* “Discuss the relationship between stress, anxiety, habits and describe how you would treat these issues with hypnotherapy”.

Introduction
Common requests for hypnotherapy treatment are those related to stress, anxiety, habits and phobias. An understanding of the relationship between these disorders, examining the similarities and the differences between each, provides the therapist with information useful in deciding how and if to treat these disorders. It could also be argued that the uniqueness of each client and each set of symptoms demands the therapist to review each case on a one to one basis and not to blur the boundaries between each of these types of disorders, which may in turn result in a less effective form of treatment being provided. Each of these disorders is discussed below, along with mention of any similarities and differences, as well as the considerations that need to be made in the treatment of these disorders. Understanding Stress

The term stress was first employed in a biological context by the endocrinologist Hans Selye in the 1930s. In his usage stress refers to a condition and stressor to the stimulus causing it. Selye researched the effects of stress on rats and other animals by exposing them to unpleasant or harmful stimuli. He found that all animals display a similar sequence of reactions, manifesting in three distinct stages, Alarm, Resistance and Exhaustion. He labeled this universal response to stressors the general adaptation syndrome or GAS. When a threat or stressor is identified or realised, the body's stress response is a state of alarm. During this stage adrenaline will be produced in order to bring about the fight-or-flight response. As Dr David Beales, a specialist in the field of stress, commented recently, “There is not enough oxygen in the brain to solve a problem or make s good decision,” This problem occurs because the blood has been diverted from the thinking brain to the emotional brain, which diverts energy to the muscles to provide the fight or flight response. (Whitten, 2009). Resistance is the second stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted. Exhaustion is the third and final stage in the GAS model. At this point, all of the body's resources are eventually depleted and the body is unable to maintain normal function. The result can manifest itself in obvious illnesses such as ulcers, depression, diabetes, trouble with the digestive system or even cardiovascular problems, along with other mental illnesses. Richard Lazarus and Susan Folkman suggested in 1984 that stress can be thought of as resulting from an “imbalance between demands and resources” or as occurring when “pressure exceeds one's perceived ability to cope”. Stress management was developed and premised on the idea that stress is not a direct response to a stressor but rather one's resources and ability to cope mediate the stress response and are amenable to change, thus allowing stress to be controllable. Treating Stress with Hypnotherapy

Based on the work of Lazarus and Folkman, in order to develop an effective stress management programme it is first necessary to identify the factors that are central to a person controlling his/her stress, and to identify the intervention methods which effectively target these factors. Lazarus and Folkman's interpretation of stress focuses on the transaction between people and their external environment (known as the Transactional Model). The model proposes that stress can be reduced by helping stressed people change their perceptions of stressors, providing them with strategies to help them cope and improving their confidence in their ability to do so. Hadley and Staudacher support this view in their book Hypnosis for Change (Hadley & Staudacher, 1996) in which they state that any hypnotherapy treatment provided to help a client manage stress must be tailored to meet the individual needs of that client. They go on to say that these needs are determined by pinpointing the individuals stress stimuli and their accompanying responses. Successful hypnotherapy treatment will include asking the client to examine the exact stimuli that contribute to their stress and their physical and emotional responses to each stimulus. This will then be followed by using suggestions within hypnotherapy to embed new responses to each of these stress stimulus.

Understanding Anxiety
One of the negative effects induced by stress is anxiety. Whereas stress is caused by an existing stress-causing factor or stressor, anxiety is stress that continues after that stressor is gone. Anxiety is a feeling of apprehension, where often the source of this uneasiness is not always known or recognized, which can add to the distress felt by the client. According to Hadley and Staudacher, anxiety does not arise directly out of painful or dangerous situations. Instead, it’s the thought of potential danger, not the actual danger, which produces the symptoms of anxiety. This is similar to the work done by Lazarus and Folkman's on their interpretation of stress. This process is referred to as the ABC model of anxiety, the situation – A, gives rise to the thought – B, which in turn causes the anxiety – C. Anxiety is sometimes considered to be a normal reaction to stress. It may help a person to deal with a difficult situation, however when anxiety becomes excessive, it may fall under the classification of an anxiety disorder. The physical effects of anxiety may be similar to those experienced by someone suffering from stress, such as heart palpitations, muscle weakness and tension, fatigue, nausea, chest pain, shortness of breath, stomach aches, or headaches. When the body prepares to deal with a threat blood pressure and heart rate are increased, sweating is increased, bloodflow to the major muscle groups is increased, and immune and digestive system functions are inhibited, engaging the fight or flight syndrome as also sometimes experienced by those suffering from stress. Treating Anxiety with Hypnotherapy

Hypnotherapy can help with the treatment of anxiety in a number of ways. Firstly, the treatment can help clients to manage the symptoms of their anxiety. For example, Hadley and Staudacher recommend the use of ‘coping statements’ within the hypnotherapy to increase the client’s ability to compose and recover themselves in situations in which they find themselves suffering from anxiety. Similarly, clients suffering from anxiety should also be provided with the knowledge and skills needed for self-hypnosis so that they can continue the work of the therapist between sessions but also in situations in which they face a level of anxiety. Research provided by the British Society of Experimental and Clinical Hypnosis support this. The outcome and process of treating subclinical anxiety with self-hypnosis and relaxation were compared. Twenty individuals who presented for treatment for stress, anxiety, and worry were assessed, exposed to a 28-day treatment programme (which involved daily measures of outcome and process variables), and re-assessed (for anxiety). It was found that both self-hypnosis and relaxation alleviated anxiety pre- to post-treatment. Although there was no difference in the outcome data, throughout treatment self-hypnosis rather than relaxation was associated with a greater sense of treatment efficacy and expectation and with a greater sense of cognitive and physical change. (British Society of Experimental and Clinical Hypnosis, 1999) Wolfe (1958) supports this in his work on ‘reciprocal inhibition’, which argues that anxiety and tension co-exist with relaxation and peace of mind. Hypnotherapy can be used to this affect by creating a trigger for the client, for example, a word that has been selected, to act as a conditioned stimulus. If, for example, the conditioned stimulus is associated with relaxation, then it will trigger off that reaction no matter how sense the client may be feeling at that point. It is however suggested that anxiety treatment provided purely at a symptomatic level is rarely adequate as the anxiety is often a manifestation of underlying disturbance. Most writers therefore advise that ‘uncovering’ techniques should be employed in such conditions (Karle & Boys, 1987). For example, the ‘affect bridge’ technique described by Watkins (1971) enables the hypnotherapist to explore the circumstances, both past and present, that are associated with the client’s experience of anxiety. Understanding Phobias

A phobia is said to be an intense and persistent fear of certain situations, activities, things, animals, or people. The main symptom of this disorder is the excessive and unreasonable desire to avoid the feared stimulus. When the fear is beyond one's control, and if the fear is interfering with daily life, then a diagnosis under one of the anxiety disorders can be made. Like anxiety, a phobia centres on our natural reaction to fear. The symptoms suffered with phobia’s are also similar to those suffered by clients suffering from stress or anxiety, such as increased heart rate, dizziness, sickness and a shortness of breath, sweating and trembling, dry mouth, confusion and full of dread. Also like stress and anxiety, phobias are more often than not linked to the amygdala, which secretes hormones that control fear and aggression. When the fear or aggression response is initiated, the amygdala releases hormones into the body to put the human body into an "alert" state, in which they are ready to move, run or fight i.e. the same fight or flight syndrome as previously discussed.

Treating Phobias with Hypnotherapy
Again, as with the treatment of stress and anxiety, there are a number of ways in which hypnotherapy is reported to aid the treatment and management of phobias. One such suggested method is hypno-desensitization, which is adapted from the same behavioural therapy technique developed by Wolpe for the treatment of anxiety, as discussed above. Researchers discovered that phobias, as with anxieties, are learned, maladaptive responses, therefore new more appropriate responses could replace them by counter conditioning. The technique known as systematic desensitization gradually exposed subjects to the stimulus whilst in a relaxed state, maintaining their exposure to the stimulus until any initial anxiety subsided. It is important for the therapist to take gather a full case-history, including understanding the triggers and associations the Patient has created relating to the phobia. The therapist can work with the client to create an ‘Anxiety Hierarchy’, a scale usually from 0-100, marking out increments of increased anxiety. This scale is used by the therapist to present the imagined scenes to the client starting at zero and working up through the hierarchy. So long as the client is very relaxed and the increments are equally spaced, momentum is gained as the client learns it is possible to cope with each scene. Because of the similarities between the nature of phobias and anxiety, the recommended hypnotherapy treatments are often also similar. Therefore, techniques such as embedding a trigger to a relaxed state within the treatment, as discussed above for the treatment of anxiety, are also effective for the treatment of phobias. Understanding Habits

A commonly used definition of a habit is that it is something that we do without thinking about it. It is said that when we learn something, the brain makes connections that create pathways for neurological activity. When we then routinely perform the same actions, the brain learns this pattern of behaviour and sets up a pathway. This pathway is a more efficient way for the brain to process the routine, as opposed to a new series of discreet tasks. This then becomes a habit. Common requests for treatment include the extinction of patterns of behaviour that have become habitual to the point of compulsion such as smoking, hair-pulling, nail-biting etc. or for the re-establishment of lost habitual behaviours such as sleeping.

Treating Habits with Hypnotherapy
One way in which hypnotherapy is said to be able to aid the treatment of habits is through the use of ‘ego-strengtheners’ associated with the extinction of the targeted behaviour. Emphasis is put on the anticipated benefits of no longer having a particular habit. Indeed, such a technique can also be a useful part of any hypnotherapy implemented for the treatment of stress, anxiety and phobias, which all involve the client working towards something that they would like to achieve. However, as suggested by Karle and Boys, “While such suggestions are a useful component in any programme and should be included, our experience is that a more powerful approach is one that explicitly tackles the behaviour itself and at the same time provides some relief and compensation for the sense of deprivation involved in ‘giving up’ and for any underlying anxieties”. For example, this may include time spent embedding new behaviour and thought patterns with the client to replace those associated with the previous habit. Ethical Considerations in the Treatment of Stress, Anxiety, Phobias & Habits Hadley and Staudacher point out that clients which are showing signs of one of these disorders may also benefit from counselling, in addition to hypnotherapy, particularly if the symptoms are long term. Similarly, clients reporting physical symptoms may be suffering from physical problems which may or may not be related to their condition. Taking the above into account, as with all forms of hypnotherapy treatment whether for stress, phobias, habits or otherwise, therapists treating anxiety should only proceed when they are confident that hypnotherapy provides a valid form of treatment, and that an alternative method is not actually more suitable. Conclusion

There are several similarities in the nature and therefore effective treatment of disorders such as stress, anxiety, phobias and habits. An understanding of these similarities, and differences, provide the therapist with information useful in the diagnosis and treatment of these disorders. However, as presented above, each client and each experience of the these disorders is different and therefore an ethical and effective hypnotherapist will take time to understand each client and gather sufficient information before diagnosing or undertaking any form of hypnotherapy treatment.

“Using the case study at the end of the module assess the client's issues and describe your treatment plan. What ethical issues might arise?

Miss E is a 29 year old female whose goal is to lose 2 ½ stone in weight. She has come out of a failed long-term relationship 6 months ago, and revealed that her former partner was very controlling and appeared to want her to remain overweight. Miss E has always struggled with her weight since she was a teenager (from the age of 12 or 13), and her parents constantly pestered her about being unattractive and eating too much. Miss E has tried various diets and invariably has always put the weight back on. She is going on an all girls holiday in 3 months and hopes to have lost the weight before then. Miss E also feels ready to look for a new relationship. Throughout my essay and based on the case study provided, I will intends to look at Miss E's issues and I shall be describing what course of treatment i believe could be beneficial for her. I will also mention ethical issues as they arise before concluding.

Obesity is a major contributory cause of death in the UK, around one in every 11 deaths in the UK is now linked to carrying excess fat. Of all the deaths in the UK that were linked to excess weight, about 66 per cent were down to obesity, and 33 per cent to being overweight. Being overweight or obese leaves people at high risk of heart disease, diabetes, high blood pressure and osteoarthritis. It also makes them much more likely to develop several types of cancer. The difference between being overweight and obese lies in a person's Body Mass Index. The body mass index (BMI) is your weight in kilograms divided by your height in metres squared. if your BMI is between 25 and 29, you would be considered overweight if your BMI is between 30 and 40, you would be considered obese if your BMI is over 40, you would be considered very obese (known as ‘morbidly obese’). A lot of people insist they need to loose weight, whether they're overweight or not. The truth is, very few people are happy with the shape and size of their bodies, regardless of whether or not they need to loose weight. To enable further understanding of Miss E's current situation i will need to gather additional information starting by her weight and height as well as her history about how she is relating to food from the childhood to now, her eating habit and her life style within any social environment, her belief system with regard to food. It is evident that Miss E wants to loose weight, but i am suspected that Miss E has deeper issues than this. Many peoples suffering from weight issues are related to emotional problems that can be acted out through their relationship with food. Binge eating can be one way to reduce anxiety frustration fears and unresolved issues.

Before assessing the case of Miss E, it is important to look at any relevant information about her life that could be used to formulate a successful treatment plan. Miss E has been overeating since she was 12 or 13 and also she had been struggling with it but was unsuccessful as she gained her old weight after every diets. It's not unusual for people to get into a cycle of dieting, overeating, feeling guilty and dieting again. This is known as 'yoyo dieting' and makes weight loss difficult to sustain. This means that she has a tendency to sabotage all effort gained. For Miss E, eating has become a habit and habits are ruled by the subconscious which is a very strong force and will usually win when in conflict with the conscious mind. Miss E's parents badgered her of being unattractive and this became her self-image and develop low self-esteem and lack of confidence, this feeling was later reinforced by the behaviour of her ex-partner who wanted her to remain overweight. Hadley and Staudacher (Chap 4, pages 60- 62, Chrysalis notes from module 6 pages 6-7) suggested that there are five common causes for overeating. It will be vital to isolate the reason(s) for Miss E overeating in order to help her through the process of hypnosis. Miss E’s hidden agenda that she is unattractive and not worthy established a secondary gain of being overweight, this mix of feelings reinforced the habit of over eating in order to replace the missing love, love of herself and from

others. This lack of love could be seen increased with the separation from her previous controlling partner which left her traumatised and anxious about having a new partner in her life. Miss E is going on all girls holiday but she is concerned about her weight, and she want to lose 2 ½ stone in 3 months. It is important to identify if this goal is realistic. The best way to sustain weight loss is to lose 2 pounds a week and based on my calculation the realistic target to be set up for Miss E's should be around 1.85 stone (12.99 weeks equivalent to 3 months, times 0.14 stones ideal weight loss per week). If a realistic goal is not set up from the beginning of the treatment, there will be a chance for sabotage (again) . Miss E is going on all girls’ holiday means that she has expectations, she likes to have and enjoy social contacts and changes. She wants to be slim and take pride of body and look into prospective better life and future. She is now looking for another partner this means that she is hopeful and wants to move forward.

It is clear that Miss E has low self-esteem, feeling of uncertainty, and need of love. As therapist our first task should be to boost her ego, self-esteem and confidence in order to ensure that her treatment for losing weight will succeed. Now let’s look into how to design a treatment plan for Miss E’s issues. To begin with, I would have to look at all information required in order to formulate an effective and individualised treatment plan.

First of all I will need to be sure that Miss E is a suitable for hypnotherapy, to be able to do so I will need to gather further information in term of her physical conditions, it would be necessary to identify if her overweight is due to genetic or metabolic factors, from taking any medications or suffering from any severe mental disorders like psychosis, a confirmation from her GP will be requested at this stage. if I realise that there are any physical or mental conditions or a contraindication from the GP to hypnosis, I should refer on Miss E to counselling. I believe Miss E is suitable for hypnotherapy. I will need to look at her personality and look at her modalities. It is important to build up a good rapport for designing induction screed and to choose what therapeutic approach could be used, direct/indirect and authoritative/permissive. I will need also to understand her belief system and get the full history of her relationship with her previous partner, this information could be explored and ventilated to relieve any traumatic feelings and to give fresh positive meaning by giving it a positive interpretation. Also, by recalling memories of childhood, like her parents badgered her as unattractive and overeating, could be used to recreate and reinterpret rational and positive meanings to reprogram her hidden agendas. It is important that, as a therapist, to not emphasise or reinforce any of her negative feelings about being overweight, instead, would engage in normalising them and consistently re framing her mind to be confident, to imagine herself with a slimmer figure, to replace the habit of comfort food to a non-fatty food, i.e. eating carrots instead of chocolate when felt lonely or stress. The use of metaphors, analogies, imageries about the benefit of slimness and eating less could be also very powerful. Anchor positive resources in the past and carry them to the present and then rehearse them to the future imaginative situations may give her less importance to food and of having the perfect figure. As discusses previously, i will need to explain that the Miss E expectation of losing 2 ½ stone is not realistic within 3 months time. It will be primordial to set an achievable target and would incorporate new patterns of behaviour like adhering to new life style, taking regular exercise, an appropriate diet to follow etc... I will also explain to her the concept and principles of hypnosis and how hypnotherapy could be applied to address her issues. I will raise her awareness and help her have a control at her danger points. Danger points are where, when and why she overeat and what feeling and which places trigger her to eat more than her real hunger feeling, because she might be doing so as driven by subconscious that is unaware to self. I would then encourage her to change these danger points by replacing them with healthy means, and new behaviours by using therapeutic suggestions-screed. I would advise Miss E to start a food diary. This homework will again help her to take control over using food and have an idea about its relationship with emotions.

I will create an induction and deepening to match to Miss Es case, either using visual imageries or kinaesthetic modality, i will place her in a special place for therapeutic platform and metaphors like ‘Ugly Duckling’ to building self-esteem and to indirectly ingrain the suggestion of the transition and transformation for better into the subconscious. by carefully worded the script, i will explore Miss E's reasons for overeating and suggest new ways of thinking through visualisations by reprogramming the subconscious into eating properly, make healthful foods more desirable and make fatty food less desirable and taking pride in her self-image, and to recreate a healthy relationship with food. It will be the process of replacing the satisfaction or comfort that food gives to her with something that gives as much emotional satisfaction in return. I will also be using her wish to have a new partner and her wish to take pride of her body while she will be on holiday to increase her motivation. It would be also useful to describe the health risks of being overweight and the benefit of loosing the extra unwanted kilos. I will change her habits through direct and indirect suggestions, the suggestions I might use during Miss E's treatment could be: envisioning the body she wants, imagining how she will feel with her new look and health, imagining how energised and confident she will feel. These visualisations and many, many more are designed to empower her so that she can take control of her choices. Hopefully she will learn to enjoy the taste of healthy food and stop craving sugary, fatty things. She should also learn to enjoy her body and not see it as a source of anxiety. I will also use ego strengthening on self esteem and cognitive methods. It is important after the screed to get feedback from Miss E, this will enable me to adjust, personalise, prioritise and focus on specific aspects to achieve the best result, the treatment could last between more or less 4 to 6 sessions.

It is obvious by this essay that Miss E is coming to seek help to loose weight but is also suffering from deeper issue like low self esteem and confidence resulting from her parents and ex-partner behaviour. By redefining a realistic goal and by using therapeutic suggestions I am confident that I could help Miss E to achieve her goals. Although, i believe that hypnotherapy would be appropriate to her, it would be perfectly acceptable to advise Miss E to consult a nutritionist and eventually a personal trainer, as well as a counsellor alongside her hypnotherapy treatment.

Miss E is a 29 year old female whose goal is to lose 2 ½ stone in weight. She has come out of a failed long-term relationship 6 months ago, and revealed that her former partner was very controlling and appeared to want her to remain overweight. Miss E has always struggled with her weight since she was a teenager (from the age of 12 or 13), and her parents constantly pestered her about being unattractive and eating too much. Miss E has tried various diets and invariably has always put the weight back on. She is going on an all girls holiday in 3 months and hopes to have lost the weight before then. Miss E also feels ready to look for a new relationship. Throughout my essay and based on the case study provided, I will intends to look at Miss E's issues and I shall be describing what course of treatment i believe could be beneficial for her. I will also mention ethical issues as they arise before concluding.

Obesity is a major contributory cause of death in the UK, around one in every 11 deaths in the UK is now linked to carrying excess fat. Of all the deaths in the UK that were linked to excess weight, about 66 per cent were down to obesity, and 33 per cent to being overweight. Being overweight or obese leaves people at high risk of heart disease, diabetes, high blood pressure and osteoarthritis. It also makes them much more likely to develop several types of cancer. The difference between being overweight and obese lies in a person's Body Mass Index. The body mass index (BMI) is your weight in kilograms divided by your height in metres squared. if your BMI is between 25 and 29, you would be considered overweight if your BMI is between 30 and 40, you would be considered obese if your BMI is over 40, you would be considered very obese (known as ‘morbidly obese’). A lot of people insist they need to loose weight, whether they're overweight or not. The truth is, very few people are happy with the shape and size of their bodies, regardless of whether or not they need to loose weight. To enable further understanding of Miss E's current situation i will need to gather additional information starting by her weight and height as well as her history about how she is relating to food from the childhood to now, her eating habit and her life style within any social environment, her belief system with regard to food. It is evident that Miss E wants to loose weight, but i am suspected that Miss E has deeper issues than this. Many peoples suffering from weight issues are related to emotional problems that can be acted out through their relationship with food. Binge eating can be one way to reduce anxiety frustration fears and unresolved issues.

Before assessing the case of Miss E, it is important to look at any relevant information about her life that could be used to formulate a successful treatment plan. Miss E has been overeating since she was 12 or 13 and also she had been struggling with it but was unsuccessful as she gained her old weight after every diets. It's not unusual for people to get into a cycle of dieting, overeating, feeling guilty and dieting again. This is known as 'yoyo dieting' and makes weight loss difficult to sustain. This means that she has a tendency to sabotage all effort gained. For Miss E, eating has become a habit and habits are ruled by the subconscious which is a very strong force and will usually win when in conflict with the conscious mind. Miss E's parents badgered her of being unattractive and this became her self-image and develop low self-esteem and lack of confidence, this feeling was later reinforced by the behaviour of her ex-partner who wanted her to remain overweight. Hadley and Staudacher (Chap 4, pages 60- 62, Chrysalis notes from module 6 pages 6-7) suggested that there are five common causes for overeating. It will be vital to isolate the reason(s) for Miss E overeating in order to help her through the process of hypnosis. Miss E’s hidden agenda that she is unattractive and not worthy established a secondary gain of being overweight, this mix of feelings reinforced the habit of over eating in order to replace the missing love, love of herself and from

others. This lack of love could be seen increased with the separation from her previous controlling partner which left her traumatised and anxious about having a new partner in her life. Miss E is going on all girls holiday but she is concerned about her weight, and she want to lose 2 ½ stone in 3 months. It is important to identify if this goal is realistic. The best way to sustain weight loss is to lose 2 pounds a week and based on my calculation the realistic target to be set up for Miss E's should be around 1.85 stone (12.99 weeks equivalent to 3 months, times 0.14 stones ideal weight loss per week). If a realistic goal is not set up from the beginning of the treatment, there will be a chance for sabotage (again) . Miss E is going on all girls’ holiday means that she has expectations, she likes to have and enjoy social contacts and changes. She wants to be slim and take pride of body and look into prospective better life and future. She is now looking for another partner this means that she is hopeful and wants to move forward.

It is clear that Miss E has low self-esteem, feeling of uncertainty, and need of love. As therapist our first task should be to boost her ego, self-esteem and confidence in order to ensure that her treatment for losing weight will succeed. Now let’s look into how to design a treatment plan for Miss E’s issues. To begin with, I would have to look at all information required in order to formulate an effective and individualised treatment plan.

First of all I will need to be sure that Miss E is a suitable for hypnotherapy, to be able to do so I will need to gather further information in term of her physical conditions, it would be necessary to identify if her overweight is due to genetic or metabolic factors, from taking any medications or suffering from any severe mental disorders like psychosis, a confirmation from her GP will be requested at this stage. if I realise that there are any physical or mental conditions or a contraindication from the GP to hypnosis, I should refer on Miss E to counselling. I believe Miss E is suitable for hypnotherapy. I will need to look at her personality and look at her modalities. It is important to build up a good rapport for designing induction screed and to choose what therapeutic approach could be used, direct/indirect and authoritative/permissive. I will need also to understand her belief system and get the full history of her relationship with her previous partner, this information could be explored and ventilated to relieve any traumatic feelings and to give fresh positive meaning by giving it a positive interpretation. Also, by recalling memories of childhood, like her parents badgered her as unattractive and overeating, could be used to recreate and reinterpret rational and positive meanings to reprogram her hidden agendas. It is important that, as a therapist, to not emphasise or reinforce any of her negative feelings about being overweight, instead, would engage in normalising them and consistently re framing her mind to be confident, to imagine herself with a slimmer figure, to replace the habit of comfort food to a non-fatty food, i.e. eating carrots instead of chocolate when felt lonely or stress. The use of metaphors, analogies, imageries about the benefit of slimness and eating less could be also very powerful. Anchor positive resources in the past and carry them to the present and then rehearse them to the future imaginative situations may give her less importance to food and of having the perfect figure. As discusses previously, i will need to explain that the Miss E expectation of losing 2 ½ stone is not realistic within 3 months time. It will be primordial to set an achievable target and would incorporate new patterns of behaviour like adhering to new life style, taking regular exercise, an appropriate diet to follow etc... I will also explain to her the concept and principles of hypnosis and how hypnotherapy could be applied to address her issues. I will raise her awareness and help her have a control at her danger points. Danger points are where, when and why she overeat and what feeling and which places trigger her to eat more than her real hunger feeling, because she might be doing so as driven by subconscious that is unaware to self. I would then encourage her to change these danger points by replacing them with healthy means, and new behaviours by using therapeutic suggestions-screed. I would advise Miss E to start a food diary. This homework will again help her to take control over using food and have an idea about its relationship with emotions.

I will create an induction and deepening to match to Miss Es case, either using visual imageries or kinaesthetic modality, i will place her in a special place for therapeutic platform and metaphors like ‘Ugly Duckling’ to building self-esteem and to indirectly ingrain the suggestion of the transition and transformation for better into the subconscious. by carefully worded the script, i will explore Miss E's reasons for overeating and suggest new ways of thinking through visualisations by reprogramming the subconscious into eating properly, make healthful foods more desirable and make fatty food less desirable and taking pride in her self-image, and to recreate a healthy relationship with food. It will be the process of replacing the satisfaction or comfort that food gives to her with something that gives as much emotional satisfaction in return. I will also be using her wish to have a new partner and her wish to take pride of her body while she will be on holiday to increase her motivation. It would be also useful to describe the health risks of being overweight and the benefit of loosing the extra unwanted kilos. I will change her habits through direct and indirect suggestions, the suggestions I might use during Miss E's treatment could be: envisioning the body she wants, imagining how she will feel with her new look and health, imagining how energised and confident she will feel. These visualisations and many, many more are designed to empower her so that she can take control of her choices. Hopefully she will learn to enjoy the taste of healthy food and stop craving sugary, fatty things. She should also learn to enjoy her body and not see it as a source of anxiety. I will also use ego strengthening on self esteem and cognitive methods. It is important after the screed to get feedback from Miss E, this will enable me to adjust, personalise, prioritise and focus on specific aspects to achieve the best result, the treatment could last between more or less 4 to 6 sessions.

It is obvious by this essay that Miss E is coming to seek help to loose weight but is also suffering from deeper issue like low self esteem and confidence resulting from her parents and ex-partner behaviour. By redefining a realistic goal and by using therapeutic suggestions I am confident that I could help Miss E to achieve her goals. Although, i believe that hypnotherapy would be appropriate to her, it would be perfectly acceptable to advise Miss E to consult a nutritionist and eventually a personal trainer, as well as a counsellor alongside her hypnotherapy treatment.

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