.png)
I am often asked whether hypnotherapy works, and if there is any research into its effectiveness. Of course, as a practitioner who has been successfully treating clients with hypnotherapy for 10 years, and based on the positive feedback and testimonials I have received, I am a strong advocate for the benefits of hypnotherapy.
To back this up, there is a huge body of scientific research and studies from around the world into the effectiveness of hypnotherapy. It is now promoted by the American Psychological Association (2020) as a therapy beneficial for “pain, anxiety, and mood disorders,” as well as helping people change negative habits such as smoking; and in the UK, hypnotherapy is becoming more and more widely accepted by medical professionals as an effective treatment for a variety of issues [44].
How does hypnotherapy work?
Hypnosis is a deep state of relaxation, focus, and increased suggestibility, and it is a very natural state of being [45]. It is similar to being in a ‘flow’ state. Most of us have experienced being lost in thought, absorbed in music, a book or a film; or immersed in work: all examples of a hypnotic state. A hypnotherapist guides the client into this mental state, and then uses hypnosis to help the individual make the positive changes they want [4].
Research suggests there are several elements to hypnosis. It quietens down the activity of the frontal cortex, which is central to attention, planning, and making decisions. This has been demonstrated through brain-imaging studies. This same region seems to disconnect from another area responsible for self-reflection and daydreaming. Activity increases in other areas engaged in filtering and integrating information. We become more open to information, more suggestible, and capable of creating more intense sensations in our minds [46].
Researchers have also found that hypnosis can calm brain regions that help control autonomic functions like heart rate, blood flow, and breathing. This is likely to be what leads to the physical relaxation that is a hallmark of hypnosis [43].
Hypnotherapy can be equally beneficial through self-hypnosis [26]. This involves listening to a pre-recorded hypnotherapy session which is designed to teach self-hypnosis and to cultivate relaxation, while providing posthypnotic suggestions. As well as proving to be an effective treatment, it helps build self-reliance and independence [1]. Self-hypnosis is accessable and inclusive, and allows for self-directed therapy.
There have been a great many scientific studies into the effectiveness of hypnotherapy to treat a variety of issues. Here is a small summary of some of them:
Depression
Hypnotherapy is increasingly used as a treatment for depression. It has been found to be as effective at relieving symptoms of depression as other psychological interventions [17]. Hypnosis appears to help in several ways. By reducing the symptoms of depression, it helps build coping skills. It shifts focus from feelings to thoughts, and can help reframe difficult situations [32]. Because most people suffering depression also experience high levels of anxiety, they often derive significant benefit from learning to relax.
One study compared the effectiveness of hypnotherapy with cognitive-behavioural therapy (CBT) for depression The hypnotherapy group produced significantly larger reductions in depression, anxiety, and hopelessness over and above the CBT group, and this effect was maintained over 12 months. This study met the APA criteria for a “probably efficacious” treatment for depression [1].
Hypnosis is a powerful tool for producing a mixture of cognitive, physical, and perceptual changes [2]. By offering a sense of hope that depression can be controlled helps develop anti-depressive pathways. We can also use hypnotherapy to increase self-esteem and self-efficacy, found to be a key element in the effective treatment of psychological disorders [2].
Stress and Anxiety
There is a huge volume of research offering compelling evidence that hypnosis is an effective treatment for stress and anxiety [19, 22, 35] For example, a review of clinical trials found the average participant treated with hypnosis reduced anxiety by more than 84% of control participants [49]. A meta-analysis of 20 studies found that hypnosis had a significant immediate effect on anxiety in cancer patients and the effect was sustained over time [11, 21]. It was found that hypnosis exploits the intimate connection between mind and body, providing relief through improved self-regulation and also beneficially affecting cognition and the experience of self-mastery [24, 42].
Sleep
Hypnotherapy offers an effective way to support improved sleep. it has been shown to significantly improve sleep quality and increase deep sleep, and reduce sleep difficulties, fatigue, and insomnia-related emotional distress. A literature review from 2018 [10] reported that over 58% of the studies found that hypnosis benefits sleep outcomes. Hypnosis was also deemed a very safe approach, as two studies that monitored both positive and negative outcomes found no adverse events in any of the 231 participants.
Further research found that hypnosis can significantly improve sleep quality in postmenopausal women [13], reduce sleep difficulties, fatigue, and emotional distress in cancer survivors [21], and increase deep sleep [12]. Research compared multiple intervention strategies, including sleep hygiene, relaxation, mindfulness, and hypnotherapy. They concluded that hypnotherapy has promising results in improving both sleep and mental health and suggested combining approaches to maximize the benefits.
Pain relief
The use of hypnosis for pain relief was pioneered in 1840 by the surgeon James Braid, and used successfully since. In 1945, while stationed at the River Valley Road POW hospital in Singapore, Michael Woodruff and a medical/dental colleague from the Royal Netherlands Forces used hypnotism as the sole means of anaesthesia for a wide range of dental and surgical procedures. It is used extensively in dentistry and childbirth [26], and gaining acceptance in treating chronic pain [43].
Because pain is the brain’s response to messages of potential threat from our nerve endings, we can use hypnotherapy to effectively ‘turn off’ the pain signals. Studies have shown that hypnotized volunteers are up to 50% more capable of handling painful stimuli [15]. Scans reveal that hypnosis can switch off pain signals, and some studies suggest that hypnosis is more effective than standard medical care when used to reduce pain during labour and childbirth [26]. The National Institute for Health and Clinical Excellence (NICE) and The British Society of Gastroenterology recommends hypnotherapy to treat Refractory IBS (Irritable Bowel Syndrome) [8].
Menopause
Hypnotherapy can help improve the most common symptoms of menopause, such as hot flashes, night sweats, anxiety and disturbed sleep. Hot flashes occur because the falling level of oestrogen affects the hypothalamus, which is the part of your brain that regulates body temperature. Because of this, it may believe your body is overheating when it’s not, triggering a cooling response: the blood vessels near your skin dilate (that flushed feeling), your blood moves faster around your body (increased heart rate), and heat evaporates from your skin (by sweating).
Hypnotherapy for hot flashes works in a few ways. Firstly, it calms down this cooling response, before it even happens, and reduces the body's stress response, reversing the raised heart rate, the rush of blood, and the sweating. In one study [14], women in the hypnosis group reported 74% fewer hot flashes, compared to 17% fewer experienced by women in the control group. The skin sensors worn by the participants indicated a 57% reduction in hot flashes in the hypnotherapy group, compared to 10% in the women in the control group.
Hypnotherapy has also been shown to improve many other aspects of life during menopause, such as improving sleep, reducing stress, and improving mood [14]. The British Medical Journal has reported that hypnosis and cognitive behaviour therapy are the only two alternative treatments to HRT that work. Having reviewed the results of rigorous clinical studies on the topic, a panel of experts commissioned by the North American Menopause Society concluded there was solid evidence that both hypnotherapy and cognitive behavioural therapy were beneficial [6].
Weight Management
A recent review of research demonstrated that hypnosis can be effective in increasing food awareness, limiting emotional eating, reducing food cravings, and improving self-acceptance of body image [37]. Hypnosis can also be used to increase behaviours that support weight management, such as eating more slowly, healthy eating, and increasing physical exercise [5].
When comparing cognitive-behavioural therapy (CBT) with and without hypnosis, people who received CBT combined with hypnosis experienced more weight loss than about 60% of those who received CBT alone and more than 79% continued to maintain this at the follow-up after the treatment ended [4]. This means that hypnosis can enhance the effects of treatment if you are already receiving CBT for weight management. Furthermore, a recent study emphasised that routine use of hypnosis for weight management leads to greater weight loss [32].
Improving Performance
Hypnosis offers a variety of ways to improve performance across many different skills such as sports, music, acting and even surgery. Hypnosis can help increase focus, facilitate learning, and intensify practice through visualisation [50, 51]. It can be used to reduce performance anxiety, reframe negative thought patterns, and overcome other potential barriers to doing your best [53]. Athletes can utilise hypnosis to reduce pain as a result of intensive training or injuries; improve sleep for better performance and recovery; and reduce anxiety [54].
A number of well-known athletes have reported that they use hypnosis to enhance their performance. A recent review summarised studies demonstrating that hypnosis assists with performance in a variety of sports [31]. Evidence also exists for better performance in laparoscopic surgery [45], rifle shooting [29], and music [9,46] following hypnosis-based treatments.
Addiction
Hypnotherapy has been shown to be helpful in supporting people to overcome addictions. Many GPs recognise that supporting patients with hypnotherapy makes them more likely to stop smoking and remain smoke-free for longer [6, 23]. A 2019 study found hypnotherapy to be as effective as motivational interviewing in patients with long-term histories of alcohol abuse, showing a significant reduction in alcohol consumption after 12 months [41]
References
1. Alladin, A. & Alibhai, A. (2007) Cognitive Hypnotherapy for Depression: An Empirical Investigation, International Journal of Clinical and Experimental Hypnosis, 55:2, 147-166, DOI: 10.1080/00207140601177897
2. Alladin A. (2010) Evidence-Based Hypnotherapy for Depression, International Journal of Clinical and Experimental Hypnosis, 58:2, 165-185, DOI: 10.1080/00207140903523194
3. Alladin, A. (2012). Cognitive hypnotherapy: A new vision and strategy for research and practice. American Journal of Clinical Hypnosis, 54(4), 249–262.
4. American Psychological Association. (2020). Hypnosis. Retrieved January 4, 2021, from https://www.apa.org/topics/hypnosis
5. Barabasz, M. & Spiegel, D. (1989) Hypnotizability and weight loss in obese subjects. Int. J. Eat. Disord. 8, 335–341
6. Baylor University (2010). "'Cool' imagery lowers hot flashes through hypnotherapy." ScienceDaily. ScienceDaily, 14 July 2010. <www.sciencedaily.com/releases/2010/07/100713215202.htm>.
7. Barnes, J., McRobbie, H., Dong, C. Y., Walker, N., & Hartmann-Boyce, J. (2019). Hypnotherapy for smoking cessation. The Cochrane Database of Systematic Reviews, 6(6).
8. Bo, S. et al. (2018) Effects of Self-Conditioning Techniques (Self-Hypnosis) in Promoting Weight Loss in Patients with Severe Obesity: A Randomized Controlled Trial. Obesity 26, 1422–1429
9. Brooker, E. (2018) Music performance anxiety: A clinical outcome study into the effects of cognitive hypnotherapy and eye movement desensitisation and reprocessing in advanced pianists. Psychol. Music 46, 107–124.
10. Chamine, I., Atchley, R. & Oken, B. S. (2018) Hypnosis Intervention Effects on Sleep Outcomes: A Systematic Review. J. Clin. Sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med. 14, 271–283
11. Chen PY, Liu YM, Chen ML. (2017) The Effect of Hypnosis on Anxiety in Patients With Cancer: A Meta-Analysis. Worldviews Evid Based Nurs. 2017 Jun;14(3):223-236. doi: 10.1111/wvn.12215. Epub 2017 Mar 7. PMID: 28267893.
12. Cordi, M. J., Rossier, L. & Rasch, B. (2020) Hypnotic Suggestions Given Before Nighttime Sleep Extend Slow-Wave Sleep as Compared to a Control Text in Highly Hypnotizable Subjects. Int. J. Clin. Exp. Hypn. 68, 105–129
13. Elkins, G. et al. (2021) Hypnosis Intervention for Sleep Disturbance: Determination of Optimal Dose and Method of Delivery for Postmenopausal Women. Int. J. Clin. Exp. Hypn. 69, 323–345
14. Elkins GR, Fisher WI, Johnson AK, Carpenter JS, Keith TZ. Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomized controlled trial. Menopause. 2013 Mar;20(3):291-8. doi: 10.1097/gme.0b013e31826ce3ed. PMID: 23435026; PMCID: PMC3556367.
15. Faymonville, M. E., Boly, M., & Laureys, S. (2006). Functional neuroanatomy of the hypnotic state. Journal of Physiology-Paris, 99(4–6), 463–469.
16. Friedrich, A., & Schlarb, A. A. (2017). Let’s talk about sleep: A systematic review of psychological interventions to improve sleep in college students. Journal of Sleep Research, 27(1), 4–22.
17. Fuhr, K., Meisner, C., Broch, A., Cyrny, B. Hinkel J, Jaberg, J. Petrasch, M., Schweizer, C. Stiegler, A., Zeep, C. Batra, A. (2021) Efficacy of hypnotherapy compared to cognitive behavioral therapy for mild to moderate depression - Results of a randomized controlled rater-blind clinical trial; Journal of Affective Disorders; Volume 286, 1 May 2021, Pages 166-173
18. Gardner, F. & Moore, Z. (2006) Clinical sport psychology. xi, 283 (Human Kinetics)
19. Gilbertson AD, Kemp K. (1992) Uses of hypnosis in treating anxiety states. Psychiatr Med. 1992;10(4):13-20. PMID: 1289958.
20. Gould, D. & Udry, E. (1994) Psychological skills for enhancing performance: arousal regulation strategies.
21. Grégoire, C. et al. (2022) Randomized, Controlled Trial of an Intervention Combining Self-Care and Self-Hypnosis on Fatigue, Sleep, and Emotional Distress in Posttreatment Cancer Patients: 1-Year Follow-Up. Int. J. Clin. Exp. Hypn. 70, 136–155
22. Hammond DC (2010) Hypnosis in the treatment of anxiety- and stress-related disorders. February 2010 Expert Review of Neurotherapeutics 10(2):263-73
23. Hasan F.M., Zagarins, S.E. Pischke, K.M., Saiyed S, Bettencourt A.M., Beal, L., Macys, D., Aurora, S., McCleary, N. (2014) Hypnotherapy is more effective than nicotine replacement therapy for smoking cessation: Results of a randomized controlled trial
24. Kaiser P. (2011) Childhood anxiety, worry, and fear: individualizing hypnosis goals and suggestions for self-regulation. Am J Clin Hypn. 2011 Jul;54(1):16-31. doi: 10.1080/00029157.2011.575965. PMID: 21922709.
25. Klein, A. (2018). Opioid crisis: Powerful but non-addictive drug could replace morphine. New Scientist. Retrieved January 4, 2021, from https://www.newscientist.com/article/2178001-opioid-crisis-powerful-but-non-addictive-drug-could-replace-morphine/
26. Landolt, A.S., Milling, L.S. (2011) The efficacy of hypnosis as an intervention for labor and delivery pain: A comprehensive methodological review; Clinical Psychology Review, Volume 31, Issue 6, pp 1022-1031,Lang EV, Benotsch EG, Fick LJ, Lutgendorf S, Berbaum ML, Berbaum KS, Logan H, Spiegel D. (2000) Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet. 2000 Apr 29;355(9214):1486-90.
27. Mahler, T. (2015). Education and hypnosis for treatment of functional gastrointestinal disorders (FGIDs) in pediatrics. American Journal of Clinical Hypnosis, 58(1), 115–128.
28. Marchant, J. (2011). Heal thyself: Self-hypnosis. New Scientist. Retrieved April 2023 from https://www.newscientist.com/article/mg21128272-000-heal-thyself-self-hypnosis/
29. Mattle, S., Birrer, D. & Elfering, (2020) A. Feasibility of Hypnosis on Performance in Air Rifle Shooting Competition. Int. J. Clin. Exp. Hypn. 68, 521–529
30. Med. Sci. Sports Exerc. 26, 478–485 (1994).
31. Milling, L. S. & Randazzo, E. S. (2016) Enhancing sports performance with hypnosis: An ode for Tiger Woods. Psychol. Conscious. Theory Res. Pract. 3, 45–60
32. Milling, L. S., Gover, M. C. & Moriarty, C. L. (2018) The effectiveness of hypnosis as an intervention for obesity: A meta-analytic review. Psychol. Conscious. Theory Res. Pract. 5, 29–45
33. Milling, L. S., Valentine, K. E., McCarley, H. S., & LoStimolo, L. M. (2018). A meta-analysis of hypnotic interventions for depression symptoms: High hopes for hypnosis? American Journal of Clinical Hypnosis, 61(3), 227–243.
34. Neurother. (2010) Feb;10(2):263-73. doi: 10.1586/ern.09.140. PMID: 20136382.
35. Olendzki, N., Elkins, G. R., Slonena, E., Hung, J., & Rhodes, J. R. (2020). Mindful hypnotherapy to reduce stress and increase mindfulness: A randomized controlled pilot study. International Journal of Clinical and Experimental Hypnosis, 68(2), 151–166.
36. Parikh, N. I. et al. (2007) Increasing Trends in Incidence of Overweight and Obesity over 5 Decades. Am. J. Med. 120, 242-250.e2.
37. Pellegrini, M. et al. (2021) The Use of Self-Help Strategies in Obesity Treatment. A Narrative Review Focused on Hypnosis and Mindfulness. Curr. Obes. Rep.
38. Potié, A., Roelants, F., Pospiech, A., Momeni, M., & Watremez, C. (2016). Hypnosis in the perioperative management of breast cancer surgery: Clinical benefits and potential implications. Anesthesiology Research and Practice, 2016, 1–8.
39. Roslim, N. A., Ahmad, A., Mansor, M., Aung, M. M. T., Hamzah, F., Hassan, H., & Lua, P. L. (2020). Hypnotherapy for overweight and obese patients: A narrative review. Journal of Integrative Medicine.
40. Rotaru, T. Ș., & Rusu, A. (2015). A meta-analysis for the efficacy of hypnotherapy in alleviating PTSD symptoms. International Journal of Clinical and Experimental Hypnosis, 64(1), 116–136.
41. Shestopal, I., & Bramness, J. G. (2019). Effect of hypnotherapy in alcohol use disorder compared with motivational interviewing. Addictive Disorders & Their Treatment, 18(3), 169–175.
42. Smith WH. (1990) Hypnosis in the treatment of anxiety. Bull Menninger Clin. Spring;54(2):209-16. PMID: 2194608.
43. Spiegel D, Bloom JR. (1983) Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosom Med. 1983 Aug;45(4):333-9.
44. Spiller R, Aziz Q, Creed F, et al. (2007) Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut 2007;56:1770–98.
45. Sroka, G., Arnon, Z., Laniado, M., Schiff, E. & Matter, I. (2015) Hypnosis-induced mental training improves performance on the Fundamentals of Laparoscopic Surgery (FLS) simulator. Surg. Endosc. 29, 1024–1029
46. Stanton, H. E. (1994) Reduction of Performance Anxiety in Music Students. Aust. Psychol. 29, 124–127
47. Sutton, J (2023) https://positivepsychology.com/hypnotherapy/
48. Thomson, H. (2019). What hypnosis does to your brain, and how it can improve your health. New Scientist. Retrieved January 3, 2021, from https://www.newscientist.com/article/mg24432550-600-what-hypnosis-does-to-your-brain-and-how-it-can-improve-your-health/
49. Valentine KE, Milling LS, Clark LJ, Moriarty CL. (2019) The Efficacy Of Hypnosis As A Treatment For Anxiety: A Meta-Analysis. Int J Clin Exp Hypn. 2019 Jul-Sep;67(3):336-363. doi: 10.1080/00207144.2019.1613863. PMID: 31251710.
50. Vealey, R. S. & Forlenza, S. T. (2015) Understanding and using imagery in sport. in Applied Sport Psychology: Personal Growth to Peak Performance 240–273
51. Whelan, J. P., Mahoney, M. J. & Meyers, A. W. (1991).Performance enhancement in sport: A cognitive behavioral domain. Behav. Ther. 22, 307–327
52. Whorwell, P. J. (2008). Hypnotherapy for irritable bowel syndrome: The response of colonic and noncolonic symptoms. Journal of Psychosomatic Research, 64(6), 621–623.
53. Williams, J. M., Zinsser, N. & Bunker, L. (2015). Cognitive techniques for building confidence and enhancing performance. in Applied sport psychology: Personal growth to peak performance 274–303
54. Wilson, M. (2008) From processing efficiency to attentional control: a mechanistic account of the anxiety–performance relationship. Int. Rev. Sport Exerc. Psychol. 1, 184–201