Reflective Journal Entries: Blushing and hyperhydrosis

From Tracy Jones, with thanks

A client contacted me for help with anxiety, causing blushing and hyperhydrosis. 

During the first session we found that she became anxious in situations where she felt ‘put on the spot’ and where she felt that all attention was focussed upon her, such as a group discussion where she was invited to speak. The symptoms were worse where men were present. During the session I explained the stress response, discussing the fight, flight, freeze response and how the mind works in two parts, the conscious and unconscious. The client also disclosed that she was in the process of leaving a relationship and beginning a new one and experienced difficulties in expressing her feelings, something that she felt was endangering her new relationship. She explained how she felt there was something blocking the words form coming out, while she spoke about this, she unconsciously placed a hand to her throat. The client also expressed difficulty in making decisions and seemed to have a lack of self belief, having to ask a multitude of people before deciding the best thing to do.

I conducted a new behaviour generator to address the decision making. I also used metaphor processing during the trance where she visualised a blockage of some sort in her throat (where she had pointed to in our discussion) and turned it into an object or form. I gave suggestions of how this may look, such as colours, or textures. I asked her to visualise it rising up in her throat and dislodging itself, eventually leaving her mouth and body completely. I then asked her to destroy it by using all of the elements. I asked her to visualise herself burning it until it turned to ashes, then throwing into a nearby stream which dissolved the ashes, leaving only dust which she buries in a hole in the ground. I then guided her to imagine seeing a vapour rising up and being carried away into the atmosphere until just pure energy was left floating in front of her. This represented the positive aspects that she could learn from the blockage which returned to her being, helping her in positive and beneficial ways. During the future pace we worked around seeing herself feeling more confident and believing in herself to make the right decisions for herself and her sons, as well as seeing herself expressing herself, as her words are important and valid.

After the session she told me how the metaphor processing had been very powerful for her. She has visualised a block of wood leaving her throat. She disclosed that in the past she had tried Reiki, and had been told that she had shakra blockages connected to her throat. She felt that the blockages had been removed during the session. She also told me how she had already begun to feel better at the beginning of the session as everything had made sense regarding the stress response and how it had turned into a vicious circle for her as she had become fearful of feeling anxious in some situations which made her more anxious and so on.

In the follow up appointment the client had made some excellent progress. She had been more able to express herself freely, she had made a couple of major decisions regarding her business and was questioning whether the new relationship was the right thing for her and her sons or more as a ‘crutch’ as she had been in a relationship for so long, she questioned if she had jumped into another in fear of the unknown, being alone.

In response to the positive feelings she experienced just from knowing that the stress response was causing her anxiety and the downward spiral she experienced in relation to being fearful of feeling anxious in certain situations, I felt that using methods to access the reasons behind the behaviour would be useful. It seemed that if the client was aware of the reasons why it was happening, she could reason with it and change her behaviour.

I decided to use affect bridge during the trance work to take her back to the first time she felt those feelings, getting to the root cause of them. I was quite wary of using this method in light of ‘false memory syndrome’, though felt that this may give the client the best chance of moving on, and knowing that with my advanced knowledge, I was aware of how to deal with a situation which may arise involving false memory.

I asked her to experience the feelings where she feels those symptoms of feeling her skin reddening, becoming clammy etc. She told me that she was at work, surrounded by men and they were all talking to her, asking her questions. She described how she felt hot and red, clammy, small, on the spot, all attention on her. I then asked the unconscious mind to take her back to an earlier time when she’d felt the same feelings. Suggesting that she may be younger during this experience. She told me how she was about 6 or 7, at school, in the girls toilets and a group of girls were pointing and laughing at her. She felt her skin becoming red, she had clammy palms and she felt embarrassed. I then asked the unconscious mind to take her back to the very first time she ever felt this way, again suggesting she may be even younger this time. She described how she was about 3 or 4 and in nursery when she’d been sat at a table with a group of her peers. She felt unwell and a boy had commented to the teacher that she wasn’t well. As everyone turned to look at her she vomited all over the floor. She described how she felt embarrassed as everyone watched her.

I explained that as a child she didn’t have the knowledge, skills and resources to be able to effectively deal with the discomfort and the emotions surrounding the situation. Though as an adult this is something that we can do, as we are more able to reason in these situations. I asked her adult self to give the child self a message which would make the child self feel better and deal with her feelings more positively. When I asked her to vocalise what this message was (I feared that this may be a crucial part of the therapy and may not be remembered out of trance) she told me that there was no verbal message, but instead a big hug to reassure the child self that everything was okay.

After the trance work she disclosed that during her childhood her parents had difficulty in physically showing affection. She said that she had remembered that day where she was ill at nursery, as her mother had collected her, there was no hug to comfort her. She told me that the session had given her exactly what she needed as she was now able to recognise where the issue had originated from and had been able to go back, giving the child self the physical reassurance she had needed.

I went on to re-enforce this. As she had given me her beliefs on the subject, I went on to say that when work like this is completed, the unconscious believes that the situation has, in reality been changed and the child self was given what she needed at that time, therefore this would now affect her behaviour in positive ways as the unconscious mind would begin to make her act as though the initial, anxiety provoking event had happened differently.

This client has taught me many things. Although she initially contacted me with hyperhidrosis , the real problem was more deeply seated and the excess sweating was merely a symptom. Initially I felt that the initial presenting problems should be addressed frist as this is the reason she had sought help. However, after meta questioning, she ad revealed that the immediate, pressing issues in her life were the difficulties with expressing herself which were endangering her new relationship, and the difficulty with decision making which she needed to address for the sake of her business. Therefore I decided to address these issues first as they needed immediate attention, knowing that the other issues could be addressed in a subsequent session.

I also learned that different clients respond well to different methods. From my perspective, I never thought of metaphor processing being a powerful tool in hypnosis, though for this client it went along well with her beliefs and past experiences with other therapies, therefore was very effective for her.

I also experienced the use of the affect bridge technique, which again proved very powerful for this client. I was able to recognise that this technique may suit the personality, beliefs and values of the client in order to bring successful change. I was also privileged to gain an insight into how experiences early on in life can have such a huge impact on life as an adult. The experience which had been affecting her in such a distressing way may be viewed as a simple, normal childhood experience which had many other individuals experienced, may have been forgotten about with the unconscious dismissing it as insignificant. However, for whatever reason, it was such of such significance to the client as a child that the unconscious had deemed it necessary to continue to protect her in similar situations for many years to come. After seeing this client I felt privileged and honoured to have been allowed such an insight into her life, and very fortunate to have gained so much knowledge, experience and enlightenment from our sessions.

She was extremely pleased with the service she had received and I felt much more confident in my skills as a practitioner as the client was full of praise for me, stating that she would recommend me to anyone and everyone. She told me that I had helped her 100%. This was amazing feedback, the feelings I had knowing that I had influenced someone’s life positively in such a way was phenomenal.

After conducting several hypnotherapy sessions now, I have noticed that a weak point that I have is timing. On reflection of the sessions I have done so far, I feel that I am taking too long during the initial questioning process. I find that much of the time, people have been holding back their feelings and emotions regarding the presenting issue, and as they have come to see someone who listens intently and is interested, asking questions etc, they feel relieved and are eager to ‘offload’. Also, I have found that many clients approach me with one primary issue, though during the beginning of the session, they disclose that they are struggling with many different areas of their life, or have various other problems they would like help with addressing. Although I think this needs to be encouraged, I feel that as a therapist, I need to filter the information out, finding the specifics of details I need to enable me to work effectively in the trance work. Also. I need to remember and to accept that not all issues can be addressed and solved in the first session, and in order to provide the best service to the client, subsequent sessions are normally needed.

I have discovered that I seem to allow the client to ruminate, and dwell on the negatives of the issues concerned for a bit too long! I recognise that I need to question more effectively in order to draw the information that I need from the client more concisely, before reframing it in order to use positive suggestions during the trance.

Now that I am more aware of these facts, I will be incorporating them into my sessions in the future. As I begin to see more clients, timing is an important factor in professional practice. If I have several clients in succession over a period of a few hours or a day, it would seem very unprofessional of me to be running hugely late. With life being so busy for many people, clients expect, and need appointments to be on time as much as possible, so I recognise that I need to progress in this area. I am becoming more accepting of the fact that it is often impossible to address several issues effectively and fully in a single session. This has been one of my mistakes in the past, though I am now learning to choose the most pressing issues to work on first, then accepting that others can be addressed in further sessions. My last case study shows that I am progressing in this area, as I chose to address the decision making and inability to express emotions during the first session, with a little work on the anxiety being done during the future pacing, then the anxiety was addressed mainly in the second session.