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DEPRESSION - A Case History
DEPRESSION - Mrs N
By Maureen Harrison, RGN BSc D Hyp

Introduction

My background is NHS nursing, working in the field of elderly care for most of my career. I am at the present time a Ward Sister working in elderly rehabilitation in North Durham Health Care NHS Trust. I have always been fascinated by the power of the mind and have studied meditation for many years. I first became interested in hypnotherapy in the early 1990s when I visited a hypnotherapist for smoking cessation and stress management. I was really thrilled that hypnotherapy helped me to give up smoking having tried several different methods in the past with no success. I had the desire to train as a hypnotherapist ever since stopping smoking but it wasn't till I discovered the LCCH's training programme that it became possible. Their courses met all my requirements and I undertook the certificate course in 1998 and completed the diploma course in September 1999 in York. This report describes a case study carried out on a patient I treated in March 1999. This patient was my first paying customer and the results really boosted my confidence. I think that it is extremely important to validate hypnotherapy and intend to build up a body of evidence which proves its effectiveness.

Background

Mrs N is a 60-year-old divorced woman with 2 married daughters aged 38 and 32 years. She has a brother and had a twin sister who died at 4-days old from pneumonia. She has known about her twin sister for most of her life but none of her family ever talked to Mrs N about her. Mrs N had been suffering from periods of depression or low mood since 1979 when her husband left her for an older woman. Her mother died at the end of 1998 and she has been suffering from depression since then. She had always had a difficult relationship with her mother but the relationship had been worse over the last few years when her mother became physically and mentally dependant and had to go into a nursing home. Mrs N had been feeling guilty because of this. Mrs N also felt that her mood was worse after Christmas each year when there was less daylight.

Case history

Mrs N first suffered from depression in 1979 and at that time she felt that she was in a deep pit that she just couldn't get out of. She pushed family and friends away even when they tried to help. The only person who was of any help was her younger daughter who ignored the fact that she seemed ill and just treated her as normal which she very much appreciated.
Mrs N visited her GP who referred her to the psychiatric department of the nearby general hospital where she saw a psychiatrist. He diagnosed her as having manic depression and prescribed Lithium which is a mood stabilising drug. However she only took it for 5 days as she describes that it made her feel like a "zombie". She went back to see the psychiatrist after 2 weeks who told her to go away and get better on her own as she obviously wasn't manic depressive. She gradually felt better over time but since then Mrs N has visited her GP several times with depression and was prescribed various antidepressants.

Discussion

I visited Mrs N approximately three weeks following her second consultation as she very kindly agreed to be the subject of a case study. Mrs N told me that she had been prompted to ring me in the first place as she had been very interested in my talk. She had been interested in the power of hypnotherapy for a long time but had never tried it before. She said that she had felt for a long time that she needed more than counselling and felt that hypnotherapy may give her what she needed.

Mrs N was quite happy to give me feedback about her hypnotherapy treatment. She said that at the first session she had felt quite apprehensive and self-conscious. She had felt keyed up as she felt that she may not give the right responses. Her first reaction following the therapy was relief that she had actually "done it". Mrs N said that she started to feel better about 2 days after the session. When she got up in the morning on the second day she stated that she felt a deep sense of peace and felt surprised that the depression had lifted so much. She was able to concentrate on doing her tapestry that day which she hadn't been able to do for a while.

She only took the medication for a short time as again it made her feel like a zombie.

She had often wondered if the late anti-depressant drugs such as Prozac might help her but had never asked her GP for them and she had never been offered them. Mrs N thinks that her GP may not have offered these new drugs because she has been reluctant to take medication in the past.

She feels that when she gets a bout of depression something usually triggers it, for example guilt feelings associated with her mother. Approximately 5 years ago Mrs N was referred to a National Health Service Counsellor for depression caused by these feelings of guilt.

Her first appointment took about 3 months to arrange and by that time she felt that she was getting better by herself. Even so Mrs N describes her first appointment as "great". Her counsellor was impressed because Mrs N showed good insight into her problem and because she had read up on it. She had 6-8 appointments but these were one month apart and Mrs N was disappointed that at each consultation she had to go through her problem again because the counsellor couldn't remember details.

Mrs N was irritated that this was using up most of the hour that was allocated. Eventually Mrs N terminated the sessions because she felt that both herself and the counsellor were wasting their time.

Mrs N feels that her problems are underpinned by the fact that she is a lone twin. She feels guilty that she survived while her twin died. Approximately 2 years ago Mrs N heard of the "Lone Twin Association" and attended a conference in London, organised by the association. She also found and visited the grave of her twin sister which she said was very therapeutic. At the conference Mrs N met the person who was in charge of the counselling service who put her in touch with a counsellor in Teeside purporting to be experienced in the problems experienced by lone twins. Again there was a few weeks delay prior to the first appointment. The sessions cost £28 each and were weekly/fortnightly. The counsellor asked her to sign a contract for 8 sessions, which Mrs N did. However after the third or fourth session Mrs N felt that she was wasting her time and money and asked to terminate the contract. The counsellor agreed. Mrs N had initially thought that the counsellor was very good, especially at listening and giving the opposite point of view but after a while she felt that she knew nothing about the "lone twin" situation and that she wasn't gaining any benefit from the sessions. Mrs N stated that she could have done what the counsellor was doing for herself.

In 1998 Mrs N had a health scare when she coughed up blood and had many different tests which showed no abnormality.

In January 1999 Mrs N attended a health and fitness class which was run locally by a health visitor at which I gave a talk followed by group hypnosis. She found this very beneficial and decided to book a formal appointment with me.

Hypnotherapy

I saw Mrs N less than a week after her initial enquiry. We very quickly built up a rapport and following the history taking I explained to Mrs N that I thought she would benefit from some ego strengthening under hypnosis and she agreed. I induced hypnosis and used the early learning sets prior to a general ego strengthening script.

Mrs N booked a second session exactly one week later. At the second session I used a progressive relaxation script followed by a healing therapy script which encouraged Mrs N to get rid of all her guilt.


Mrs N said that even though initially she was going to cancel the second session because she felt so much better she found it of even more benefit than the first session. She said that she was more relaxed than at the first session and that some aspects were more like counselling than the first session. She said that she was amazed at the benefit of the second session of hypnotherapy which asked her to picture a shower which washed away all her guilt feelings. Mrs N said that without any apparent effort from herself the awful guilt feelings just melted away.

Mrs N concluded by stating that hypnotherapy has been of great benefit to her; more effective than she thought it would be. The words she used were that "it was so easy". She had the feeling that she was receiving treatment rather than having to make any effort and in her own words stated that she "felt that the conscious element had been removed". Mrs N was of the opinion that hypnotherapy was value for money and that if she had any psychological problems in the future she would go straight to a hypnotherapist.

Conclusion

Mrs N had suffered greatly over the years from the awful symptoms of depression and had tried to help herself as well as visiting her GP. She had tried various medications which had not helped. She had also visited 2 counsellors for 10-12 sessions in total before deciding to try hypnotherapy. One of the counsellors was private and was funded by herself. She was able to compare hypnotherapy with two previous programmes of formal counselling and stated that she gained much more benefit from hypnotherapy and that it was value for money.

Mrs N said "I nearly cancelled the second session of hypnotherapy as I felt so well. I felt better than I had felt in a long time. I would definitely turn to hypnotherapy if I had any psychological problems in the future".

Maureen Harrison RGN BSc D Hyp


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