Overcoming phobias with Cognitive Behavioural Hypnotherapy

A phobia can make ordinary moments - a lift, a spider in the bath, a flight booking, a high balcony - feel overwhelming:

Cognitive behavioural hypnotherapy brings together two practical and evidence-based approaches:

• CBT helps make sense of the thoughts, feelings, body sensations and behaviours that keep fear going

• hypnotherapy uses deep focused relaxation, among other things, to calm the nervous system so that new responses can develop more easily

Cognitive behavioural hypnotherapy works best when there's a collaborative approach: both the client and therapist are in partnership doing the work.

We'll work step by step, usually using up to 12 sessions, at a pace that works for you.

A phobia is learned, maintained and can be unlearned

Common examples of phobia are fears of flying, heights, spiders, other animals, needles, or enclosed spaces. Fear is part of the body’s protective system. When the brain detects danger, the nervous system can move into fight, flight or freeze. Heart rate rises, breathing changes, muscles tense, and attention narrows.

That response is useful when you're in real danger, but becomes a problem when the 'alarm system' goes off in situations that are safe, manageable, or only uncomfortable. The phobia itself is a learned 'hypnosis': by working on the problem, you can 'de-hypnotise' yourself away from it.

How we work on the phobia

Conceptualisation

Early sessions involve building a clear conceptualisation. This is a 'map' of the following key components of the phobia:

• triggers

• thoughts

• emotions

• body sensations

• actions (such as avoidance or escape)

• consequences, both short term and long term

  
  

For example, a person with a spider fear may see a shape on the wall. The thought might be, “It will jump on me” or “I won’t cope.” Anxiety rises, the stomach tightens, and they leave the room. The immediate consequence is relief. The longer-term consequence is that spiders feel even harder to face next time and therefore the phobia keeps going in circles. A clear conceptualisation makes it easier to understand what action to take to resolve the problem.

Conceptualisation helps you make sense of the phobia

Deep, focused relaxation

Deep focused relaxation helps reduce that sense of being hijacked by emotion and sensation.

In this way, the body learns what safety feels like, your attention becomes steadier, and you can mentally rehearse a different response while feeling more grounded.

Relaxation includes:

• slow, steady breathing

• muscle relaxation

• guided imagery

• rehearsal of coping statements or planned actions

Desensitisation

Most people do not overcome a strong fear by jumping straight into the hardest situation. We'll work together to understand which aspects of the phobia are least to most challenging (for example, looking at a cartoon image of a spider at one end of the hierarchy, versus picking a spider up and putting it outside at the other end). We'll then tackle them step by step to build your self-efficacy (the felt sense that you can handle the problem).

This can be done through imaginal exposure, where we use hypnotherapy to rehearse the situation in your mind. It can also involve behavioural experiments, where the person faces the situation in real life.

Cognitive restructuring to tackle catastrophic thinking

Phobias often come with frightening predictions. These thoughts can feel like facts because the body reacts so strongly.

Cognitive restructuring helps examine those predictions with curiosity rather than fear. This may include asking:

• what am I predicting will happen?

• how likely is that outcome?

• what evidence does or does not support it?

• what is a more balanced thought?