Student Case Study – A Blood Phobia

Another Doc Martin? By Lottie Wadsworth

Spring 2015

James wanted help with his blood phobia, whenever he sees blood or thinks that there is going to be blood he feels faint.

The first occasion that James remembers having this problem was when he fell off his bike at the age of 17. He hit his tooth badly and felt faint. There was not any blood. He rushed home so that he could lie down. Subsequently he went to the dentist who said that the tooth had been killed and nerves needed to be removed. He initially started to do this without a local anaesthetic injection but then had to give an injection as James was in pain. Prior to that incident, James did not recall having any problems. The context of the problem now is that he has the feeling of faintness when he cuts himself, such that there is dripping blood (more than a paper cut). He is ok again once there is a plaster. He also has the feelings if he is having injections at the dentist or if he has to have blood taken by a nurse. It is also a problem for him if his children are hurt or if there is something bloody on television.

James was able to give a full description of the various components to his problem, we call this the structure of the problem, which he described as follows: He described a light headed feeling that had the impression of being in a panoramic view, where there was a red quarter circle growing as the feeling got worse and encroaching on a black quadrant.

His hearing was funny with a ringing coming into both ears. He would feel hotter and sweaty.

His chest was tight – he describes this as a yellow oblong. (A yellow oval when freely breathing)

His limbs feel heavy.

Uncomfortable, fidgety feeling which is eased by lying down.

When we look at the structure of a problem we can become aware of the trance phenomena involved in the problem which can often be used to help us in creating tailored hypnotic language for the client. In this case the trance phenomena involved was sensory distortion and time distortion.

James described some feelings of anxiety and nervousness surrounding the problem. If he thinks that he is going to see blood he will avoid it if possible for example by switching the television channel. This anticipation of a negative future experience is the trance phenomena – age progression. The feeling of faintness will begin if he cannot avoid it. It seems that James is able to manage the feelings to a certain extent, whilst actively having to deal with the blood but the feelings then overwhelm him once he is able to relax a little.

The only way to stop it is then for him to sit down or lie down until it goes away. If he knows he is going to have an injection, then he feels stupid that he is going to have the feeling of faintness. Feeling stupid is often a fear of being judged by others and we might describe this as positive hallucination as we don’t really know what the others involved might think and therefore we are imagining something that isn’t really there. Once the feeling has gone, he doesn’t think about it anymore. When we forget our problem this is the trance phenomena called Amnesia.

James found it difficult to provide much detailed information about his solution state, perhaps because he does not encounter the problem very often in day to day life. This can happen sometimes with a client and so I took what I did manage to get and together with awareness of the structure of his problem use this to create his tailored self-hypnosis download – what we call Wordweaving.

As part of his solution state I was able to identify elements of change he believed he would notice in his environment, behaviours, capabilities and his sense of identity. This was gathered from the following statements.

‘Blood wouldn’t affect me as much. I would be able to carry on’ (environment / behaviour)

‘I could consider giving blood but can’t think about that now’ (behaviour)

‘My mind would listen to me. My family and determination will help me. I would have methods of stopping the feelings at any point’ (capabilities)

‘I am able to cope. I am happier’ (identity)

As the information on solution state is limited, I could also include in my Wordweaving some more generic wording about change which James’ unconscious can take from it what it needs to.

Treatment plan

I suggested that we carry out timeline reconsolidation. To go back to the first event connected with the problem and to reframe it. The first event may well be the bike accident as James does not remember having a problem prior to that. However, James was asked to remain open-minded as there could be something else that he cannot remember.

Timeline reconsolidation is an excellent tool and will hopefully solve the problem. However, if there are any residual feelings we can try structure interventions such as spinning or Dropthrough. These would provide James with tools to help him control his feelings. Also, if the bike accident was simply a traumatic event and there is no learning for James to be able to reframe and reconsolidate the memory, then I can move into Fast Rewind and restructure the memory instead before reconsolidating it back into the unconscious.

Timeline Reconsolidation

We briefly discussed the process of timeline as James’ way of filtering information meant that an understanding of what was involved would help to engage him fully with it. James identified the direction and colour of his timeline and then moved above it. I asked his unconscious to take him back to the first event connected with his problem so that by doing so he could let go of that problem completely and for good. James went back to the bike accident and was able to go into some detail as to what was going on. I asked him if there was a connection between that event and the problem he has had up until now what it would be. He said that it was not knowing whether he was hurt or not and not wanting to faint. I asked James if there was something that the him at that age could learn that by learning it would allow him let go of the problem. James said that ‘there was no harm done’ and ‘the human body’s not as fragile as you think’. As James was readily able to come up with the learning, I decided to continue rather than to switch to Rewind but could have switched later if necessary. I asked James to pass that learning down to the younger him, which he did.

I then asked James to move along his timeline to just before the bike accident and asked whether the feelings had gone. He said that he didn’t feel anything. This suggests that the bike accident was indeed the first event connected with the problem. I then asked James’ unconscious to move back along the timeline all the way to the present, noticing any other events connected to the problem and letting go of the effects of the problem. I decided not to ask James to associate into the bike accident event before returning to the present as it was a traumatic event with some pain involved.

Finally, I asked James to imagine going out to an event in the future, which if it had happened in the past would have been connected with the problem he once had. James said that it now felt ok.

I finished by delivering my Wordweaving and counted James back into the room.

James was happy with how things had gone. He had noticed lots of events as he had come back to the present and I said that was great, as it meant that his brain was processing the changes resulting from the learnings he had passed down to his younger self. This was a good sign that the work we did will have resolved the problem he once had. As James does not frequently encounter situations relating to his previous problem we agreed that it would be best not to arrange any further sessions now and for him to see how things go. If he finds that he does have any residual issues then we can do some more work so that he has tools he can use to manage the feelings as they arise. I gave James the task of listening to the recording of the Wordweaving that I will provide.

Extract from Wordweaving.

And as you look forward from today you might be surprised how soon you start to notice all those things that mean that you are changing. It may (possibility) be a television programme that doesn’t affect you as it once would have done or perhaps your ability to carry on after one of your children has a mishap or something else entirely whatever it is doesn’t really matter just the growing knowledge that you have all the determination you need and that means that you are able to cope. And it may not be until afterwards looking back that you may realise how much more calmly you can deal with situations so that you may not even remember the feelings you once had. Instead you may enjoy the new feeling of coolness that clearness of hearing that feeling in your chest that means you can breathe freely.

The more curious you become about this the more you might notice that your mind will listen to you and because of that you are happier. And that’s more or less the right thing.

And as you are sitting here listening to my voice, you may begin to wonder how many things can change. All those things you can imagine in the future that you may start (time) to experience differently, those things about you that are growing stronger, things that in the past you may not even have considered becoming possible. And we both know how important it is to you. And as your unconscious mind knows all the things you need to make these changes stronger and more powerful and more lasting…

Two weeks later:

James reported that he no longer feels faint when discussing blood or watching something gory on television. He enjoyed watching Silent Witness without having to turn away! He had not had to deal with any blood directly but was feeling a bit nervous about the prospect of doing so. We discussed the possibility of having another session to give James some techniques that he could use to manage any faintness should it arise but he decided to wait and see what happens. He will continue to listen to the Wordweaving in the meantime.