaks the connection between these events and experience negative feelings. The patient receives help in addressing the underlying cause of this disorder and in finding more effective coping behaviors; thus, “intervention participants revealed increased active coping and decreased negative mood” (Antoni, 2013). With regard to therapists, they work on the conscious mind and subconscious mind of patients. They address the personal perception of the event for the improvement of mood and self-esteem as well as recovery of the patient’s feeling of freedom (Oneal, Patterson, Soltani, Teeley, & Jensen, 2008). The pessimistic and negative thoughts, which usually accompany depression, are also decreased. Applied hypnotherapy combines imagery and suggestion to effect positive changes in the unconscious processes of the person who suffers from depression.
Unlike the treatment of depression, hypnotherapy used for the treatment of anxiety is oriented to the search of the roots of this disorder and endeavors to change the personal perception of the past events even by releasing emotions (Katzman et al., 2014). Thus, therapists help patients to break the closed cycle of feelings of guilt and painful thoughts, hopelessness, and worthlessness. The powerful self-suggestion helps to develop a more positive outlook on life and events. Hypnosis in the treatment of anxiety has the aim to facilitate making an effective response in a difficult situation (Gallagher et al., 2013).
The Impact of Conscious and Unconscious Characteristics
As it was mentioned above, therapists simultaneously and directly handle both conscious and unconscious mental processes of the patient. The approach is also known as the waking state reframing (Yapko, 2006). It is widely used for the treatment of depression by the understanding, reframing, and changing of labels and beliefs which “have been imprinted by trauma and trough their repetition” (Yapko, 2006). Also, the waking state reframing is applied to resolve the problem of personal anxiety by setting positive goals and establishing “an expectancy that these goals could and would be reached” (Yapko, 2006). Thus, this is one of the major steps in countering the negative expectations of patients.
The success of hypnotherapy is based on the fact that the patient remains to be focused and at the same time his body is relaxed. Among the most obvious indicators of hypnosis are breathing changes, infrequent eye linking, relaxed facial expression and body position, and increased blood flow (Yapko, 2006). The patient feels the combination of physical easiness and mental awakening. Hence, the conscious mind becomes less alert since “consciousness went out altogether to come into existence again at a later moment” (Ward & Wegner, 2013). At the same time, the therapist works with the mind of the patient. During this therapy, the mind is considered to be divided into two parts, namely conscious and unconscious. The patient is deemed to have control over the conscious part of the mind, while the unconscious one (or subconscious) remained to be under little control or totally uncontrolled (Yapko, 2006). In other words, the conscious mind is part that thinks what to say and to do, while the unconscious mind is part that is responsible for actual actions and sayings. In fact, therapists address the subconscious part of mind because their aim is to change the existing beliefs and feelings to make the patient to feel better, instead of simply saying what to do. Moreover, the application of hypnosis “increased experimental flexibility by allowing target processing of specific sensory events” (Landry, Appourchaux, & Raz, 2014). Therapists usually use metaphors for the improvement of the patient’s condition. Instead of simply saying that a person is no longer afraid of riding a horse, a therapist makes the suggestion to the patient that “riding a horse is like riding a car”. Usually, several suggestions are used in the hypnotherapy treatment of anxiety and depression because the therapist does not know which of them will be better perceived by the patient.
Specialists utilize imaginative and relaxation techniques as well as special audiotapes for hypnosis. The process of putting the patient into a deep state of emotional and physical relaxation during the hypnosis opens “the doorway to the unconscious” (Yapko, 2006). Hence, the therapist receives the ability to provide information that can more effectively and efficiently change the patient’s behavior. As a result, the emotional and physical background of stress can be reduced easily and faster.
Major Issues, Boundaries, and Ethics in the Counseling Hypnotherapeutic Relationship
There are several issues connected with the treatment of depression and anxiety using hypnotherapy. Apparently, therapists should pay considerable attention to the patient’s condition and problems. If the therapist does not obtain a clear understanding of what should be treated and how the treatment should be performed, hypnosis will not have the necessary result. Moreover, it can even hurt the individual or increase depression or anxiety because there is the risk that therapists will create false memories as a result of the unintended suggestions. The reason is that “hypnosis leads to accurate memory reporting increases resilience to misleading information and decreases the likelihood of false recall” (Wagstaff, Wheatcroft, & Jones, 2011).
The major aspect of hypnotherapy is that it should be performed by a specialized licensed therapist who has appropriate skills and knowledge (Sucala et al., 2013). It is notable that hypnosis cannot totally replace other types of psychotherapy since “the best use of hypnosis is not to replace traditional approaches to anesthesia or other medical treatments, but rather to be used as an adjunct to best clinical practices” (Montgomery, Schnur, & Kravits, 2013). Usually, hypnotherapy is used to help a person recover from possible repressed memories which can be connected with their psychological problems.
Hypnotherapy is closely connected with ethics. Since a therapist is working with both conscious and unconscious state of minds, they should pay attention to the elimination of the possibility of breach of any ethical norms and avoidance of harm. One of the major responsibilities of the therapist is to heal the human mind with the least harm to a patient. In fact, the patient should clearly understand what is going to happen prior to beginning the therapy. The person should give their consent to perform the psychological intervention. Moreover, the free and unchallenged opportunity to refuse to undergo hypnosis at any time should be secured by the therapist. The additional attention should be paid to confidence because under hypnosis, the patient can reveal sensitive and personal information. The therapist should respect the patient and secure all the information received during the hypnotherapy. Furthermore, they should obtain written permission from the patient on writing or recording the session (de Pascalis, Varriale, & Cacace, 2015).
Evaluation and Analysis of Evidence-Based on Hypnotherapeutic Intervention for Working with Depression and Anxiety
The hypnotherapy intervention has numerous benefits over the other methods of treatment of anxiety and depression. These benefits are based on the fact that the therapist directly and simultaneously establishes connections with conscious and unconscious states of patients’ minds. Apparently, the successful application of hypnosis to treatment of depression and anxiety leads to the improvement of the patient’s mood and self-esteem as well as recovery of the feeling of freedom by changing or replacing personal negative attitudes to past or future events. The therapist helps the patient not only to set concrete goals but also to believe that these goals could be and would be reached; thus, “clinicians take full advantage of all potential hypnotic effects to help patients achieve a number of treatment goals” (Jesen & Patterson, 2014). The additional benefit of such treatment is its cost-effectiveness because patients are not obliged to spend money on purchasing medication or procedures, among others (Hammond, 2010). Moreover, it should be stated that hypnotherapy can be performed outside health care providing institutions (Dickson-Spillmann, Haug, & Schaub, 2013). People can use methods of self-talk and self-hypnosis in any place and at any time (Finlayson et al., 2015).
However, the application of this method is connected with various challenges. The intensity of treatment to a considerable extent is dependent on the patient’s ability to be in a state of hypnosis, but not only on the therapist’s skills (Smith, 2011). At the same time, the knowledge and professionalism of the practitioner are very important for the avoidance of the negative impact of hypnotherapy on the individual. Both the patient and therapist should clearly understand that this method of treatment cannot replace other methods and cannot be used in all cases. For example, it is not appropriate for a person with psychotic symptoms. Hence, the value of hypnotherapy as a way of helping to manage depression and anxiety should not be overwhelmed.
In conclusion, the current work studies hypnotherapy as a treatment of depression and anxiety as well as the therapist’s influence on conscious and unconscious states of the patient’s mind. The major difference between treatments of the described disorders is the goal of the psychological intervention, which is either the development of better coping behavior or the transformation of personal perception of past events. Practitioners use hypnosis to relax the patient’s body and focus their mind on finding the solution to the described disorders. The considerable influence on the personal mind is connected with various issues and boundaries. The therapist should have enough knowledge and experience for the clear determination of the patient’s problems and avoidance of harming the individual by the creation of wrong memories. It is crucial to understand that the described methodology cannot be applied for the treatment of all types of psychological problems. Hence, it cannot totally replace other methods of treatment.