What is hypnotherapy?

The term "hypnosis" is derived from the Greek word hypnos, meaning "sleep." Hypnotherapists typically use exercises that bring about deep relaxation and an altered state of consciousness, also known as a trance. Many people routinely experience a trance-like state while they are watching television or sitting at a red light. A person in a trance or deeply focused state is unusually responsive to an idea or image, but this does not mean that a hypnotist can control his or her mind and free will. On the contrary, hypnosis can actually teach people how to master their own states of awareness. By doing so they can affect their own bodily functions and psychological responses.

What is the history of hypnosis?

Throughout history, trance states have been used by shamans and ancient peoples in ritualistic activities. But hypnosis as we know it today was first associated with the work of an Austrian physician named Franz Anton Mesmer. In the 1700s, Mesmer used magnets and other hypnotic techniques (hence the word, mesmerized) to treat people, and while he achieved a number of dramatic "cures" for blindness, paralysis, headache, and joint pain, the medical community was not convinced. Mesmer was accused of fraud and his techniques called unscientific.

Hypnotherapy regained popularity in the mid-1900's due in to the notoriety and career of Milton H. Erickson (1901-1980), a successful psychiatrist who used hypnosis in his practice. In 1958, both the American Medical Association and the American Psychological Association recognized the therapy as a valid medical procedure. And since 1995, the National Institutes of Health has recommended hypnotherapy as a treatment for chronic pain. Other conditions for which hypnotherapy is frequently used include anxiety and addiction; see the section entitled What illnesses or conditions respond well to hypnotherapy?

How does hypnosis work?

When something new happens to us, we remember it and learn a particular behavior in response to that circumstance. Memories stored in our brains hold the original physical and emotional reactions that occurred when the given memory was first formed. Each time similar events occur again, the physical and emotional reactions attached to the memory are repeated. These reactions may be inappropriate or unhealthy. In hypnotherapy, the trained therapist guides you to remember the event that led to the first reaction, separate the memory from the learned behavior, and reconstruct the event with new, healthier associations.

During hypnosis, a person's body relaxes while his or her thoughts become more focused and attentive. Like other relaxation techniques, hypnosis decreases blood pressure and heart rate, and alters certain types of brain wave activity. In this relaxed state, a person will feel very at ease physically yet fully awake mentally. In this state of deep concentration people are highly responsive to suggestion. If you are trying to quit smoking, for example, a therapist's suggestion may successfully convince you that in the future you will have a strong dislike for the taste of cigarettes.

There are several stages of hypnosis. The process begins with reframing the problem; becoming relaxed, then absorbed (deeply engaged in the words or images presented by a hypnotherapist); dissociating (letting go of critical thoughts); responding (complying whole-heartedly to a hypnotherapist's suggestions); returning to usual awareness; and reflecting on the experience.

What happens during a visit to the hypnotherapist?

During your first visit to a hypnotherapist, he or she will ask you questions about your medical history and what brought you to see them – in other words, what condition it is that you would like to clear up. The specialist will then, likely, explain to you what hypnosis is and how it works. You will then be directed through relaxation techniques with a series of mental images and suggestions intended to change behaviors and alleviate symptoms. For example, people who suffer from panic attacks may be given the suggestion that, in the future, they will be able to relax at will. The hypnotherapist will also teach you the basics of self-hypnosis and give you an audiotape for home use. This enables you to recreate the feelings you experienced during the session and reinforce the learning on your own.

How many treatments will I need?

Each session lasts about an hour, and most people begin to improve within 4 to 10 sessions. Together, you and your hypnotherapist will monitor and evaluate your progress over time. Children (aged 9 to 12), because they are easily hypnotized, tend to respond after only one or two visits.

What illnesses or conditions respond well to hypnosis?

Hypnosis is used in a variety of settings – from emergency rooms to dental offices to outpatient clinics – to relieve conditions with an emotional or psychological component. Studies suggest that hypnosis may improve immune function, increase relaxation, decrease stress, and ease feelings of anxiety.

Hypnotherapy is effective in reducing the fear and anxiety that accompany pain and uncomfortable medical or dental procedures. For example, when used during an operation, hypnosis may improve recovery time and decrease anxiety as well as pain following the surgery. Clinical trials on burn patients suggest that hypnosis decreases pain (enough to replace pain medication) and speeds healing. Generally, studies indicate that using hypnosis can lessen your need for medication, improve your mental and physical condition before an operation, and reduce the time it takes to recover. Dentists also use hypnotherapy to control gagging and bleeding.

A hypnotherapist can teach you self-regulation skills. For instance, someone with arthritis may be told that he or she can turn down pain like the volume on a radio. Hypnotherapy can also be an effective tool for managing chronic illness. Self-hypnosis can enhance a sense of control, which is often eroded by chronic illness. Children may benefit the most from hypnosis, probably because they are most easily hypnotized.

Studies on children in emergency treatment centers show that hypnotherapy reduces fear, anxiety, and discomfort and improves self-control and cooperation with medical personnel.

In another study, 83 percent of children significantly or completely recovered from the following:

• obesity
• asthma
• fecal incontinence
• anxiety
• pain
• problematic habits (sleep walking, thumb sucking, nail biting)

Other problems or conditions that respond well to hypnotherapy include:

• inflammatory bowel diseases (namely, Crohn's disease and ulcerative colitis)
• sleep disorders, including insomnia
• addictions
• warts
• bedwetting
• fibromyalgia
• irritable bowel syndrome
• phobias
• labor and delivery
• fractures
• skin disorders (such as acne, psoriasis, and eczema [atopic dermatitis])
• migraine headaches
• stress
• tinnitus (ringing in the ears)
• cancer related pain
• weight loss
• eating disorders, namely anorexia and bulimia
• indigestion (dyspepsia)

Are there any risks associated with hypnotherapy?

Before considering hypnotherapy, you must obtain a proper diagnosis from a physician to understand what is being treated. This is especially true if your condition is psychological in nature (for example, a phobia or anxiety), in which case it is important to first be evaluated by a psychiatrist. Without an accurate diagnosis, it is possible that hypnotherapy may exacerbate your symptoms. Also, very rarely, hypnotherapy leads to the development of "false memories" fabricated by the unconscious mind; these are called confabulations.

How can I find a hypnotherapist?

Most hypnotherapists are licensed medical doctors, registered nurses, social workers, or family counselors who have received additional training in hypnotherapy. For example, members of the American Society of Clinical Hypnosis (ASCH) must hold a doctorate in medicine, dentistry, podiatry, or psychology, or a master's level degree in nursing, social work, psychology, or marital/family therapy with at least 20 hours of ASCH-approved training in hypnotherapy. Similarly, the American Psychotherapy and Medical Hypnosis Association provides certificates for licensed medical and mental health professionals who complete a six to eight week course.

To receive a directory of professionals practicing hypnotherapy near you, contact:

• The American Society of Clinical Hypnosis on the Web at http://www.asch.net/ or call 312-645-9810
• The Society for Clinical and Experimental Hypnosis on the Web at http://ijceh.educ.wsu.edu/sceh/scehframe.htm or by phone at 509-332-7555
• The American Association of Professional Hypnotherapists on the Web at http://www.aaph.org or by phone at 650-323-3224.

Supporting Research

Abela MB. Hypnotherapy for Crohn's disease: a promising complementary/alternative therapy. Integr Med. 2000;2(2/3):127-131.

Allison DB, Faith MS. Hypnosis as an adjunct to cognitive-behavioral psychotherapy for obesity: a meta-analytic reappraisal. J Consult Clin Psychol. 1996;64(3):513-516.

Allison DB, Fontaine KR, Heshka S, et al. Alternative treatments for weight loss: a critical review. Crit Rev Food Sci Nutr. 2001;41(1):1-28.

Anbar RD. Hypnosis in pediatrics: applications at a pediatric pulmonary center. BMC Pediatr. 2002;2910:11.

Andersson G, Lyttkens L. A meta-analytic review of psychological treatments for tinnitus. Br J Audiol. 1999;33(4):201-210.

Anton PA. Stress and mind-body impact on the course of inflammatory bowel diseases. Semin Gastrointest Dis. 1999;10:14-19.

Ashton C Jr, Whitworth GC, Seldomridge JA, et al. Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. J Cardiovasc Surg (Torino). 1997;38(1)69-75.

Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatr Clin North Am. 1999;46:977-992.

Belsky J, Khanna P. The effects of self-hypnosis for children with cystic fibrosis: a pilot study. Am J Clin Hypn. 1994;36(4):282-292.

Berman BM, Swyers JP. Complementary medicine treatments for fibromyalgia syndrome. Baillieres Best Pract Res Clin Rheumatol. 1999;13(3):487-492.

Blancahrd EB, Scharff L. Psychosocial aspects of assessment and treatment of irritable bowel syndrome in adults and recurrent abdominal pain in children. J Consult Clin Psychol. 2002;70(3):725-738.

Bootzin RR, Perlils ML. Nonpharmacologic treatments of insomnia. J Clin Psychiatry. 1992;53(suppl):37-41.

Calvert EL, Houghton LA, Cooper P, Morris J, Whorwell PJ. Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterology. 2002;123(6):1778-1785.

Ernst E, Pittler MH, Stevinson C. Complementary/alternative medicine in dermatology: evidence-assessed efficacy of two diseases and two treatments. Am J clin Dermatol. 2002;3(5):341-348.

Farhadi A, Bruninga K, Fields J, Keshavarzian A. Irritable bowel syndrome: an update on therapeutic modalities. Expert Opin Investig Drugs. 2001;10(7):1211-1222.

Faymonville ME, Defechereux T, Joris J, Adant JP, Hamoir E, Meurisse M. Hypnosis and its application in surgery. Rev Med Liege. 1998;53(7):414-418.

Gonsalkorale WM, Houghton LA, Whorwell PJ. Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness. Am J Gastroenterol. 2002;97(4):954-961.

Ginandes CS, Rosenthal DI. Using hypnosis to accelerate the healing of bone fractures: a randomized controlled pilot study. Altern Ther Health Med. 1999;5(2):67-75.

Hackman RM, Stern JS, Gershwin ME. Hypnosis and asthma: a critical review. J Asthma. 2000;37(1):1-15.

Houghton LA, Larder S, Lee R, et al. Gut focused hypnotherapy normalizes rectal hypersensitivity in patients with irritable bowel syndrome (IBS). Paper presented at: Annual Meeting of the American Gastroenterological Association; May 16-19, 1999; Orlando, FL.

Kirsch I. Hypnotic enhancement of cognitive-behavioral weight loss treatments—another meta-reanalysis. J Consult Clin Psychol. 1996;64(3):517-519.

Kirsch I, Montgomery G, Sapirstein G. Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis. J Consult Clin Psychol. 1995;63(2):214-220.

Kohen DP, Olness KN, Colwell SO, Heimel A. The use of relaxation-mental imagery (self-hypnosis) in the management of 505 pediatric behavioral encounters. J Dev Behav Pediatr. 1984;5(1):21-25.

Kohen DP, Wynne E. Applying hypnosis in a preschool family asthma education program: uses of storytelling, imagery, and relaxation. Am J Clin Hypn. 1997;39:169-181.

Lang EV, Benotsch EG, Fick LJ, et al. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet. 2000;355(9214):1486-1490.

Leventhal LJ. Management of fibromyalgia. Ann Intern Med. 1999;131(11):850-858.

Liossi C, Hatira P. Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations. Int J Clin Exp Hypn. 1999;47:104-116.

Martin AA, Schauble PG, Rai Sh, Curry RW, Jr. The effects of hypnosis on the labor processes and birth outcomes of pregnant adolescents. J Fam Prac. 2001;50:441-443.

Murtagh DR, Greenwood KM. Identifying effective psychological treatments for insomnia: a meta-analysis. J Consult Clin Psychol. 1995; 63(1):79-89.

Ohrbach R, Patterson DR, Carrougher G, Gibran N. Hypnosis after an adverse response to opioids in an ICU burn patient. Clin J Pain. 1998;14(2):167-175.

Olness K. Hypnotherapy: a cyberphysiologic strategy in pain management. Pediatr Clin North Am. 1989;36(4):873-884.

Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM. Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life. A systematic review. J Pain Symptom Manage. 2000;20:374-387.

Patterson DR, Adcock RJ, Bombardier CH. Factors predicting hypnotic analgesia in clinical burn pain. Int J Clin Exp Hypn. 1997; 45:377-395.

Peebles-Kleiger MJ. The use of hypnosis in emergency medicine. Emerg Med Clin North Am. 2000;18:327-328.

Raskin R, Raps C, Luskin F, Carlson R, Cristal R. Pilot study of the effect of self-hypnosis on the medical management of essential hypertension. Stress Med. 1999;15:243-247.

Saichek KI. Hypnotherapy. In: Novey DW, ed. Clinician's Complete Reference to Complementary and Alternative Medicine. St. Louis, Mo: Mosby; 2000:53-63.

Schafer DW. Hypnosis and the treatment of ulcerative colitis and Crohn's disease. Am J Clin Hypn. 1997;40:111-117.

Sellick SM, Zaza C. Critical review of 5 nonpharmacologic strategies for managing cancer pain. Cancer Prev Control. 1998;2(1):7-14.

Shenefelt PD. Hypnosis in dermatology. Arch Dermatol. 2000;136:393-399.

Spiegel D, Moore R. Imagery and hypnosis in the treatment of cancer patients. Oncology. 1997;11:1179-1189.

Stradling J, Roberts D, Wilson A, Lovelock F. Controlled trial of hypnotherapy for weight loss in patients with obstructive sleep apnoea. Int J Obes Relat Metab Disord . 1998;22:278-281.

Sugarman LI. Hypnosis in a primary care practice: developing skills for the "new morbidities." J Dev Behav Pediatr. 1996;17(5):300-305.

Torem MS. The use of hypnosis with eating disorders. Psychiatr Med. 1992;10(4):105-118.

Vickers A, Zollman C. Hypnosis and relaxation therapies. BMJ. 1999;319(7221):1346-1349.

Weaver MF, Jarvis MA, Schnoll SH. Role of the primary care physician in problems of substance abuse. Arch Int Med. 1999;159:913-924.

Wood GJ, Zadeh HH. Potential adjunctive applications of hypnosis in the management of periodontal diseases. Am J Clin Hypn. 1999;41(3):212-225.

Wright BR, Drummond PD. Rapid induction analgesia for the alleviation of procedural pain during burn care. Burns. 2000;26:275-282.

Young D. The use of hypnotherapy in the treatment of eating disorders. Contemporary Hypnosis. 1995;12:148-153.