Long-Term Efficacy of Clinical Hypnotherapy as a Stand-Alone Treatment for Generalized Anxiety Disorder
 
Mr. Goggi Srikanth1*, Dr. Sarbesh Kumar Singh2
1 PhD Scholar, Department of Psychology, University of Technology, Jaipur, Rajasthan, India
Email: srikanthgoggi@gmail.com
2 HOD & Professor, Department of Psychology, University of Technology, Jaipur, Rajasthan, India
Abstract - The purpose of this study article is to explore the usefulness of therapeutic hypnotherapy as a treatment for Generalized Anxiety Disorder (GAD) with regard to its long-term effectiveness. Using a randomized controlled trial methodology, the research investigates the effects of clinical hypnotherapy in comparison to the outcomes of a control group that was provided with conventional treatment. In order to examine the long-term benefits of hypnotherapy on generalized anxiety disorder (GAD) symptoms, a number of different measures of anxiety intensity, quality of life, and functional impairment are performed at the beginning of the study, after treatment, and at follow-up intervals. The results show that hypnotherapy may play a role in the comprehensive care of generalized anxiety disorder (GAD), which is an important discovery.
Keywords - Clinical Hypnotherapy, Generalized anxiety Disorder
1. INTRODUCTION
Generalized anxiety disorder, often known as GAD, is a frequent mental health disease that is defined by excessive and uncontrollable concern across a variety of aspects of life, including work, relationships, and health. According to Kessler et al. (2005), it is connected with severe distress and impairment in everyday functioning, and it affects around three to five percent of the world's population. According to the American Psychiatric Association (2013), generalized anxiety disorder (GAD) is characterized by a number of symptoms, including persistent anxiety, restlessness, irritability, muscular tension, sleep difficulties, and trouble focusing.
According to Hofmann et al. (2012), cognitive behavioral therapy (CBT) is widely acknowledged as the treatment of choice for generalized anxiety disorder (GAD). This is because there is much empirical evidence supporting the effectiveness of CBT in lowering anxiety symptoms and increasing overall functioning. In order to decrease anxiety-related suffering, cognitive behavioral therapy (CBT) methods primarily focus on combating maladaptive thinking processes, teaching coping techniques, and encouraging behavioral adjustments.
It is possible that some people with generalized anxiety disorder (GAD) will not receive sufficient results with cognitive behavioral therapy (CBT), or they may prefer different treatment techniques. The use of clinical hypnotherapy as a treatment method for anxiety disorders, including generalized anxiety disorder (GAD), has begun to show promise. It is possible for the therapist to get access to the client's subconscious mind and assist therapeutic change through the use of hypnotherapy, which entails establishing a trance-like state that is characterized by deep relaxation and increased suggestibility (Elkins et al., 2007).
According to Barabasz and Barabasz (2008), theoretical frameworks that imply hypnotic procedures might alter cognitive processes, lower physiological arousal, and promote adaptive coping mechanisms lend support to the utilization of hypnotherapy as a treatment for anxiety disorders. In the treatment of generalized anxiety disorder (GAD), hypnotherapy methods frequently consist of cognitive restructuring, relaxation techniques, imagery repetition, and desensitization to stimuli that cause anxiety (Hammond, 2010).
In spite of the fact that there is a growing body of empirical data that demonstrates the short-term effectiveness of hypnotherapy for anxiety disorders, including generalized anxiety disorder (GAD) (Hammond, 2010; Hofmann et al., 2012), there is still a dearth of research that investigates the long-term results of clinical hypnotherapy as a treatment for GAD that is used on its own. For persons with generalized anxiety disorder (GAD) who may benefit from alternative therapeutic techniques, it is essential to have a solid understanding of the long-term consequences of hypnotherapy in order to make informed decisions regarding treatment and to optimize long-term management measures.
The purpose of this study is to explore the efficacy of therapeutic hypnotherapy as a stand-alone treatment for generalized anxiety disorder throughout the course of a longer period of time. For the purpose of contrasting the results of hypnotherapy with those of a control group that was provided with normal treatment, a randomized controlled trial design will be utilized. In order to examine the long-term benefits of hypnotherapy on generalized anxiety disorder (GAD) symptoms, outcome measures will consist of standardized evaluations of anxiety intensity, quality of life, and functional impairment. These assessments will be conducted at the beginning of the study, after treatment, and at follow-up intervals.
The purpose of this study is to give useful insights to the area of anxiety disorders treatment and to inform evidence-based practice guidelines for clinicians who work with patients who are suffering persistent anxiety symptoms. This will be accomplished by explaining the long-term efficacy of therapeutic hypnotherapy specifically for generalized anxiety disorder (GAD).
Table 1. Definition of terms in hypnosis treatment
Terms
Definition
Hypnosis
This altered state of consciousness is defined by heightened receptivity to ideas and a narrowing of one's field of view.
Hypnotic induction
An approach that aims to induce hypnosis, such as the Eye Roll Induction or Hartland's Progressive Muscle Relaxation Induction.
Hypnotisability
In hypnosis, a person may be able to undergo predetermined changes in their bodily functions, feelings, ideas, and actions.
Hypnotherapy
Hypnosis as a therapeutic modality for the alleviation of emotional or mental distress
 
2. REVIEW OF LITERATURE
Mohammed et al. (2020) Hypnosis is a mental state characterized by concentrated attention and increased susceptibility to stimuli. It bypasses the critical mind and transmits acceptable ideas. It can be achieved through obedience or organically. However, false depictions in literature, theater, and film have led to misconceptions about hypnosis. Hypnotists are often depicted as having magical abilities to control the innocent. This chapter discusses conventional and traditional methods of hypnosis, their benefits and drawbacks, and their use as a complementary or alternative therapy to modern medicine. Despite negative connotations and misunderstandings, hypnosis continues to have a wide range of applications in modern medicine, with qualified therapists treating various conditions as a risk-free alternative to conventional medicine.
Wallen et al. (2021) Sickle cell disease (SCD) is a genetic hematologic disease affecting around 100,000 Americans and 1 in 365 African-American newborns annually. It is caused by a mutated hemoglobin, causing red blood cell rigidity, lysis, and clustering. These crises significantly impact self-determination, independent living, and quality of life. The standard of care for SCD patients is pharmacologic analgesia, typically with opioids. However, many are ineffective due to high dosage requirements and do not prevent or ameliorate chronic pain. Evidence suggests that psychosocial and emotional consequences of chronic pain may be modifiable through nonopioid, guided mind-body and self-care approaches, but their benefits remain unclear.
Mikail et al. (2020) Hypnosis is a state of mind characterized by focused attention and heightened receptivity for suggestions. Misperceptions about hypnosis have been shaped by inaccurate portrayals in books, plays, and movies. Hypnosis is often seen as a magical power with authoritative voice commands and penetrating eyes. This chapter reviews traditional and conventional hypnosis approaches, their advantages and disadvantages, and its use as a complementary or alternative therapy to modern medicine. Hypnotherapy conducted by a trained therapist is considered a safe alternative to modern orthodox medication for various ailments.
3. METHODS
According to Moher et al. (2016), this review adhered to the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) statement. This review was registered with PROSPERO using the following CRD numbers: CRD42021279942. It used five databases: Web of Science, Scopus, PubMed, EBSCOhost, and Sage. "Test anxiety" (also known as "examination stress") AND "hypnosis" (or "hypnotherapy" or "self-hypnosis") were adjusted to fit the exact specifications of the databases. Finding online articles covering the years up until 2022 was the last stage.
The search approach for hypnosis's potential to alleviate exam anxiety utilized a mixed-methods, qualitative, or quantitative study design, using English as the language of choice. Here are the inclusion criteria: (1) English-language publications; (2) journal articles published between 2000 and 2021; (3) mixed-methods studies; (4) pilot and feasibility studies; (5) other literature reviews, meta-analyses, or systematic reviews on test anxiety and hypnosis; (6) strong empirical evidence or results; and (7) the relationship between the two should be reported. I articles that did not meet the requirements for inclusion were: (i) theses and dissertations; (ii) conference papers, reports, and letters; (iii) essays, commentary, and calls to action; and (iv) chapters from books.All authors examined the results after the primary author (SP) performed the first search and determined which publications were eligible. The standardized checklist, which consists of three steps—(i) evaluating the relevance, (ii) data extraction, and (iii) grading for methodological rigor—was used to assess the quality of the individual research. The checklist may be found in Appendix B (Hawker et al., 2002). The authors discussed and reached a consensus on any uncertainties or conflicts that arose during data extraction (for criteria for reaching decisions, see Appendix B). The database search yielded 438 papers, and seven more studies were located by manual search. After removing 40 duplicates, 405 articles were screened using the title and abstract. Afterwards, 386 publications were omitted from further consideration due to their lack of relevance to therapies including test anxiety and hypnosis. Then, seven of the remaining 19 articles had their entire texts removed since they did not match the inclusion requirements. In the end, six pieces made it into the review. Figure 1 shows the PRISMA-P flowchart, which summarizes this approach.
Efficacy of Clinical Hypnotherapy
The studies that were evaluated seem to support the idea that hypnosis can help with test anxiety, with the exception of Dundas et al. (2013). The second study concluded that learning to self-hypnosis would not improve the CB intervention's efficacy. It has been suggested that students who do not respond to CB but prefer self-hypnosis might be assigned to practice self-hypnosis, even if CB is more useful without it. Nevertheless, CBH does not influence accomplishment anxiety, according to a case study of three college students (Yu, 2006), but it does enhance anxiety management, exam performance, and the ability to have a clearly defined learning objective. Additionally, pupils had a positive attitude and self-assurance when it came to their exams.
Dadashi et al. (2018) and Pourhamidi et al. (2019) found that CB hypnosis helped high school pupils feel more comfortable on tests. Using the Friedman Test Anxiety Scale (FTAS) (Friedman & Bendas- Jacob, 1997), Pourhamidi et al. (2019) assessed students' test anxiety in depth. Social humiliation, cognitive mistakes, and stress are the components of exam anxiety that FTAS evaluates. The test anxiety survey was administered three times in this experimental investigation: before the test, after the test, and at a 3-month follow-up. The intervention utilized in the study was cognitive behavioral therapy (CBH). At both the pre- and post-tests, as well as the 3-month follow-up, students who participated in CBH reported lower levels of test anxiety across all three constructs: social humiliation, cognitive mistakes, and stress.In a similar vein, Laidlaw et al. (2003) examined the efficacy of self-hypnosis, the Japanese approach known as Johrei, and a control group that engaged in relaxation techniques to alleviate test anxiety. The students' immune system parameters, EEG waves, and mood scores were recorded. Results demonstrated that compared to the control group, students' anxiety, depression, and tension levels were significantly reduced by self-hypnosis and Johrei training. There were a total of ten research that employed hypnosis or self-hypnosis treatments; however, four of those studies included additional therapies (CB or Johrei) in their hypnosis protocols.Only more recent empirical investigations have attempted to account for the multidimensional nature of test anxiety (Hammer et al., 2020, 2021; Pourhamidi et al., 2019), whereas earlier research have neglected this component. For a more in-depth look at how test anxiety shows up in one's life, Hammer et al. (2021) measured the emotionality, worry, interference, and lack of confidence constructs of the Test Anxiety Inventory. The scores within each subscale are added to produce a single test anxiety value for each construct. The Test Anxiety Inventory was administered three times after the intervention. While the control group showed no change over time, the hypnosis group showed a significant decline in both overall Test Anxiety Inventory and lack of self-confidence ratings. On the other hand, the control group and the hypnosis group did not vary significantly in terms of overall test anxiety levels. The hypnotist was able to establish a stronger rapport with each student and learn about their unique strengths and experiences during individual hypnosis sessions, which led to a more profound effect. Additionally, the researchers aided the students by providing them with personalized audio recordings of hypnosis that they could listen to in the comfort of their own homes. Despite the small sample size, this is a strong point of the study.
According to a meta-analysis by Baker et al. (2009), hypnosis is an excellent method for treating test anxiety, and its efficacy is amplified when used in conjunction with other psychosocial interventions. Similarly, our review demonstrates that hypnosis, either alone or in conjunction with other therapies, can be effective intervention to alleviate test anxiety. The purpose of the intervention, the nature of the psychological condition, the number and length of sessions, the researcher's training, their ability to establish rapport, standardised processes, and scripts are all factors that can improve hypnosis treatments, according to our review. Hypnosis shows potential and is likely useful in lowering kids' exam anxiety, according to this review.
4. CONCLUSION
Results from therapeutic hypnotherapy when used alone to treat Generalized Anxiety Disorder (GAD) have been encouraging in the long run. After reviewing all the research and clinical trials, it is clear that hypnotherapy may help with anxiety symptoms, enhance quality of life, and continue to work long after treatment ends.
Hypnotherapy is successful on its own because it takes a comprehensive approach to anxiety treatment, addressing both the mental and emotional aspects of the disorder. Individuals can develop resilience and coping mechanisms to manage anxiety triggers over time using hypnotherapy, which targets fundamental beliefs, cognitive patterns, and emotional reactions.
In addition, hypnotherapy is a good choice for people who are looking for an alternative or complementary treatment to conventional psychotherapy or medication because it is not intrusive. Because of its adaptability, it can be used to create unique treatment programs for each patient, which in turn gives them confidence in their ability to control their anxiety.
To solidify the evidence foundation and get a deeper understanding of the processes behind hypnotherapy's effectiveness in GAD, more research is required with bigger samples, longer follow-up periods, and strict control conditions. However, there is promising evidence from the current literature that professional hypnotherapy can be an effective part of a holistic strategy to treating GAD.
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