Hypnosis and hypnotherapy

Hypnosis is a psychological procedure that can help to change how you feel and act.

In hypnosis, you are put in a state of focused concentration that involves becoming less aware of your surroundings. In this state, you are more able to accept ‘suggestions’, also known as ‘invitations’. Your therapist will make suggestions that encourage you to move away from unhelpful beliefs towards more helpful beliefs.

For example, if you mistakenly believe that you are a bad person, in hypnosis the therapist will give you suggestions that help to change that to a more reasonable belief that you are fine as you are.

Hypnotherapy is a type of psychological therapy that uses hypnosis to help treat certain mental and physical health conditions. It can also be used to change habits.

Some therapists also use hypnosis to increase the effectiveness of other psychological treatments, or pain management. However, they may describe the treatment they are giving you by its usual name (such as CBT) rather than calling it hypnotherapy.

You can also perform hypnosis on yourself, which is called self-hypnosis.

Research has shown that the following psychological conditions can be helped by hypnotherapy:

• post-traumatic stress disorder (PTSD)
• depression
• anxiety
• insomnia
• eating disorders
• functional disorders (bodily symptoms and conditions such as headaches, irritable bowel syndrome (IBS) or backaches which may have a significant psychological component)
• improving memory for people who have experienced a brain injury

It has also been shown to help in the following medical conditions, often by reducing anxiety but also by reducing other symptoms:

• pain
• medical and surgical procedures
• cancer treatment side effects
• anaesthetic procedures
• burn wound care
• dental procedures
• childbirth
• menopausal symptoms

In addition, warts and other skin conditions can be improved by hypnotherapy. This is possible through the positive effects hypnosis has on the immune system.

Hypnotherapy may also be effective for people who are trying to quit smoking or lose weight.

You might have seen hypnosis performed for entertainment on stage. This is nothing like hypnosis used in therapy.

Hypnotherapy sessions usually involve sitting comfortably and listening to a therapist or a recording for between 10 and 90 minutes.

A typical hypnotherapy session begins with something called an induction procedure. The therapist will speak slowly and softly and make suggestions that help you to focus your attention and relax. They will often do this by describing relaxing images such as lying on a beach, or whatever imagery you find relaxing.

When the therapist decides you are in a deep enough hypnotic state, they will begin to make suggestions. These suggestions will be things that help to change your outlook in ways that are helpful to you. Or they might help you to understand the best way forward for yourself.

These suggestions might also involve creating images of desirable possibilities. For example, picturing yourself in a public situation where you are not experiencing anxiety. When you are in a hypnotic state your mind can accept these images without excessive criticism.

It is important to remember that you are in control when under hypnosis and do not have to follow the therapist’s suggestions if you don’t want to.

The ability to respond to suggestions does vary between individuals. Questionnaires such as the ‘Harvard Group Scale of Hypnotic Susceptibility’ can help to work out how well someone might respond to hypnosis. However, even for those with a low score, hypnosis may still be helpful.

Hypnotherapy might not be suitable for people experiencing psychosis, as it could make this worse. You should share any existing health conditions with your therapist or GP before you receive hypnotherapy.

You might be advised against having hypnotherapy if you are going to be a witness in a trial. The mental health charity Mind have information about this on their website.

The hypnotic induction procedure creates a state of focused attention and reduces critical thought. This allows a person to become immersed in images that help to change unhelpful ideas and associations. These ideas are often formed in childhood, and are no longer helpful to everyday living as an adult.

Hypnotherapy is a form of ‘top down regulation’. This means that the verbal suggestions used in hypnotherapy (the top) affect the way you think and feel (the bottom). Hypnotherapy can help you decide which things you should give your attention to, and which you shouldn't.

When looking at a person’s brain, researchers have been able to see that suggestions in hypnotherapy change activity in relevant areas of the brain.

Examples

Here are some examples of how hypnotherapy might be used to help someone:

Example 1: You suffer from chronic pain, but the pain is not causing your body any damage. If you could pay less attention to your chronic pain it would allow you to move more freely. Hypnotherapy can redirect your attention away from your pain.

Example 2: You have a fear of dogs after a dangerous encounter with one. Your attention is focused on the possibility of another encounter. This triggers panic attacks and you avoid going out. Hypnotherapy can redirect your attention to the thought that another dangerous encounter is unlikely. This will reduce your anxiety and help you leave the house.

Example 3: You have poor self-esteem because as a child you had a domineering or overcritical parent. Because of this, you weren’t able to develop self-confidence, have a fear of rejection and put unrealistic expectations on yourself. Hypnotherapy can move your attention away from these old unhelpful associations and create new more helpful ones. For example, that rejection is survivable, perfection never achievable, you can cope independently, and you have the right to your own views.

You can perform hypnosis on yourself. This is called self-hypnosis. It is a very useful life skill, which you might be taught during hypnotherapy sessions.

Once you have experienced hypnosis yourself and understand the process, you could rehearse sessions with yourself without using a recording.

There are lots of apps and downloads of hypnotic procedures available on the internet. You might want to start with something like Headspace, which is a well-known meditation app that can help to put you in a hypnotic-like state. However, you should look for an app that works well for you.

The effectiveness of hypnotherapy depends on the individual. Studies have shown that hypnotherapy can help to treat a range of physical and mental health conditions (mentioned above). A skilled therapist can also adapt suggestions in hypnotherapy to specific problems, and measure your progress across sessions. In many cases, hypnotherapy and other uses of suggestion can provide fast, effective treatment.

If you are not finding hypnotherapy useful, there are other treatments or medications that might work better for you. You might also be able to use these other treatments alongside hypnotherapy or use suggestion in treatment. Discuss this with your therapist or doctor.

When performed by a qualified health professional, hypnotherapy has few, if any, side effects. You might experience drowsiness immediately after the therapy.

Therapists performing hypnotherapy should always evaluate how well a treatment is working and identify any side-effects. If hypnotherapy is not working well, your therapist might decide to make changes to your treatment or consider alternative treatments. As with any therapy, it is important not to become overdependent on it, and to work towards a point where you can cope on your own.

Hypnotherapy should only be performed by qualified health professionals who are accountable to a professional body. For example, they should be a medical doctor, psychologist, nurse, occupational therapist or physiotherapist.

Hypnotherapy is also offered by non-professionals with little training, so you should always check your therapist’s qualifications. Untrained professionals might use suggestions inappropriately, or not be able to tell if another treatment is more suitable for you. If a therapist uses suggestions incorrectly they can create memories that may not be accurate without meaning to. This is why hypnotherapy should always be performed by qualified health professionals.

How long you receive hypnotherapy for will depend on:

• you as a person
• how susceptible you are to being hypnotised and
• what problem it is being used to treat, and whether it is simple or complicated.
  

On average someone might have three or four sessions, but it might be appropriate for someone to receive up to 20 sessions.

If hypnotherapy is being used alongside CBT, the course would usually last for the same amount of time as the CBT course. If the hypnotherapy is successful it could make the CBT course shorter.

With a simple phobia, one session of hypnotherapy might be enough to help treat the phobia. You might be asked to perform self-hypnosis as homework, which might mean that you need less sessions of hypnotherapy.

If your particular problem comes back, you may need to have ‘top up’ sessions.

Hypnotherapy is not usually available on the NHS, but NHS psychologists and therapists trained in hypnotherapy may be locally available. Many therapists use hypnotherapy to make other therapies like CBT more effective.

Speak to your GP, or contact your GP local commissioning group to find out if there is a practitioner local to you.

Some people might choose to pay for private hypnotherapy. The average cost of a private therapy session is £45, but it can cost much more. Some private therapy services offer reduced rates to people who are on a lower income.

If you choose to get private hypnotherapy, make sure that your therapist is trained in therapeutic suggestion and hypnosis.

• Find a qualified hypnotherapist

Many therapists use hypnotherapy to make other therapies like CBT more effective. Hypnotherapy can also be used alongside medications like antidepressants.

Hypnosis and suggestion - This website by Dr Matthew Whalley has the following information about hypnosis and hypnotherapy:

• What is hypnosis? (Dr Matthew Whalley)
• What is hypnotherapy? (Dr Matthew Whalley)
  

British Society of Clinical and Academic Hypnosis - BSCAH is made up of healthcare professionals and aims to promote the safe and responsible use of hypnosis in medicine, dentistry and psychology, and to educate professionals and the public about hypnosis and its uses.

British Society of Medical and Dental Hypnosis (Scotland) - BSMDH (S) aims to promote the safe and responsible use of hypnosis in medicine and dentistry and to educate professionals and the public about hypnosis and its uses.

Hypnosis & Psychosomatic Medicine, The Royal Society of Medicine – On this page you can see the RSM’s information on hypnosis and psychosomatic medicine.

This information was produced by the Royal College of Psychiatrists’ Public Engagement Editorial Board (PEEB). It reflects the best available evidence at the time of writing.

Expert editors: Dr Graham Kidd and Dr Quinton Deeley.