International Handbook of Clinical Hypnosis - E-Lib FK UWKS

STRESS AND ANXIETY DISORDERS 117
phasic response that is being sought. Practice may be needed daily for 6±12 months
and regularly after that time maybe 2±3 times a week).
The modern use of hypnosis is a very effective technique in reducing inappropriate
or prolonged arousal. Self-hypnosis can be used to alter the phasic responses or the
habitual elevation in basal arousal levels Stanley, Norman & Burrows, 1999). If the
patient can use hypnosis and the therapist is properly trained in its use, it not only
speeds up treatment perhaps by as much as one-third) but also enhances the sense of
self-control and problem resolution in the future, thereby becoming part of stress
prevention as well. There are contraindications to the use of hypnosis and its
inappropriate use can worsen the patient's condition Stanley, 1994). Effective training
is essential for the use of hypnosis to be safe Stanley, Rose & Burrows, 1998).
Exercise and the maintenance of physical ®tness also reduce the inappropriate
arousal responses to stressful life events. The effects are reported immediately after
exercise and following a regular exercise programme Markoff, Ryan & Young,
1982; Ransford, 1982). Both basal and phasic physiological responses are reduced
as a result of increased physical ®tness. Once more motivation of the patient to
maintain this programme is dif®cult even after the rationale is explained.
Where stress is not the result of challenges being turned into threats, stress
management may need to consider lifestyle changes. Constant, ongoing stimulation
even positive stimulation) may accumulate to manifest itself in a hyperarousal
stress response. The patient needs to accept the requirement for restoration of
biological and psychological homeostasis, or in other words the reduction of basal
arousal back into the middle of the range. Lifestyle and behavioral changes of this
sort are dif®cult to achieve and maintain. It is rarely easy for patients to make the
connection between constant stimulation of their lifestyle and the stress-related
disorders they suffer or may likely suffer. They are often deriving such bene®ts
from their current lifestyle, that they are ambivalent if not downright resistive to
change. Even if they do make signi®cant changes, they have dif®culty in maintaining
them as the pay-off is not clear and the habitual behaviors that have more
evident rewards return). Ongoing tangible or self-administered rewards for suitable
lifestyle change may need to be built into the stress management. Effective time
management, exercise programmes, relaxation, recreation, changes in diet, alcohol
use and other drug use including smoking) need to be considered. These are
dif®cult to achieve until the patient makes the connection and not just intellectually)
between their lifestyle and their health. Even with this connection being
made, motivation to change must be present or be cultivated. Hypnosis may be
used to develop the individual motivation.
ANXIETY DISORDERS
While anxiety is a normal emotion experienced at some time by virtually all
humans, `pathological' anxiety, excessive or inappropriate to the situation, may