Robert London, M.D.

Robert London MD

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Part II: Treating Anxiety in Pregnancy Without Meds

Relaxation/hypnosis and guided imagery effectively address anxiety in pregnancy.

Posted Apr 09, 2014

Relaxation Techniques Help Pregnant Patients with Anxiety

Part I of this two-part series on treating anxiety in pregnancy dealt with one component of the cognitive-behavioral therapy approach: restructuring thought patterns. Part II deals with using relaxation/hypnosis coupled with guided imagery.

Planned pregnancy can be a time for feeling wonderment at the changes in one's body, looking forward to motherhood, and experiencing a brand new aspect of life. But for women who are under financial duress, it can also be a period of worry, stress, and anxiety. This anxiety may get worse and more pronounced as the weeks progress.

In my practice, I treat anxiety in pregnancy using a nonmedical approach. A previous article discussed the use of restructuring thought patterns. Another highly effective technique in helping a patient work through her anxiety is hypnosis used in conjunction with guided imagery.

Using Hypnosis to Enhance Focus

Hypnosis is a wonderful tool that's both misunderstood and underused by mental health professionals. Hypnosis is not sleep but an alert state enabling sustained, focused concentration from the patient. When applied by a trained professional, hypnosis helps the patient relax in the session, which quiets internal chatter that's making her anxious. It also allows the patient to process information in a manner that's different from the way it's processed in a regular alert state.

I use a quick relaxation technique, which allows the patient to focus on the strategy being taught. I still like, after all these years, the method developed by Dr. Herbert Spiegel and Dr. David Spiegel in their classic book, Trance and Treatment: Clinical Used of Hypnosis.

Using Guided Imagery to Modify Behavior

There are several guided imagery techniques I use with patients who are struggling with anxiety, but one that has worked well for treating pregnant women is the Split-Screen Technique.

This is where different types of anxiety and stressors are "projected" onto an imaginary screen followed by pleasant thoughts and images being projected in various formats in order reduce or overcome the anxiety. The pleasant thoughts usually overcome the anxiety. The approach will vary from person to person depending on the anxieties or stressor being dealt with.

This type of approach, reciprocal inhibition of the unpleasant or troubling thoughts or behavior, coupled with a competing new pleasant set of thoughts, has been shown to be effective and long-lasting. Relaxation with pleasant, non-anxiety-provoking images or thoughts is usually incompatible with stressful and anxiety-provoking experiences. Therefore, the screen technique is a good beginning to a rapid resolution of anxiety.

Helping New Thought Patterns "Stick"

It's good for the patient to become comfortable with this method. However, the need for her to know and understand this strategy, practice it, and modify it to suit her specific, ongoing needs is equally important in its success.

Helping a pregnant patient manage the natural anxiety associated with such an enormous life change is a process that requires neither prescription medications nor lots of time. It can happen remarkably swiftly when we help the patient restructure her thought patterns, and then use relaxation/hypnosis along with guided imagery to help her modify her reactions to anxiety-provoking thoughts.

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This blog aims to present psychiatric/psychological information to a general readership, offering insights into a variety of emotional disorders, as well as social issues that affect our emotional well-being. It includes the ideas and opinions of Dr. London and other leading experts. This blog does not provide psychotherapy or personal advice, which should only be done by a mental health care professional during a personal evaluation.

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