Clinical Hypnosis & Hypnotherapy
Hypnosis is a state of focused attention with reduced peripheral awareness and heightened suggestibility, which is used not as a therapy in its own right but as an adjunct that amplifies the effect of an accompanying psychological or medical intervention.
Not a treatment in itself. A state in which other treatments may work better.
Who built it
James Braid
1795–1860Scottish surgeon
Coined "hypnotism" and reframed mesmerism as a psychological rather than magnetic phenomenon — the beginning of its scientific respectability.
Early hypnosisMilton H. Erickson
1901–1980Psychiatrist
Indirect, permissive, utilisation-based hypnosis; the use of metaphor, confusion and the client’s own resistance. Enormously influential on strategic and solution-focused therapy, and a figure whose case reports are more compelling than his evidence.
EricksonianErnest R. Hilgard
1904–2001Stanford psychologist
The experimental study of hypnosis: standardised susceptibility scales, neodissociation theory, and the demonstration that hypnotic analgesia is a robust laboratory phenomenon.
Experimental hypnosis
Theory of personality
Hypnotic suggestibility is a stable, measurable individual trait with a substantial heritable component. Roughly 10–15% of people are highly suggestible, 10–15% minimally so, and the majority fall in between. This is one of the more reliable findings in the area, and it means the intervention’s applicability is genuinely person-dependent.
Competing accounts
State theories
- Hypnosis involves an altered state of consciousness
- Neodissociation: an executive control system divides
- Some neuroimaging support for altered connectivity
- Explains the involuntariness patients report
Sociocognitive theories
- Hypnosis is role enactment, expectation and motivated responding
- No special state required
- Explains findings without new entities
- Struggles with the phenomenology and with some analgesia data
Theory of psychopathology
Hypnosis has no theory of psychopathology and does not require one. It is a modifier applied to whatever treatment is being delivered. This is why the correct term is usually "hypnotically assisted" rather than "hypnotherapy" — the therapy is the CBT, the pain management or the exposure protocol, and the hypnosis is the amplifier.
Theory of change
- 1Induction: focused attention, typically through fixation, progressive relaxation, or conversational absorption.
- 2Deepening: intensifying the state.
- 3Therapeutic suggestion: the active component, whether symptom-focused, ego-strengthening or imagery-based.
- 4Post-hypnotic suggestion: linking a response to a future cue.
- 5Alerting: return to ordinary awareness, always with time to reorient.
- 6Self-hypnosis training so the effect can be produced without the clinician.
Key concepts
The vocabulary you need to read the literature and to be understood in supervision.
Where it sits in the transtheoretical grid
Which change processes the system leans on, and at what level of content it aims.
- Counterconditioning
Substituting an incompatible response for the problem response - relaxation, assertion, exposure, defusion, opposite action.
- Consciousness raising
Increasing information about oneself and the problem - feedback, interpretation, education, observation.
- Stimulus control
Restructuring the environment so that problem cues are less likely and healthy cues more likely.
- Helping relationship
Being open and trusting about problems with someone who cares; the relationship as vehicle, and as medicine in its own right.
- Symptom & situational problems
- Maladaptive cognitions