What is hypnosis?
Hypnosis refers both to the art of inducing a trance state and the state itself. This state resembles, but is not the same as, ordinary sleep.
A trance state in hypnosis is characterised by the following:
Selective attention.
The subject’s attention narrows to the hypnotist’s voice, the suggestions given, to changes in muscular activity, to the developing sensations that accompany the descent into trance.
Depotentiation.
Conscious thought processes either decrease, or are hived off from the developing trance state, thus cutting out conscious interference.
Responsive to suggestion
As depotentiation of the conscious mind develops, the subject enters without inhibition into the suggestions provided. These include suggestions for relaxation, sleep, eye-closure, hand or arm catalepsy, and trance deepening.
Relaxation/sleepiness
The hypnotic trance is similar to the state you enter just before you drop off to sleep in bed. While the body has in fact entered the sleep state there is still some peripheral awareness of what is happening. As trance deepens the subject develops what has been likened to a somnambulistic state.
Muscular inhibition
One of the most striking features of hypnosis is that subjects experience increasing difficulty in exercising the muscles in and around the eyes, and in their hands and arms. Muscular inhibition is a key indicator of successful trance.
Brain changes in hypnosis.
Observation of brain processes in trance using MRI scans on hypnotised subjects demonstrates decreased vigilance, increased mind-body interaction, and reduced self-consciousness.
How does hypnosis work?
Hypnosis is not an abnormal state, but an extension of the person’s natural ability to enter into a state of reverie. Examples include daydreaming; driving a car on the motorway and going into ‘automatic’ mode; or becoming absorbed in a movie.
The skilled hypnotist induces trance through a combination of directions and suggestions. These include:
- Capturing the subject’s attention with hand movements, or with a pendulum.
- Dividing conscious activity from unconscious activity
- Creating a focus on the hypnotist’s rhythmical, sleep-inducing voice
- Securing eye-closure – first voluntary, then involuntary
- Deepening trance. For example, inviting the client to descend in an imaginary lift to a somnambulistic state.
- Securing other hypnotic phenomena: arm catalepsy, changes in sensory experience, or ideo-motor responses (e.g. involuntary movements of the fingers)
The aim is to induce a state of trance in which therapeutic techniques can be employed to the client’s benefit.
Self-hypnosis, for most people, is easy to learn and there are many tapes and teaching manuals available on the web for that purpose.
Cautionary note: it is not advisable to use self-hypnosis without professional supervision if you suffer from an untreated mental health disorder with major symptoms.
What is hypnotherapy?
Hypnotherapy is the use of trance for therapeutic purposes. It differs from the style of hypnosis used on stage or tv shows, in which the aim is to produce tricks for entertainment. Professional hypnotherapists are bound by strict rules relating to client consent, ethical responsibility, and safeguarding. Hypnotic techniques are applied to specific therapeutic goals agreed beforehand with the client.
Hypnotic techniques in therapy include:
- Memory recall and resolution of distress
- Desensitisation and other calming procedures (e.g. for anxiety)
- Visualisation techniques
- Mental rehearsal
- Symptom reduction (e.g symptoms of IBS)
- Sleep production (for insomnia)
- Anaesthesia (e.g. for pain management)
Typically, hypnotherapy employs recorded tapes for daily use by the client, as a supplement to the techniques employed in face-to-face sessions.
Although some hypnotherapists employ hypnosis as their sole clinical tool, most use hypnosis alongside other therapeutic approaches, such as brief therapy, solution-focused therapy, stress-management, cognitive-behaviour therapy and psychodynamic therapy.
Applications of hypnosis in therapy
Anxiety
Research shows that hypnosis is an effective tool in the treatment of anxiety. One major study reported 79% improvement in symptoms of anxiety in groups receiving hypnotic treatment compared to control groups. However, improvement was more likely to be found when hypnotherapy was used in combination with other types of therapy.
Chronic pain
Research also demonstrates the effectiveness of hypnosis in pain management. One study published in 2021 reported around 73% reduction in pain in groups receiving hypnosis compared to control groups.
Hypnosis is commonly used in dentistry for patients unable to use pharmacological anaesthetics.
Insomnia
Hypnotherapy is a common treatment for insomnia and a 2018 review found an overall 58% improvement in sleep when compared to control groups. However, insomnia is a complex behavioural problem which involves more than just getting off to sleep. It also requires attention to the environment (bedroom), sleeping habits, and brain patterns which interfere with sleep (e.g. rest-activity cycles and the internal body clock). For those reasons hypnosis is more likely to be successful when used in combination with a cognitive-behavioural approach such as the Stanford Protocol.
Habit replacement
Problem habits include smoking, over-eating, nail-biting, hair-pulling and bruxism (teeth grinding). However, hypnotherapy has mixed results with these types of problem. Earlier studies of smoking cessation in hypnosis, for example show that hypnotherapy is effective in achieving short-term cessation for many clients. However, a recent (2019) review concluded that relapse may be higher than thought, and that long-term benefits were slight.
Habits are complex behaviours which involve learned behaviours, thoughts, emotions, environmental stress, and secondary gain from the habit itself. All these factors must be taken into account to develop an effective individual plan for the client, and hypnosis should be combined with other approaches if the plan is to succeed.
Symptom reduction
Hypnosis has long been used for the relief of symptoms of eczema, psoriasis, irritable bowel syndrome and headache. Studies of the use of hypnosis in dermatitis, for example, show a positive impact in reducing symptoms and the use of medication.
However, hypnosis is best employed in combination with medical treatments and other therapeutic approaches. It is most effective when there is a stress-related dimension to the physical problem.
