The wounded self: new approach to understanding and treating anxiety disorders

This article synthesizes the concept of "wounded self" in the understanding and psychological treatment of anxiety disorders. The focal point of this concept is the notion of self-wounds or early unresolved emotional injuries. According to this conceptualization, anxiety represents an unconscious fear of unbearable insult to the wounded self, which is protected by maladaptive conscious strategies such as avoidance, cognitive distortions, or emotional constriction. This perspective provides a theoretical basis for blending elements of psychodynamic, behavioral, cognitive, and experiential therapies in the psychological management of anxiety disorders. As cognitive hypnotherapy embodies all of these therapeutic elements, its application to anxiety disorders is described in this article. Various hypnotherapeutic techniques for symptomatic relief and for eliciting and healing the wounded self are discussed and exemplified by a case. This case illustrates that symptom-focused treatment is necessary, but not sufficient. A more durable treatment requires resolution of underlying conflicts that drive the anxiety.