Feelings of depression can be a normal reaction to some of life’s events or stressors such as a bereavement, job loss, retirement, injury, illness or the termination of a relationship. Therefore depression can be triggered by a normal reaction to the traumatic events one encounters in life such as: marital conflict, physical or sexual abuse, economic deprivation, social skills deficits, problem solving skills deficits, self-management skills deficits, dysfunctional ways of thinking and perceiving the world.
Anxiety disorders effect 60% of those who have depression and these include social phobias, agoraphobia, panic attacks, post traumatic stress disorder, generalized anxiety disorder etc.
Hypnopsychotherapy is ideally suited to those who are depressed because depressed people are highly aroused. Therefore, hypnotherapy is first necessary to calm them down using trance hypnosis combined with relaxation skills, breathing retraining, guided imagery, relaxation conditioning techniques and solution-focused therapy.
How do I know I need help for depression?
If you are suffering from three or more of the following symptoms for a period of more than two weeks you may be suffering from depression.
- Persistent feelings of sadness and hopelessness
- Insomnia, early waking, difficulty getting up
- Loss of interest/pleasure in activities once enjoyed such as hobbies, socialising, work, intimacy etc
- Diminished ability to think or concentrate
- Fatigue, weakness, lack of enthusiasm, decreased energy.
- Chronic pain that fails to respond to typical treatments. For example headaches and stomach aches.
- Eating disturbances. Over-eating or under-eating.
- Restlessness, irritability, temper loss.
- Persistent thoughts of suicide and death.
- Low self esteem, guilt or shame.
- Increased crying.
- Increased use of alcohol or drugs.
- Persistent feelings of anxiety, stress, fear.
Why is hypnopsychotherapy an effective approach to treatment?
The United States Public health Service Agency, mandated in 1979 to provide guidelines for the treatment of depression, initiated a literature search from 1975-1990 which looked at some 100,000 pieces of research. Over 3,500 of the best studies were selected to form the guidelines and were peer reviewed by 73 professional societies including the British Psychiatric Society and the British Psychological Society.
The guidelines for effective treatment are:
- Therapy should be active, time limited, focused on current problems and aimed at symptom resolution and not personality change.
- Psychotherapy should be considered the first line treatment approach if the depression is mild to moderate, if it is non-psychotic, not chronic, not highly recurrent and if the client wants it.
- Medication should be the first line treatment if the depression is very severe, if there have been two prior episodes, if there is a family history of depression and if the patient wants it.
This massive research programme quite clearly shows that the types of psychological treatment that are effective in lifting depression are brief, short term therapies such as short term solution focused hypnotherapy, cognitive and behavioural therapy.
Targeting seven basic pillars associated with depression
“The hypnotherapist should identify the client’s current problem and design a solution-focused recording to change his/her negative thinking process”
- To quiet the rumination process and let sleep take over naturally. To teach the client the ability to compartmentalize and to address boundary issues relating to the waking state and the ability to sleep. (rumination is a key factor in depression) Rumination is usually about either irresolvable issues or else issues that are very unlikely to occur. It is necessary to establish a boundary that separates ones waking activities from being able to both fall asleep and stay asleep. Need to create a separate time to analyse one’s life and to try and solve all of ones problems, for example, lying in bed while waiting to sleep is definitely the wrong place. Need to make the bedroom a stress-free place.
- To break the pattern of hopelessness and negative expectation. The hypnotherapist needs to build positive expectation – to look at the future optimistically – that positive change is inevitable.
- To break the patterns of feeling stuck, helpless and hopeless. The hypnotherapist needs to address issues of rigidity and to encourage flexibility. Control issues:- depressed people evaluate distortions o what is and isn’t controllable in their life. They may feel like victims of life and circumstances leading to subjective feelings of helplessness (victim mentality). Alternatively, they may suffer from the illusion of control in which the client believes he/she can control things and make things happen that are in fact beyond the individuals actual range of powers.
- To teach a clear sense of personal boundaries and how to maintain them. Depressed people complain about feeling overwhelmed. They may be globally aware of all the problems that are facing them in life, seemingly all at once, which would be overwhelming for any one. Thus it becomes a specific goal in treatment to teach the client not only to identify all the problems, but to achieve some sense of priority and establish a sensible sequence in which the problems are going to be addressed. You need to teach your client the skill of compartmentalisation which involves the ability to separate one aspect of experience from another – to discover ‘where to draw the line.’
- To turn guilt into liberation. Excessive or inappropriate guilt is a typical and emotionally powerful component of the overall experience of depression. Guilt usually surfaces when the client does not live up to someone’s expectations or even their own expectations. Clients may feel personally responsible for how other people think, the choices that other people make, the things that others do and the things that other people do not do. You need to teach the client to know what they are and are not responsible for and to make it clear that they have to let other people make their own choices responsibly.
- Preventing life’s stressors controlling the clients’ coping ability. Everyone has problems, stressors, disappointments, rejections, humiliations, losses and other hardships and circumstances that are occasionally painful. The client must be taught that when bad things happen that they are usually transient, there are things you can bounce back from and move on from in your life and they represent only one portion of life, not all of life. The goal is to make the clients’ life a satisfying one, an enjoyable one, where they are able to experience the kind of things that they want to be able to experience. There are lots of things that fall in the realm of the clients control and they can do a lot of things to prevent unnecessary stresses, and avoid potentially depressing circumstances.
- To turn indecisiveness into empowerment. Empowerment means the ability to choose, to recognise that at any given moment of time the client has the ability to choose whether they’ll respond and how they’ll respond to different people and different circumstances. It means have an orientation towards the future that allows them to be goal orientated and clear and deliberate in their understandings of how the things that they do right now will impact on the events yet to come.
Depression is treated with solution-focused hypnopsychotherapy which involves a combination of cognitive behavioural therapy and hypnoanalytical psychotherapy which takes an average of 8 to 12 sessions.