Hypnotherapy, Hypnosis for Psychological Disorders

Learn about the effectiveness of hypnotherapy, hypnosis for treatment of addictions, to stop smoking, eating disorders, erectile dysfunction, pain and insomnia.

Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

• Background
• Theory
• Evidence
• Unproven Uses
• Potential Dangers
• Summary
• Resources

Background

Hypnotherapy-like practices were used in ancient Egypt, Babylon, Greece, Persia, Britain, Scandinavia, America, Africa, India and China. The Bible, Talmud, and Hindu Vedas mention hypnotherapy, and some Native American and African ceremonies include trance states similar to hypnotherapy. Hypnotherapy (also called hypnosis) comes from the Greek word hypnos, meaning sleep.

Modern Western hypnotherapy can be traced to the Austrian physician Franz Anton Mesmer (1734-1815); the word "mesmerize" is based on his name. Mesmer suggested that illness is caused by an imbalance of magnetic fluids in the body and can be corrected by "animal magnetism." He believed that a hypnotherapist's personal magnetism can be transferred to a patient. His beliefs were initially questioned but were revived by 19th century English physicians. In the mid-20th century, the British and American Medical Associations and the American Psychological Association endorsed hypnotherapy as a medical procedure. In 1995, the U.S. National Institutes of Health issued a consensus statement noting the scientific evidence in favor of the use of hypnotherapy for chronic pain, particularly pain associated with cancer.

There are three main phases of hypnotherapy: presuggestion, suggestion, and postsuggestion.

• The presuggestion phase involves focusing one's attention using distraction, imagery, relaxation or a combination of techniques. The aim is to reach an altered state of consciousness in which the mind is relaxed and susceptible to suggestion.

• The suggestion phase introduces specific goals, questions or memories to be explored.

• The postsuggestion phase occurs after the return to a normal state of consciousness, when new behaviors introduced in the suggestion phase may be practiced.

Hypnotherapy sessions may vary from a brief visit to longer, regularly scheduled appointments.

Some people seem to be more susceptible to hypnotherapy than others are, and there are several tests designed to determine a person's degree of hypnotizability or suggestibility.

The goals of hypnotherapy vary. They can include behavior change or treatment of a psychological condition. It is important that the person being hypnotized is under his or her own control at all times and is not controlled by the hypnotherapist or anyone else. Self-hypnosis is sometimes used in addition to sessions with a hypnotherapist, although study of self-hypnosis is limited.

In the United States, there is no universally accepted standard or licensing for hypnotherapists. There is wide variation in training and credentials. Certification is granted by multiple organizations, with different requirements. Many hypnotherapists are not licensed medical professionals. However, some doctors, dentists and psychologists use hypnotherapy in their practices.

Books, audiotapes and videotapes are available for training in self-hypnosis, although they have not been scientifically evaluated. Group sessions may also be offered. Hypnotherapy may be used with other techniques such as cognitive behavioral therapy.

Theory

The way that hypnotherapy works is not well studied or understood. Some research reports that changes in skin temperature, heart rate, intestinal secretions, brain waves and the immune system occur. However, similar changes are reported with other forms of relaxation. Neurologic and endocrine effects have been proposed, including alterations to the hypothalamic-pituitary-adrenal axis or the limbic system (the emotional center of the brain).

There has been scientific debate about whether hypnotherapy represents a specific altered state of consciousness. There are reports that suggestion alone, without hypnotherapy, may achieve many of the same results. However, this research is not conclusive.

Evidence

Scientists have studied hypnotherapy for the following uses:

Pain
Studies of hypnotherapy suggest a benefit for various types of pain, including low back pain, surgery-related pain, cancer pain, dental procedure-related pain, burn pain, repetitive strain injury, temporomandibular joint disorders, facial pain (masticatory, myofascial pain disorders), sickle cell disease-related pain, irritable bowel syndrome, oral mucositis, tension headache, osteoarthritis pain and chronic pain. A 1995 consensus statement by the U.S. National Institutes of Health notes that, "Evidence supporting the effectiveness of hypnosis in alleviating chronic pain associated with cancer seems strong... with other data suggesting the effectiveness of hypnosis in other chronic pain conditions, which include irritable bowel syndrome, oral mucositis, temporomandibular disorders, and tension headaches." As early small phase I clinical trial of girls aged 6 to 18 years examined the effects of a hypnosis/acupuncture treatment for chronic pain. Results from child and parent showed a decrease in pain and anxiety. However, most studies are small without clear design or results. It is not clear if a specific hypnotherapy technique or treatment duration is best, or what types of pain are most affected. Therefore, although the early evidence is promising, better research is necessary to make a strong recommendation.

Procedure-related pain
Early evidence has shown that hypnosis may alleviate procedure-related pain. In a prospective, controlled study of pediatric cancer patients, the effects of hypnosis and pain were studied. The patients reported less pain and anxiety during medical cancer treatment with hypnosis. However, studies are limited, and more information is needed to make any recommendations.

Anxiety
Several studies in children and adults report that hypnotherapy reduces anxiety, especially before dental, medical procedures or radiation. A small phase I clinical trial of girls aged 6 to 18 years examined the effects of a hypnosis/acupuncture treatment for chronic pain. Results from child and parent showed a decrease in pain and anxiety. Research also suggests children with anxiety prior to undergoing a medical procedure may benefit from hypnosis. However, most studies are small without clear design or results. There are no reliable comparisons of hypnotherapy with anti-anxiety drugs. It is not known if hypnotherapy produces different results than does meditation or biofeedback. Some research suggests that hypnotherapy may be less effective than group therapy or systematic desensitization. Better research is necessary to make a strong recommendation.

Conversion disorder (an anxiety disorder)
Early evidence shows that hypnosis may help in the treatment of conversion disorder (motor type). However, studies are limited, and more information is needed to make any firm conclusions.

Tension headache
Reports suggest that several weekly hypnotherapy sessions can improve the severity and frequency of headaches. Preliminary research suggests that hypnotherapy is equivalent to other relaxation techniques, biofeedback or autogenic training. However, most studies are small without clear design or results. Better research is necessary to make a strong recommendation.

Adjunct to cognitive behavioral therapy
Hypnotherapy is sometimes combined with other techniques, such as cognitive behavioral therapy, to treat anxiety, insomnia, pain, bedwetting, post-traumatic stress disorder and obesity. Initial research reports benefits, although most studies are not well designed.

Labor
Preliminary research does not provide clear answers about the effectiveness of hypnotherapy on labor. Better studies are necessary to make a conclusion.

Nausea, vomiting
Research on the use of hypnotherapy for nausea and vomiting related to chemotherapy, pregnancy (hyperemesis gravidarum) and surgical recovery has mixed results. Better research is needed to make a firm conclusion.

Chemotherapy side effects
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Insomnia
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Irritable bowel syndrome
Preliminary research suggests hypnotherapy may reduce the sensory and motor component of the gastrocolonic response in patients with irritable bowel syndrome. Better studies are necessary to make a conclusion.

Impotence, erectile dysfunction
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Rheumatoid arthritis
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Tinnitus (ringing in the ears)
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Allergy, hay fever
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Asthma
Preliminary research on the use of hypnosis for the management of asthma symptoms does not provide clear answers. Anxiety associated with asthma may be relieved with hypnosis. Better studies are necessary to form a firm conclusion.

Skin conditions (eczema, psoriasis, atopic dermatitis)
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Fibromyalgia
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Weight loss
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Postsurgical recovery
Research suggests that hypnotherapy may be helpful for pain, wound healing and anxiety after surgery. Several studies report that hypnotherapy may shorten hospital stays and may improve psychological well being after surgery. However, most studies are not well designed. It is not clear that hypnotherapy has any effect on physical healing.

Bedwetting
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Test taking, academic performance
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Eating disorders
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Stomach ulcers
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Fractures
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Hemophilia
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Heartburn
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Drug addiction
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Alcohol dependence
Preliminary research does not provide clear answers. Better studies are necessary to make a conclusion.

Smoking cessation
Hypnotherapy is often used by people trying to quit smoking, and it is sometimes included in smoking cessation programs. Studies in this area report mixed results; most research reports no significant sustained benefits. Better-designed research is necessary to make a strong recommendation.

Dyspepsia (difficulty with digestion)
Early evidence shows that hypnotherapy may aid in digestion. A randomized, controlled clinical trial examined the effects of hypnosis on dyspepsia. Further research is needed to confirm these findings.

Menopausal disorders
Early evidence shows that hypnotherapy may be beneficial in the treatment of hot flashes and may improve quality of life in women who are experiencing menopausal symptoms. Further research is needed to make a recommendation.

Jaw clenching
Preliminary research suggests jaw clenching may be related to hypnotic susceptibility. Better designed research is necessary to make a strong recommendation

Unproven Uses

Hypnotherapy has been suggested for many uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using hypnotherapy for any use.

Potential Dangers

The safety of hypnotherapy is not well studied. Hypnotherapy may worsen symptoms in people with psychiatric illnesses such as schizophrenia, manic depression, multiple personality disorder or dissociative disorders. Because limited data are available, hypnotherapy is sometimes discouraged in people at risk of seizures. Upsetting memories may surface in people with post-traumatic stress disorder. It has been suggested that some types of hypnotherapy lead to false memories (confabulation), although scientific research on this topic is limited.

Hypnotherapy should not delay the time it takes to see a health care provider for diagnosis or treatment with more proven techniques or therapies. And hypnotherapy should not be used as the sole approach to illness. Consult with your primary health care provider before starting hypnotherapy.

Summary

Hypnotherapy is used for a wide variety of health conditions. Preliminary evidence suggests that hypnotherapy may be beneficial in the management of chronic pain of various causes, anxiety (especially before dental or medical procedures) and tension headache. Initial research suggests that hypnotherapy is not effective for smoking cessation. Research in these areas must be better designed to confirm this. Other areas have not been well studied enough to draw firm conclusions. Hypnotherapy may be unsafe in patients with psychiatric disorders or at risk of seizures. Consult with your primary health care provider before starting hypnotherapy.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

back to: Alternative Medicine Home ~ Alternative Medicine Treatments

Resources

1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Hypnotherapy, Hypnosis

Natural Standard reviewed more than 1,450 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

1. Abbot NC, Stead LF, White AR, et al. Hypnotherapy for smoking cessation. Cochrane Database Syst Rev 2000;(2):CD001008.
2. Anbar RD. Self-hypnosis for anxiety associated with severe asthma: a case report. BMC Pediatr 2003;3(1):7.
3. Anbar RD, Hall HR. Childhood habit cough treated with self-hypnosis. J Pediatr 2004;144(2):213-217.
4. Baglini R, Sesana M, Capuano C. Effect of hypnotic sedation during percutaneous transluminal coronary angioplasty on myocardial ischemia and cardiac sympathetic drive. Am J Cardiol 2004;93(8)1035-1038.
5. Brodie EA. A hypnotherapeutic approach to obesity. Am J Clin Hypnosis 2002;164(3):211-215.
6. Bryant RA, Moulds ML, Guthrie RM. The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. J Consult Clin Psychol 2005;73(2):334-340.
7. Bryant RA, Somerville E. Hypnotic induction of an epileptic seizure: a brief communication. Int J Clin Exp Hypn 1995;43(3):274-283.
8. Butler LD, Symons BK, Henderson SL, et al. Hypnosis reduces distress and duration of an invasive medical procedure for children. Pediatrics 2005;115(1):77-85.

1. Calvert EL, Houghton LA, Cooper P, et al. Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterol 2002;123(6):1778-1785.
2. Cyna AM. Hypno-analgesia for a labouring parturient with contra-indications to central neuraxial block. Anaesthesia 2003;58(1):101-102.
3. Cyna AM, McAuliffe GL, Andrew MI. Hypnosis for pain relief in labour and childbirth: a systematic review. Br J Anaesth 2004;93(4):505-511.
4. Davoli M, Minozzi S. Summary of systematic revisions of the efficacy of smoking cessation therapy [Article in Italian]. Epidemiol Prev 2002;Nov-Dec, 26(6):287-292.
5. Gay MC, Philippot P, Luminet O. Differential effectiveness of psychological interventions for reducing osteoarthritis pain: a comparison of Erikson [correction of Erickson] hypnosis and Jacobson relaxation. Eur J Pain 2002;6(1):1-16.
6. Ginandes C, Brooks P, Sando W, et al. Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial. Am J Clin Hypn 2003;Apr, 45(4):333-351.
7. 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.
8. Green JP, Lynn SJ. Hypnosis and suggestion-based approaches to smoking cessation: an examination of the evidence. Int J Clin Exp Hypn 2000;48(2):195-224.
9. Houghton LA, Calvert EL, Jackson NA, et al. Visceral sensation and emotion: a study using hypnosis. Gut 2002;Nov, 51(5):701-704.
10. Kircher T, Teutsch E, Wormstall H, et al. Effects of autogenic training in elderly patients. [Article in German]. Z Gerontol Geriatr 2002;Apr, 35(2):157-165.
11. 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.
12. Lang EV, Laser E, Anderson B, et al. Shaping the experience of behavior: construct of an electronic teaching module in nonpharmacologic analgesia and anxiolysis. Acad Radiol 2002;Oct, 9(10):1185-1193.
13. Langenfeld MC, Cipani E, Borckardt JJ. Hypnosis for the control of HIV/AIDS-related pain. Int J Clin Exp Hypn 2002;50(2):170-188.
14. Langlade A, Jussiau C, Lamonerie L, et al. Hypnosis increases heat detection and heat pain thresholds in healthy volunteers. Reg Anesth Pain Med 2002;Jan-Feb, 27(1):43-46.
15. Liossi C, Hatira P. Clinical hypnosis in the alleviation of procedure-related pain in pediatric oncology patients. Int J Clin Exp Hypn 2003;Jan, 51(1):4-28.
16. Mehl-Madrona LE. Hypnosis to facilitate uncomplicated birth. Am J Clin Hypn 2004;46(4):299-312.
17. Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomized controlled clinical trial of a hypnosis-based treatment for patients with conversion disorder, motor type. Int J Clin Exp Hypn 2003;Jan, 51(1):29-50.
18. Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomized controlled clinical trial on the additional effect of hypnosis in a comprehensive treatment programme for in-patients with conversion disorder of the motor type. Psychother Psychosom 2002;Mar-Apr, 71(2):66-76.
19. Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomized controlled clinical trial of a hypnosis-based treatment for patients with conversion disorder, motor type. Int J Clin Exp Hypn 2003;51(1):29-50.
20. Montgomery GH, David D, Winkel G, et al. The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesth Analg 2002;94(6):1639-1645.
21. Montgomery GH, DuHamel KN, Redd WH. A meta-analysis of hypnotically induced analgesia: how effective is hypnosis? Int J Clin Exp Hypn 2000;48(2):138-151.
22. Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH. Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. Int J Clin Exp Hypn 2002;Jan, 50(1):17-32.
23. Moore R, Brodsgaard I, Abrahamsen R. A 3-year comparison of dental anxiety treatment outcomes: hypnosis, group therapy and individual desensitization vs. no specialist treatment. Eur J Oral Sci 2002;110(4):287-295.
24. National Institutes of Health Consensus Development Program. Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. NIH Technol Statement Online 1995;Oct 16-18:1-34.
25. Page RA, Handley GW, Carey JC. Can devices facilitate a hypnotic induction? Am J Clin Hypn 2002;Oct, 45(2):137-141.
26. Palsson OS, Turner MJ, Johnson DA, et al. Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms. Dig Dis Sci 2002;Nov, 47(11):2605-2614.
27. Simren M, Ringstrom G, Bjornsson ES, et al. Treatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome. Psychosom Med 2004;66(2):233-238.
28. Staplers LJ, da Costa HC, Merbis MA, et al. Hypnotherapy in radiotherapy patients: a randomized trial. Int J Radiat Oncol Biol Phys 2005;61(2):499-506.
29. Tal M, Sharav Y. Jaw clenching modulates sensory perception in high- but not in low-hypnotizable subjects. J Orofac Pain 2005;19(1):76-81. Y
30. ounus J, Simpson I, Collins A, Wang X. Mind control of menopause. Womens Health Issues 2003;Mar-Apr, 13(2):74-78.
31. Zeltzer LK, Tsao JC, Stelling C, et al. A phase I study on the feasibility and acceptability of an acupuncture/hypnosis intervention for chronic pediatric pain. J Pain Symptom Manage 2002;Oct, 24(4):437-446.
32. Zsombok T, Juhasz G, Budavari A, et al. Effect of autogenic training on drug consumption in patients with primary headache: an 8-month follow-up study. Headache 2003;Mar, 43(3):251-257.

back to: Alternative Medicine Home ~ Alternative Medicine Treatments