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Taking care of yourself doesn’t mean me first, it means me too

Uncategorizedon May 15th, 2018No Comments

Mental Health Awareness Doesn’t Mean Me First – It Means Me Too


vision board, determination, motivation, weight loss, quit smoking

Anxiety, depression, Different Approaches, Mindfulness, Quit Smoking, Self Esteem, Stress, stressed out, Weight Losson February 6th, 20183 Comments

Vision Board workshop



For info, please do not hesitate to contact Barbara, at:

Clinical hypnosis may be career of the future

Uncategorizedon May 13th, 2017No Comments

Clinical hypnosis may be career of the future

April 14, 2017

Clinical hypnotherapists can help employees cope with the negative impact of stress and other psycho-social contributors that may lead to future depression.


depressBy Sheila Menon

Everyone can expect to suffer from depression at least once in their lifetimes. This global problem affects 20 million people in the US and an estimated 40% of Malaysians.

Even the Malaysian Employers Federation (MEF) concurs that there has been a visible increase in the number of work-related depression cases. The problem is growing and by 2030 depression is expected to become one of the most debilitating illnesses, causing loss of income, loss of workdays to the job industry and increased expenditure to healthcare providers and patients.

Depression is often contagious resulting in families and friends being dragged into feelings of misery, helplessness and low self-esteem.

There are two ways of tackling the problem. The first is by providing better education and coping skills so that people are more resilient or inoculated against the disease. The other is through effective psychotherapy, including clinical hypnotherapy to treat people with this illness.

There are three primary causes of depression; biological, psychological and social. Biological components may sometimes need medication. But increasingly, the therapeutic relationship between patient and therapist is considered important.

In fact talking therapies which include clinical hypnosis are considered a first treatment option for mild and moderate depression. Clinical hypnosis is an ideal rapport-based treatment, and research also indicates that hypnosis itself can specifically target the symptoms of depression and reverse their effect.

Clinical hypnosis to help employees cope with stress

This year the World Health Organisation launched a one-year awareness campaign and the London College of Clinical Hypnosis (LCCH Asia) has expanded its training to provide future therapists with the skills and tools to help both individuals and organisations deal with depression.

This stems from the growing belief that consultants will be required to provide specialist training to the industry. These consultants will help employees acquire the skills to cope with the negative impact of stress and other psycho-social contributors which may lead to future depression.

In short, clinical hypnosis just may be the career of the future, establishing a new group of professionals who are equipped to provide preventative training for groups as well as therapeutic treatment for patients.

Asian culture often avoids conversation about emotions, which means that Malaysians are sometimes reluctant about reporting depression. They may worry about being labeled as crazy, or considered weak or lazy.

People with depression can find it very hurtful to be told to snap out of it or buck up. The clinical hypnotherapist therefore has an important role to play and research shows that 90% of people can recover from depression with the right support and help.

Growing acceptance of clinical hypnotherapy in Malaysia

In Malaysia, the legislation governing Allied Healthcare and Complementary Medicine professionals means that more people are open to visiting clinical hypnotherapists.

In the Klang Valley alone, 40% of patients welcome the opportunity to see alternative therapists. An increased number of medical professionals offer clinical hypnosis as an adjunct to mainstream treatment and clinical hypnosis is also available in a growing number of hospitals.

One of the reasons for the popularity of clinical hypnosis is that it treats the biological, psychological and social aspects of the disease. This means it can provide relief for the associated symptoms of insomnia and physical discomfort as well as the mental anguish, intrusive negative thoughts and low self-esteem common to depression.

Clinical hypnotherapy has the additional benefit of combining well with all other forms of psychotherapy and is shown to enhance the efficacy of other therapy because clinical hypnosis works with both the conscious (analytical mind) and the unconscious (emotions).

Clinical hypnosis is part of a new approach to medicine and healthcare known as integrative medicine, which is expected to put the heart back into medicine.

Paruresis Treatment – Pee Phobia

Phobiason November 20th, 2014No Comments

By Jorg Thonnissen – Psychologist and Hypnotherapist in Perth

These days I deal quite frequently with clients who work in the mining industry and as a consequence of their employment condition have to provide urine samples to show that they are drug free. It isn’t uncommon to find that peeing into a cup while being observed can create a condition called paruresis.

In other words, that person finds it difficult or impossible to urinate when other people are around – something that then sets off a whole rafter of psychological issues which can be likened to performance anxiety. This challenging condition is also known by a number of other names such as ‘avoidant paruresis’ , ‘shy bladder syndrome’, ‘psychogenic urinary retention’ or ‘pee-phobia’.Paruresis is related to social phobia and it is ranking in severity second to the fear of public speaking (Loriente, 2007; Soifer, Zgourides, Himle, & Pickerling, 2001).

It affects men and women from all walks of life. On the lower scale, paruresis is an event that occurs now and then. For instance, one may find that while in a public urinal one is unable to urinate when flanked by other men. In more severe cases, a person suffering from paruresis can only urinate when complete privacy is ensured.

From a psychological perspective, a person with paruresis could be of an overly sensitive, shy, conscientious personality and thus may be fearful of being judged or criticised by others or just simply crumbles under the enormous pressure that builds up when they are expected to do it ‘there and then’.

Paruresis as such is not a physical condition hence an urologist or GP can do little because nothing is wrong with the person’s urinary tract. It is all about relaxing the urinary sphincter so that the urine can flow from the bladder down the urethra but because anxiety overstimulates the person’s nervous system and literally ‘clamps’ the sphincter shut. Thus the cycle begins whereby the failure to urinate then increases the anxiety which makes matters worse.

This issue can be addressed with the help of relaxation strategies, hypnotherapy and CBT in order to help reduce anxiety. In addition, if the experienced difficulties are threatening my clients’ job security I usually also write a letter that can be presented to the employer or staff doing the drug and alcohol testing ensuring that the client gets the right amount of ‘space’ or suggesting that other methods should be employed. Combined, this usually does the ‘trick’.


Loriente, Z. C. (2007). [What is paruresis or shy bladder syndrome? A transdisciplinary research]. Actas urologicas espanolas, 31(4), 328-337.

Soifer, S., Zgourides, G. D., Himle, J., & Pickerling, N. L. (2001). Shy bladder syndrome: Your step-by-step guide to overcoming paruresis: New Harbinger Pubns Inc.

Which Weight Loss Programs Work and The Brain Structures That Control Thirst and Hunger

Uncategorizedon August 16th, 2014No Comments

What brain structure(s) control thirst and hunger, and how is this done?



From an anatomical point of view, the hypothalamus plays a central role in stimulating and processing feeding-related stimuli. Its activity may be modulated by the activity of other functional areas including the insula (which is involved in interoceptive monitoring) and the prefrontal cortex (which is responsible for cognitive control of impulses) (Carlson, 2012).

Neuroimaging studies have found that hunger is associated with the hypothalamus and insula, as well as additional areas involved in reward and motivation processing. These areas include the orbitofrontal cortex, the anterior cingulate, the parahippocampus and the hippocampus, the thalamus, caudate nucleus, precuneus, putamen and cerebellum.

In contrast, satiation relies on a neuroanatomical network that includes the ventromedial and dorsolateral prefrontal cortices, and the inferior parietal lobule.

Furthermore, research has found that insulin and free fatty acids may function as metabolic modulators of postprandial neuronal events in the brain (Tataranni et al., 1999).


In generating the sensation of thirst, studies have shown that the anterior cingulate cortex plays a critical role (Denton et al., 1999). In addition, similarly to the sensation of hunger, the insula is also a critical component in the generation of thirst signals, and together with the anterior cingulate may act as cortical effector regions for thirst.

Furthermore, a major sensory site implicated in the generation of thirst is the lamina terminalis in the forebrain. Finally, signals are integrated in several intergrative sites across the brain, including the nucleus of the tractus solitarius, the lateral parabrachial nucleus, the raphe nuclei, the median preoptic nucleus, and the septum.

However, much of the pathway involved in the generation and processing of thirst remains to be elucidated (McKinley, Denton, Oldfield, De Oliveira, & Mathai, 2006).

Another interesting line of research suggests that the neuropeptide oxytocin can act as an anorexigenic signal in the central nervous control of food intake. In men, it has been found that oxytocin significantly reduced snack consumption, and specifically restraining the intake of chocolate cookies by 25%.

In addition, oxytocin attenuated adrenocorticotropic hormone and cortisol, and reduced the meal-related increase in plasma glucose. However, hunger-driven food intake was not affected, suggesting that oxytocin may regulate non-homeostatic, reward-related energy intake beyond its role in social bonding (Ott et al., 2013).


How do hunger and thirst interact?

 One of the main processes responsible for food intake is ghrelin, which acts in the hypothalamus to stimulate food intake. Ghrelin administration, however, also inhibits thirst.

Recently it has been proposed that decreased drinking behavior can be the cause of decreased food intake. One of the ways in which this happens is through obestatin, which is a posttranslational product of ghrelin preprohormone (Zhang et al., 2005).

However, thirst is also influenced by non-thirst related cues, in addition to those associated with food intake. Several such stimuli play a role, including nauseogenic stimuli, anxiety (e.g. psychogenic polydipsia), and ambient circulatory pressure. For example, changes in mean arterial pressure modulate pharmacologically driven water drinking.

Increased arterial pressure affects high- and low-pressure baroreceptive mechanisms, which in turn may not only reduce vasopressin suppression, but also the drive to consume fluid. In contrast, stimuli that are hypotensive, stimulate vasopressin release and water drinking, as well as increased autonomic outflow.

Elevations in mean arterial blood pressure can buffer drinking responses to thirst stimuli, most likely through baroreflex activation, and hypotension can also alter drinking behavior when the thirst centers in the brain are not alerted to the drop in pressure because of a compromised baroreflex (Yosten & Samson, 2014).


Which weight loss program works?

 A weight-loss program based on the mechanisms discussed above would need to take into account recent advances in our understanding of how ghrelin and oxytocin modulate appetitive stimuli and food intake.

It is also known that weight loss is promoted by reducing dietary energy density. A recent study found that diets that are low in energy density promote weight loss and weight loss maintenance by opposing increases in ghrelin, and promoting increases in peptide YY, which is a peptide that is produced in the brainstem and is thought to play an important role in reducing appetite (Hill, Rolls, Roe, De Souza, & Williams, 2013).

Ghrelin is currently the only known hormone with an appetite-stimulating role, and its role in increased appetite, food cravings and food intake have received extensive empirical attention in recent years.

Ghrelin levels rise before meals and decrease after meals; it induces short-term feeding and long-term body weight increase, by not only stimulating appetite but also decreasing fat utilization; it may also be involved in the rewarding nature of food, as it acts on the mesolimbic dopamine system.

While individuals who engage in caloric restriction diets show an increase in ghrelin levels after weight loss (potentially indicating stronger craving), individuals who lost weight after weight-loss surgery did not show the same reaction. Because weight-loss surgery is an extreme and very risky procedure for weight-loss, other weight-loss strategies have been proposed to reduce ghrelin or its impact (Adams, Greenway, & Brantley, 2011).

Research shows that ghrelin levels are directly correlated with stress hormones, and that stress management interventions such as exercise and sleep contribute to reducing ghrelin secretion and corresponding appetite.

Research studies show that while short- and long-term aerobic exercise does not appear to reduce ghrelin levels, resistance exercise (e.g. weight training) can decrease ghrelin. With regard to sleep, studies show that sleep deprivation stimulates ghrelin secretion, while improved sleep reduces ghrelin (Adams et al., 2011).

Thus, there is evidence to show that behavioral interventions that focus on stress reduction and involve exercise (resistance training) and improved sleep habits can contribute to weight-loss and maintaining weight-loss via a modulation of ghrelin secretion.

While weight-loss programs would need to focus on ghrelin levels and monitor these throughout the treatment, baseline levels of ghrelin have also been identified as an important indicator for treatment success.

Thus, obese individuals who have higher leptin levels and lower ghrelin levels at baseline seem to be more resistant to weight loss after a low caloric diet intervention due to metabolic adaptation (Labayen et al., 2011).

Finally, in addition to diet and exercise, recent research suggests that oxytocin can function as an appetite inhibitor in the brain, specifically in relation to cravings that are not hunger-driven (Ott et al., 2013).

Oxytocin is classically viewed as a peptide that is critical for the reproductive physiology of mammalian females (e.g., uterine contractions and delivery, milk ejection and maternal care), but is also plays a key role in complex pro-social behaviors (e.g. maternal behavior, infant attachment, emotional control, pair bonding, reward, moral judgment, selfless decision-making and interpersonal relationships) (Cai & Purkayastha, 2013).

Oxytocin and derived peptides are currently viewed as the next generation anti-obesity and anti-diabetic drug. In a recent clinical study, oxytocin was delivered via nasal spray (an established practice for improving neuropsychiatric symptoms) multiple times per day, and this successfully lowered body weight in obese patients compared to placebo.

Furthermore, the therapeutic effect amplified with the increase of treatment duration from 4 to 8 weeks, and the effect of weight loss was reflected by decreases in waist and hip circumferences of patients.

In addition, oxytocin treatment appears to also improve the lipid profile of patients by lowering serum low density lipoprotein and cholesterol levels, and improving postprandial blood glucose and insulin levels. Additionally, this effect was not found to be a result of weight-loss, but rather to be more directly influenced by oxytocin.

Also important to note is the fact that oxytocin showed these improvements without the any negative side effects on cardiovascular, liver or kidney functions (Cai & Purkayastha, 2013).

Thus, a weight-loss program, lasting between 8-12 weeks, focusing on low caloric intake coupled with changes in sleep and exercise patterns may prove beneficial. In addition, intranasal oxytocin administration may have an added benefit in reducing weight and maintaining weight-loss, however this is not yet an approved treatment for obesity.


 Adams, C. E., Greenway, F. L., & Brantley, P. J. (2011). Lifestyle factors and ghrelin: critical review and implications for weight loss maintenance: Lifestyle factors and ghrelin. Obesity Reviews, 12(5), e211–e218. doi:10.1111/j.1467-789X.2010.00776.x

Baron-Cohen, S. (2005). Sex Differences in the Brain: Implications for Explaining Autism. Science, 310(5749), 819–823. doi:10.1126/science.1115455

Cai, D., & Purkayastha, S. (2013). A new horizon: oxytocin as a novel therapeutic option for obesity and diabetes. Drug Discovery Today: Disease Mechanisms, 10(1-2), e63–e68. doi:10.1016/j.ddmec.2013.05.006

Carruth, L. L., Reisert, I., & Arnold, A. P. (2002). Sex chromosome genes directly affect brain sexual differentiation. Nature Neuroscience, 5(10), 933–934. doi:10.1038/nn922

Carlson, N. R. (2012). Physiology of Behavior 11th Edition: Pearson.

Denton, D., Shade, R., Zamarippa, F., Egan, G., Blair-West, J., McKinley, M., & Fox, P. (1999). Correlation of regional cerebral blood flow and change of plasma sodium concentration during genesis and satiation of thirst. Proceedings of the National Academy of Sciences, 96(5), 2532–2537. doi:10.1073/pnas.96.5.2532

Gross, J. J. (2013). Emotion regulation: Taking stock and moving forward. Emotion, 13(3), 359–365. doi:10.1037/a0032135

Gross, J. J., Sheppes, G., & Urry, H. L. (2011). Cognition and Emotion Lecture at the 2010 SPSP Emotion Preconference: Emotion generation and emotion regulation: A distinction we should make (carefully). Cognition & Emotion, 25(5), 765–781. doi:10.1080/02699931.2011.555753

Hill, B. R., Rolls, B. J., Roe, L. S., De Souza, M. J., & Williams, N. I. (2013). Ghrelin and peptide YY increase with weight loss during a 12-month intervention to reduce dietary energy density in obese women. Peptides, 49, 138–144. doi:10.1016/j.peptides.2013.09.009

Izard, C. E. (2009). Emotion Theory and Research: Highlights, Unanswered Questions, and Emerging Issues. Annual Review of Psychology, 60(1), 1–25. doi:10.1146/annurev.psych.60.110707.163539

Labayen, I., Ortega, F. B., Ruiz, J. R., Lasa, A., Simón, E., & Margareto, J. (2011). Role of Baseline Leptin and Ghrelin Levels on Body Weight and Fat Mass Changes after an Energy-Restricted Diet Intervention in Obese Women: Effects on Energy Metabolism. The Journal of Clinical Endocrinology & Metabolism, 96(6), E996–E1000. doi:10.1210/jc.2010-3006

Lentini, E., Kasahara, M., Arver, S., & Savic, I. (2013). Sex Differences in the Human Brain and the Impact of Sex Chromosomes and Sex Hormones. Cerebral Cortex, 23(10), 2322–2336. doi:10.1093/cercor/bhs222

McCarthy, M. M., Arnold, A. P., Ball, G. F., Blaustein, J. D., & De Vries, G. J. (2012). Sex Differences in the Brain: The Not So Inconvenient Truth. Journal of Neuroscience, 32(7), 2241–2247. doi:10.1523/JNEUROSCI.5372-11.2012

McKinley, M. J., Denton, D. A., Oldfield, B. J., De Oliveira, L. B., & Mathai, M. L. (2006). Water Intake and the Neural Correlates of the Consciousness of Thirst. Seminars in Nephrology, 26(3), 249–257. doi:10.1016/j.semnephrol.2006.02.001

Ngun, T. C., Ghahramani, N., Sánchez, F. J., Bocklandt, S., & Vilain, E. (2011). The genetics of sex differences in brain and behavior. Frontiers in Neuroendocrinology, 32(2), 227–246. doi:10.1016/j.yfrne.2010.10.001

Ott, V., Finlayson, G., Lehnert, H., Heitmann, B., Heinrichs, M., Born, J., & Hallschmid, M. (2013). Oxytocin Reduces Reward-Driven Food Intake in Humans. Diabetes, 62(10), 3418–3425. doi:10.2337/db13-0663

Parkinson, B., & Totterdell, P. (1999). Classifying Affect-regulation Strategies. Cognition & Emotion, 13(3), 277–303. doi:10.1080/026999399379285

Suls, J., & Bunde, J. (2005). Anger, Anxiety, and Depression as Risk Factors for Cardiovascular Disease: The Problems and Implications of Overlapping Affective Dispositions. Psychological Bulletin, 131(2), 260–300. doi:10.1037/0033-2909.131.2.260

Tataranni, P. A., Gautier, J.-F., Chen, K., Uecker, A., Bandy, D., Salbe, A. D., … Ravussin, E. (1999). Neuroanatomical correlates of hunger and satiation in humans using positron emission tomography. Proceedings of the National Academy of Sciences, 96(8), 4569–4574. doi:10.1073/pnas.96.8.4569

Yosten, G. L. C., & Samson, W. K. (2014). Separating Thirst from Hunger. In L. A. De Luca, J. V. Menani, & A. K. Johnson (Eds.), Neurobiology of Body Fluid Homeostasis: Transduction and Integration. Boca Raton (FL): CRC Press. Retrieved from

Zhang, J. V., Ren, P.-G., Avsian-Kretchmer, O., Luo, C.-W., Rauch, R., Klein, C., & Hsueh, A. J. W. (2005). Obestatin, a peptide encoded by the ghrelin gene, opposes ghrelin’s effects on food intake. Science (New York, N.Y.), 310(5750), 996–999. doi:10.1126/science.1117255

Dealing with procrastination

Uncategorizedon June 24th, 2014No Comments

What is procrastination?

Consider the following scenario:

It is already late February and your best intentions to start exercising and eat healthy have been postponed since you made your new year’s resolution. You promised yourself every Saturday that on Monday you will start your new healthy lifestyle and exercise regime.

Monday arrives and you are very tired from the weekend, you feel as if you may be developing a sinus infection, or it is too cold to get up so early so you decide to start tomorrow. And “tomorrow” never comes. In the meantime you gained weight, became more lethargic and less enticed by the idea of exercise. This is a scenario most of us are familiar with in some way or another.

Procrastination is the voluntary delay of any action despite the knowledge that putting it off will likely result in a negative outcome (Sirois & Pychyl, 2013). People delay all types of activities both in their social and occupational lives. A stay at home mother may delay cleaniDeathtoStock_Wired3ng a particular room, or de-cluttering a cupboard while a corporate employee may delay preparing for a presentation or writing a report. A smoker may delay quitting smoking, while a runner may delay his training program.

Studies have indicated that prevalence of procrastination is around 20-25% of the population, while academic procrastination; the delay of studying or writing of term papers, is even higher and up to 70% of students will admit to procrastination (Klingsieck, 2013b).

Further research in the area of procrastination shows that procrastination rarely has good results and the definition of procrastination includes the fact that the action is delayed despite the knowledge that there is a negative outcome (Sirois & Pychyl, 2013). In fact, studies show that academic procrastination is generally associated with poor results, higher levels of anxiety and lower levels of self-efficacy (Klingsieck, 2013a).

In fact numerous studies agree that procrastination is associated with a variety of negative outcomes with a significant connection between self-reported procrastination and negative emotional experience such as lowered self-efficacy and performance (Krause & Freund, 2014).

In many cases, procrastination is also closely linked to an element of perfectionism. It has been suggested that procrastinating behaviour stems from excessively high standards and that perfectionism, anxiety and low self-confidence are often maintaining factors in the procrastinating behaviour (Rice, Richardson & Clark, 2012).

As a result, procrastination is not a pleasant experience and often results in more anxiety and emotional discomfort yet most people do not seek treatment for procrastination. Most people struggle alone to overcome procrastination.

Dealing with procrastinating

Many studies have suggested that procrastination is less likely to occur in personalities that have high levels of self-motivation, are self-determined and have an internal locus of control (Klingsieck, 2013b). In this sense, overcoming procrastination would then mean setting more realistic standards for behaviour and task performance, increasing self-confidence, increasing motivation levels and sense of mastery over tasks, as well as working with goal setting parameters.

In many cases fear of failure is what often leads to and maintains procrastinating (Krause & freund, 2014), so help for procrastinators would include goal setting work that assists the individual to set realistic goals with realistic expectations of performance as well as helping the individual deal with their fear of failure.

While many people wish to stop procrastinating, they simply find themselves in a vicious, anxiety provoking cycle where they feel stuck and are unable to make any real and lasting changes. Few people will seek professional assistance in treating procrastination and will attempt to make changes on their own. However, seeking help from a professional may be more effective in overcoming procrastination.

Hypnotherapy has been a popular adjunct to therapy in the past, particularly as an adjunct to cognitive behaviour therapy as it deepens the individual’s understanding of the concepts. Hypnotherapy, with its relaxed state of focused awareness, allows the individual to more readily accept suggestions aimed at reducing anxiety and fear of failure, as well as reinforcing the internal locus of control and self-confidence.

Such suggestions and positive changes may result in the individual overcoming procrastination by feeling more in control and more able to complete the task, rather than delaying it due to fear of failure or anxiety around the task. Hypnotherapy sessions will also focus on goal setting that is realistic and achievable and work on lessening perfectionism and excessively high standards if performance.

Again, this reduces the anxiety surrounding the task and, thus, reduces the need to procrastinate as a coping mechanism.


Procrastination is very much a maladaptive coping behaviour used to delay actions or tasks that cause anxiety due to fear of failure, unrealistic standards of performance, perfectionism and low self-confidence. Those individuals that feel in control, are self-motivated and confident are less likely to procrastinate than those that don’t.

As a result, treatment of procrastination should involve assisting the individual with increasing their level of self-confidence, teaching appropriate and realistic goal setting and dealing with the anxiety resulting from fear of failure or perfectionism.

Hypnotherapy is an especially useful tool in helping people cope with anxiety in general, as well as increasing self-confidence and motivation. Dealing with issues such as fear of failure and feeling out of control is another way in which hypnotherapy can help people to stop procrastinating.


Klingsieck, K. B. (2013). Procrastination in Different Life-Domains: Is Procrastination Domain Specific?. Current Psychology32(2), 175-185

Klingsieck, K. B. (2013). Procrastination: When good things don’t come to those who wait. European Psychologist18(1), 24-34

Krause, K., & Freund, A. M. (2014). How to beat procrastination: The role of goal focus. European Psychologist19(2), 132-144

Rice, K. G., Richardson, C. E., & Clark, D. (2012). Perfectionism, procrastination, and psychological distress. Journal Of Counseling Psychology59(2), 288-302

Sirois, F., & Pychyl, T. (2013). Procrastination and the Priority of Short-Term Mood Regulation: Consequences for Future Self. Social & Personality Psychology Compass7(2), 115-127


The Different Types Of Anxiety Disorders

Anxietyon June 21st, 2014No Comments

Anxiety disorders include a range of disorders such as generalised anxiety disorder (GAD), social anxiety disorder, separation anxiety, panic disorder and even post natal anxiety. While the presentation of anxiety is the same for all anxiety disorders; namely the consistent, yet vague feeling of nervousness and apprehension coupled with physical symptoms such as heart palpitations, sweating, trembling and dizziness (to name only a few), each anxiety disorder has a specific pattern of presentation that allows it to be distinguished from the others.

Generalised anxiety disorder is a common anxiety disorder in which the person experiences uncontrolled and unfocussed worry that is not necessarily rationally related to any recent stressful events.

The person struggles with a persistent feeling of nervousness and threat and experiences restlessness, sleep disturbance, muscle tension along with the common presentation of anxiety Tyrer & Baldwin, 2006).

Social anxiety differs from generalised anxiety disorder as it becomes more situation specific. In this sense, people struggling with social anxiety experience a persistent fear of drawing any attention to themselves when they are in social situations. They believe that others will see their negative attributes and judge them negatively, leading to rejection (Morrison & Heimberg, 2013). Their anxiety, thus, is situation specific and experienced only when in social situations.

Panic disorder, on the other hand is less situation specific and is characterised by spontaneous and unpredictable panic attacks, which are episodes of acute anxiety coupled with a fear of dying as well as physical symptoms of heart palpitations, shortness of breath, racing heart, sweating, dizziness, numbness and disorientation (Sadock & Sadock, 2003). These attacks can occur at anytime and anywhere and, as such, they exacerbate general anxiety as the person is often feeling apprehensive about the next possible attack, especially as the person can have several attacks one day and then only one attack every few days or weeks.

Essentially, they are unpredictable and therefore result in a general feeling of anxiety. As a result, panic disorder sufferers may become agoraphobic and fear going out into public lest they experience another panic attack (Sadock & Sadock, 2003).

Separation anxiety is more commonly experienced during childhood and is an expected part of childhood when the child learns that it can be separated from the mother. A separation anxiety disorder, however, is diagnosed when there is excessive and inappropriate anxiety relating to the possible separation from a significant care-giver (Sadock & Sadock, 2003).

Adult separation anxiety disorder is a relatively recent term that has symptoms paralleling those of childhood separation anxiety, but with onset after age 18 (Silone, Momartine, Marnane, Steel & Manicavasagar, 2010). In this sense, those struggling with separation anxiety disorder will experience persistent and excessive anxiety about separating from significant people in their lives. They may also struggle with excessive worry about harm befalling those they love (Silone et al, 2010).

Post natal anxiety is anxiety experience after childhood and in relation to mothering and parenting in general. The adjustment to becoming a parent is a frequent source of stress and the anxiety experienced by new parents is quite common. A significant percentage of women, however, struggle with pathological anxiety and depression (Giakoumaki, Vasilaki, Lili, Skouroliakou & Liosis, 2009).

In the past symptoms of anxiety were associalted with post natal depression, but recently, post natal anxiety has been given more attention as a disorder on its own. Mothers struggling with post natal anxiety will experience the common presentation of anxiety in relation to their mothering and nurturing skills resulting in frequent self-doubt about their parenting skills and anxiety around whether they are harming the child and doing a good enough job of mothering.

All anxiety disorders present with the common symptoms of nervousness and apprehensiveness that is bigger than and inappropriate to the given situation. This sensation is coupled with physiological symptoms such as heart palpitations and shortness of breath. There are a variety of specific anxiety disorders ranging from panic disorder, to social anxiety and even post natal anxiety. While they all have a general experience of anxiety common to them, they each present in a very specific way.

Giakoumaki, O. O., Vasilaki, K. K., Lili, L. L., Skouroliakou, M. M., & Liosis, G. G. (2009). The role of maternal anxiety in the early postpartum period: Screening for anxiety and depressive symptomatology in Greece. Journal Of Psychosomatic Obstetrics & Gynecology30(1), 21-28

Morrison, A. S., & Heimberg, R. G. (2013). Social anxiety and social anxiety disorder. Annual Review of Clinical Psychology, 9, 249 –274

Sadock, B. J. & Sadock, V. A. (2003): Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry. Philedelphia Lippincott Williams & Wilkins

Silove, D., Momartin, S., Marnane, C., Steel, Z., & Manicavasagar, V. (2010). Adult separation anxiety disorder among war-affected Bosnian refugees: Comorbidity with PTSD and associations with dimensions of trauma. Journal Of Traumatic Stress23(1), 169-172.

Tyrer, P., & Baldwin, D. (2006). Generalised anxiety disorder. The Lancet368(9553), 2156-2166

What is Social Anxiety?

Anxietyon June 20th, 2014No Comments

Social anxiety
is a type of anxiety disorder that is typically characterised by a fear of negative scrutiny by other people (Hedman, Strom, Stunkel & Mortberg, 2013). Most people have some level of anxiety when entering new and unfamiliar social situations.

To some extent, most people fear negative judgement by others. Social anxiety disorder is when this anxiety becomes debilitating and results in impairment in social and occupational functioning.

Those struggling with social anxiety disorder experience an exaggerated and inappropriate fear of being negatively evaluated by those around them in both social and performance situations (Seedat, 2013) to the point at which their performance and functioning in social situations is impaired or they avoid them altogether by withdrawing completely from social situations.

social anxiety

Hypnotherapy to Treat Social Anxiety

In these situations people may experience the usual symptoms of anxiety; namely racing heart or heart palpitations, sweating, trembling, stuttering, and feeling dizzy, nervous butterflies in the stomach, upset stomach such as diarrhoea, dry mouth and shortness of breath.

This intense anxiety is situation specific, unlike generalised anxiety disorder, and the person tends to experience anxiety only when in social or performance situations, or when anticipating such events.

Due to the fact that a primary characteristic of social anxiety is a heightened sensitivity to a perceived threat of negative evaluation, it has further been suggested that people struggling with social anxiety also tend to have a general hypersensitivity to threats in their environment (Kimbrel, 2008).

As such, people with social anxiety disorder tend to be hypersensitive to any evaluation from those in their social and occupational situations. Perceiving risk of negative evaluation and a fear of being excluded is a common anxiety to most people. Social anxiety, however, is more debilitating and those struggling with it find it very difficult to cope in those situations.

Due to the fact that this form of anxiety is so common, some have even theorised that social anxiety is an evolutionary way of preventing an individual from behaving in ways which
may exclude them from the general community or society (Hedman et al., 2013).

Social anxiety disorder, along with specific phobias, have an earlier onset than other anxiety disorder and typically start at around 13 years of age with an onset age of 25 or later being rare (Seedat, 2013). It is typically an adult disorder and there are more females that struggle with social anxiety disorder than males (Seedat, 2013).

The most studied and effective treatment for social anxiety disorder is cognitive behaviour and behaviour therapy where important factors for success include the individual’s motivation and commitment to treatment and having available alternate coping strategies and support structures (Sadock & Sadock, 2003).

The cognitive behaviour therapy techniques involve psycho-education around the disorder – the symptoms and presentation as well as education around the factors that maintain it. In this sense, the individual is shown how his anxiety behaviours (such as withdrawing from conversation) actually exacerbate and feed into the social anxiety.

People struggling with social anxiety tend to have a heightened awareness of self and often negatively evaluate their own behaviours in social situations, leading to anxiety attacks and anxiety behaviours, which then feed back into negative self-perceptions and fuel the belief that others are also evaluating them negatively. Cognitive behaviour therapy looks at these irrational beliefs and self-perceptions and attempts to challenge the negative thought patterns that result in anxious behaviours.

tumblr_n8zm0d48Jx1st5lhmo1_1280Relaxation training and other coping skills are also taught alongside the therapy (Seedat, 2013). Hypnotherapy can be a very useful tool in therapy to reinforce relaxation and coping skills and to adjust self-perceptions in social situations. Overcoming social anxiety disorder is no easy task, but is certainly achievable through committed treatment with a psychiatrist or psychologist and the use of cognitive behaviour techniques.

Hedman, E., Ström, P., Stünkel, A., & Mörtberg, E. (2013). Shame and Guilt in Social Anxiety Disorder: Effects of Cognitive Behavior Therapy and Association with Social Anxiety and Depressive Symptoms. Plos ONE8(4), 1-8.

Kimbrel, N. A. (2008). A model of the development and maintenance of generalised social phobia. Clinical Psychology Review. 28, 592-612

Sadock, B. J. & Sadock, V. A. (2003): Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry. Philedelphia Lippincott Williams & Wilkins

Seedat, S. S. (2013). Social anxiety disorder (social phobia). South African Journal Of Psychiatry, 192-196

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Binge Eating and Overeating

Uncategorizedon June 9th, 2014No Comments

What is an eating disorder?

An eating disorder refers to an abnormal relationship with food and pattern of eating. Most people struggling with an eating disorder will fear gaining weight, with weight loss as a primary goal and will take on certain behaviours in order to lose weight and sustain weight loss. The two most common types of eating disorders categorized by the Diagnostic Statistical Manual of Mental illness (DSM) are anorexia nervosa and bulimia nervosa. Other eating disorders include binge eating disorder and eating disorder not otherwise specified (Sadock &Sadock, 2003).

Anorexia Nervosa is diagnosed when there is a strong refusal to maintain body weight at or above the minimally normal weight for the person’s age and height. The person is intensely afraid of gaining weight and has a disturbed self-perception of their body shape and size (Sadock & Sadock, 2003). Most people struggling with anorexia will restrict their intake of food and engage in excessive exercise or purging activities to reduce calorie intake.

Bulimia nervosa is diagnosed when there are recurrent episodes of binge eating (eating an amount of food that is much larger than they would normally eat and experiencing a lack of control while eating), and recurrent inappropriate behaviour to prevent weight gain suc
h as self induced vomiting and misuse of laxatives or enemas (Sadock & Sadock, 2003).

Binge eating disorders are diagnosed when the person does not suffer from anorexia nervosa as their body mass index is at or above the normal mark and they do not suffer from bulimia nervosa because they do not use inappropriate methods of weight control such as vomiting or laxative misuse (Telch & Agras, 1996). In this sense, it seems that binge eaters make use of food to regulate their moods and to manage difficult emotions, particularly anger, sadness and feelings of inadequacy (Telch & Agras, 1996).

Understanding compulsive eating disorder

Another way of understanding binge eating disorder is as a compulsive eating disorder. In this sense, the person who is struggling feels compelled to over eat and struggles to maintain control while eating. Compulsive eating, or binge eating is characterized by eating very rapidly until feeling over-full and uncomfortable, eating large amounts of food, mostly eating alone and then feeling disgusted with oneself and depressed about the overeating (Mantle, 2003).binge eating perth

Due to the large amounts of calories consumed during compulsive eating episodes, binge eaters normally gain weight quite rapidly. Remember that there is no attempt to regulate weight through excessive exercise or calorie restriction as in anorexia, or self-induced vomiting and laxative misuse as in bulimia. As such, the binge eater is likely to gain weight and can face serious health consequences such as diabetes, obesity, heart disease, high blood pressure and high cholesterol (Smith, Segal & Segal, 2014).

There are many theories around the maintaining factors of binge eating disorders, namely affect-driven models, which suggest that the binge eating episode induces a more manageable emotion (such as guilt) than the emotion preceding the binge (depression) (Stein, Kenardy, Wiseman, Dounchis, Arnow & Wilfley, 2007). Alternate affect driven theories posit that the binge eating focusses attention to the exclusion of all else and thereby offers an escape from uncomfortable feelings and moods, or theorize that negative emotions can now be blamed on the binge eating rather than require any self-awareness or insight (Stein et al., 2007).

Treating compulsive eating

There have been a range of treatments available for eating disorders ranging from Cognitive Behavioural therapy through to ego state therapy. The most important issue here is that binge eaters do not know how to stop eating. Therapy, therefore, often focusses on the emotional regulation aspect, teaching more effective coping skills and teaching problem solving so that the patient can learn how to stop eating. In the last 30 years or so there has been the addition and encouragement of the use of hypnotherapy in the treatment of binge eating and other eating disorders, although this is still a relatively new form of treatment and still in the trial and error phase (Vanderlinden & Vandereycken, 1988).

The most common difficulty in treating eating disorders is that most patients are in denial regarding their condition and are, therefore, treatment resistant. In this sense, hypnotherapy can be a useful treatment modality in using ideomotor signaling, age regression and ego-state therapy to identify the origins of the persons distorted cognitions and emotional difficulties that precipitate their eating disorder (Mantle, 2003). Learning how to stop eating is about identifying the triggers to the compulsive eating episodes and learning more effective coping skills to dealing with difficult emotions and moods. Hypnotherapy is also useful here to assist patients to gain control over their emotions, as well as their thoughts and behaviours. In fact using hypnosis to supplement weight control through the use of visualization (Mantle, 2003) to encourage healthy eating styles and the use of relaxation to learn more effective coping skills also assists binge eating patients to gain efficacy over their eating behaviours and emotional coping strategies.

There are different types of eating disorders including anorexia, bulimia and binge eating disorder. Compulsive eating occurs when the person loses control while eating and eats more than they usually would and to a point of feeling uncomfortably full. The person does not know how to stop eating and often uses the binge to cope with difficult emotions and thoughts. Binge eating can lead to serious health conditions and, as such, it is important to treat the condition. In recent years, hypnotherapy has become a recommended treatment approach in that it is effective, despite the patient’s resistance, in identifying the triggers to the binge eating episodes and helps to teach more effective coping skills in dealing with negative emotions and thoughts. Relaxation techniques are taught and visualization techniques assist in encourage more healthy eating patterns and teaching the patient how to stop their compulsive eating.


Mantle, F. (2003). Eating disorders: The role of hypnosis. (Cover story). Paediatric Nursing15(7), 42-45

Sadock, B. J. & Sadock, V. A. (2003): Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry. Philedelphia Lippincott Williams & Wilkins

Smith, M., Segal, R. &Segal, J. (2014, February): Binge Eating Disorder Symptoms, Causes, Treatment, and Help. Retrieved from

Stein, R. I., Kenardy, J., Wiseman, C. V., Dounchis, J., Arnow, B. A., & Wilfley, D. E. (2007). What’s driving the binge in binge eating disorder?: A prospective examination of precursors and consequences. International Journal Of Eating Disorders40(3), 195-203.

Telch C, Agras W (1996) Do emotional states influence binge eating in the obese? International Journal of Eating Disorders. 20, 271-280

Vanderlinden, J., & Vandereycken, W. (1988). The use of hypnotherapy in the treatment of eating disorders. International Journal of Eating Disorders7(5), 673-679.

Quit Smoking Naturally With Hypnotherapy

Quit Smokingon June 5th, 2014No Comments

World-wide people are struggling with nicotine addictions making it one of the biggest public health issues. In fact, there are approximately 650 million smokers world-wide (Wise & Correia, 2008) half of which will die, or are dying from smoking related health problems (Le Foll & George, 2007).

This is an enormous cost to health systems and highlights the need to encourage smokers to kick the habit. However, as many smokers will tell you, the addiction to nicotine is one of the hardest to overcome most probably because there is a behavioural compulsion included in the addiction (Rouse, 2007). In order to assist patients in quitting a number of interventions have been used, from pharmacological interventions through to behavioural and also hypnotherapeutic interventions.

Despite the increasing popularity of pharmacological interventions, hypnotherapy remains a popular choice amongst patients wishing to quit smoking naturally (Hely, Jamieson & Dunstan, 2011). Regardless of the method used to quit smoking, there are some practical tips the smoker can keep in mind to make the process easier, which will certainly assist with quitting.


Tips to quit smoking

Quit Smoking Hypnotherapy Perth

The first thing to bear in mind is that the patient needs to be fully motivated and really want to quit smoking in order for them to be successful at it. It cannot be a case of “quitting because my wife wants me to” or because the doctor said so. The motivation and need to stop smoking must come from the individual him/herself.

Due to the fact that pharmacological interventions are not capable of addressing underlying behavioural issues, these methods often come short and need to be complemented with the patient’s own change in lifestyle, or preferably some hypnotherapeutic intervention. Rouse (2007) suggests changing the behaviours that are connected to the habit.

In this sense, it is useful to break associations with smoking by, for example, changing from drinking coffee in the morning (which is associated with smoking a morning cigarette) to drinking a glass of orange juice instead. It also helps to change routines so that the habit of smoking becomes interrupted. Behavioural compulsions and the habit of smoking can often be the biggest factors to overcome. In this case, hypnotherapy can be especially useful.

Hypnotherapy involves inducing an altered state of consciousness through the use of relaxation and visualization and then offering therapeutic suggestions which may reinforce the health benefits of quitting, highlighting the dangers of continued smoking, changing the person’s perceptions of smoking and offering suggestions to assist in dealing with nicotine cravings (Hely et al. 2011). As the person is in a suggestible and relaxed state, these therapeutic suggestions often reinforce the desire to stop smoking which is then carried into normal waking life making it easier to withstand cravings and break the habit.


The effects of quitting smoking

Stop Smoking Perth

Research shows that people who have quit smoking for 6 months or more are more likely to be successful as the relapse rates tend to decrease after the 6 month mark (Hely et al. 2011). Of course the health benefits are tenfold even after the 3 month mark where there is significantly reduced toxin exposure, improved pulmonary function and general improvement in health and wellness. Of course the
re are also perceived risks involved in quitting smoking. Many people are concerned with cravings and possible weight gain (Weinberger, Mazure & McKee, 2010).


While these remain potential difficulties, continued hypnotherapy may assist in cementing the benefits and reinforcing the need to abstain from smoking. Hypnotherapeutic suggestions may also be used in reducing weight gain and reinforcing healthy eating habits. Furthermore, the relaxation training can also assist in learning to cope with stress more effectively rather turning to nicotine.


Smoking is an extremely difficult habit and addiction to break. The costs to health systems and to personal wellbeing are enormous and there is a wealth of evidence pointing towards the need for people to quit. Although pharmacological interventions are popular, they don’t seem to target the behavioural and psychological component in smoking and, as such, fall short. Hypnotherapy is an increasingly popular method to quit smoking naturally and assists by providing suggestions that reinforce the benefits of quitting, the desire to quit and assists in dealing with cravings. There are many health benefits to quitting smoking, but there are also perceived risks which may also be alleviated through the use of continued hypnotherapy.


Hely, J. M., Jamieson, G. A., & Dunstan, D. (2011). Smoking cessation: A combined cognitive behavioural therapy and hypnotherapy self-help treatment protocol.Australian Journal Of Clinical & Experimental Hypnosis, 39(2), 196-227.


Le Foll, B., & George, T. P., (2007). Treatment of tobacco dependence: Integrating recent progress into practice. Canadian Medical Association Journal, 177, 1373–1380. Rouse, D. (2007). creating a healthier life. Better Nutrition, 69(4), 46-47.

Weinberger, A. H., Mazure, C. M., & McKee, S. A. (2010). Perceived risks and benefits of quitting smoking in non-treatment seekers. Addiction Research & Theory, 18(4), 456-463

Wise, L., & Correia, A. (2008). A review of nonpharmacologic and pharmacologic therapies for smoking cessation. Formulary 43(2), 44–64