A case study involving the use of Hypnotherapy for Psoriasis
by Paul Howard D.Hyp MNCH
Introduction
Sally was one of the clients in a study I conducted on the effects of Hypnotherapy on Plaque Psoriasis. Having seen various studies on how Hypnotherapy can be very helpful in tackling psoriasis I asked for volunteers on a self-help forum through the Internet. Sally was one of the volunteers that asked to be included.
Although she lived a long way from my practise I explained that she would need to see me once a week for 8 weeks. I also explained to her that she would need to get a PASI form filled out by her GP to show the extent her body was covered by psoriasis at the start of the study. I also asked her to take photographs of her psoriasis. She had used no medication, only moisturising cream, for over 2 years.
The therapy was conducted over 8 sessions. The treatment plan I had devised allowed for 3 sessions of Hypno-analysis followed by 2 sessions of suggestion therapy, 2 sessions of NLP and finally a self-hypnosis session. I also gave Sally a CD with two different tracks on it - more about that later.
Background
Sally is a 28-year-old woman working in an IT company, which she perceived as a highly stressful job at the time. She lives with her boyfriend “Steve”. She was a 20 a day smoker. Sally had quite severe Plaque Psoriasis on both knees and both elbows. She was very conscious of it, always wearing long sleeves and long skirts or trousers. She would never uncover herself except in front of Steve. He was very supportive of her and the psoriasis did not seem to be a problem for him.
Sally had suffered with psoriasis for 22 years. She had tried steroid creams and everything else her GP had to offer, as well as chinese herbal remedies, acupuncture, and UV treatment (which had had limited success). In 22 years she had always had some psoriasis, and nothing had reduced it significantly.
What is Psoriasis?
The top layer of skin is much thicker in psoriasis. It gets this way because the normal growth cycle of skin cells has been accelerated to 3 or 4 days, compared to 28-30 days in normal skin. Skin cells accumulate at the surface. The white, flaky build-up that sheds from the skin is actually dead skin cells. The epidermis is about twice as thick as normal in psoriasis. The bottom level of the epidermis where cells multiply is particularly active (cells are proliferating 28 times faster than normal skin). The blood vessels of the skin expand in psoriasis. There is also increased blood flow in psoriatic skin, necessary to bring nutrients to the rapidly growing skin cells. This combination leads to the redness of the psoriasis lesions. The dermis is where the inflammation originates. Immune system cells are drawn into the dermis as part of the immune response that takes place in psoriasis and these cells send inflammatory signals to the skin cells.
My aims as the Therapist
My aim during the early therapy sessions was to establish if an initial sensitising event was present, using Transforming therapy, taught to me whilst training with Gil Boyne. This was then followed with some suggestion therapy utilising the limited success Sally had achieved with her UV treatment to attempt to heal her existing Psoriasis quickly. This was supported by track 1 on the CD I gave to her. Track 1 was a relaxation induction (Hartland) followed by suggestions of her being on a beach in warm sunshine and her feeling the sun on her skin.
I then intended to use NLP to change her beliefs regarding the psoriasis by changing her view that she was a victim, to one that she was a winner and could change her life, so that she would not think about her psoriasis all the time, like she had at the beginning. Finally to teach her self-hypnosis.
The Technique
I used instant induction techniques including a standing induction, and a form of the Elman technique i.e. closing hands. After the induction I would continue to deepen the trance until I was satisfied that the client would go no deeper.
I used 90-minute sessions throughout the treatment.
Treatment: session 1
During the initial interview, I established that her mother was a perfectionist and very controlling and her father was very relaxed and quite laid back. Her father tended to work a lot and found it quite difficult to show his emotions. When questioned Sally said that she believed her mother didn't love her although she loved her mother. She believed her father did love her and she loved him.
When asked how her psoriasis made her feel, she revealed that it made her feel dirty, lonely, upset and unattractive.
The initial interview took nearly an hour. At this point I induced hypnosis and used her own words about her psoriasis to bring the feelings up and to heighten them. I then used these strong feelings as the royal road back into the sub-conscious to the first time she felt this way.
She was six when it transpired that she was in a room with her mother and her mother was packing up the house because they were moving. Sally felt very lonely as she was leaving her two best friends. She asked her mother why they had to move and was told to “shut up and help”. At this point Sally felt extremely lonely and unloved.
I then set up a gestalt session with her mother where Sally told her how she really felt and asked her to explain what was going on. Eventually her mother apologised for not explaining but would not give a reason why they had to move.
After doing some integration I terminated the trance. Sally had been crying a lot during the session and after allowing her a few minutes to compose herself, I asked her about the event. She explained that she had no conscious memory of this event but would ask her parents about it. I cautioned her not to confront her parents but just to get some information.
I asked Sally how she felt about what had been revealed. She said she was very surprised that this memory had come back to her unbidden.
The session lasted over 2 hours
Session 2
Sally had discovered that her father had made a business deal that had gone wrong and because of this it had been necessary for them to move. Her mother had been very angry and unhappy.
Upon inducing Hypnosis again Sally went straight back to the same time. We discovered that she was very upset about leaving her friends Jane and Mark, also aged six. They were twins that she had known all her young life. Apparently they had been out when she had gone round to say good-bye. Her mother was not happy about having to do this just before they left and was very dismissive of the fact that they were out.
Once again we set up a gestalt session where there was a very powerful exchange between Sally and her mother. During the gestalt session Sally was shouting and swearing at her mother telling her how she felt about that time. During this time I noticed how scared Sally was of her mother and how much anger there was towards her.
Once again we did the integration of this new information, getting Sally to realise how it affected her as she grew and how it was still affecting her now.
Upon termination of the trance I asked Sally how she felt. Once again it had been quite a traumatic session. She explained that she felt very drained but strangely calm.
Session 3
At the start of this session Sally reported that she had felt very relaxed all week, something she hadn't felt for a long time. She said she also felt a bit sad as she had not thought of her childhood friends in a long time, she had apparently lost contact with them after they had moved.
She had had trouble this week holding her temper with her mother and had become irritated whenever she spoke to her. I explained to her that there was no blame, had she had the same conditioning and experiences as her mother, she would have done exactly the same.
During this session we did a gestalt session with her friends Jane and Mark, where Sally said good-bye (with a lot of emotional release). We then set up another gestalt with her mother where Sally confronted her on her controlling nature. Eventually she came to the realisation that her mother was not to blame, and after another powerful gestalt session Sally became very calm.
We went on to regress her back to the new house where she was desperately unhappy. She had no friends and was being bullied at school. It was at this time that her psoriasis started. We integrated all this information and she realised that this was possibly the reason why she had developed psoriasis.
Upon termination Sally reported it felt as if a huge weight had been lifted off her shoulders. She felt light-headed and was smiling from ear to ear.
Session 4
At the start of this session Sally reported that she had felt really good all week, even when she had talked with her mother. All thoughts of confronting her mother had gone and she felt at peace with her now. In fact when her mother had started her controlling behaviour on the previous Sunday during a visit, she had simply smiled to herself and let it wash over her. She reported that things at work were still stressful.
During this session I used suggestion therapy on her psoriasis healing and her work becoming less stressful. I also introduced the CD using Track 1 Warm beach, which I asked her to play once a day.
Session 5
Sally told me that her relationship with her mother had improved even more. Her mother had asked how the hypnotherapy was going, and in spite of not being able to tell her everything she has discovered about herself, they were able to have a frank and open conversation. She also reported that she thought that her psoriasis was marginally better.
During this session we worked on her self-image, getting her to feel better about herself and seeing an image of her body without psoriasis.
Session 6
There was now a significant improvement in Sally's psoriasis, which she was able to show me for the first time. It was at this point she gave me the photos she had taken at the beginning and there was no doubt that there was an improvement. Sally was really excited.
During this session we enhanced the image of her body completely clear of psoriasis and I anchored it to the word PSORIASIS - so every time she thought about or someone mentioned the word she would see a picture of herself in a bikini on a beach completely clear of it.
Session 7
Sally arrived at my consulting rooms in a skirt to just below her knees and a T-shirt. Apparently she had been wearing these sorts of clothes to work all week and although people had mentioned and commented on her psoriasis, she explained to me that it no longer bothered her. There was a further improvement in the psoriasis this week.
During this session we did a lot of Timeline work and further suggestion therapy on work related stress.
Session 8 (Final Session)
Only a slight improvement on the psoriasis this week, however Sally reported that she was really happy with her body now and felt sure the rest would go in time.
During this session I taught her Self-hypnosis so she could continue reducing her psoriasis, which by now was reduced approximately 75%.
Post Treatment
Both Sally and I felt her progress over the trial was such that we were sure it would continue until she was completely free of psoriasis. I asked her to use track 2 of the CD as well to help with her Self-hypnosis.
I have seen Sally on 2 occasions since. Once was 3 months later to do a follow up, and her psoriasis was almost gone, about a 90% reduction. Then a year later where it has virtually disappeared, on her scale 99%!
Conclusions and Recommendations
It is interesting to note that Sally never really attained a very deep level of trance. Levels of trance do not seem to be a contributing factor in the response. Finding and eliminating the ISE (initial sensitising event) and any convincers I believed to be an important factor.
I think it is very important to change the image the clients invariably have of themselves as being dirty or unclean. The fact is that Sally felt unlovable because of her Psoriasis, and her mother's attitude was also a large contributing factor of her maintaining her Psoriasis.
During the trial I worked with 7 clients. Of these seven 2 achieved over 95% reduction, 2 achieved over 50%, and 3 saw no improvement at all in the actual Psoriasis. However, even these 3 reported a completely different attitude towards their Psoriasis. So who know what the future holds.
Below is the actual email sent to me by the client 18 months after her treatment
"Hi Paul,
We've taken some more pics which you can use on any marketing material or in any studies about hypnosis and psoriasis. The focus is a bit dodgy so let me know if you need better pictures.
The great thing is, I know I'll never have psoriasis again because I won't let it happen. Being psoriasis free has given me a newfound confidence - I feel great about myself and my lovely clear skin. I am more confident at work and with friends socially because I'm not dreading having to answer questions about what's wrong with my skin. It's a huge weight off my mind - I don't have to spend hours picking out an outfit that has to cover 80% of my body and I can go clothes shopping in the summer for short sleeves and skirts! My only regret is that I didn't try hypnotherapy about twenty years ago, but better late than never. "
Sally's arms at the start of our sessions
Sally's legs at the start of our session
Sally's arms at the end of 8 sessions
Sally's arms 18 months later
Sally's legs at the end of 8 sessions
Sally's legs 18 months later
Paul Howard
The Surrey Institute of Clinical Hypnotherapy http://www.sich.co.uk/
PaulH@sich.co.uk
