Clinical Hypnotherapy Treats Anxiety, Pain, Behavioral Disorders

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Hypnotherapy can treat pain, anxiety, and behavioral disorders.
Hypnotherapy can treat pain, anxiety, and behavioral disorders.

“You are getting sleepy...very sleepy.” Everyone has seen the proverbial sketch — with a swinging pocket watch moving before a person's eyes — where an individual is being hypnotized, but the truth is most people don't put much stock in hypnotic techniques.

Yet several studies examining the use of clinical hypnotherapy have provided interesting results that indicate a viable clinical role for hypnotic suggestion when it is conducted under the care of a trained therapist or health-care professional. In fact, hypnotherapy is considered a safe complementary and alternative medical treatment.

Background

Hypnosis is an altered state of consciousness that exists somewhere between wakefulness and sleep. It can be described as a trance-like state wherein an individual has heightened focus and concentration.1 Under hypnotic suggestion, a person can concentrate intensely on a specific thought, memory or feeling while blocking out distractions.

The term “hypnosis” comes from the Greek word hypnos, meaning sleep. Franz Anton Mesmer, an 18th century Austrian doctor, is widely considered the father of modern hypnosis.2 Mesmer was an ardent believer in the healing powers of an unknown magnetic force that he thought laid within the human body.

He was confident he could tap that force and channel it to cure ailments, a practice that became known as “mesmerism” in late-18th-century Europe — and incidentally is the origin of the modern verb “to mesmerize.” Mesmer's theories and radical therapy are credited with providing the springboard for hypnotherapy today.

By 1847, hypnosis was formally accepted by the Roman Catholic Church.2, 3 It was not until the 1950s, that medical hypnotherapy began to gain acceptance in the United States. Researchers at Stanford University were the first to develop a valid method for measuring hypnotized subjects. The Stanford Hypnotic Susceptibility Scales showed that at least 95% of people tested could be hypnotized to some degree, and those standards have remained undisputed since the scales' inception.4

Science

Although the mechanism of action in hypnosis is unknown, a number of important theories about hypnotic states provide glimpses into the brain's inner workings. These theories suggest that in hypnotized individuals there is a contradiction in the level of awareness. Thus, the person receptive to hypnosis must exhibit a decreased awareness of immediate, physical surroundings and, at the same time, a markedly heightened, sensitized awareness of the thoughts and visualizations put forth by the hypnotherapist.5

Studies using functional magnetic resonance imaging and electroencephalography in individuals with high hypnotic susceptibility have demonstrated increased relaxation in muscle tension and auditory stimuli, but also heightened activity in areas of the brain housing deeper memory and autonomic functions.5

Medical hypnotherapy today is most commonly used for pain management, treatment of anxiety or psychosomatic illness, and treatment of behavioral disorders. 

One study measured the effect of hypnotic suggestion on fibromyalgic pain. In this trial, 45 fibromyalgia patients with uncontrolled pain were randomized to receive either hypnosis with relaxation suggestions, hypnosis with analgesia suggestions or relaxation training alone.6 Hypnosis with analgesia suggestions provided the greatest relief, and hypnosis with relaxation suggestions were no better than relaxation training alone, data showed.6

In a review study of the clinical efficacy of hypnosis for controlling migraine and tension headaches, a National Institute of Health Technology Assessment Panel determined that hypnotherapy met appropriate criteria to be defined as a “well-established therapy.”7,8 This study suggests that the mechanism of analgesia from hypnosis does not involve endorphin-production pathways.8 Prior studies demonstrated similar results through the failure of a posthypnotic administration of naloxone, an opiate antagonist.9

Hypnosis is often used to help control such behaviors as smoking or overeating. In two separate meta-analyses conducted over the course of 10 years examining nearly 700 clinical trials and involving more than 70,000 participants, hypnosis was found to be the most successful smoking-cessation method when compared with unassisted attempts to quit.10, 11 Cessation rates stemming from hypnotherapy ranged from a mean of 36% to greater than 50%, with 12-month abstention levels well over 80%.10,11  

Studies of the use of hypnosis to treat obesity have been less positive, but not without merit. When comparing hypnosis alone to hypnosis plus another assistive therapy for weight management — such as behavior modification — combination therapy showed a clear advantage.12  

Safety in administration

Under the care of a licensed therapist or health-care professional, hypnosis is considered a safe alternative medical treatment. However, if a patient is relying on hypnotherapy over mainline therapy, the pros and cons must be clearly elucidated.

Summary

More research on clinical hypnotherapy is needed, but clinicians can feel confident in suggesting this alternative form of therapy to patients in need.

References

1. Anxiety and Panic Disorders Health Center page. WebMD website.
2. Stewart JH. "Hypnosis in contemporary medicine." Mayo Clin Proc. 2005;80:511-524.
3. Vickers A, Zollman C. "ABC of complementary medicine: Hypnosis and relaxation therapies." BMJ. 1999;319:1346-1349.
4. Penn State Probing Questions page. Penn State University website.
5. Egner T, Jamieson G, Gruzelier J. "Hypnosis decouples cognitive control from conflict monitoring processes of the frontal lobe." Neuroimage. 2005; 27:969-978.
6. Castel A, Perez M, Sala J et al. "Effect of hypnotic suggestion on fibromyalgic pain: Comparison between hypnosis and relaxation." Eur J Pain. 2007;11:463-468.
7. Chambless D, Hollon S. "Defining empirically supported therapies." J Consult Clin Psychol. 1998;66:7-18.
8. Hammond C. "Review of the efficacy of clinical hypnosis with headaches and migraines." Int J Clin Exp Hypn. 2007;55:207-219.
9. Patterson D, Jensen M. "Hypnosis and clinical pain." Psychol Bull. 2003;129:495-521.
10. Green J, Lynn S. "Hypnosis and suggestion-based approaches to smoking cessation: An examination of the evidence." Int J Clin Exp Hypn. 2000;48:195-224.
11. Ahijevych K, Yerardi R, Nedilksy N. "Descriptive outcomes of the American Lung Association of Ohio hypnotherapy smoking cessation program." Int J Clin Exp Hypn. 2000;48:374-387.
12. Kirsch I. "Hypnotic enhancement of cognitive-behavioral weight loss treatments: Another meta-reanalysis." J Consult Clin Psychol. 1996;64:517-519.

All electronic documents were accessed on March 6, 2012.

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