To investigate the effectiveness of cognitive hypnotherapy (CH), hypnosis combined with cognitive-behavioral therapy (CBT), on depression, 84 depressives were randomly assigned to 16 weeks of treatment of either CH or CBT alone. At the end of treatment, patients from both groups significantly improved compared to baseline scores. However, the CH group produced significantly larger changes in Beck Depression Inventory, Beck Anxiety Inventory, and Beck Hopelessness Scale. Effect size calculations showed that the CH group produced 6%, 5%, and 8% greater reduction in depression, anxiety, and hopelessness, respectively, over and above the CBT group. The effect size was maintained at 6-month and 12-month follow-ups. This study represents the first controlled comparison of hypnotherapy with a well-established psychotherapy for depression, meeting the APA criteria for a "probably efficacious" treatment for depression.
In conventional hypnosis, you approach the suggestions of the hypnotist, or your own ideas, as if they were reality. If the hypnotist suggests that your tongue has swollen up to twice its size, you'll feel a sensation in your mouth and you may have trouble talking. If the hypnotist suggests that you are drinking a chocolate milkshake, you'll taste the milkshake and feel it cooling your mouth and throat. If the hypnotist suggests that you are afraid, you may feel panicky or start to sweat. But the entire time, you are aware that it's all imaginary. Essentially, you're "playing pretend" on an intense level, as kids do.
Mendelsohn et al.’s study is important because it demonstrates that hypnotic suggestions influence brain activity, not just behavior and experience. Hypnotic effects are real! This fact has been demonstrated clearly in earlier work, for instance, by psychologist David Oakley (University College London) and colleagues, who compared brain activation of genuinely hypnotized people given suggestions for leg paralysis with brain activation of people simply asked to fake hypnosis and paralysis.
In this special mental state, people feel uninhibited and relaxed. Presumably, this is because they tune out the worries and doubts that normally keep their actions in check. You might experience the same feeling while watching a movie: As you get engrossed in the plot, worries about your job, family, etc. fade away, until all you're thinking about is what's up on the screen.
A trancelike state resembling sleep, usually induced by a therapist by focusing a subject's attention, that heightens the subject's receptivity to suggestion. The uses of hypnosis in medicine and psychology include recovering repressed memories, modifying or eliminating undesirable behavior (such as smoking), and treating certain chronic disorders, such as anxiety.
Before people subject themselves to hypnotherapy they are advised to learn as much about the process and about the chosen therapist as is necessary to feel comfortable. Rapport and trust are two key ingredients in making a potential hypnotherapy patient comfortable. Therapists should be open and willing to answer all questions regarding qualifications, expertise, and methods used. A well-qualified professional will not undertake the use of hypnosis without interviewing the patient to ascertain their level of understanding of the process. This is very important for two reasons. First, it allows the patient the opportunity to have questions answered and to develop some rapport with the therapist. Second, it is important for the therapist to know the patient's expectations since meeting these expectations will enhance the likelihood of success.
Hypnotherapy is a use of hypnosis in psychotherapy. It is used by licensed physicians, psychologists, and others. Physicians and psychologists may use hypnosis to treat depression, anxiety, eating disorders, sleep disorders, compulsive gambling, and posttraumatic stress, while certified hypnotherapists who are not physicians or psychologists often treat smoking and weight management.
Most relaxation techniques require daily practice to be effective. A variety of formats for teaching relaxation and meditation exist, including classes as well as individual sessions. Relaxation can be taught in 1 session by conducting and audio taping a relaxation session. Using the audio tape, patients can then practice the techniques daily at home. Methods such as progressive muscle relaxation are easy to learn; yoga, tai chi, and meditation can take years to master completely.
The American Psychological Association published a study comparing the effects of hypnosis, ordinary suggestion, and placebo in reducing pain. The study found that highly suggestible individuals experienced a greater reduction in pain from hypnosis compared with placebo, whereas less suggestible subjects experienced no pain reduction from hypnosis when compared with placebo. Ordinary non-hypnotic suggestion also caused reduction in pain compared to placebo, but was able to reduce pain in a wider range of subjects (both high and low suggestible) than hypnosis. The results showed that it is primarily the subject's responsiveness to suggestion, whether within the context of hypnosis or not, that is the main determinant of causing reduction in pain.
Barber et al. noted that similar factors appeared to mediate the response both to hypnotism and to cognitive behavioural therapy, in particular systematic desensitization. Hence, research and clinical practice inspired by their interpretation has led to growing interest in the relationship between hypnotherapy and cognitive behavioural therapy.:105
Trance is commonplace. People fall into traces many times without even being aware that it happened. Examples of this are: reaching the destination of a morning commute, but not recalling the passing of familiar landmarks; daydreaming while sitting in a college classroom; or that anxiety-free state achieved just before going to sleep. The difference between these altered states and clinically used hypnotherapy is that a professionally trained person is involved in helping the patient achieve the trance, which can be done in many ways.
The British Psychological Society commissioned a working group to survey the evidence and write a formal report on hypnotherapy in 2001. They found, “Enough studies have now accumulated to suggest that the inclusion of hypnotic procedures may be beneficial in the management and treatment of a wide range of conditions and problems encountered in the practice of medicine, psychiatry and psychotherapy.”
“That study changed the whole landscape,” said Dave Patterson, a psychologist at the University of Washington in Seattle, who has been using hypnosis since the 1980s to help burn victims withstand the intense pain that comes with the necessary but excruciating bandage removal and wound cleaning. Since the ’90s, other well-designed, controlled studies have been published showing similar changes in brain activity. In another slightly trippy example, researchers suggested to people in a hypnotic state that the vibrant primary colors found in paintings by Piet Mondrian were actually shades of gray. “Brain-scan results of these participants showed altered activity in fusiform regions involved in color processing,” notes psychologist Christian Jarrett.
In 2002, the Department for Education and Skills developed National Occupational Standards for hypnotherapy linked to National Vocational Qualifications based on the then National Qualifications Framework under the Qualifications and Curriculum Authority. NCFE, a national awarding body, issues level four national vocational qualification diploma in hypnotherapy. Currently AIM Awards offers a Level 3 Certificate in Hypnotherapy and Counselling Skills at level 3 of the Regulated Qualifications Framework.