Hypnotherapy is a poorly understood technique that has multiple definitions, descriptions, and forms. It is generally agreed that the hypnotic state is different from both sleep and ordinary wakefulness, but just exactly what it consists of remains unclear. Hypnosis is sometimes described as a form of heightened attention combined with deep relaxation, uncritical openness, and voluntarily lowered resistance to suggestion. Thus, one might say that when you watch an engrossing movie and allow yourself to surrender to it as if it were reality, you are undergoing something indistinguishable from hypnosis.
In therapeutic hypnosis, the hypnotherapist uses one of several techniques to induce a hypnotic state. The most famous (and dated) technique is the swinging watch accompanied by the suggestion to fall asleep. Such “fixed gaze” hypnosis is no longer the mainstay.
More often, hypnotists use progressive relaxation methods, such as those described in the article on relaxation therapies . Other methods include mental misdirection (think of a suspense movie that leads you down the wrong path) and deliberate mental confusion. The net effect is the same; the person being hypnotized is in a state of heightened willingness to accept outside suggestions.
Once the client is in this state, the hypnotherapist can make a suggestion aimed at producing therapeutic benefit. At its most straightforward, this involves direct affirmation of the desired health benefit, such as, “You are now relaxing the muscles of your neck, and you will keep them relaxed.” Indirect or paradoxical suggestions may be used as well, especially in schools of hypnotherapy such as Ericksonian hypnosis and Neurolinguistic Programming (NLP).
It is also possible to learn to give oneself suggestions by inducing a state of hypnosis; this is called self-hypnosis.
Uses of Hypnotherapy
Hypnotherapy is commonly used for the treatment of addictions, as well as for reducing fear and anxiety surrounding stressful situations, such as surgery or severe illness. Other relatively common uses for hypnotherapy include insomnia, childbirth, pain control in general, and nocturnal enuresis (bed wetting). However, the evidence that hypnotherapy is effective for these uses remains incomplete at best.
What Is the Scientific Evidence for Hypnotherapy?
It is more difficult to ascertain the effectiveness of a therapy like hypnosis than a drug or a pill for one simple reason: it isn’t easy to design a proper double-blind, placebo-controlled study of this therapy.
Researchers studying the herb St. John’s wort , for example, can use placebo pills that are indistinguishable from the real thing. However, it’s difficult to conceive of a form of placebo hypnosis that can’t be detected as such by both practitioners and patients. For this reason, all studies of hypnosis have made various compromises to the double-blind design. Some randomly assigned participants to receive either hypnosis or no treatment. In the best of these studies, results were rated by examiners who didn’t know which participants were in which group (in other words, blinded observers). However, it isn’t clear whether benefits reported in such studies are due to the hypnosis or less specific factors, such as mere attention.
Other studies have compared hypnosis to various psychological techniques, including relaxation therapy and cognitive psychotherapy. However, the same issues arise when trying to study these latter therapies as with hypnosis, and the results of a study that compares an unproven treatment to an unproven treatment are not very meaningful.
In some studies, participants were allowed to choose whether they received hypnosis or some other therapy. Such nonrandomized studies are highly unreliable; the people who chose hypnosis, for example, might have been different in another way.
Even less meaningful studies of hypnotism simply involved giving people hypnosis and monitoring them to see whether they improved. Studies of this type have been used to support the use of hypnotherapy for hundreds of medical conditions. However, for at least a dozen reasons, such open-label trials prove nothing at all, and we do not report them here. The reasons why are discussed in the article Why Does This Database Rely on Double-blind Studies? Note, however, that one criticism of open-label studies discussed in that article does not apply here: concerns regarding the placebo effect.
In studies of most medical therapies, researchers must take pains to eliminate the possibility of a placebo effect . This concern, however, loses its relevance when hypnotism is in question. It isn’t a criticism of a study on hypnosis if an observed benefit turns out to be caused by the power of suggestion. After all, hypnosis consists precisely of the power of suggestion! (The placebo effect is only one of many problems with open-label studies, however. For more information, see the article referenced above.)
Given these caveats, the following is a summary of what science knows about the medical benefits of hypnotherapy.
The Possible Benefits of Hypnotherapy
Other conditions for which hypnosis has shown promise in controlled trials include the following:
- Burn injury (reducing pain) 8
- Hay fever25
- Labor and delivery , other gynecologic procedures 28
- Nocturnal enuresis23
- Chest pain of unknown cause (unrelated to the heart) 26
- Peptic ulcers15
- Pain associated with diagnostic procedures 31
- Temporomandibular joint (TMJ) syndrome32
- Tension headache and other forms of headache
- Vertigo and headache caused by head injury24
However, the quality of many of the supporting studies is poor, and their results are frequently inconsistent.
What to Expect in a Hypnotherapy Session
Hypnotherapy sessions usually last 30 to 60 minutes. They typically involve some questions and answers, followed by the hypnosis itself. Some hypnotists teach their clients self-hypnosis so they can reinforce the formal session.
How to Choose a Hypnotherapist
As with all medical therapies, it is best to choose a licensed practitioner in states where a hypnotherapy license is available. Where licensure is not available, seek a referral from a qualified and knowledgeable medical provider.
In the hands of a competent practitioner, hypnotherapy should present no more risks than any other form of psychotherapy. These risks might include worsening of the original problem and temporary fluctuations in mood.
Contrary to various works of fiction, hypnosis does not give the hypnotist absolute power over his subject. However, as with all forms of psychotherapy, the hypnotherapist does gain some power over the client through the client’s trust; an unethical therapist can abuse this.
- Reviewer: EBSCO CAM Review Board
- Review Date: 07/2012 -
- Update Date: 03/12/2013 -