However, differences in the definition of the disorder make studies more difficult. This may explain why studies on PA are incomparable with one another (Kenny, 2005).
Barlow (2000) gives a simple explanation on the development of PA. Genetics and previous life experiences provide the foundation for PA as it produces a generalized depressed mood. Specific environmental stimuli then initiate a heightened sense of anxiety. Among performers such as musicians, the stimulus is usually social evaluations. This then trigger development self-evaluation that disrupts concentration and performance. In effect, a person with PA acquire cognitive, behavioural and physiological responses to anxiety.
BASICS OF HYPNOTHERAPY
Hypnotherapy is a guided process into a state of relaxation. It does not remove the uncontrollable symptoms, such as anxiety or addiction, but only provides a means to manage them (Nongard and Thomas, 2009).The use of hypnotherapy in managing stress during performances has been supported by clinical and experimental data. Admittedly, however, the efficacy of applying hypnotherapy in improving performance is still inconclusive (Kenny, 2005; Yu, 2006).
According to Wagstaff (2000), there is no scientific evidence that says hypnosis can trigger psychotic disorders among patients. In contrast, Gruzelier (2000) reported that among the adverse effects of hypnosis include transient headache, chronic psychopathology, seizure, stupor, and schizophrenia. In such disagreements on the safety of hypnosis, the risks mentioned above should be disclosed to the patient. Hypnotherapy are said to be effective in solving uncontrollable urges, emotions and feelings, such as alcoholism, anger management, asthma, depression, drug addiction, eating disorders, eczema, insomnia, migraine, obsessive compulsive disorder, pain control, past life regression, psoriasis, sexual abuse, sexual problems, stammering, and smoking. Despite the seemingly wide range of conditions in which hypnotherapy can be used, those with epilepsy, schizophrenia or clinical depression need to get their psychiatrist’s consent before taking sessions (http://www.thehypnotherapyassociation.co.uk/whatcantreat.php). ASSESSMENT OF PROBLEMS As is the case in the study of Yu (2006), it should be asked what she thinks causes the anxiety during performances. The patient was then made to answer two questionnaires, Subjective Units of Discomfort Scale (SUDS) and Achievement Anxiety Test (AAT), in order to objectively quantify the amount of anxiety. If, through AAT, it was found that the anxiety was more facilitating than debilitating, then it is possible that anxiety did not interfere with her presentation (fear that she did not enunciate properly, that her thoughts were not clear, etc.), but were instead directed toward the results of her speech (Did her clients like it? Will they invest?). In addition, a traumatic event leading to the feeling of anxiety must be elicited, since hypnotherapy alone had been found to be ineffective against Post-traumatic Stress Disorders (PTSD) (Cukor et al., 2010). In such cases, a multifaceted therapy is needed. Finally, the patient was also made to identify the emotional, behavioural, physical and mental symptoms of stress through a checklist prepared by Palmer and Dryden (1995) and Burns (1980). SESSION PROPER After identifying the problems of the patient, the intervention was then planned. There are many choices of therapy mode, meditation, biofeedback, hypnotherapy, systematic desensitization, behavioural rehearsal, cognitive and behavioural-cognitive. Studies on the effect of hypnotherapy on music PA had been inconclusive. The use of systematic desensitization on music PA did not prove to be effective anxiety, heart