Hypnosis is first and foremost a self-accepted journey away from the reality of the moment. Although the trance state is often referred to as if the patient is asleep, nothing could be further from the truth. The patient is fully awake at all times. The hypnotic subject is simply in a heightened, more receptive state of mind. This fact is proven with inductions called open-eye techniques, where the patient keeps his/her eyes open during the hypnotherapy. Full and deep trance is still achievable.
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Hence, the social constructionism and role-taking theory of hypnosis suggests that individuals are enacting (as opposed to merely playing) a role and that really there is no such thing as a hypnotic trance. A socially constructed relationship is built depending on how much rapport has been established between the "hypnotist" and the subject (see Hawthorne effect, Pygmalion effect, and placebo effect).
We experience trance states every day of our lives. When you are day-dreaming, in deep thought, or even watching television, you are in a trance. When you are going to sleep at night, you are in a trance. Trance states are observed in science by brainwave activity. These waves change when a person's brain becomes relaxed. A trance can be light, or very deep like deep sleep.
People have been pondering and arguing over hypnosis for more than 200 years, but science has yet to fully explain how it actually happens. We see what a person does under hypnosis, but it isn't clear why he or she does it. This puzzle is really a small piece in a much bigger puzzle: how the human mind works. It's unlikely that scientists will arrive at a definitive explanation of the mind in the foreseeable future, so it's a good bet hypnosis will remain something of a mystery as well.
But for the comparison between PHA and functional amnesia to be most meaningful, we need to know that they share underlying processes. One way to test this is to identify the brain activity patterns associated with PHA. In a groundbreaking study published in Neuron, neuroscientist Avi Mendelsohn and colleagues at the Weizmann Institute in Israel did just that using functional magnetic resonance imaging (fMRI). They carefully selected 25 people to participate in their experiment. Although all were susceptible to hypnosis, earlier testing had shown that half could respond to a PHA suggestion (labelled “the PHA group”) and half could not (the “non-PHA group”). In the Study session of their experiment, participants watched a 45-minute movie. One week later, in the Test session, participants returned to the laboratory and were hypnotized while they lay within the fMRI scanner. During hypnosis, people in both the PHA and non-PHA groups received a suggestion to forget the movie until they heard a specific cancellation cue.
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Braid can be taken to imply, in later writings, that hypnosis is largely a state of heightened suggestibility induced by expectation and focused attention. In particular, Hippolyte Bernheim became known as the leading proponent of the "suggestion theory" of hypnosis, at one point going so far as to declare that there is no hypnotic state, only heightened suggestibility. There is a general consensus that heightened suggestibility is an essential characteristic of hypnosis. In 1933, Clark L. Hull wrote:
Abnormal results can occur in instances where amateurs, who know the fundamentals of hypnosis, entice friends to become their experimental subjects. Their lack of full understanding can lead to immediate consequences, which can linger for some time after the event. If, for example, the amateur plants the suggestion that the subject is being bitten by mosquitoes, the subject would naturally scratch where the bites were perceived. When awakened from the trance, if the amateur forgets to remove the suggestion, the subject will continue the behavior. Left unchecked, the behavior could land the subject in a physician's office in an attempt to stop the itching and scratching cycle. If the physician is astute enough to question the genesis of the behavior and hypnosis is used to remove the suggestion, the subject may experience long-term negative emotional distress and anger upon understanding exactly what happened. The lack of full understanding, complete training, and supervised experience on the part of the amateur places the subject at risk.
A person with depression experiences a wide variety of emotions. According to the University of New Hampshire, hypnotherapy can help a person learn to reduce and/or better control feelings of anxiety, stress, and sadness. Hypnotherapy is also used to treat negative behaviors that could be worsening a person’s depression. These behaviors may include smoking and poor eating and sleeping habits.
Hypnosis, when using proven therapeutic procedures, can be a highly effective form of treatment for many mental, psychosomatic, and physical disorders. For example, through the use of regressive techniques, an adult patient may mentally voyage back to a point in youth that was particularly troublesome, allowing the healing of old emotional wounds. Another patient can be led to understand that emotional pain has been converted to physical pain, and that the pain can be eliminated once the source has been addressed. Or, a person suffering from chronic pain can be taught to control the pain without use of medications. There are a number of techniques for correcting dysfunctional behaviors such as self-destructive habits, anxiety disorders, and even managing side effects of various medical treatments and procedures.
In order for a hypnotherapist to convey positive suggestions for change, the patient must be in a receptive state. The state is called trance and the method of achieving a trance is through induction. Induction techniques are many and varied and involve the therapist offering suggestions that the patient follows. The formerly common "your eyes are getting heavy" suggestion may still exist, but other more reliable and acceptable (by the patient) forms of induction have come to the forefront. The artful hypnotherapist is always aware of the present condition of the patient and uses this information to lead him/her down the path of induction. In its lighter stages, trance can be noted by the relaxation of muscles. At this point, hands can levitate when given the suggestion, and paresthesia, a feeling of numbness, can be induced. In a medium trance, a patient can be led to experience partial or complete amnesia , or failure to recall events of the induction after the fact. A deep trance opens the patient to powerful auditory, visual, or kinesthetic experiences. The phenomenon of time distortion is experienced most profoundly at this level. Patients may believe they have been away briefly, and may react with disbelief when told they were away much longer. Although some work can be done in lighter states of trance, the best circumstance for implementing change is when the patient reaches a deep trance state. At this level, the patient is focused inwardly and is more receptive to positive suggestions for change. This is also the point at which the therapist can invoke posthypnotic suggestions, or instructions given to the patient so he/she will perform some act or experience some particular sensation following awakening from the trance. For example, these suggestions, if accepted by the patient, can be formed to make foods taste bad, cigarettes taste bad, delay impulses, curb hunger, or eliminate pain. However, it should be noted that posthypnotic suggestions given to a person, which run counter to the person's value system or are not something they are likely to do under ordinary circumstances, will not be accepted and therefore not implemented.