What is hypnosis and hypnotherapy?
This is a question that I often get from clients, colleagues and friends. Most people have heard of hypnosis or recall a stage show entertainment form of it where the performer gets a volunteer from the audience to quack like a duck and everyone laughs. Unfortunately, this presentation creates distrust and continues the myth of losing control of your thoughts and actions to a stranger.
The Mayo Clinic defines hypnosis as a trance-like state in which you have heightened focus and concentration. Hypnosis is usually done with the help of a therapist using verbal repetition and mental-imagery. When you’re under hypnosis, you usually feel calm and relaxed, and are more open to suggestions. It’s important to know that although you’re more open to suggestions during hypnosis, you remain in control over your behavior.
Before starting hypnosis, the careful process of evaluating and assessing the client for their appropriateness in using hypnosis is essential. Hypnosis can be used to help you gain control over undesired behaviors, help you cope with anxiety or pain, and give you access to insight you may not have had before (Mayo Clinic).
Hypnosis is only one part of hypnotherapy. The term hypnotherapy refers to a holistic psychotherapeutic approach to treating common mental health problems like anxiety, depression, and trauma, as well as other issues like chronic pain.
How is hypnosis used in therapy?
In hypnotherapy, the therapist utilizes progressive relaxation, guided visualization and verbal repetition to induce a hypnotic state in which the client attains a sense of deep relaxation in the moment. This enables the therapist to guide the client to the feelings and thoughts that are blocking them from creating change in their lives. After creating a trusting and safe environment, the therapist begins a gradual “induction” experience into the memories, feelings and somatic clues left behind, searching for their origins in order to release and transform them. This is a way of directly accessing a person’s subconscious mind and uncovering the creative, emotional and physical information your body receives and has stored over the years. This information and access allow the client and therapist to locate the origins of limiting beliefs, disruptive behaviors and habitual reactions. Accessing fears, memories and repressed emotions, can help clarify difficult issues and bring resolution to persistent problems.
What is the theory behind hypnosis?
There are several theories related to hypnosis, but I have found the most effective evidence-based approach to be Ego States Therapy. Ego states are the parts of our personality that cause us to act different ways in different situations. Often, there are parts of our personalities that may be hidden or reluctant to communicate with not only the therapist, but to our own self. John and Helen Watkins, authors of Ego States Theory and Therapy, assert that hypnosis is a direct, safe and effective way to contact an ego state and determine what other parts are in conflict with it. During any guided-journey with a client, it is crucial to create a feeling of safety to prevent the client from re-experiencing difficult feelings from their past, and to allow their ego states to feel safe before revealing themselves.
Who is hypnotherapy for?
Hypnosis has been used to treat various medical, psychological and psychosomatic conditions for over two centuries (Spiegel, 2013). There have been many studies conducted on the efficacy of hypnosis, or hypnotherapy, over the past few decades. The studies range over a wide variety of conditions and symptoms. Specifically, research has focused on hypnotherapy in relation to individuals with cancer, trauma, acute and chronic pain, depression and anxiety (Spiegel, 2013).
What issues or symptoms is hypnotherapy effective with according to research?
1. Chronic pain. Studies have found hypnosis to assist in the reduction of chronic pain (Jensen et al., 2008). Participants in Jensen et al,’s (2008) study reported reduction in pain following sessions of hypnotherapy and for several months after. Similarly, participants in a study involving hypnosis as treatment for chronic low back pain (CLBP) reported improvement following sessions, as well (Tan, Fukui, Jensen, Thornby, &Waldman, 2010). It is important to note that effects have not been showed to remain significant over a long-term period of time (Jensen et al., 2008, Tan et al., 2010). Furthermore, Jensen’s (2008) study indicated the importance of clients learning hypnotic techniques from their therapist to use on their own so that they may find relief between or after the discontinuation of therapy. In fact, the majority of the sample reported to continue to use the techniques indicating the value participants placed on hypnotherapy.
2. Terminal illness or cancer. Taylor and Ingleton (2003) found that a combination of cognitive behavioral therapy (CBT) and hypnotherapy left cancer patients with a better ability to cope with the procedure-related and psychological-related impacts of cancer. Patients described that they were better able to relax with the use of this intervention. The researchers found that the therapeutic relationship was a large mediating factor in the success of the interventions. Liossi and White’s (2001) study found hypnosis to be an effective modality in treating terminally ill cancer patients. The study found that this intervention helped increase quality-of-life in participants, as well as decrease feelings of anxiety and depression associated with the stress and difficulty of adjusting to life with illness. It is important to note that participants did not report enhancement in physical quality of life, but rather psychological quality of life. While hypnotherapy has been found to help patients with cancer cope with their illness, reduce anxiety and find moments of relaxation, the majority of sample sizes are extremely small and most findings have been insignificant, especially for adults (Chen, Liu, & Chen, 2017).
3. Anxiety and depression. Cognitive hypnotherapy (CH) was found to significantly reduce the symptoms of depression in a sample of adults (Alladin &Alibhai, 2007). Feelings of depression, anxiety and hopelessness were all reported to have been significantly decreased. The combination of CBT and hypnotherapy in this study was found to be effective not only during therapy, but at six and twelve-month follow-ups. Case studies conducted on the effects of hypnotherapy as treatment for individuals with depression have also yielded positive results (Schreiber, 2010). The five individuals followed in the Schreiber’s study found that participants’ levels of anxiety and feelings of depression were lessened over the course of treatment sessions. Additionally, meta analyses conducted on the efficacy of hypnosis in the treatment of depression found a medium effect size (Shih, Yang, & Koo, 2009). The researchers of this study suggest that this alternative means of treatment can be beneficial for those struggling with depression.
4. Trauma and Abuse. Hypnosis has also been studied in relation to trauma. A case study following a woman struggling with trauma related to child sexual abuse found that hypnosis can help clients gain access to traumatic memories and aid in desensitizing clients to past trauma (Poon, 2007). Hypnosis allows clients to engage in this process in a safe environment. In Poon’s (2007) particular case study, the client reported a significant reduction in trauma symptoms. The lessening of symptoms was also able to be measured and confirmed through observation and objective tests. Additionally, a study conducted on the efficacy of hypnosis on burn patients yielded positive results (Shakibaei, Harandi, Gholamrezaei, Samoei, & Salehi, 2008). The re-experiencing of trauma was reportedly reduced among participants. It is notable that this study had a small sample size and several limitations so that results may not be generalizable as is the case with case studies.
How do I find out if hypnotherapy is a good fit for me?
If you are looking to try hypnosis, it’s important to find a certified therapist with at least a master’s level degree in social work, marital/family counseling, nursing or psychology in addition to a specific number of hours of approved training in hypnotherapy.
At C.R.E.A.T.E. Outcomes Psychological Services, we have therapists who are trained in hypnosis and qualified to provide hypnotherapy. Despite media’s portrayal of hypnosis, hypnotherapy is a long-standing, evidence-based approach to psychotherapy that is effective for a host of problems.
Alladin, A., & Alibhai, A. (2007). Cognitive hypnotherapy for depression: An empirical investigation. Intl. Journal of Clinical and Experimental Hypnosis, 55(2), 147-166.
Chen, P. Y., Liu, Y. M., & Chen, M. L. (2017). The Effect of Hypnosis on Anxiety in Patients With Cancer: A Meta‐Analysis. Worldviews on Evidence‐Based Nursing, 14(3), 223-236.
Jensen, M. P., Barber, J., Hanley, M. A., Engel, J. M., Romano, J. M., Cardenas, D. D., … & Patterson, D. R. (2008). Long-term outcome of hypnotic-analgesia treatment for chronic pain in persons with disabilities. Intl. Journal of Clinical and Experimental Hypnosis, 56(2), 156-169.
Liossi, C., & White, P. (2001). Efficacy of clinical hypnosis in the enhancement of quality of life of terminally ill cancer patients. Contemporary Hypnosis, 18(3), 145-160.
Mayo Clinic. (n.d.). Hypnosis. Retrieved November 21, 2018, from https://www.mayoclinic.org/tests-procedures/hypnosis/about/pac-20394405
Poon, M. W. L. (2007). The value of using hypnosis in helping an adult survivor of childhood sexual abuse. Contemporary Hypnosis, 24(1), 30-37.
Schreiber, E. H. (2010). USE OF HYPNOSIS IN PSYCHOTHERAPY WITH MAJOR DEPRESSIVE DISORDERS. Australian Journal of Clinical and Experimental Hypnosis (Online), 38(1), 44.
Shakibaei, F., Harandi, A. A., Gholamrezaei, A., Samoei, R., & Salehi, P. (2008). Hypnotherapy in management of pain and reexperiencing of trauma in burn patients. Intl. Journal of Clinical and Experimental Hypnosis, 56(2), 185-197.
Shih, M., Yang, Y. H., & Koo, M. (2009). A meta-analysis of hypnosis in the treatment of depressive symptoms: a brief communication. Intl. Journal of Clinical and Experimental Hypnosis, 57(4), 431-442.
Tan, G., Fukui, T., Jensen, M. P., Thornby, J., & Waldman, K. L. (2009). Hypnosis treatment for chronic low back pain. Intl. Journal of Clinical and Experimental Hypnosis, 58(1), 53-68.
Taylor, E. E., & Ingleton, C. (2003). Hypnotherapy and cognitive‐behaviour therapy in cancer care: the patients’ view. European Journal of Cancer Care, 12(2), 137-142.
Watkins, J. G., & Watkins, H. H. (1997). Ego states: Theory and therapy. New York: WW Norton.