Example Case History

Case History

1. Sarah - Eczema

1.1 Introduction

The following case history is presented with the permission of the client. Her name and certain details of her life have been changed to protect her identity.

Sarah has allowed her experience to be shared in this way in order to dispel some of the mystery that surrounds the area of hypnotherapy. The details recorded in this case history took place over six sessions. The case study is not presented as a template for a typical course of hypnotherapy because everyone is treated as an individual.  It is important to highlight that the incidents described are not presented as a cause of Sarah's eczema - eczema is a medical condition.  What is described are incidents where Sarah learnt how to act in certain ways emotionally.  This behaviour intensified the effects of stress on her eczema.  The effect of hypnotherapy can possibly be described as allowing Sarah to modify her reaction to stress thereby reducing its impact on her eczema.

For those who do not wish to read the full case history a synopsis has been provided.

1.2 Synopsis

Sarah (25), a marketing executive, visited Stephen Rigby for help to control eczema on her hands and face with which she had suffered since the age of five.

Using hypnotherapy and counselling it was discovered that the eczema was stress related and was caused by the internalisation of emotion. Sarah’s subconscious had learned to channel emotion into eczema at the age of five when she decided (with a child’s logic) to hide her real feelings about school from her excited mother. This need to hide emotion was reinforced by two more distressing childhood incidents.

Using hypnotic technique, Sarah become aware of and made changes in her attitude to life and her attitude to emotion.

As a result Sarah achieved her objectives of:

• A dramatic reduction to night-time scratching
• An end to her compulsion to uncontrolled scratching
• A noticeable improvement to the quality of her skin (at a time of year when she would expect her eczema to get worse).

Sarah also experienced the following additional improvements to her life:

• Improved relationships with her family, friends and work colleagues
• Less stress at work
• A more positive outlook to life.

1.3 Presenting the Problem (as the client understood it)

Sarah came to me for help with her eczema. Eczema is a common skin disease. It includes different types of dermatitis, or inflamed (red, itchy rash) skin. The exact cause of eczema is not known. Sarah experienced the classic symptoms of a rash on her face and hands. This rash became worse during cold weather and the itching disturbed her sleep. Sarah would scratch her hands in her sleep and would often wake with her hands bleeding. Sometimes when she was awake the desire to itch became an uncontrollable compulsion. On those occasions nothing would stop Sarah scratching until her hands were extremely painful. Sarah had first suffered with the complaint at the age of five. She had suffered severely in her teens and had not been free of it for her entire working life.

Sarah obtained cortisone cream from her doctor but over the years it had thinned the skin on her hands and that made them prone to splitting and tearing when scratched. To cut down on the use of cortisone creams Sarah used a number of different moisturisers and avoided getting her hands wet.

1.4 What Sarah wanted from Hypnotherapy

Sarah wanted to:

• Control her eczema
• Stop the itching in her sleep that was making her increasingly tired
• Stop the compulsion for uncontrolled itching that was painful and distressing.

1.5 Underlying Problem (the root cause)

Conversation with Sarah revealed that her eczema got worse when she experienced increased stress at work. Using counselling skills we determined that the times when her eczema was particularly bad (early and late teens) were associated with periods of severe emotional distress (the divorce of her parents with the loss of her father then reuniting with her father in her late teens).

A key discovery was that during the incident in her early teens Sarah did not express the extreme sadness that one would expect her to have felt. We determined that the eczema was the way Sarah contained her emotion.

Using a number of hypnotic techniques we explored:

• How Sarah felt about her current life
• What incident had started the eczema when she was a child
• What incident had started her uncontrollable scratching urges
• What Sarah might do to prevent the scratching in the night.

We discovered that the eczema had begun around the time that Sarah started school (possibly her very first day). The experience of starting school is particularly stressful for a five year old but Sarah’s mother had been so excited for her that Sarah had not wanted to say how distressing it was for her. At five Sarah learnt to turn her emotion inward and produce the symptoms of eczema. This is how Sarah treated emotion from this point onwards. The uncontrollable urge to scratch until she hurt herself was added in her early teens when she overheard an adult conversation (news of the impending divorce) that she knew was causing hurt to her mother. As a child she could do nothing – the frustration was turned against herself. Using visualisation we discovered that, subconsciously, Sarah regarded her eczema as something comforting. The symptoms were the problem and these fought against each other each wanting relief from each other. The scratching in the night was the result of this contention. In her daily life Sarah was trapped in the feelings that she experienced when her parents informed her of the divorce.

1.6 Sarah’s actions

Sarah used her discoveries about herself and did the following:

• She allowed herself to start to show her emotions. She did this with those with whom she was already close and even developed a liking for “weepy” films.
• She became more assertive at work as she realised the importance of her own emotions
• Visualised the contention between the different symptoms that caused the night-time itching and turned that contention into cooperation.

1.7 Benefits experienced by Sarah as a result of her therapy

As a result Sarah achieved her objectives of:

• A dramatic reduction to night-time scratching
• An end to her compulsion to uncontrolled scratching
• A noticeable improvement to the quality of her skin (at a time of year when she would expect her eczema to get worse)

Sarah also experienced the following additional improvements to her life:

• Improved relationships with her family, friends and work colleagues
• Less stress at work
• A more positive outlook to life

1.8 Scanned Letter from Client

By kind permission, Sarah has also allowed this letter to appear on the website (identifying information has been removed)