Reflective Journal Entries: Blushing

From Tracy Jones, with thanks

Reflective Journal of practice:

One of my first clients presented with blushing. He explained that although he felt confident in his abilities at work, he found himself blushing profusely when asked to talk about the job either on a one to one basis or within a group. He told me how he becomes very stressed before and during meetings and also suffers the same symptoms during social gatherings.

During the meta questioning he told me that many male family members also displayed the same behaviour, including his sons. His mother and father had died at quite a young age.

As a new therapist, I took a while to decide the best intervention to use for his problems. He had explained that he had become fearful of blushing within these situations and I felt that the main problem was that he had almost become traumatised by the feelings he experienced in certain situations and this was affecting his ability to function effectively.

I decided to use the phobia cure, which I had thought was a strange technique to use as this was not a phobia, though I felt that because of his fear of these situations it may be successful if used with other methods too. During the trance I asked him to imagine himself in front of a cinema screen with a remote control in his hand. I asked him to remember one of the situations where he felt most affected by his symptoms. He played through the ‘film’ several times, each time changing it slightly, adding colour, making the picture bigger etc. As he appeared calm in trance during this, I asked him to play the film again, this time with him stepping into the screen. We then played it through again with him in the picture this time, noticing how his skin was of normal colour, feeling calm, relaxed, confident etc.

I went on to use a new behaviour generator as I felt, being a new therapist, not so confident in my abilities with the fast phobia cure, and wanted to give him the best chance of success. The future pacing was based upon the following two weeks where he had lots of meetings at work planned. I encouraged him to see himself in the meetings feeling confident etc.

After the session he reported feeling more relaxed than he had for a long time and told me he had slept really well that night where he had struggled to sleep previously due to worry and stress.

After a longer period of two weeks the client reported that he had felt more relaxed and less stressed, though the blushing problem remained.

In evaluation of my performance I felt that during the meta questioning I didn’t reach the root cause of the blushing in certain situations which for this client, may have been important. If he could have found out the reasons behind the problem, he could have possibly reasoned with them to come to a solution. I also felt that the therapy could have been more effective had I asked to see him for a second session. Being a new therapist I guess I felt ‘awkward’ at asking him to arrange a second session, taking up his time and money. I realised from this experience that for the therapy to work effectively I would always ask for a follow up appointment, and now, when perspective clients contact me, I always make it clear that two sessions at a minimum are required.

Also during the meta questioning, I think as a new therapist I felt reluctant to ‘pry’, not wanting to ask questions which may make the client feel uncomfortable. However, I realise now that to get to the bottom of issues, this is something which is often essential, and can be done in ways which minimise discomfort for the client and can provoke their thoughts on the subject, helping them to think about things differently.