This article's
lead sectionmay be too short to adequately
summarize the key points. Please consider expanding the lead to
provide an accessible overview of all important aspects of the article.(August 2023)
Hypnotherapy, also known as hypnotic medicine,[1] is the use of
hypnosis in
psychotherapy.[2][3] The efficacy of hypnotherapy is not well supported by scientific evidence,[1][4][5] and, due to the lack of evidence indicating any level of efficacy,[6] it is regarded as a type of
alternative medicine by reputable medical organisations such as the
National Health Service.[7]
"Induces hypnotic state in client to increase motivation or alter behavior patterns: Consults with client to determine nature of problem. Prepares client to enter hypnotic state by explaining how hypnosis works and what client will experience. Tests subject to determine degree of physical and emotional suggestibility. Induces hypnotic state in client, using individualized methods and techniques of hypnosis based on interpretation of test results and analysis of client's problem. May train client in self-hypnosis conditioning."[8]
In the 1950s,
Milton H. Erickson developed a radically different approach to hypnotism, which has subsequently become known as "Ericksonian hypnotherapy" or "Neo-Ericksonian hypnotherapy." Based on his belief that dysfunctional behaviors were defined by social tension, Erickson coopted the subject's behavior to establish rapport, a strategy he termed "utilization." Once rapport was established, he made use of an informal conversational approach to direct awareness. His methods included complex language patterns and client-specific therapeutic strategies (reflecting the nature of utilization). He claimed to have developed ways to suggest behavior changes during apparently ordinary conversation.[10]
This divergence from tradition led some, including
Andre Weitzenhoffer, to dispute whether Erickson was right to label his approach "hypnosis" at all.[11] Erickson's foundational paper, however, considers hypnosis as a mental state in which specific types of "work" may be done, rather than a technique of induction.[12]
The founders of
neuro-linguistic programming (NLP), a method somewhat similar in some regards to some versions of hypnotherapy, claimed that they had modelled the work of Erickson extensively and assimilated it into their approach.[13][14] Weitzenhoffer disputed whether NLP bears any genuine resemblance to Erickson's work.[11]
Solution-focused
In the 2000s, hypnotherapists began to combine aspects of
solution-focused brief therapy (SFBT) with Ericksonian hypnotherapy to produce therapy that was goal-focused (what the client wanted to achieve) rather than the more traditional problem-focused approach (spending time discussing the issues that brought the client to seek help). A solution-focused hypnotherapy session may include techniques from NLP.[15]
Cognitive/behavioral
Cognitive behavioral hypnotherapy (CBH) is an integrated psychological therapy employing clinical hypnosis and
cognitive behavioral therapy (CBT).[16] The use of CBT in conjunction with hypnotherapy may result in greater treatment effectiveness. A meta-analysis of eight different researches revealed "a 70% greater improvement" for patients undergoing an integrated treatment to those using CBT only.[17]
In 1974,
Theodore X. Barber and his colleagues published a review of the research which argued, following the earlier social psychology of
Theodore R. Sarbin, that hypnotism was better understood not as a "special state" but as the result of normal psychological variables, such as active imagination, expectation, appropriate attitudes, and motivation.[18] Barber introduced the term "cognitive-behavioral" to describe the nonstate theory of hypnotism, and discussed its application to behavior therapy.
The growing application of cognitive and behavioral psychological theories and concepts to the explanation of hypnosis paved the way for a closer integration of hypnotherapy with various cognitive and behavioral therapies.[19]
Many cognitive and behavioral therapies were themselves originally influenced by older hypnotherapy techniques,[20] e.g., the
systematic desensitisation of
Joseph Wolpe, the cardinal technique of early behavior therapy, was originally called "hypnotic desensitisation"[21] and derived from the Medical Hypnosis (1948) of
Lewis Wolberg.[22]
Curative
Peter Marshall, author of A Handbook of Hypnotherapy, devised the Trance Theory of Mental Illness, which asserts that people suffering from depression, or certain other kinds of neuroses, are already living in a trance. He asserts that this means the hypnotherapist does not need to induce trance, but instead to make them understand this and lead them out of it.[23]
Mindful
Mindful hypnotherapy is therapy that incorporates
mindfulness and hypnotherapy. A pilot study was made at
Baylor University, Texas, and published in the International Journal of Clinical and Experimental Hypnosis. Gary Elkins, director of the Mind-Body Medicine Research Laboratory at Baylor University called it "a valuable option for treating anxiety and stress reduction” and "an innovative mind-body therapy". The study showed a decrease in stress and an increase in mindfulness.[24]
Relationship to scientific medicine
Hypnotherapy practitioners occasionally attract the attention of mainstream medicine. Attempts to instill academic rigor have been frustrated by the complexity of client suggestibility, which has social and cultural aspects, including the reputation of the practitioner. Results achieved in one time and center of study have not been reliably transmitted to future generations.[25]
In the 1700s
Anton Mesmer offered pseudoscientific justification for his practices, but his rationalizations were debunked by a commission that included
Benjamin Franklin.
Clinicians choose hypnotherapy to address a wide range of circumstances; however, according to Yeates (2016), people choose to have hypnotherapy for many other reasons:
"Ignoring specific issues such as performance anxiety, road rage, weight, smoking, drinking, unsafe sex, etc., those seeking hypnotherapy today do so because of ill-defined, vague feelings that: (a) their health is far from optimal; (b) their worry about past/present/future events is excessive and debilitating; (c) they are not comfortable with who they are; (d) they're not performing up to the level of their true potential; and/or (e) their lives are lacking some significant (but unidentified) thing."[26]
Menopause
There is evidence supporting the use of hypnotherapy in the treatment of
menopause related symptoms, including
hot flashes.[27][28][29] The
North American Menopause Society recommends hypnotherapy for the nonhormonal management of menopause-associated
vasomotor symptoms, giving it the highest level of evidence.[30]
Irritable bowel syndrome
The use of hypnotherapy in treating the symptoms of
irritable bowel syndrome is supported by research, including randomized controlled trials.[31][32][33][34] A 2015 audit of 1000 patients undertaking gut-focused hypnotherapy in normal clinical practice found that hypnotherapy was an effective intervention for refractory IBS.[35] Gut-directed hypnotherapy is recommended in the treatment of irritable bowel syndrome by the
American College of Gastroenterology clinical guideline for the management of IBS.[36]
Childbirth
Hypnotherapy is often applied in
the birthing process and the post-natal period,[37][38][39][40][41] but there is insufficient evidence to determine if it alleviates pain during childbirth[42][43] and no evidence that it is effective against post-natal depression.[44]
Bulimia
Literature shows that a wide variety of hypnotic interventions have been investigated for the treatment of
bulimia nervosa, with inconclusive effect.[45] Similar studies have shown that groups suffering from bulimia nervosa, undergoing hypnotherapy, were more exceptional to no treatment, placebos, or other alternative treatments.[45]
Anxiety
Hypnotherapy is shown to be comparable in effectiveness to other forms of therapy, such as cognitive-behavioral therapy, that utilize relaxation techniques and imagery.[46] It has also shown to be successful when used to reduce anxiety in those with dental anxiety and phobias.[47]
PTSD
Post Traumatic Stress Disorder (PTSD) and its symptoms have been shown to improve due to implementation of hypnotherapy, in both long and short term.[48] As research continues, hypnotherapy is being more openly considered as an effective intervention for those with PTSD.[49]
Depression
Hypnotherapy has been shown to be effective when used to treat long term depressive symptoms. It has been shown to be comparable to the efficacy of cognitive-behavioral therapy, and when used in tandem, efficacy seems to increase.[50]
Other uses
Among its many other applications in other medical domains,[51] hypnotism was used therapeutically, by some
alienists in the Victorian era, to treat the condition then known as
hysteria.[52]
Modern hypnotherapy is widely accepted for the treatment of certain habit disorders, to control irrational fears,[53][54] as well as in the treatment of conditions such as
insomnia[55] and
addiction.[56] Hypnosis has also been used to enhance recovery from non-psychological conditions such as after surgical procedures,[57] in
breast cancer care[58] and even with gastro-intestinal problems.[59]
Efficacy
A 2003 meta-analysis on the efficacy of hypnotherapy concluded that "the efficacy of hypnosis is not verified for a considerable part of the spectrum of psychotherapeutic practice."[60]
In 2007, a meta-analysis from the Cochrane Collaboration found that the therapeutic effect of hypnotherapy was "superior to that of a waiting list control or usual medical management, for abdominal pain and composite primary IBS symptoms, in the short term in patients who fail standard medical therapy", with no harmful side-effects. However the authors noted that the quality of data available was inadequate to draw any firm conclusions.[61]
Two Cochrane reviews in 2012 concluded that there was insufficient evidence to support its efficacy in managing the pain of childbirth[42] or post-natal depression.[44]
A 2014 meta-analysis that focused on hypnotherapy's efficacy on irritable bowel syndrome found that it was beneficial for short term abdominal pain and other gastrointestinal issues.[62]
In 2016, a literature review published in La Presse Médicale found that there is not sufficient evidence to "support the efficacy of hypnosis in chronic anxiety disorders".[63]
In 2019, a Cochrane review was unable to find evidence of benefit of hypnosis in smoking cessation, and suggested if there is, it is small at best.[64]
A 2019 meta-analysis of hypnosis as a treatment for anxiety found that "the average participant receiving hypnosis reduced anxiety more than about 79% of control participants," also noting that "hypnosis was more effective in reducing anxiety when combined with other psychological interventions than when used as a stand-alone treatment."[65]
In a 2022 meta-analysis on hypnotherapy's efficacy on dental anxiety, it was found that "hypnosis can also be regarded as powerful and successful method for anxiety reduction," but also stated that further research is required.[47]
Occupational accreditation
United States
The laws regarding hypnosis and hypnotherapy vary by state and municipality. Some states, like Colorado, Connecticut and Washington, have mandatory licensing and registration requirements, while many other states have no specific regulations governing the practice of hypnotherapy.[66]
UK Confederation of Hypnotherapy Organisations (UKCHO)
The regulation of the hypnotherapy profession in the UK is at present the main focus of
UKCHO, a non-profit umbrella body for hypnotherapy organisations. Founded in 1998 to provide a non-political arena to discuss and implement changes to the profession of hypnotherapy, UKCHO currently represents 9 of the UK's professional hypnotherapy organisations and has developed standards of training for hypnotherapists, along with codes of conduct and practice that all UKCHO registered hypnotherapists are governed by. As a step towards the regulation of the profession, UKCHO's website now includes a National Public Register of Hypnotherapists[69] who have been registered by UKCHO's Member Organisations and are therefore subject to UKCHO's professional standards. Further steps to full regulation of the hypnotherapy profession will be taken in consultation with the Prince's Foundation for Integrated Health.
The National Council for Hypnotherapy (NCH)
The National Council for Hypnotherapy is a Professional Association, established in 1973 to create a National Membership Organisation for independent Hypnotherapy Practitioners.
The organisation is not for profit with a Board of 12-15 people composed of Executives and Directors, the latter usually ‘in practice’ Hypnotherapists and trainers of Hypnotherapy. The current Chair, Tracey Grist has been in position since 2016.
The NCH is a VO (Verifying organisation) for the CNHC, which means that NCH members meet the criteria to become Registrants of the CNHC.
The NCH membership meet the national hypnotherapy training standards via the externally verified Hypnotherapy practitioner Diploma (HPD) through the NCFE.
Members agree to follow the CECP; the NCH’s ethical code of practice, all members are expected to be insured to practice, meet supervision requirements and annual CPD expectations. [70]
Australia
Professional hypnotherapy and use of the occupational titles hypnotherapist or clinical hypnotherapist are not government-regulated in Australia.
In 1996, as a result of a three-year research project led by Lindsay B. Yeates, the
Australian Hypnotherapists Association (founded in 1949), the oldest hypnotism-oriented professional organization in Australia, instituted a peer-group accreditation system for full-time Australian professional hypnotherapists, the first of its kind in the world, which "accredit[ed] specific individuals on the basis of their actual demonstrated knowledge and clinical performance; instead of approving particular 'courses' or approving particular 'teaching institutions'" (Yeates, 1996, p.iv; 1999, p.xiv).[71] The system was further revised in 1999.[72]
Australian hypnotism/hypnotherapy organizations (including the Australian Hypnotherapists Association) are seeking government regulation similar to other mental health professions. However, currently hypnotherapy is not subject to government regulation through the
Australian Health Practitioner Regulation Agency (AHPRA).
See also
Wikimedia Commons has media related to Hypnotherapy.
Atavistic regression – hypnosis-related concept introduced by the Australian scholar and psychiatrist Ainslie MearesPages displaying wikidata descriptions as a fallback
^Kirsch I, Montgomery G, Sapirstein G (April 1995). "Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis". Journal of Consulting and Clinical Psychology. 63 (2): 214–220.
doi:
10.1037/0022-006X.63.2.214.
PMID7751482.
^Bryant RA, Moulds ML, Guthrie RM, Nixon RD (April 2005). "The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder". Journal of Consulting and Clinical Psychology. 73 (2): 334–340.
doi:
10.1037/0022-006x.73.2.334.
PMID15796641.
^Weitzenhoffer AM (October 1972). "Behavior therapeutic techniques and hypnotherapeutic methods". The American Journal of Clinical Hypnosis. 15 (2): 71–82.
doi:
10.1080/00029157.1972.10402222.
PMID4679810.
^Roberts RL, Na H, Yek MH, Elkins G (October 2017). "Hypnosis for Hot Flashes and Associated Symptomsin Women with Breast Cancer". The American Journal of Clinical Hypnosis. 60 (2): 123–136.
doi:
10.1080/00029157.2017.1334622.
PMID28891773.
S2CID8491901.
^"Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society". Menopause. 22 (11): 1155–1172, quiz 1173–1174. November 2015.
doi:
10.1097/GME.0000000000000546.
PMID26382310.
S2CID14841660.
^Whorwell PJ, Prior A, Faragher EB (December 1984). "Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome". Lancet. 2 (8414): 1232–1234.
doi:
10.1016/s0140-6736(84)92793-4.
PMID6150275.
S2CID8842451.
^Miller V, Carruthers HR, Morris J, Hasan SS, Archbold S, Whorwell PJ (May 2015). "Hypnotherapy for irritable bowel syndrome: an audit of one thousand adult patients". Alimentary Pharmacology & Therapeutics. 41 (9): 844–855.
doi:
10.1111/apt.13145.
PMID25736234.
S2CID25993844.
^Phillips-Moore J (April 2005).
"HypnoBirthing". The Australian Journal of Holistic Nursing. 12 (1): 41–42.
PMID19175270. Retrieved 22 September 2012.
^Wainer N (2000). "HypnoBirthing. A radical change on our perspective of pain in childbirth". Midwifery Today with International Midwife (55): 36–38.
PMID11189565.
^Mottershead N (March 2006). "Hypnosis: removing the labour from birth". The Practising Midwife. 9 (3): 26–7, 29.
PMID16562656.
^
abSado M, Ota E, Stickley A, Mori R (June 2012). Sado M (ed.). "Hypnosis during pregnancy, childbirth, and the postnatal period for preventing postnatal depression". The Cochrane Database of Systematic Reviews. 6 (6): CD009062.
doi:
10.1002/14651858.CD009062.pub2.
PMID22696381.
^Crimlisk HL, Ron MA (1999). "Conversion hysteria: History, diagnostic issues, and clinical practice". Cognitive Neuropsychiatry. 4 (3): 165–180.
doi:
10.1080/135468099395909.
^Crawford HJ, Barabasz AF (1993). "Phobias and intense fears: Facilitating their treatment with hypnosis". In Rhue JW, Lynn SJ, Kirsch I (eds.). Handbook of clinical hypnosis. Washington, DC, US: American Psychological Association. pp. 311–337.
doi:
10.1037/10274-015.
ISBN978-1-55798-440-1.
^Webb AN, Kukuruzovic RH, Catto-Smith AG, Sawyer SM (October 2007). "Hypnotherapy for treatment of irritable bowel syndrome". The Cochrane Database of Systematic Reviews (4): CD005110.
doi:
10.1002/14651858.CD005110.pub2.
PMID17943840.
^Pelissolo A (March 2016). "Hypnosis for anxiety and phobic disorders: A review of clinical studies". Presse Médicale. 45 (3): 284–290.
doi:
10.1016/j.lpm.2015.12.002.
PMID26944812.
^Valentine KE, Milling LS, Clark LJ, Moriarty CL (July 2019). "The efficacy of hypnosis as a treatment for anxiety: a meta-analysis". The International Journal of Clinical and Experimental Hypnosis. 67 (3): 336–363.
doi:
10.1080/00207144.2019.1613863.
PMID31251710.
S2CID195763179.