Fear of Flying – Case Study

The following case study is designed to walk you step-by-step through an authentic clinical hypnotherapy session. Firstly, watch the complete session video below, then proceed to the step-by-step guide which follows.

Complete Session

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Stage 1: Acquisition and Utilisation

BRIEFING: During my initial consultation with Brian, I asked: “What do you do to relax yourself?” Generic scripts are not as effective as scripts that have been tailored specifically for the client. My aim was to create a bespoke script that would appeal to Brian’s interests and way of life. I aimed to elicit this information and then include it in my script, which is why this stage is entitled Acquisition and Utilisation.

Brian told me he enjoyed walking the dogs in the countryside (particularly in the pine woods by the beach). I intended to use this information in my script.

Brian also told me that he found the “Inbetweeners” very funny. I elicited this information so that I could utilise humour in the Swish Pattern to change Brian’s associations and change his state at will (you will have observed this in the video above). I will explain more when we reach this section below.

Step 2: Induction

Breathing Induction

As with the previous case study, this session starting with a deep breathing induction. Deep breathing is conducive to relaxation and deep trance. My aim at this point in the session is to relax Brian’s body and begin quietening the critical factor of his conscious mind (the part of his conscious mind that interprets, judges, analyses etc.) The critical factor impedes concentration and can also reject new psychological strategies, preventing them from entering the unconscious. So we need to quieten it down.

Step 3: Progressive Relaxation Deepener

Progressive Relaxation Deepener

Now we have initiated the trance process via the breath induction, we need to deepen the state. Here, I utilise the Progressive Relaxation deepener. I encourage Brian to draw a bright light down through the various parts of the body, in order to relax the body progressively. The body and the mind are closely interrelated; so when we relax the body, the mind will tend to follow. My aim here is to deepen the state induced in the induction, continuing to relax Brian’s body and disengage the critical factor.

Stage 4: Relaxed Scene Deepener

Relaxed Scene Deepener

Next, I continue to deepen my client’s trance by utilising the Relaxed Scene Deepener.

Important Note: using the sense modalities

Earlier in this course we spoke about the five sense modalities: visual, audio, smell, taste and feeling. It is extremely important to incorporate a variety of these during every session. Many inexperienced therapists make the mistake of assuming that the client can SEE everything. So the script concentrates solely on the visual modality: “See the tall trees reach out into the clear blue sky”, “see the calming stream” and so on. If your client processes information primarily in the auditory or kinaesthetic modality, this script will fail to engage him/her. To counteract this problem use as many of the modalities as possible. Here are some examples:

  • “Feel the texture of the grass beneath your feet” (Kinaesthetic)
  • “Hear the sounds of the birds singing in the hedgerow” (Auditory)
  • “the scent of wild flowers hangs in the air” (Olfactory – smell)
  • “see the tall trees reach out into the clear blue sky” (Visual)

In addition, during this stage I use METAPHOR. Referring to the ocean as “an ocean of possibilities.” Metaphor has a powerful impact on the unconscious mind.

Stage 5: Descending Count Deepener

Descending Count Deepener

I incorporated a descending count deepener at this point, whilst continuing to deepen Brian’s state. Here, he draws numbers in the sand with a stick and the ocean washes the number away. Metaphorically, I’m actually encouraging his awareness to sink deeper down into his psyche and improve the depth of trance.

Stage 6: Intervention

Intervention 1

Now, the intervention begins. The intervention is that part of the session where the change-work takes place. In this particular session, our aim is to alleviate Brian’s fear of flying (aerophobia).

I continue to work on Brian’s breathing to maintain his trance, whilst guiding his attention to the airport. Next I use a REFRAME, encouraging him to perceive this experience as an opportunity to grow, rather than something to dread. Remember, a REFRAME is defined as taking a different perspective of a situation. I compound this reframe, using SUGGESTION to encourage Brian to relinquish the fear and embrace this opportunity.

I use DISTRACTION next , encouraging Brian to use any anxiety that may arise as a trigger to focus on his breath. In doing this, Brian’s focus will be shifted from the disasterising thoughts in his mind, to the gentle flow of his breath. The negative psychological strategies in his mind (pictures, movies, sound etc.) are giving rise to his fear and panic, If we disrupt these by shifting his focus of attention to his breath, then his fear will subside. We are reprogramming Brian’s mind here. Instead of allowing the automated response of fear to overwhelm him, we counteract it with a shift in focus. Hence, Brian stays relaxed and calm. This theme continues in the video below…….

Intervention 2 (main intervention video)

I educate Brian next, informing him that his anxiety is not a measure of the danger he is in, it’s simply a negative aspect of his mind presenting unrealistic and disasterising psychological strategies. Remember, a psychological strategy is a sequence of internal pictures and sounds that give rise to an action or an emotional state; in this case fear. For example, Brian thinks of an airport or a plane and sees a coloured video in his mind of a plane in flames on the runway or dropping into the ocean. The plane or the airport are anchors (or triggers) that give rise to these negative psychological strategies. These are automated responses that we need to reprogram.

I also encourage Brian to feel the anxiety rather than try to resist it, as resistance will simply exacerbate it. If we allow a feeling to be without judging it or trying to repel it, it will pass. This process is known as MINDFULNESS.

I SUGGEST to Brian that immediately any anxiety arises, his mind will be transported to his destination: New York. Again, here, we are disrupting the automated negative strategies that give rise to Brian’s phobia. The old way of responding was to feel the anxiety and panic, now it’s feel the anxiety and allow it to activate positive thoughts; thoughts of a place he loves. He repeat and emphasise this association to strengthen it.

NOTE: the brain doesn’t differentiate between IMAGINATION and ACTUALITY: if someone can imagine being a certain way in a certain situation, they can do it in reality. If Brian can IMAGINE being calm and detached at the airport and for the duration of the flight, he can do it for real!

As well as re-emphasising the importance of deep breathing, I now work on Brian’s associations. I SUGGEST that every time he feels anxiety arising, he should immediately think of his favourite character from the Inbetweeners. Remember, Brian told me in the acquisition stage at the beginning that the Inbetweeners really made him laugh. So now I SUGGEST that he allows the emergence of anxiety to be a trigger for him to think of his favourite character from the Inbetweeners. My objective is not to get him rolling around with laughter, it’s to negate his fear. When fear is met with laughter, it usually results in both of them being negated and a degree of balance attained. So we are using humour here to negate his fear and maintain balance and equanimity.

Intermittently, I use a scale of one to ten to check the level of Brian’s anxiety. This gives me some indication as the whether or not my techniques are working and the needed change is happening. I continue by reinforcing everything I’ve done so far in the session, and also use EGO STROKING, which simply means I praised my client for his good work so far.

The remainder of the intervention stage is spent reinforcing the techniques, suggestions and associations I used early. This repetition will impact Brian’s unconscious mind and influence his future responses. New neural pathways will be created in his brain and he will become free of the psychological chains that have bound him in the past. His mind will be reprogrammed, results in liberation and freedom.

Stage 7: emergence (closing the session)

Closing the Session

Finally, it’s time to close the session in the way you have become accustomed.

OUTCOME: in the months following this session, Brian flew to Amsterdam and New York. His anxiety levels never reached more than 1 out of 10!

Classroom (ZOOM) Discussion of this case