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WORKSHOP ON “ANXIETY”

BRUCE BONNETT I. DEFINITIONS OF “NORMAL ANXIETY” AND “ANXIETY DISORDER” A. Important to know the difference, because referral necessary for anxiety disorders. See, for example, California Bus. & Prof. Code section 2908: A psychology license is not necessary for “persons utilizing hypnotic techniques by referral from persons licensed to practice medicine, dentistry or psychology, OR persons utilizing hypnotic techniques which offer avocational or vocational self-improvement and do not offer therapy for emotional or mental disorders,

. . .” (emphasis added).

B. National Institute of Mental Health The National Institute of Mental Health, the lead federal agency for research on mental disorders, states that: “Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships. There are several different types of anxiety disorders

. Examples include generalized anxiety disorder, panic disorder, and social anxiety disorder. . . .

Generalized Anxiety Disorder

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People with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms. . . .

Panic Disorder

People with panic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom. . . .

Social Anxiety Disorder

People with social anxiety disorder (sometimes called ‘social phobia’) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others.” (emphasis added).1

C. Some anxiety is useful “. . . anxiety refers to the anticipation of some potential threat that may, or may not, happen in the future. . . . In an anxious state, people are readying themselves and preparing themselves to cope with a future problem or dilemma that they anticipate will cause some kind of harm if not prevented from occurring. In this respect, anxiety is a normal, beneficial emotion. . . . anxiety and fear actually motivate us to take necessary action. For example, picture a young mother and her child are crossing the street. The mother suddenly realizes they are in the direct path of an oncoming car. Imagine what would happen if she did not feel the least bit afraid. Now imagine a law student preparing to take his

1 https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

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bar exam so that he can become an attorney. What if he didn't have any anxiety over whether he passed or failed his bar exam? . . . Unfortunately, a problem arises when the fear response is triggered but there is no actual threat in our environment. Thus, the response serves no useful purpose. This is called a false alarm.”2

D. DSM-IV-TR “The DSM-IV-TR recognizes the following diagnosable anxiety disorders: generalized anxiety disorder, panic disorder, panic disorder with agoraphobia, phobias, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), separation anxiety, and childhood anxiety disorders. You can read specific descriptions of each anxiety disorder in a publication by the National Institutes of Mental Health . . . and in a statement released by the surgeon general . . . .” 3

E. DSM-5 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition “Anxiety Disorders Separation Anxiety Disorder | Selective Mutism | Specific Phobia | Social Anxiety Disorder (Social Phobia) | Panic Disorder | Panic Attack Specifier | Agoraphobia | Generalized Anxiety Disorder | Substance/Medication-Induced Anxiety Disorder | Anxiety Disorder Due to Another Medical Condition | Other Specified Anxiety Disorder | Unspecified Anxiety Disorder\

2 https://www.mentalhelp.net/articles/normal-and-abnormal-anxiety-what-s-the-difference/ 3 http://www.huffingtonpost.com/2011/12/15/anxiety-stress-difference_n_1152590.html

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Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances.”4

F. How to decide if your client’s presenting issue might be close enough to an anxiety disorder that you want to get a referral? “Identifying the Differences Between Normal Anxiety and an Anxiety Disorder 1. Identify the timing of the anxiety. Normal levels of anxiety may occur right before or during an event. You may feel stressed out or anxious because of the situation, and this is often normal. However, if you have an anxiety disorder, then you may be anxious for days or weeks leading up to an event. The time you spend feeling anxious may be much greater than the situation warrants. For example, if you are anxious about a job interview, it is normal if the anxiety occurs around the time of the interview. However, if you have an anxiety disorder, the anxiety may begin a week or so before the interview and it may also continue after the interview is over. 2. Evaluate the duration of the anxiety. Normal anxiety happens when a stressor occurs around you. Because the threat goes away or your body becomes used to the situation, the anxiety eventually goes away. If you suffer from an anxiety disorder, you may experience anxiety due to a stressor, but it may feel like it never goes away. For example, if you have an exam, you may be anxious the night before the exam, then during the exam. You may even be a bit nervous afterwards. If you have an anxiety disorder, the anxious feelings may occur for weeks before you have the exam,

4http://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890425596.dsm05

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then last way after the exam is over. Anxiety due to an anxiety disorder can last for months. 3 Examine the source of the anxiety. Anxiety occurs for many different reasons. Normal anxiety happens due to everyday situations. If you have an anxiety disorder, you may feel anxious for no discernible reason or due to something that may not be a big deal to others. You may feel normal anxiety because of an exam, a job interview, a first date, or an argument. If you have an anxiety disorder, small things, like going to the grocery store or answering the phone, may cause intense anxiety. 4. Determine if the anxiety interferes with your life. Normal anxiety won’t keep you from doing anything that you want to do. Anxiety disorders often interfere with your life. You may cancel plans or avoid social situations. You may also skip work, class, or meetings due to your anxiety. You may avoid going places because you think people are going to judge you. You may also be afraid of being embarrassed or humiliated. You may avoid a place or object because you have an irrational fear of it. 5. Think about how often the anxiety occurs. Normal anxiety happens randomly, usually around a significant event in your life. If you have an anxiety disorder, you may experience anxiety often, even every day. You may feel anxiety when nothing is happening. The anxiety is a recurring event. You may start to feel anxiety about having anxiety. You may get nervous you’re going to have a panic attack, which causes anxiety. You may feel fear or a feeling of doom for no reason. 6. Monitor for any accompanying tasks. If you have an anxiety disorder, you may find yourself performing tasks or rituals, or experiencing images related to a traumatic event. Some anxiety disorders may cause you to undergo repetitive actions. Other disorders may cause you to have nightmares or flashbacks. For example, you may wash your hands over and over or have to check

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something a certain amount of times. You may have severe nightmares or flashbacks after experiencing a traumatic events.”5

ALSO… “Karen Swartz, M.D., the Director of Clinical Programs at the Johns Hopkins Mood Disorders Center, says the main difference between worry and GAD [Generalized Anxiety Disorder] is that the symptoms are more frequent with GAD. In a Depression and Anxiety Health Alert, she mentions one study that found that people without GAD tended to worry an average of 55 minutes a day, while those with GAD worried for 310 minutes each day. That’s one hour compared to five. She identified a few other differences, as well: Normal Worry: Worrying does not interfere with your job or social life. GAD: Worrying significantly interferes with your work or social activities. Normal Worry: You feel that your concerns are controllable and can be dealt with at a later time. GAD: You feel that your worrying is out of your control. Normal Worry: Your worries cause only mild distress. GAD: Your worries are very distressing and pervasive. Normal Worry: A specific cause initiated your worrying. GAD: Worrying began for no reason.

5 http://www.wikihow.com/Spot-the-Difference-Between-Normal-Anxiety-and-Anxiety-Disorder

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Normal Worry: Your worries are limited to a specific topic or a small number of topics. GAD: You worry about a broad range of topics, like job performance, money, personal safety or the safety of others, etc. Normal Worry: Significant worrying lasts only for a brief period. GAD: You have experienced excessive worrying for six months or more. Normal Worry: Your worrying is not usually accompanied by physical or other psychological symptoms. GAD: Three or more physical or psychological symptoms occur with your worrying (such as sleep problems, irritability, tense muscles, problems concentrating, fatigue or restlessness).”6

II. ONE DESCRIPTION OF HYPNOTHERAPY FOR ANXIETY ISSUES “Hypnotherapy is becoming a more recognized method for reducing feelings of anxiety. Hypnotherapy for anxiety can help boost confidence and self-belief, while reducing feelings of fear and intense worry. It can help you develop the ability to access the calm state of mind needed to overcome the often-overwhelming emotions you are living with. Hypnotherapy for anxiety aims to access your unconscious. Using the power of suggestion, it works to promote positive change. These suggestions can be tailored to help you learn what triggers

6 http://psychcentral.com/blog/archives/2014/01/02/the-differences-between-normal-worry-general-anxiety-disorder/

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your anxiety and why, as well as changing the way you react towards them. Hypnotherapy can begin to teach you how to regain a sense of control and normality. It can help you understand what triggers your anxiety and how to cope when you start to feel anxious. . . . What happens during a hypnotherapy session? To begin, you will need to discuss with your hypnotherapist what you hope to achieve from hypnotherapy. It is likely they will ask you questions about your life to try and establish any triggers or causes for the way you feel. The therapist will then explain how hypnosis for anxiety works. They will explain the process to you, so you know what to expect and if you are completely happy to continue the session. After your initial consultation, your hypnotherapist will begin by helping you enter a relaxed state of mind. They may then ask you to focus on a time when you have felt anxious. You may be asked to focus on the physical sensations, as well as thinking of what may trigger your anxiety. Once you have recognized these sensations, your hypnotherapist will offer calming words or “suggestions”. What they say will depend on you and your personal situation. For example, if you have recognized a trigger to be pressure at work or university, the suggestion may be, “You can do this. Take a moment to breathe and clear your head then tackle the problem." The idea behind this technique is that when you start to feel anxious or fearful, the suggestions or calming words will enter your conscious mind and help you cope. Your hypnotherapist may also teach you techniques to help you relax and calm yourself down when you feel anxious feelings building. You may find that you only need one or two sessions to help you understand why you feel this way and what you can do to cope, or you may need more. In terms of how many sessions you have, you

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will be able to discuss this with your hypnotherapist. Together, you will work to decide how many sessions you would like and what techniques you believe will be most effective. Your hypnotherapist may teach you self-hypnosis techniques that you can turn to when you feel you need them. They may offer you recordings and teach you simple methods to practice at home. Practicing these techniques after your sessions is an easy way to continue working on your anxiety and taking the next steps in your journey.”7

III. STUDIES ABOUT ANXIETY/STRESS AND HYPNOSIS

In 2010, a researcher from the University of Utah School of Medicine reviewed the experimental literature on the use of self-hypnosis for the treatment of anxiety-related conditions. He concluded that existing research “provides compelling evidence that hypnosis is an efficacious treatment for state anxiety (e.g., prior to tests, surgery and medical procedures) and anxiety-related disorders, such as headaches and irritable bowel syndrome.” i

In 2013, researchers from the Department of Psychology at Lund University in Sweden studied the effect of participants’ use of hypnosis for two weeks (via audio recording). They found the hypnotic intervention had a medium-to-large beneficial effect on the participants’ experience of stress, burnout and wellbeing.ii

In 2013, researchers from the University of Dehli studied 7 college students pursing a Ph.D. The study showed that hypnotherapy is an effective intervention strategy to help patients diagnosed with anxiety symptoms.iii

7 http://www.hypnotherapy-directory.org.uk/articles/anxiety.html

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In 2006, researchers from Yale University School of Medicine studied the stress and anxiety of 76 patients before and after surgery.iv The 26 patients who received hypnosis were significantly less anxious postintervention. Moreover, on entrance to the operating rooms, the hypnosis group reported a significant decrease of 56% in their anxiety level. The study authors conclude that hypnosis significantly alleviates preoperative anxiety.v

In 1991, a professor at the University of Wisconsin-Milwaukee studied 44 introductory psychology students who were given 4 sessions of hypnosis for exam stress compared to 50 similar students who did not receive any hypnosis. Those students who received hypnosis showed a decrease in exam anxiety as well as improvements in test achievement. vi

In 1994, researchers from the University of Tasmania studied 40 music students who experience considerable anxiety when they perform. Results indicate that hypnotherapy is likely to assist musicians in the reduction of their stage fright.vii

In 1989, researchers studied 56 medical students. Those students who received 9 hypnosis sessions improved significantly in coping with exam stress.viii

IV. PRO’S AND CON’S OF HYPNOTHERAPY FOR ANXIETY DISORDERS For a detailed discussion, you may be interested in reading the following 34-page article that in detail analyzes the use of hypnosis for a number of particular anxiety disorders: “Using Hypnosis in the Treatment of Anxiety Disorders: Pros and Cons”, 2013, by Catherine Fredette1, Ghassan El-Baalbaki,, Sylvain Neron and Veronique Palardy (University of Quebec at Montreal and Mcgill University, Quebec, Canada) http://www.intechopen.com/books/new-insights-into-

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anxiety-disorders/using-hypnosis-in-the-treatment-of-anxiety-disorders-pros-and-cons

V. WHERE TO FIND JUST A FEW HYPNOSIS SCRIPTS ABOUT ANXIETY, STRESS, ETC. A. Corydon Hammond. (1990) Handbook of Hypnotic Suggestions and Metaphors (unofficially known as “The Big Red Book”). 1. “Hypnotic Treatment Techniques with Anxiety” (p. 157). 2. “The Closed Drawer Metaphor” (p. 172). 3. “Stress Reduction Trance: A Naturalistic Ericksonian Approach” (p. 170). 4. “Rational-Emotive Suggestions About Anxiety” (p. 168). 5. “Suggstions/Metaphor to Begin Reframing” (p. 167). 6. “The Autogenic [self-generated] Rag Dog” (p. 165). B. Ron Havens & Catherine Walters. (2002) Hypnotherapy Scripts: A Neo-Ericksonian Approach to Persuasive Healing 1. “The Worst Thing: A Metaphor Script For Anxiety Disorders” (p. 152). 2. “Alien Thoughts: A Metaphor Script For Obsessive-Compulsive Disorders” (p. 158).

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C. Marlene Hunter. (1994) Creative Scripts For Hypnotherapy 1. “De-Fusing Panic” (p. 110). D. www.HypnoticWorld.com [online script service; members have access to over 800 scripts]. 1. Panic Attacks Relaxation 2. Fast Anxiety Release 3. Child Anxiety Release 4. Anxiety Release – Bridge of Time 5. Anxiety Release 6. Wash Away Stress 7. Many more. E. Linda Thomson (2005) Harry the Hypno-potamus Metaphorical Tales for the Treatment of Children , Volume 1 1. General Anxiety “Marlene Worry Warthog” (p. 39). 2. Society Anxiety “Shy Sherryl Turtle” (p. 43). 3. Performance Anxiety “Wark Cockatoo” (p. 67). 4. Anxiety Attacks “Linda Gazelle” (p. 33). VI. LAUGHING/HUMOR AND ANXIETY

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Bruce tries, when possible, to incorporate humor into his sessions, including sessions for clients with anxiety issues. Here are some reasons why: A. Article by Mayo Clinic staff “When it comes to relieving stress, more giggles and guffaws are just what the doctor ordered. . . . Laughter is a great form of stress relief, and that's no joke. A good laugh has great short-term effects.

When you start to laugh, it doesn't just lighten your load mentally, it actually induces physical changes in your body. Laughter can:

Stimulate many organs. Laughter enhances your intake of oxygen-rich air, stimulates your heart, lungs and muscles, and increases the endorphins that are released by your brain. Activate and relieve your stress response. A rollicking laugh fires up and then cools down your stress response, and it can increase your heart rate and blood pressure. The result? A good, relaxed feeling. Soothe tension. Laughter can also stimulate circulation and aid muscle relaxation, both of which can help reduce some of the physical symptoms of stress.

Long-term effects

Laughter isn't just a quick pick-me-up, though. It's also good for you over the long term. Laughter may: Improve your immune system. Negative thoughts manifest into chemical reactions that can affect your body by bringing more stress into your system and decreasing your immunity. In contrast,

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positive thoughts can actually release neuropeptides that help fight stress and potentially more-serious illnesses. Relieve pain. Laughter may ease pain by causing the body to produce its own natural painkillers. Increase personal satisfaction. Laughter can also make it easier to cope with difficult situations. It also helps you connect with other people. Improve your mood. Many people experience depression, sometimes due to chronic illnesses. Laughter can help lessen your depression and anxiety and may make you feel happier.8

B. Another Article About Humor and Anxiety Laughter Can Chase Away Anxiety Posted on December 25, 2014 by Tanya J. Peterson, MS, NCC “Anxiety isn’t funny. It is, instead, rather humorless. When my head pounds and spins, when my chest constricts and spasms in a fit of coughing, when I feel worried and afraid for reasons too vague to wrap my mind around and simultaneously too specific to pull my mind out of, the last thing I feel like doing is laughing. Nothing seems remotely funny. Finding humor can be difficult when we live with anxiety; however, if we can begin to look for our laughter, we can find that humor can be a great coping skill. Researchers are discovering that laughter has many benefits. Among the ways laughter lifts us is by increasing our overall well-being and boosting our mental health. When we live with anxiety day in and day out or are in the throes of a panic attack, our stress hormones, such as cortisol and

8 http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456

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epinephrine, pulse through us. As a result, we remain tense, coiled for action, and anxious. . . . Although there are no quick fixes for anything in life, remarkably, a good laugh can instantly begin to reduce these nasty stress hormones that are intertwined with anxiety. Laughter gets to work immediately, and a regular “diet” of laughter continues to decrease anxiety over time. How is it that laughter can reduce anxiety when anxiety is no laughing matter? The act of laughing is similar to deep breathing in its ability to increase the oxygen in our bodies. Coupled with reducing stress hormones, the increased oxygen in the body helps lead to muscle relaxation. All of this helps reduce the physical symptoms of anxiety. Laughing feels good. It’s addictive; we keep wanting more. When we laugh regularly, our anxiety begins to decrease. When we embrace humor and give ourselves a chance to be a little bit lighter for even a short while each day, we shift our focus. Rather than seeing the world within and without as a worrisome place, we start to see it as a good, safe, perhaps even fun, place. We start to see beyond the anxiety. Sure, the anxiety lingers for a while, but every time we can laugh we loosen its stronghold. Introducing intentional laughter into our lives decreases stress hormones. Breathing deeply during the act of laughing relaxes muscles. Thinking about something funny shifts our focus to new things. Embracing humor regularly helps our outlook become more positive. Humor and laughter diminish anxiety.” C. 6 Ways to Reduce Stress & Anxiety with Humor

“Turn on your humor radar and tap on the healing power of laughter to beat stress with this useful guide

We all know that laughter is the best medicine: It boosts our

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immunity system, reduces stress and anxiety, improves relationships and gives us hope. Laughter probably makes us richer too since it has the magical effect of bringing people closer together, creating a more conducive atmosphere for business deals to happen. But the irony is many of us don’t laugh enough and even more lead a humorless, stressful and unhappy existence.

How then can we laugh more and stress less? The first crucial step is, perhaps, to stop associating humor as something frivolous, childish, or time wasting. Imagine what this world will be like if everyone uses humor everyday to spice up his or her life? We will be less uptight, laugh more, improve our health and make this world so much more livable and fun!

Humor is a viable and great way to live. It is about seeing the playfulness in life, even when things seem hopeless; it is about choosing to laugh instead of vexing and stressing over life’s absurdities. But a good sense of humor is never insensitive. It pokes fun and heals everyone without putting anyone down or makes one feels inferior or uncomfortable. Of course, like every good and simple thing in life (meditation comes to mind), it is an art that takes conscious efforts to cultivate and master. But for those who chooses this path, a joyful and deeply satisfying ride awaits.

So are you ready to open yourself up for more laughter and spread more joy? Then, kick off your shoes, loosen your buttons and look at some fun and easy ways to cut stress and enjoy life more with humor:

1. Keep a Laughter Treasure Chest

Why Humor: To introduce more humor into your life, you need to expose yourself to more laughing matters. A good way is to build your very own laughter treasure chest which you can draw on whenever you need a funny idea or a happiness boost. But instead of gold bars, rubies, diamonds and rare antiques, you will have humorous books such as this, comics (like this one), funny movies,

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newspaper cuttings, tear-off from magazines, jokes, self-concocted stories and anything else that crack you up in your chest.

If you prefer a digital treasure trove of laughter, simply substitute all the above-mentioned items with their digital equivalents. Good online resources you can put in your e-library include Comics.com, Youtube’s Comedy Channel, JibJab, NYT’s Laugh Lines Blog and Awkward Family Photos.

How to Laugh More: Access your treasure chest at least three times a week, twenty minutes each time. Fish out an item randomly, offline or online, and enjoy your reward thoroughly without inhibitions. It is probably a good idea NOT to do this at your workplace!

2. Solve Problems with Humor

Why Humor: Why limit the use of humor to leisure pastime? Why not use humor as a tool to solve real-life problems? Say you are anticipating a stressful event, like an appointment with your dentist, a stay with a less than friendly relative, or a speech which you cannot refuse. Instead of being overwhelmed by the thought of it, use humor creatively to see you through the situation.

How to Laugh More: Bring along one or two comics or humor books to liven up long period of anxious waiting, make some self-deprecating statements to ease up tense conversations, or insert a comic strip to build rapport with your audience. The possibilities are endless. The importance is to keep humor in mind and use its healing power to dissolve stress and tension

3. Turn on Your Humor Radar

Why Humor: Many people go about their days unconsciously looking for faults and problems, making their life and that of others a living hell. If this sounds a lot like you, it is not too late to change your ways.

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How to Laugh More: Swap your fault-finding detector with a humor-locating radar. Pay attention to chances for chuckle instead of opportunities for trouble. Keep an eye for funny moments and you will start to see more of them in your life. Want to bring your humor radar to the next level? Try picking up hidden comic relief during challenging times, such as a face-to-face meeting with your biggest foe. Be very cautious though!

4. Have a Date with Humor

Why Humor: The often used excuse for the lack of humor in life is, there is simply no time for something as trivial as laughing. But since you know that laughing is a potent antidote to chronic stress, then you may as well make time for laughter, just like the way you’d allocate time for sleeping, eating and working.

How to Laugh More: Each week, make a date with yourself or someone who looks like he or she can use a good dose of laughter. The only thing to do during a humor date is to relax and laugh till you cannot get up straight. If you are bringing someone else along, be sure to agree on the humor-inducing material or activity beforehand. Because one man’s humor can well turn out to be another man’s bored-to-death penalty.

5. Make a Face

Why Humor: Consumed by stress and anxiety, and have no access to your laughter treasure chest? Use your face. Make funny faces, contort your facial expressions, or simply, smile. Contrary to common beliefs, you don’t have to smile only when you are happy. Studies found that the opposite is also true: We can smile for no reason and actually start feeling better.

How to Laugh More: Just say cheese (or kimchi for the vegans) to yourself and hold it for a minute or two. You will instantly push your happiness marker a few notch higher and downgrade your stress and anxiety level correspondingly. For better results, do a comic face by pulling your mouth, nose and eyes in opposing

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directions, all at the same time. Want to learn advanced face-deforming tricks? Look no further than face contortionists like the ever so funny Mr. Bean for inspirations.

6. Join a Laughter Club

Why Humor: If you are fortunate enough to live in a city where there is laughter clubs, join one right away. That will give you regular stress-relieving doses of laughter as you meet up with like-minded people for the sole purpose of having a roaring good time. None exists where you live? Don’t despair. Set one up right in your home. Recruit family members, friends, neighbors or your pets. Or set up a club of one. Laughing at the idea? That is all you ever need.

How to Laugh More: A number of humor groups or clubs exist all over the world. The first place to search is the laughter clubs by Laughter Yoga. It is a global organization, which started in India, set up with the aim of spreading unconditional laughter to improve one’s health and well-being. You will learn how to laugh for no reason, which by the way is a great skill to pick up, and get to join many others in the simple but life-enhancing act of laughing your head off.”9

VII. JUST A FEW EXAMPLES ANXIETY-RELATED PRESENTING ISSUES OF REAL CLIENTS OF BRUCE’S Anxiety about: -picking the right dress for an important business function -getting negative comments about a paper 9 https://theconsciouslife.com/6-ways-to-reduce-stress-anxiety-with-humor.htm

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submitted as part of tenure process for a professor

- vomiting -being around vomit - getting nauseous in front of someone - getting pregnant before one is too old -freeways -tests (memory) -stage fright (incl. chem prof) -big speech -sports performance (baseball, volleyball, etc.) -failure to meet goals (smoking cessation) -spiders -injections/blood drawn -surgery -flying -death (stage IV cancer patient) -living alone -one man play -social phobia (handsome; face jewelry) VIII. SOME QUOTES ABOUT ANXIETY Calming Quotes for People with Anxiety10

1. “P.S. You’re not going to die. Here’s the white-hot truth: if you go bankrupt, you’ll still be okay. If you 10 https://www.psychologytoday.com/blog/anxiety-zen/201409/22-calming-quotes-people-anxiety

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lose the gig, the lover, the house, you’ll still be okay. If you sing off-key, get beat by the competition, have your heart shattered, get fired…it’s not going to kill you. Ask anyone who’s been through it.” ~Danielle LaPorte 2. “Anxiety is love’s greatest killer. It makes others feel as you might when a drowning man holds on to you. You want to save him, but you know he will strangle you with his panic.” ~Anais Nin 3. “Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.” ~Jodi Picoult 4. “Life is ten percent what you experience and ninety percent how you respond to it.” ~Dorothy M. Neddermeyer 5. “Every time you are tempted to react in the same old way, ask if you want to be a prisoner of the past or a pioneer of the future.” ~Deepak Chopra 6. “If you trade your authenticity for safety, you may experience the following: anxiety, depression, eating disorders, addiction, rage, blame, resentment, and inexplicable grief.” ~Brene Brown

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7. “The largest part of what we call ‘personality’ is determined by how we’ve opted to defend ourselves against anxiety and sadness.” ~Alain de Botton 8. “Smile, breathe, and go slowly.” ~Thich Nhat Hanh 9. “People have a hard time letting go of their suffering. Out of a fear of the unknown, they prefer suffering that is familiar.” ~Thich Nhat Hanh 10. “You don’t have to control your thoughts. You just have to stop letting them control you.” ~Dan Millman 11. “If you always do what you’ve always done, you’ll always get what you’ve always got.” ~Steven Hayes 12. “The only thing that could spoil a day was people. People were always the limiters of happiness except for the very few that were as good as spring itself.” ~Ernest Hemingway 13. “People become attached to their burdens sometimes more than the burdens are attached to them.” ~George Bernard Shaw 14. “Anxiety is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel

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into which all other thoughts are drained.” ~Arthur Somers Roche 15. “Nothing diminishes anxiety faster than action.” ~Walter Anderson 16. “Anxiety does not empty tomorrow of its sorrows, but only empties today of its strength.” ~Charles Spurgeon 17. “Good humor is a tonic for mind and body. It is the best antidote for anxiety and depression. It is a business asset. It attracts and keeps friends. It lightens human burdens. It is the direct route to serenity and contentment.” ~Grenville Kleiser 18. “People tend to dwell more on negative things than on good things. So the mind then becomes obsessed with negative things, with judgments, guilt and anxiety produced by thoughts about the future and so on.” ~Eckhart Tolle 19. “The other thing is that if you rely solely on medication to manage depression or anxiety, for example, you have done nothing to train the mind, so that when you come off the medication, you are just as vulnerable to a relapse as though you had never taken the medication.” ~Daniel Goleman

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20. “You wouldn’t worry so much about what others think of you if you realized how seldom they do.” ~Eleanor Roosevelt 21. “You can’t always control what goes on outside. But you can always control what goes on inside.” ~Wayne Dyer 22. “Nothing can bring you peace but yourself.” ~Ralph Waldo Emerson

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KEEP PRACTICING!

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i Expert Rev Neurother. 2010 Feb;10(2):263-73. doi: 10.1586/ern.09.140. https://www.ncbi.nlm.nih.gov/pubmed/20136382 Hypnosis in the treatment of anxiety- and stress-related disorders. Hammond DC1. Author information: University of Utah School of Medicine, PM&R, 30 No. 1900 East, Salt Lake City, UT 84132-2119, USA. d.c.hammond@utah.edu Abstract: Self-hypnosis training represents a rapid, cost-effective, nonaddictive and safe alternative to medication for the treatment of anxiety-related conditions. Here we provide a review of the experimental literature on the use of self-hypnosis in the treatment of anxiety and stress-related disorders, including anxiety associated with cancer, surgery, burns and medical/dental procedures. An overview of research is also provided with regard to self-hypnotic treatment of anxiety-related disorders, such as tension headaches, migraines and irritable bowel syndrome. The tremendous volume of research provides compelling evidence that hypnosis is an efficacious treatment for state anxiety (e.g., prior to tests, surgery and medical procedures) and anxiety-related disorders, such as headaches and irritable bowel syndrome. Although six studies demonstrate changes in trait anxiety, this review recommends that further randomized controlled outcome studies are needed on the hypnotic treatment of generalized anxiety disorder and in documenting changes in trait anxiety. Recommendations are made for selecting clinical referral sources. ii Hypnotic tape intervention ameliorates stress: a randomized, control study. http://www.ncbi.nlm.nih.gov/pubmed/23427838 Results: The results show that, as compared with baseline and wait-list conditions, the hypnotic intervention had a medium-to-large beneficial effect on participants' experience of stress, burnout, and well-being. Some participants also decreased their use of the coping strategy escape-avoidance postintervention. Notes: This study (N?=?35) used a randomized control design, and participants were collected from a variety of groups. After evaluating their degree of stress and burnout, coping styles, general well-being, and hypnotizability, participants were matched by stress level and randomly assigned to an intervention or wait-list group. The intervention comprised an audio recording of a hypnotic induction accompanied by suggestions for progressive relaxation, imagery, and anchoring to be used for 2 weeks. Int J Clin Exp Hypn. 2013 Apr;61(2):125-45 By: E. Cardeña, C. Svensson, F. Hejdström, Department of Psychology, Center for Research on Consciousness and Anomalous Psychology, Lund University, P.O. Box 213 SE-221 00, Lund, Sweden

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iii “Effect of Clinical Hypnotherapy on Anxiety Symptoms”, Delhi Psychiatry Journal Vol. 16, No. 1, April 2013. v Hypnosis Reduces Preoperative Anxiety in Adult Patients. http://bscw.rediris.es/pub/bscw.cgi/d4448193/Saadat-Hypnosis_reduces_preoperative_anxiety_adult_patients.pdf Results: Patients in the hypnosis group were significantly less anxious postintervention as compared with patients in the attention-control group and the control group. Moreover, on entrance to the operating rooms, the hypnosis group reported a significant decrease of 56% in their anxiety level whereas the attention-control group reported an increase of 10% in anxiety and the control group reported an increase of 47% in their anxiety. The study authors conclude that hypnosis significantly alleviates preoperative anxiety. Notes: This study examined the effect of hypnosis on preoperative anxiety. Subjects were randomized into 3 groups, a hypnosis group (n 26) who received suggestions of well-being; an attention-control group (n26) who received attentive listening and support without any specific hypnotic suggestions and a “standard of care” control group (n 24). Anxiety was measured pre- and postintervention as well as on entrance to the operating rooms. Anesth Analg, 2006, Vol. 102, No 5, pp. 1394-1396 By: H. Saadat, J. Drummond-Lewis, I. Maranets, D. Kaplan, A. Saadat, S. M. Wang, Z. N. Kain, Center for the Advancement of Perioperative Health, Departments of Anesthesiology, Pediatrics, and Child Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA vi Hypnotherapy and test anxiety: Two cognitive-behavioral constructs: The effects of hypnosis in reducing test anxiety and improving academic achievement in college students. http://psycnet.apa.org/psycinfo/1992-24581-001 Results: There was a decrease in test anxiety and improvements in achievement for the hypnosis group. The treatment gains were maintained at 6-wk follow-up. Notes: Investigated the effects of cognitive-behavioral hypnosis in reducing test anxiety and improving academic performance. 44 introductory psychology students received 4 sessions of hypnosis and 50 Hawthorne controls received no treatment over the same time period. Subjects’ midterm test grades and scores on the Test Anxiety Inventory were examined. Australian Journal of Clinical Hypnotherapy and Hypnosis, Vol 12(1), Mar 1991, 25-31 By: Marty Sapp, Professor, Department of Educational Psychology, University of Wisconsin-Milwaukee. vii Reduction of performance anxiety in music students. http://www.tandfonline.com/doi/abs/10.1080/00050069408257335#.UipPQRavszI Results: Results indicate that hypnotherapy is likely to assist musicians in the reduction of their stage fright. Notes: Many music students experience considerable anxiety when they perform. The present article describes a two-session hypnotherapeutic approach combining relaxation, positive suggestion, and symbolic success imagery designed to reduce this performance anxiety. The subjects of the study were 40 second- and third-year music students studying at a conservatorium of music who were paired on the basis of their Performance Anxiety Inventory scores. One member of each pair was allocated at random to an experimental group and the other to a control group. Further administrations of the Performance Anxiety Inventory (PAI) took place immediately after conclusion of the two-session treatment and 6 months later. At the time of this follow-up, subjects completed an

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anecdotal report providing information on their performance over the previous 6 months. Results indicate that the method is likely to assist musicians in the reduction of their stage fright. Australian Psychologist, Volume 29, Issue 2, 1994 By: Harry E. Stanton, The University of Tasmania viii Study 4: Hypnosis and Medical Student Stress Coping with examination stress through hypnosis: an experimental study. http://www.ncbi.nlm.nih.gov/pubmed/2919571 Results: The hypnosis group improved significantly in coping with examination stress. Notes: Fifty-six volunteer medical students participated. The hypnosis and waking groups attended eight group sessions once a week with general ego-strengthening and specific suggestions for study habits, with a ninth session of age progression and mental rehearsal. Subjects in these two groups practiced self-suggestions (in self-hypnosis or waking respectively) daily for the study period of 9 weeks. The control group experienced sessions of passive relaxation induced by light reading for the same period of time. Am J Clin Hypn. 1989 Jan;31(3):173-80 By: B. M. Palan, S. Chandwani