International Handbook of Clinical Hypnosis - E-Lib FK UWKS

118 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
appear in the form of an anxiety disorder. The distinction between normal and
`pathological' anxiety needs to be established for each. Normal anxiety has a
protective function in threatening situations and may enhance motivation to resolve
the threat. On the other hand, pathological anxiety serves no useful purpose and is
associated with an inability to function at a satisfactory level. It has been estimated
that perhaps as many as 10% of the population may experience an anxiety disorder.
HYPNOTIZABILITY AS AN INFLUENCE IN ANXIETY DISORDERS
An association between hypnotic susceptibility and several anxiety disorders has
been suggested. Frankel 1976) ®rst presented evidence that phobic patients show
greater hypnotic susceptibility than other patient groups and that a disproportionate
number of his 24 phobic patients were in the highly hypnotizable range, when
assessed using standardized assessments of susceptibility. There is some additional
evidence supporting this observation Frankel & Orne, 1976; Gerschman, Burrows,
Reade & Foenander, 1979; Foenander, Burrows, Gerschman & Horne, 1980;
Frischolz, Spiegel et al. 1982; Robney, Hollander & Campbell, 1983; John,
Hollander & Perry, 1983; Kelly, 1984) but two studies, using different assessment
techniques, have failed to ®nd greater hypnotic susceptibility in phobic patients
Gerschman, Burrows & Reade, 1987; Owens, Bliss, Koester & Jeppsen, 1989).
Frankel 1974) has also speculated that the heightened hypnotic susceptibility may
be implicated aetiologically in the development and maintenance of phobic conditions.
TREATMENT OF ANXIETY
Management of the anxiety disorders may include psychotherapy, pharmacotherapy
or both. The primary goals of psychological and hypnotically based therapies for
the treatment of anxiety disorders are: the exposure of the patient via imagery or
reality) to the situation provoking the anxiety thereby allowing deconditioning,
habituation or desensitization); cognitive re-evaluations of the situation to alter the
perception of threat; determining the personal signi®cance symbolic) of the stress
or anxiety provocation; increasing the sense of self-ef®cacy in the patient's ability
to deal with the stress-eliciting situation and the stress or anxiety symptoms; and
the rehearsal of coping strategies. Despite the applicability and ef®cacy of
hypnosis-based behavioral, cognitive and other psychotherapy interventions, there
is a need to understand patient differences and to individualize treatment interventions
Jackson & Stanley, 1987). There is a need to bear this in mind when deciding
on clinical interventions appropriate for individual patients. Insight-oriented psychotherapy
attempts to assist the patient in ®nding, understanding and thereby
changing the cause of the anxiety. In this approach anxiety is assumed to be
symbolic of some other issue, which the patient is not facing or is not aware of. In
contemporary therapy, insight-oriented therapy approach is less common, as