WHAT IS HYPNOTHERAPY?

Hypnotherapy, also known as hypnotic medicine, is the use of hypnosis in psychotherapy. The efficacy of hypnotherapy is not well supported by scientific evidence and, due to this lack of evidence indicating any level of efficacy, it is regarded as a type of alternative medicine by reputable medical organizations such as the National Health Service.

The job of the hypnotherapist is described in the United States Department of Labor's Dictionary of Occupational Titles (DOT).

Hypnotherapy, also known as hypnotic medicine, uses hypnosis in psychotherapy. Scientific evidence does not strongly support the efficacy of hypnotherapy. Due to this lack of evidence, reputable medical organizations such as the National Health Service regard it as a type of alternative medicine.

A hypnotherapist or hypnotist induces a hypnotic state in the client to increase motivation or alter behavioral patterns. They start by consulting with the client to understand the nature of the problem. Then, they prepare the client to enter a hypnotic state by explaining how hypnosis works and what the client will experience. They conduct tests to determine the degree of physical and emotional suggestibility. Based on the test results and analysis of the client's problem, they use individualized methods and techniques of hypnosis to induce a hypnotic state in the client. Additionally, they may train the client in self-hypnosis conditioning.

The form of hypnotherapy practiced by most Victorian hypnotists, such as James Braid and Hippolyte Bernheim, primarily involved direct suggestion for symptom relief, along with some use of therapeutic relaxation and occasional aversion to alcohol and drugs.

In the 1950s, Milton H. Erickson developed a radically different approach to hypnotism that has since become known as "Ericksonian hypnotherapy" or "Neo-Ericksonian hypnotherapy." Erickson believed that dysfunctional behaviors were a result of social tension, and he used the subject's behavior to establish rapport, a technique he called "utilization." Once rapport was established, he used an informal conversational approach to direct awareness. His methods included using complex language patterns and specific therapeutic strategies tailored to each client (which reflects the nature of utilization). Erickson claimed to have developed ways to suggest behavior changes during ordinary conversation.

"The founders of neuro-linguistic programming (NLP), a method somewhat similar in some regards to some versions of hypnotherapy, claimed that they had modeled the work of Erickson extensively and assimilated it into their approach. However, Weitzenhoffer disputed this claim, questioning whether NLP truly reflects the essence of Erickson's work."

During the 2000s, hypnotherapists started to blend elements of solution-focused brief therapy (SFBT) with Ericksonian hypnotherapy to create a goal-focused approach to therapy. This approach aimed to address what the client wanted to achieve, as opposed to the more traditional problem-focused method that involved discussing the issues that led the client to seek help. A solution-focused hypnotherapy session might involve techniques from neuro-linguistic programming (NLP).

In 1974, Theodore X. Barber and his colleagues published a review of research in which they argued, following the earlier social psychology of Theodore R. Sarbin, that hypnosis should be better understood not as a "special state," but as the result of normal psychological variables such as active imagination, expectation, appropriate attitudes, and motivation. Barber introduced the term "cognitive-behavioral" to describe the nonstate theory of hypnosis and discussed its application to behavior therapy.

The growing use of cognitive and behavioral psychological theories and concepts in explaining hypnosis has led to a closer integration of hypnotherapy with various cognitive and behavioral therapies.

Many cognitive and behavioural therapies were themselves originally influenced by older hypnotherapy techniques, e.g., the systematic desensitization of Joseph Wolpe, the cardinal technique of early behaviour therapy, was originally called "hypnotic desensitization" and derived from the Medical Hypnosis (1948) of Lewis Wolberg.

Peter Marshall, the author of "A Handbook of Hypnotherapy," developed the Trance Theory of Mental Illness. This theory asserts that individuals who are experiencing depression or certain other types of neuroses are essentially already in a trance. According to Marshall, this means that a hypnotherapist does not need to induce a trance but instead needs to help the individual understand this state and guide them out of it.

Mindless hypnotherapy is a process that incorporates mindlessness 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."

Hypnotherapy practitioners occasionally attract the attention of mainstream medicine. Attempts to instill academic rigour 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.

In the 1700s, Anton Mesmer provided pseudoscientific justification for his practices, but a commission that included Benjamin Franklin debunked his rationalizations.

There is evidence supporting the use of hypnotherapy in treating menopause-related symptoms, including hot flashes. The North American Menopause Society recommends hypnotherapy for the nonhormonal management of menopause-associated vasomotor symptoms, giving it the highest level of evidence.

Hypnotherapy has been found to be effective in treating the symptoms of irritable bowel syndrome, as supported by research, including randomized controlled trials. The American College of Gastroenterology clinical guidelines for IBS management recommend the use of gut-directed hypnotherapy in the treatment of irritable bowel syndrome.

Hypnotherapy is often used during childbirth and the post-natal period, but there is not enough evidence to determine its effectiveness in reducing childbirth pain or alleviating post-natal depression.

Literature indicates that a wide variety of hypnotic interventions have been studied for the treatment of bulimia nervosa, but the evidence regarding their effectiveness is inconclusive. Studies have shown that individuals with bulimia nervosa who underwent hypnotherapy were compared to those who received no treatment, placebos, or alternative treatments.

Hypnotherapy is shown to be comparable in effectiveness to other forms of therapy, such as cognitive-behavioral therapy, that utilize relaxation techniques and imagery. It has also been shown to be successful when used to reduce anxiety in those with dental anxiety and phobias.

Research has shown that hypnotherapy can help improve symptoms of Post Traumatic Stress Disorder (PTSD) in both the short and long term. As a result, hypnotherapy is increasingly being considered as an effective intervention for individuals with PTSD.

Hypnotherapy has been proven effective in treating long-term depressive symptoms. It has been found to be equally effective as cognitive-behavioral therapy, and the combined use of both therapies seems to enhance efficacy.

Historically, hypnotism was used therapeutically by some psychiatrists in the Victorian era to treat the condition then known as hysteria. Modern hypnotherapy has been used to treat certain habit disorders and control irrational fears and dependency.

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."
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.
Two Cochrane reviews in 2012 concluded that there was insufficient evidence to support its efficacy in managing the pain of childbirth or post-natal depression.
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.
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."
In 2019, a Cochrane review was unable to find evidence of the benefit of hypnosis in smoking cessation and suggested if there is, it is small at best.
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."
In a 2022 meta-analysis on hypnotherapy's efficacy on dental anxiety, it was found that "hypnosis can also be regarded as a powerful and successful method for anxiety reduction," but also stated that further research is required.