Three cases

Alex is a 37yr old business executive who has had problems with eczema “all his life”; it has got worse recently and he is wondering whether hypnosis would help him.He had a reasonably happy childhood and did well at school. He does, however, remember being bullied by some older boys when in his first couple of years at secondary school. His parents are still alive and in fairly good health. He says he gets on well with them but has a better relationship with his mother. His father was “a hard man, but fair” and never demonstrably affectionate. Alex remembers feeling that he had let his father down when he failed to achieve as good results in his exams as he was expected to and that his father was often critical of him, especially during his teens. Alex is happily married with 3 teenage children and is working long hours at a demanding job. He has no obvious interests outside work and home. Recently he has found himself becoming “irritable” and is having some problems sleeping. He agrees that his eczema always flares up when he feels stressed. He also feels that he is not valued by his Company and that he is taken for granted. What problems do you think will need addressing?If he is resistant to the idea of looking at anything other than his eczema how would you proceed?

Julie is a 39 year old who presented with anxiety symptoms and an increase of problems with her irritable bowel syndrome. She had had a slight “accident” with soiling about 6 months ago and was becoming increasingly anxious about being near a toilet when she went out. She felt that it “was always on my mind” and that because of this she was going out less and less. She worked in the reception at a hospital and had witnessed an attack at work 8 months ago – she dated her increased anxiety symptoms to this time and had been off work with anxiety for about 4 months. She had no other history of note, having a “normal” childhood and being happily married with a child of 12. She felt she had always been “a bit of a worrier” and that she “took after my mother!”

What problems do you think you would need to address in therapy?If you only had 3 sessions how might you plan your approach?

Nicola has a long history of classic migraine headaches. She is a 54 year old teacher and realises that her migraines are often triggered by stress. She is reluctant to take medication and feels that apart from fairly high stress levels engendered by her job she does not have any other problems.

Would you need any further history?

What would be your approach?