11 Sept 2020
If one hundred people were all to experience the same unpleasant situation, they would each respond differently, both psychologically and behaviourally. Factors that influence this include their personality traits, positive and negative life experiences and their present circumstances, together with their attitude towards that situation. For those who are more resilient, they may more easily ‘process’ an unpleasant event, take any learnings from the experience and move on, whereas for others who are less resilient, it will have greater impact on them, becoming a traumatic or stressful event.
A traumatic event is something which, for that individual, creates a significant amount of stress or disturbance, whether that is due to terror, horror, a sense of helplessness, or the real or perceived threat of serious/life changing injury or death. As a result, anyone can be affected by a traumatic event, not just those immediately in or near the experience or incident, but also those attending to the situation (e.g. rescue workers, healthcare professionals) and the friends, relatives, even colleagues of those involved. For some, simply seeing the event reported on television may have an impact, rather than seeing the incident or experiencing the effect on survivors first hand. A traumatic event can also be either a short/one-off episode (e.g. a car crash), or extended over a period of time/individual events (e.g. being held hostage, or experiencing earthquakes). Where the duration of intense difficulty or danger is prolonged, it can be considered a crisis. This intense period is subjective and depends on each individual’s perception of a situation where the ‘intolerable difficulty’ exceeds the person’s current resources and coping mechanisms.
The most common crises that clients may report will be relating to situations, incidents and events, such as being a victim of crime, being caught up in a natural disaster, or being in an accident. However, you may also encounter clients who are experiencing an inner crisis about some aspect of their life, or relating to the direction they are taking, or their ‘purpose’ in life (existential crisis), perhaps in the form of a client having a midlife crisis, with a slump in their life satisfaction.
Strategies to help clients increase their coping strategies during a crisis
Common reactions to a traumatic event can include depression, grief and fear. Physically a client may report sensations including dizziness and nausea. Clients may also report being unable to engage in their normal activities, feeling less able to perform at work and socially, alterations in the appetite and sleeping habits, even lacking the motivation to take care of their personal hygiene.
Hypnotherapy can be of great help to people wishing to cope better with a traumatic event or crisis, helping them deal with something that has the potential to overwhelm them or cause trauma. This may take the form of emotional support and stabilisation, building inner resources, and developing effective coping strategies.
Whether the client’s crisis has an emotional context or a situational one, you can help them develop some emotional and physical resources, increase their resilience and give both practical and psychological support.
As a therapist, a good starting point is to be a good listener. Yet there is far more to listening than hearing what someone is saying. Active listening and truly being present in the conversation is important. When they speak with you, it may be the first time that they have talked, out loud, about the situation and their thoughts and feelings about it. This is their time to share, and it can be aided by taking a client-centred position of ‘unconditional positive regard’ offering acceptance (that they are allowed to feel what they feel) and continued support.
Beyond letting the client consciously explore their experience, you will be able to support and guide them towards simple solutions, whilst empowering them to engage in the change process, rather than being ‘passive’ in the therapy process, and having therapy ‘done to’ them. In addition to the standard goal setting and solution-focused treatment planning where you consider behavioural (habit) and cognitive (belief) changes, you may choose to engage in some insight-generating work (analytical therapy) to help a client gain deeper understanding, particularly of subconscious influences.
Three particular areas to include when planning therapy sessions to help clients with crises are, boosting decision-making skills, developing a positive approach to self-care and helping clients to seek and accept support.
One definition of stress is, “when the demands placed upon someone exceeds their ability to cope”. Stress can occur as a result of cumulative pressure (e.g. overworking), or in response to an aversive stimulus (e.g. unpleasant situation) that is difficult to cope with, or as a dynamic response which considers both of those aspects, as well as the role of cognitive factors, such as the client’s beliefs, thoughts and attitudes.
When someone is stressed, there is often an impact on their decision-making abilities. As a result, they may find themselves distracted by minor tasks or they may even lack the ability to focus and prioritise at all. Where a client may have lacked focus during a single event, they might end up having negative perceptions about their ability to cope in other challenging situations in the future. Teaching them how to focus and manage their decision-making can give them confidence in their own abilities and boost their resilience. This can also be of benefit if a client is presently immersed in an ongoing stressful situation, or is anxiously anticipating future events. Work prior to and during hypnosis can be reinforced with role play, mental rehearsal, and developmental (homework) tasks for beyond the therapy session.
Being under pressure can be exhausting. The more tired someone is, the less resilient they may feel. Helping a client explore ways in which they can prioritise their time and actions, and make time for themselves can enable them to conserve their energy, so they are better able to focus on addressing whatever challenges or problems they encounter. As well as helping a client develop the beliefs and skills to manage their time and make decisions, and other psychological stress management techniques, it can also be good to direct a client towards better supporting their body physically. You may find that when under pressure, the client pays less attention to their diet and hydration, perhaps eating quick ready-meals rather than something nutritious, and drinking more coffee than water in order to push through fatigue. At a time when the body is under pressure already (from stress), it makes sense to support it with even better nutrition and hydration, rather than less. In addition, poor sleep is common during periods of stress, yet working to get plenty of sleep can help the physical body as well as the mind, and can boost someone’s perception of being able to cope. Something as simple as teaching the client self-hypnosis to be used at the end of the day, so that they can work through and release tensions and focus on a good night’s sleep, can be highly beneficial and empowers the client with engaging in their own self-care.
Where a client has a supportive family or friends, they may already be accessing that support. However, not everyone will have a support network (or be comfortable relying on it). There are many different resources you can introduce a client to, including community provisions (e.g. crisis centre), charities and support groups. The latter can be helpful if they are action focused (so, rather than just focusing on, “oh how terrible this is”, a “we will share our skills and experience to help each other” agenda can be a lot more helpful). Where there is a support network, it can be useful to encourage a client to share their feelings to help family and friends understand that they are seeking their support in improving their ability to cope. You may help a client to develop assertiveness in order that they can feel more comfortable when seeking support.
Talking of friends and family, when hypnotising friends and family do bear in mind how relationship dynamics may be affected. They may be particularly cautious about sharing with you the intimate details of an unpleasant situation, whether because they don’t want to upset you, or that they don’t want you to change how you think about them. It can be more helpful, with significant events, to refer them on to another professional hypnotherapist, in order to maintain your normal relationship.
Therapists working with crisis clients
Commonly you will be working with clients to develop new healthy behavioural responses (habits), using direct suggestions relating to their desired outcome. As well as that, you will aim to instil positive, resourceful ways of thinking, whilst dealing with any limiting beliefs, such as identifying and addressing any cognitive distortions and helping a client understand these for what they are, so that change can occur. For example, with ‘black and white thinking’, a client may feel that a situation must be ‘100% good’, otherwise it is ‘100% bad’ (which is not true).
Talking of beliefs, your own beliefs as a hypnotist or hypnotherapist will also influence client outcomes. If you lack confidence in a particular area, then working to boost your skills and develop more confidence can lead to better outcomes for the therapist and the client. It is also helpful to work to increase your own resilience as a hypnotherapist so that you are more able to address a client’s issues directly, rather than possibly being influenced by your own circumstances. If you are working a lot with clients who have trauma or stress, then it is also important to engage in personal self-care as a therapist to help you work more effectively in helping clients make positive changes and enhance their quality of life, without being affected by secondary traumatic stress.
Ultimately, by taking a solution-focused and goal-focused approach to crisis and traumatic event experiences, you can help a hypnotherapy client let go of undesirable responses and develop new healthier thoughts, behaviours and coping strategies. This not only helps them move forward from the original incident, but also gives them coping strategies to apply to any future incidents.
We hope that this blog about helping clients respond to a crisis has been helpful. If you have any questions about this topic or anything else for that matter, do please get in touch, because we’re always happy to help!
– written by Dr Kate Beaven-Marks