I was recently contacted by Saket (name changed), who expressed a longstanding fear of heights that has affected him throughout his life. The catalyst for his seeking help occurred during a site visit with his wife as they were considering purchasing a new house. Standing on the balcony of the 25th floor, Saket looked down and felt his fear overwhelm him. Recognising the impact this fear could have on his ability to live comfortably in the new house, he reached out to me for assistance.
Following our initial conversation, we promptly arranged an online consultation session to further explore Saket’s concerns and provide guidance.
Fear Counselling – Complete Session Flow
Saket shared his current challenge, explaining, “I have experienced a fear of heights for as long as I can remember. The mere thought of slipping and falling has always frightened me, even in secure and enclosed environments. As a result, I have often avoided situations that involved being at a significant height, such as declining invitations to go on treks with my friends, despite my genuine interest in doing so.”
He continued, “However, last week I accompanied my wife to view a potential new home. She was thrilled about the place, so I decided to confront my fear and give it a try. But when I stood on the balcony, my fear resurfaced, overwhelming me. I had to quickly retreat to another room to calm down and regain my composure. This experience made me realise that I can no longer ignore this fear as it hinders my ability to live my life to the fullest.”
Upon understanding Saket’s challenges, I initiated the process by providing him with a psycho-educational overview of the approach I employ. I introduced Cognitive Hypnotic Psychotherapy, an eclectic form of psychotherapy known for its effectiveness in addressing fears and phobias. Subsequently, I guided him through the pre-coaching process, ensuring he had a clear understanding of the therapeutic journey ahead.
With Saket now familiarized with the fear counselling therapy process, I outlined the specific steps we would undertake to address his situation:
- Clearly defining the existing problem, allowing us to focus on its precise nature.
- Establishing a concrete and observable outcome for our sessions, ensuring clarity in defining what he aims to achieve.
- Identifying the thoughts and emotions that trigger his reactions when in high-altitude environments.
- Distinguishing between a fear and a phobia, helping us discern the intensity and impact of his experiences.
- Engaging in cognitive restructuring, which involves modifying his thoughts and beliefs while concurrently reconditioning associated emotions.
- Reconstructing his experience by altering the unconscious narrative that contributes to his fear.
By following these structured steps, we can systematically work towards addressing Saket’s fear of heights and empowering him to lead a more fulfilling life.
Session 1: Defining Challenge and Desired Outcome
The first session of Fear and Phobia Counselling focused on guiding Saket in defining his current situation, desired outcome, and envisioned future. To commence the session, I requested Saket to succinctly summarise the challenge he wished to overcome through therapy, using his own words.
Saket expressed, “I experience feelings of fear and anxiety when I find myself at a location that is elevated, specifically when I look down from a height greater than four floors. This fear often leads me to react in a manner that feels childish, such as hastily retreating to another room or avoiding social situations altogether.“
Next, using the SOFT SEA MODEL , I prompted Saket to reframe his problem statement using a specific format: “I feel… about… when…” This exercise aimed to encourage a more precise articulation of his concerns.
Saket complied, sharing his refined statement: “I feel scared and anxious about standing at a high-altitude place when I am looking down from a height of above four floors.”
With the problem statement established, I directed Saket to envision his desired outcome at the conclusion of our sessions. Using the format “I wish…,” he was invited to express his aspirations.
Saket stated, “I wish to be able to calmly assess whether my life is genuinely at risk when I find myself at a height and respond accordingly.“
Seizing this opportunity to delve deeper, I inquired about the specific behavioral changes Saket would like to observe within himself in such situations after a fear counselling sessions, as well as the transformative impact these changes would have on his life.
Saket elaborated, “I envision myself confidently standing at a significant height, looking downward without experiencing fear or anxiety, knowing that I am safe and free from harm.“
Curious to understand the emotional state accompanying his envisioned calmness, I inquired further.
“If you were not feeling scared, what emotions would you be experiencing?” I asked.
Saket contemplated and responded, “In the absence of fear, I would feel a sense of calm.”
Continuing the exploration, I prompted Saket to identify an indicator or manifestation of his newfound calmness.
After thoughtful consideration, he shared, “I have pondered this extensively. I visualise myself standing on the balcony of a tall building, similar to the apartment we viewed, engaged in a conversation with my wife while savouring a cup of coffee. From this vantage point, I observe children playing below.”
To enhance Saket’s engagement in the therapeutic process, I assigned him a home task. I requested him to expand upon the transformative aspects of his life, illustrating how his existence would differ in the absence of this fear.
Session 2: Identifying the thoughts and emotions behind the fear and reaction
In the subsequent session, we began by reviewing the progress made in our previous session. I inquired about the homework assignment, during which Saket encountered difficulties in contemplating being at heights. Despite these challenges, he managed to complete the task.
While examining Saket’s homework assignment, I probed further to identify the specific locations that triggered his anxiety or fear. Taking these locations into account, I introduced the concept of the Release Metaphor, illustrating how he could utilize it as a temporary method for anxiety relief.
Following our discussion on the release metaphor, I instructed Saket to recall a recent event where he found himself at a height and experienced significant fear or anxiety. Additionally, I encouraged him to recollect an unrelated funny or comical scene from his past that still evokes hearty laughter.
With these events identified, I proceeded to guide Saket through the NLP Fast Phobia Cure technique, designed to facilitate the alleviation of his fears.
By the conclusion of the session, Saket visibly exhibited a sense of calmness regarding future encounters with height-related situations. He expressed increased confidence in approaching such scenarios, and a noticeable relief was evident on his face.
Session 3: Restructuring the thoughts and emotions leading to fear
In the subsequent session, Saket shared a significant breakthrough with me. He recounted his recent visit to the 25th-floor apartment, which he had previously found daunting due to his fear of heights. To his surprise and delight, he described how he successfully navigated the entire event with remarkable calmness. Not only did he manage to stand on the balcony, but he also engaged in a composed conversation with his wife about the house. Interestingly, his wife even noticed a positive change in his demeanor during the experience.
Reflecting on this achievement, Saket expressed his happiness, yet acknowledged lingering doubts and a desire for increased confidence when planning future height-related activities. He stated, “Although I remained calm once I arrived there, I still harboured some reservations during the planning phase. If only I could feel more confident, then everything would be perfect.”
Curious about the specific moments when Saket felt scared or doubtful, I inquired about the triggers. He highlighted two instances: when someone described the height of a place and when he was preparing to visit a location at a certain altitude. To delve deeper into his desired mindset, I requested him to articulate his desired thoughts and emotions.
Saket formulated his desired thought as “I am completely safe” and identified the desired emotion as confidence. Recognising the importance of thought restructuring, I proceeded to work with Saket on reshaping his thoughts to align with his desired outcome with the help of When-then Statements.
Furthermore, I employed the emotional anchoring process to assist Saket in cultivating a sense of confidence during the planning stages of future events that involved higher altitudes. This technique aimed to anchor and reinforce his positive emotions, fostering a greater sense of assurance and readiness.
By employing these strategies, we aimed to enhance Saket’s overall confidence and further diminish any residual doubts or apprehensions associated with height-related situations.
Session 4: Closure
During our session, we took the opportunity to reflect on the previous week’s progress. Saket shared exciting news that he had made plans to embark on a trek with his friends in the upcoming month—an experience that, for the first time in his life, filled him with genuine excitement.
Notably, Saket expressed newfound confidence in his ability to purchase an apartment situated in a high-rise building. He felt reassured that he would now be entirely comfortable residing in such a place, thanks to the progress he had made in overcoming his fear of heights.
To empower Saket with a valuable tool for managing any future concerns, I introduced him to the practice of self-hypnosis. This technique would enable him to access a state of deep relaxation and focus, allowing him to address and overcome any anxieties that may arise.
By equipping Saket with self-hypnosis, he would possess a powerful resource to navigate potential challenges and maintain his newfound sense of calm and control in the face of height-related situations.
My Observation about this fear counselling
During the course of our sessions, I have noticed that certain processes may initially appear confusing to clients and even elicit amusement, particularly in the case of the Fast Phobia Cure technique. However, it is important to emphasise that these approaches yield remarkable, efficient, and enduring results, even if their underlying rationale may not immediately resonate with the client.
While clients may not initially grasp the logical connection or reasoning behind these techniques, it is crucial to reassure them that the effectiveness of these methods lies in their ability to bypass conscious resistance and work directly with the unconscious mind. By engaging the unconscious processes, we can facilitate profound and transformative changes, often surpassing the expectations of the client.
Therefore, even if clients find certain processes unconventional or amusing, it is essential to emphasize their potential for producing rapid and significant positive outcomes. Encouraging clients to maintain an open mind and trust in the therapeutic process can enhance their willingness to embrace these techniques and experience the transformative benefits they offer.
References of techniques used for helping clients manage stress
The techniques employed in this case study draw from various methodologies, including :
- SOFT SEA Coaching Model
- Release Metaphor
- Fast Phobia Cure technique
- When-then Statements
- Emotional anchoring
These approaches have been integrated to create a comprehensive and effective therapeutic process.
By applying these evidence-based techniques and building upon a solid theoretical framework, counsellors can effectively support their clients’ progress and help them achieve their desired outcomes.