Hypnotic Exposure Therapy (HET)
In cognitive behavioural therapies the term exposure is used to described limited experiencing of the situation or trigger that has been causing an anxiety and or phobic response. Clark & Beck (2012,p129 cited in Robertson 2013,p275) refer to it as “systematic, repeated and prolonged presentation of external objects, situations or stimuli, or internally generated thoughts, images or memories, that are avoided because they provoke anxiety“.
How does exposure work?
There are a number of rationales or theories:
- Stress inoculation therapy: from CBT based work suggests that repeated exposure increases ability to cope.
- Reframing: Using hypnotic or NLP based suggestion the nature of the experience can be modified.
- Acceptance: from mindfulness, teaches that accepting the fear and allowing it to pass without conflict reduces associated discomfort since the fear of terminal harm is disproved and additional anxieties about the situation are removed.
Does exposure therapy work?
If basic principles are followed then exposure therapy can be very effective. It is a corner stone of NICE recommended cognitive behavioural psychological therapies, and there is huge research evidence already in existence. CBT and hypnosis based exposure therapy is part of the range of recommended anxiety and phobia treatments by Anxiety UK (man UK anxiety charity).
There are however required elements. Different authors and researchers have defined them slightly differently, Clark & Beck 2010,p240 cited in Robertson 2013,p281) for example point out that the therapy needs to be :
- Planned and systematic
- Predictable and controllable
- Graded exposure starting from moderate
- Prolonged exposure leading to a sense of mastery
- Occurs regularly, i.e. daily
- Ended once anxiety has reduced substantially
- Prevention of avoidance and safety seeking
- Automatic thoughts are properly questioned
- Acceptance of feelings and focus on feared situation
The nature of hypnotherapy based psychotherapy sessions is such that sessions are by nature planned, controlled and agreed, graded appropriately, permit repeatedly if recorded, end appropriately, reframe behaviours and thoughts and promote acceptance. Non trance, light trance or traditional relaxation trance states can all be used to provide hypnotic exposure therapy.
What would be addressed with exposure therapy?
CBT or hypnotic exposure therapy methods are used for phobias, performance, panic attacks, anxiety and generally any situation where the triggers or environment generally have caused a sense of fear, anxiety or panic.
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