"Using the case study provided at the end of the module, identify and explain the client's issues and devise a course of treatment for him, taking into account any ethical issues”.

In this essay I will be exploring the issues raised in the case study provided which is about a 45 year old man named 'Mr. X'. I shall be explaining the issues Mr. X has expressed as I have understood them. To be in a position to help Mr X I need to identify issues that arise from the initial interview and produce a course of treatment that I feel would enable Mr X to meet his identified goals. I will be taking in consideration any ethical issues that need to be accounted for.

Mr. X is a 45 year old man who has worked at the same Estate Agency for 18 years. He has presented to me the issue that he would like to apply for the manager’s position at his branch but his lack of confidence is holding him back. Mr. X has stood in for the current manager on many occasions so he knows that he is capable of doing the job but has reservations as he doesn’t want to cause any upset amongst the other staff or management if he is not successful. Further discussion with Mr. X revealed that one of the reasons he would like the job as manager is so that his mother would be proud of him and show him a little more respect. She is currently living in a home and he visits her regularly every Friday night although he says she tends to pick on him. Mr. X isn’t clear how or why his mother picks on him, just that she does. It also transpires that Mr. X’s colleagues tend to go out for a drink after work on a Friday night on a fairly regular basis but because of his commitment to visiting his mother he feels he cannot join them. He believes that they find him boring and unsociable because of this. Mr. X has considered changing the day he visits his mother on the odd occasion so he can join his colleagues but feels his mother wouldn’t understand this and would pick on him even more than usual. He has also thought about asking his colleagues to join him on a different night of the week for drinks but believes they would say no and fears their rejection. Mr. X has a girlfriend which he describes as a ‘sort of girlfriend.’ He says he would like to propose to her but, again, fears rejection. He also doesn’t feel as if he has much to offer her which is another reason the manager’s job is an attractive prospect. Mr. X seems to be a man who is very aware of other people’s feelings and worries about how he comes across and what others think of him. I have assessed him as visual in modality.

To gather the above information, an initial consultation would have happened. During this consultation I would have used my initial consultation notation form which is where the information would be recorded for future reference. I would have collected information that would identify not only the reason for the appointment but family medical and life history. Any previous experience of therapies and the outcomes. And importantly, identifying the motivator. What is the true and most important reason for seeking to change? What is the desired outcome? How will he know when he is 'cured'? It would also be crucial during the initial consultation to decide whether hypnotherapy would be the right route for him to go down or whether he would need to be forwarded on to someone else.
I think the most likely underlying factor with the issues that Mr.X has raised is that he was subjected to critical parenting throughout his life, which has unfortunately made him develop anxiety, fear of success, failure and of change. It is clear that he has low self-esteem and maybe has a hidden agenda that deep down he is content with his life but thinks he needs to change to please others which would mean taking on extra responsibilities both at work and in his personal life. There does not appear to be much understanding by Mr. X as to why he lives the way he does and why he feels so negatively about all aspects of his life. However, he does seem to have some understanding that the way he thinks about life and his self- perception are holding him back from living the life he wants to be living and should be living. His behavior patterns seem to be deep rooted within. His self-perception is preventing him from moving forward with his life and embracing opportunities that are in front of him resulting in this impacting negatively on both his work and private life. I feel that it would be crucial to gather extra information, such as what was the role that his father played in his life, how did he feel emotionally when growing up and what is the current relationship with his girlfriend like and how does he feel about it deep down as these questions could really determine why he feels the way he does in the present moment.

When you have a critical and controlling parent you learn not to trust yourself and question the decisions you make which tends to cause stress, anxiety, hurt feelings, uncertainty and insecurity. Self-doubt replaces your normal developmental need to discover things for yourself, learning to complete tasks and be competent. You become fearful, distrustful and insecure about your own decisions and abilities. Criticism leads to significant anxiety and stress. Criticised children tend to be pessimistic, fearful and are reluctant to make themselves a part of activities. They may isolate themselves, be depressed and irritable. It is clear to see the profound impact Mr X's childhood has had in his life in the present moment and that all his issues are a by-product of it. Although I recognise that I am not qualified enough nor experienced enough to conduct regression work, I would maybe recommend regression for Mr.X which would enable him go back to the underlying problems in his childhood to address and trace why he feels the way he does now. Regression is discovering and reliving earlier experiences that have caused present complaints and conditions. Those forgotten experiences contain emotional wounds that never healed or triggered persistent half-conscious convictions. Because Mr.X has unhealed wounds he is carrying around issues that need to be healed. But as I know that I am currently not qualified to do regression work (as previously stated) I would be sure to forward Mr.X on to another therapist. However, because Mr. X's mother is still a slight problem to him in his life in the present moment as she doesn't show him much respect it may not be necessary to partake in regression work.

Although Mr.X hasn't mentioned it directly, it is clear to see that he has low self-confidence. Because of his lack of self-confidence most areas of his life have been deeply affected; from how he feels in the workplace to his relationship with his mother and to his relationship with his 'sort of' girlfriend'. Because of this lack of self-confidence he cares what people think a lot and he assumes that the outcome to most things will be negative. From the information that Mr.X has given it is unclear to see what things he does in his spare time; such as hobbies an interests. The only thing stated that he does is visit his mother in the home she lives in and it's hard to tell whether he does this out of choice or whether he feels like he has to as it is stated that she picks on him. It is clear to see that the relationship he has with his mother impacts his self-confidence deeply as he has spent a lot of time around her. Using his mother as an excuse for not socialising may be a secondary gain for him as his mother refuses to let him change and that gives him a sense of security. He clearly fears change and responsibility so putting the blame on his mother (although not directly) could take the attention away from taking responsibility for his own life. It seems as if his mother puts her problems and habits onto him and now he is walking around with all these negative attributes that weren't his in the first place. He lacks his own identity and all he needs is the confidence to stand up to his mother so he can attain some form of self-discovery and live a fulfilled life.

From the information given by Mr. X it is clear to see that he is a sensitive and empathetic man and that he is in major need of boosting his self-esteem and changing his thought patterns. From the information given I feel like hypnotherapy would be a fantastic route for him. There are definitely not any reasons as to why I shouldn't treat Mr.X as he hasn't stated that he is on any medication or has any bad medical history. Hypnotherapy would seek to discover the root cause of his low self- esteem and use the power of suggestion to create more positive thought patterns. Reprogramming Mr X's beliefs could lead to an increase in self-esteem and help him to overcome negative thinking patterns. Hypnotherapy would also help Mr.X relieve his anxiety so he can finally go for that promotion that he really wants and socialise with his work colleagues without any fear of rejection. I would suggest that he has a few sessions to really activate the new suggestions.

Mr.X has been assessed visual in modality so I would make sure that the script that he is given during hypnosis is very descriptive and helps him achieve a deep relaxation. It is also stated that Mr.X is aware of the feelings of other so I would say that he is also kinaesthetic, so I would incorporate this during his sessions also. I would make sure that during the hypnosis that he visualises burning all the negative thought patterns he has; low self-esteem, disappointments, blame etc. And continues onto a flowerbed (or something similar) and plants new seeds of change. I would use powerful suggestions that would help him love himself and forgive himself. The whole purpose behind hypnotherapy for Mr.X is to leave the sessions feeling elated with a new sense of self. Although his mother still picks on him in the present having hypnotherapy sessions will really boost his self-esteem so he can stand up to her and say 'no'. To be sure that Mr.X continues progressing after the sessions I would encourage him to practice the use of affirmations[1] daily so he can proceed with changing his negative thought patterns. Although I know that I am not a qualified counsellor I would also suggest that Mr.X has counselling along side the hypnotherapy sessions but I would obviously make sure I would forward him onto a suitable therapist.

In this essay I have evaluated a case study I was given and analysed the underlying reasons behind the issues I have been presented. It is clear to see that the main reason behind Mr X's predicaments is his low-self esteem which has been majorly impacted by critical parenting. Through realising how his problems have a secondary gain and a hidden agenda I have concluded that hypnotherapy and the use of affirmations would be the correct route of therapy for him. I would hope that this would be very transformational for Mr.X as he is definitely an ideal candidate!

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[1] Affirmation is the act of confirming something to be true, or is a written or oral statement that confirms something is true.