Does hypnotherapy/hypnosis, in any form, for any type of disorder, work?

Question

Does Hypnosis Work for Treating, or Curing, any Form of any Mental Disorder?

Let's say my definition of hypnosis is related mostly to the classical way people think about it. This is subjective of course, but I've purposefully made it that way. I do realize at times it may overlap into other types of therapy as well.

If there are other forms of hypnosis I'd like to hear about those too though!

Citation/Research Wise:

• I'd like to know if its backed by literature. I want the specific citation's abstract quoted.

• I'd like to know their findings, conclusions, and methodologies and your analysis of that.

• I'd like to know how long the treatments lasted after they stopped being hypnotized.

• I'd like to know how effective it was for whatever specific goals that it was used to treat. How long did the affects last if there were any?

• I'd like to know if you found any potential errors or flaws in the study - and you're overall analysis of that.

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Citing Wikipedia is not an acceptable answer or comment as it is not a reputable source, it's citations are. If you are going to do that, pick the most compelling and valid studies (no matter the disorder), or something like a meta analysis that Wikipedia cites and then post that along with the answer to the above questions. Thanks.

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Anecdotally:

• I'd like to know what it feels like to be hypnotized if you've had the experience of it.
• I'd like to know why if it worked really well for you then why did you stop doing it or have you actually continued?

It can be any disorder of any kind, just as long as someone could classify it as a psychological "problem" in some context. The more angles you come at it with the better though.

Answer 1

What is Hypnosis?

First of all, we need to define hypnosis. Hypnosis, by definition, is a natural state attained by individuals. It is the calm, place achieved by meditation, reflective thought or day dreaming. In and of itself, yes hypnosis can be beneficial to all individuals. A caveat applies to this statement, however, as to the current mental state of an individual. One could suggest that hypnosis is to the human mind, as eating vegetables is to the human body; nourishing and vital for our well being.

What is therapeutic hypnosis?

Hypnotherapy, which is the use of hypnosis as a therapy is another thing. It has been proven to have success. However, it's success is contingent upon the individuals willingness for change, insight, and mental capacities (as are Factors Influencing Successful Psychotherapy Outcomes). Hypnotherapy teaches the individual to use hypnosis as a therapeutic technique. Hypnotherapy has success rates in helping mental disorders. A person is more suggestible under hypnosis.

When I refer to mental capacities, I am not so much referring to intellect, as mental health. For psychotic illness, by definition, is unable to be improved with logic or reasoning, any form of therapy, other than medication to adjust the brains chemistry, after which, other therapeutic processes may assist in the individual's well being. _{**note my comment about psychosis is broad; I believe it is too big a topic to detail here*}

What is Hypnotherapy and How Does it Differ From Hypnosis?

Hypnosis is a totally natural state of mind. When under hypnosis you will feel very relaxed, just like that wonderful feeling when you are tired lying in your bed and you are so overcome with comfort that you wish the moment could last forever. Through simple hypnotic, relaxation techniques you can easily attain this state at which time it becomes easy, with the help of a trained hypnotherapist, to visualise yourself becoming healthier, happier, more confident, a non-smoker.

Hypnotherapy, or self-hypnosis once you've learnt to use the tools for yourself, can be a very effective tool for asking the right kind of 'internal' questions. ..//...

Many people claim that they have never been hypnotised, but they do admit to having drifted off whilst thinking about a loved one, forgetting large chunks of a car journey (commonly known as highway hypnosis), or 'going somewhere else' while reading a book. These are all examples of natural trance states. One of the great things about hypnosis is that in the hands of a reputable practitioner it is harmless and produces no damaging side effects, whilst providing positive therapeutic benefits. (1)

How is hypnosis used within current therapies?

Hypnosis is the principle used in mindfulness, a popular therapeutic technique used in a variety of therapies, including Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT); which was developed from CBT by Dr Marsha Linehan. It is specifically designed to help people with Borderline Personality Disorder.

Hypnosis is also commonly practiced to assist individuals with problems of addiction; examples being smoking and weight loss. _{citations to follow}

It has also shown to have beneficial effects in pain management. _{citations to follow}

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- Does Hypnosis Work for Treating, or Curing, any Form of any Mental Disorder?

This can be answered with an uncategorical Yes, as an adjunct to the therapeutic process.

It has proven useful in assisting personality disorders, addiction, pain management, phobias, anxiety and depression, as broad examples.

• 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.

  Hypnotherapy has been used to stop self-destructive and addictive habits like smoking. It has also been used to curb the urge to eat for overeaters, to stem the disruptive actions of tics, cure insomnia , stop bed-wetting, and minimize anxiety. Excessive stress can be generated from any number of sources and can be the springboard for anxiety. Some of the more prominent sources of anxiety and stress for which people seek hypnotherapy are: public speaking, test taking, and job stress. Hypnotherapy also works well for other anxiety disorders such as phobias and has proven to be an effective treatment for mild to moderate depression. In one study, hypnotherapy was used in conjunction with traditional cognitive therapy, to assist persons who had severe aversion to needles. The treatment was necessary, because it was essential that each participant receive periodic medical injections. However, the participants would have become non-compliant without the adjunct intervention of hypnotherapy. In another case, involving care for terminally ill cancer patients, it was concluded that hypnotherapy was more effective at enhancing quality of life and relieving anxiety and depressive symptoms, when compared to others who received traditional care. (2)(9)(10)(11)(12)(13)(14)(15)(16)

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- I'd like to know if its backed by literature. I want the specific citation's abstract quoted.

There have been numerous studies demonstrating the usefulness of hypnosis within a therapeutic setting and the long term benefits.

The following links and excerpts provide citations with conclusive research about the efficacy of Hypnosis as a useful and lasting therapeutic technique. I have inserted bold to highlight the various conditions being discussed.

It is argued (a) that the integration of techniques from behavior modification and hypnosis can expedite therapy for specific disorders and (b) that hypnosis intensifies the perceptual and cognitive factors involved in "visual voyages" or hypnagogic experiences, evocation of fantasies, feeling states, and "altered states of consciousness" to bring about behavioral changes. (4) Hypnosis and behavior modification: Imagery conditioning.

Thus hypnosis was shown to be more effective than nonhypnotic techniques for reducing procedural distress in children and adolescents with cancer. (5) Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer

Hypnosis, when used by trained professionals, in other words, can allow those who suffer from panic attacks to learn to effectively and rapidly regulate their internal states. These techniques, in addition to curing phobic conditions or panic attacks, support patients, allowing them to regain the possibility of managing their own well-being and restoring their sense of self mastery, which is often lowered by these disordersibid. (3)

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I have merged the following points

- I'd like to know their findings, conclusions, and methodologies and your analysis of that.
- I'd like to know if you found any potential errors or flaws in the study - and you're overall analysis of that.

I cannot analysis or critique all these studies, as there are many studies which demonstrate the effects of hypnosis. The nature of any study, is it is time consuming and requires much work and effort outside of the scope of these types of questions and answers. I agree with this answer here, to this question Striking a balance between citations and common sense in answers about providing effective answers.

The question about potential flaws, in this study, it is made clear that, given the small difference between therapeutic techniques, with or without the addition of hypnosis, there was a significant difference for patients, having hypnosis as part of their treatment.

These results were particularly striking because of the few procedural differences between the hypnotic and nonhypnotic treatments. (3)

There is also the issue, that hypnosis, as a therapy per se, is generally used as part of an integrated therapeutic approach. One example being, children undergoing treatment for cancer, are not given hypnosis in isolation, it is within a structured supportive framework. So the measure of hypnosis, per se, is difficult to quantify at times; as the willingness to use hypnosis as a therapeutic technique, also demonstrates a more holistic viewpoint in the management of the individuals health. Almost akin to natural therapies, as hypnosis is a natural tool, available to individuals and does not need to be taught to be practiced. Being a natural tool available, it can be taught to those who neglect to use it. Much like education about a healthy diet. It is a healthy practice for the mind.

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I have merged these questions- "I'd like to know how long the treatments lasted after they stopped being hypnotized." In these studies the hypnosis was a part of the therapeutic process, so the hypnosis continued whilst the therapy continued.

- I'd like to know how long the treatments lasted after they stopped being hypnotized.
- I'd like to know how effective it was for whatever specific goals that it was used to treat. How long did the affects last if there were any?

Effects seemed particularly pronounced for treatments of obesity, especially at long-term follow-up, indicating that unlike those in nonhypnotic treatment, clients to whom hypnotic inductions had been administered continued to lose weight after treatment ended. These results were particularly striking because of the few procedural differences between the hypnotic and nonhypnotic treatments. (6)

This paper discussed the usefulness and longer term effectiveness of hypnosis for people with Post Traumatic Stress Disorder.

This research represents the first controlled treatment study of hypnosis and cognitive– behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT– hypnosis), or supportive counseling (SC). CBT comprised exposure, cognitive restructuring, and anxiety management. CBT– hypnosis comprised the CBT components with each imaginal exposure preceded by a hypnotic induction and suggestions to engage fully in the exposure. In terms of treatment completers (n 69), fewer participants in the CBT and CBT– hypnosis groups met criteria for posttraumatic stress disorder at posttreatment and 6-month follow-up than those in the SC group. CBT– hypnosis resulted in greater reduction in reexperiencing symptoms at posttreatment than CBT. These findings suggest that hypnosis may have use in facilitating the treatment effects of CBT for posttraumatic stress. (7)

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This study demonstrates that the beneficial effects of hypnotherapy appear to last at least five years. Thus it is a viable therapeutic option for the treatment of irritable bowel syndrome. (8)

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- I'd like to know what it feels like to be hypnotized if you've had the experience of it.

As to personal experience I have experienced self and therapeutic hypnosis at varying stages throughout my life. It creates a feeling of relaxation and peace. It gives me a personal power of feeling more self control and reducing distress levels.

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- I'd like to know why if it worked really well for you then why did you stop doing it or have you actually continued?

Personally, I have practiced it throughout my entire life. The times I need it the most, are the times I practice it the least. It is something I should tattoo on myself to remind me to use it more often, as it is helpful. Not a cure all, but helps me in any and every situation. It slow down my emotional reaction time and intensity and assists in making ill-timed, rash and bad judgements. It is when in a distressed state it is the hardest to practice. I am glad for this question, as it is a reminder to me, to practice this and I need to practice it daily.

To go into explanation as to why people have discontinued, would be similar to asking, how long is a piece of string. People stop therapy or positive coping techniques for a vast number of reasons. I cannot begin to address this within the scope of this answer. I have posted this question:
What are the key predictive traits of therapeutic success?

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_{(1) What is Hypnotherapy and How Does it Differ From Hypnosis? Oxford Hypnotherapy
(2) Hypnotherapy Encyclopedia ofMental Disorders
(3) PANIC ATTACKS AND PHOBIAS: HEALING WITH HYPNOSIS Milton H Erickson Institute
(4) Hypnosis and behavior modification: Imagery conditioning.
Kroger, William S.; Fezler, William D.
Oxford, England: J. B. Lippincott. (1976). xxv 426 pp.
(5) Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer Richard W. Olmsted (Editor), M.D. Lonnie ZeltzerCorresponding author contact information, Ph.D. Samuel LeBaron University of Texas Health Science Center at San Antonio, San Antonio, Texas USA
(6) Hypnosis as an adjunct to cognitive-behavioral psychotherapy: A meta-analysis. Kirsch, Irving; Montgomery, Guy; Sapirstein, Guy Journal of Consulting and Clinical Psychology, Vol 63(2), Apr 1995, 214-220. doi: 10.1037/0022-006X.63.2.214
(7) The Additive Benefit of Hypnosis and Cognitive–Behavioral Therapy in Treating Acute Stress Disorder
Richard A. Bryant, Michelle L. Moulds, Rachel M. Guthrie, and Reginald D. V. Nixon University of New South Wales
Journal of Consulting and Clinical Psychology Copyright 2005 by the American Psychological Association 2005, Vol. 73, No. 2, 334 –340 0022-006X/05/$12.00 DOI: 10.1037/0022-006X.73.2.334
Gut. 2003 Nov;52(11):1623-9.
(8) Long term benefits of hypnotherapy for irritable bowel syndrome. Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ Department of Medicine, University Hospital of South Manchester, Manchester, UK. wgonsalkorale@compuserve.com
(9) Iglesias, A. & Iglesias, A. (2005). Awake alert hypnosis in the treatment of panic disorder: a case report. American Journal of Clinical Hypnosis, 47(4), 249-256.
(10) McNeal, S.A. (2001). EMDR and hypnosis in the treatment of phobias. American Journal of Clinical Hypnosis, 43:3/43:4, 263-274.
(11) Kirsch, I., Montgomery, G. & Sapperstein, G. (1995) Hypnosis as a adjunct to cognitive-behavioral psychotherapy: a meta analysis. Journal of Counseling and Clinical Psychology, 63, 214-220.
(12) Crawford, H.J. & Barbasasz, A.F. (1993). Phobias and intense fears: facilitating their treatment with hypnosis. In J. W. Rhue, S. J. Lynn & I. Kirsch, (Eds.), Handbook of clinical hypnosis (pp.311-338) Washington, D.C.: American Psychological Association.
(13) King, Brenda J, Michael Nash, David Spiegel, and Kenneth Jobson. Hypnosis as an intervention in pain management: A brief review. International Journal of Psychiatry in Clinical Practice 5 (2001): 97–101.
(14) Liossi, Christina and Paul White. Efficacy of clinical hypnosis in the enhancement of quality of life of terminally ill cancer patients. Contemporary Hypnosis 18 (2001): 145–160.
(15) Segal, Robert. Hypnosis in the treatment of an eating disorder. Australian Journal of Clinical & Experimental Hypnosis 29 (2001): 26–36.
(16) Yapko, Michael. Hypnosis in treating symptoms and risk factors of major depression. American Journal of Clinical Hypnosis 44 (2001): 97–108.}

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Answer 2

Hypnosis "works" only insofar as it induces¹ a trance. Hypnosis is not a type of therapy. Hypnosis does not cure any disorders or do anything at all, except induce a trance.

Hypnotherapy, from the perspective of psychodynamic theory, utilizes this trance to directly access the subconscious. In traditional hypnotherapy (of the Victorian era), direct suggestions were "planted" in the "unprotected" subconscious; in modern Ericksonian hypnotherapy, the unconscious is stimulated to participate in the healing process.

So the question we are dealing with asks:

Does hypnotherapy work for any type of disorder?

Yes, it does. Standard works (Burrows & Dennerstein, 1980; Brown & Fromm, 1986; Cheek & LeCron, 1968; Crasilneck & Hall, 1985; Hammond, 1990; Kossak, 1989; Kroger & Fezler, 1976; Peter et al., 1991; Revenstorff, 1993; Lynn et al., 1996; Wester & Smith, 1984; Erickson, 2007-2010; O'Hanlon & Hexum, 1990) show that hypnosis has been successfully applied to a multitude of psychosomatic, psychiatric and somatic cases including:

• behavioral problems
  • nail biting
  • enuresis (bedwetting)
  • smoking
  • overweight
  • academic and athletic increase in performance
• psychoneurotic disorders
  • phobias, obsessive-compulsive disorders
  • depressive reactions
  • post-traumatic stress disorder
  • dissociative disorders
  • sleep disorders
• psychosomatic disorders
  • chronic pain
  • migraine, tension headache
  • morbus crohn, ulcers
  • asthma, hay fever
  • hypertonia (high blood pressure)
• somatic disorders
  • immunology: warts, dermatosis, ichtyosis, tumors
  • vasomotoric: bleeding control, morbus raynaud, wound healing
  • acute pain: obstetrics, dentistry, postoperative pain
  • neurology: amnesia, rehabilitation after brain lesions

In addition to case studies, there is a growing number of controlled group studies on the effectiveness of hypnotherapy which show empirically confirmed indications for this method. Meta-analyses have become the accepted method of judging the effectiveness of a therapeutic procedure, so I will confine myself to these in the following overview.

In a meta-analysis (Rominger, 1995) of 36 control group studies with more than 1200 patients the effect sizes ranged from g = .54 to g = .95². This corresponds (converted after Rosenthal, 1984) to a correlation between treatment and effect ranging from r = .26 to r = .44. From this a success rate (in %) can be estimated for treated and untreated patients (table 1).

                 Number of Studies    Success Rate    Success Rate
                                      untreated (%)   treated (%)
all studies      36                   31              69
smoking           4                   30              70
anxiety           6                   29              71
pain             14                   37              63

Table 1. Results of a meta-analysis of hypnotherapy (after Rominger, 1995).

In a more recent meta-analysis, Bongartz et al. (1999) found comparable results in 112 studies with 5600 patients (table 2).

                       Number of Studies    Success Rate    Success Rate
                                            untreated (%)   treated (%)
psychotherapy (all)    85                   32              68
addiction               6                   37              63
somatoform disorders   11                   35              65
anxiety                11                   26              74
behavioral problems     4                   33              67
pain (all)             27                   35              65
pain (cancer)           6                   36              64
pain (surgery)          8                   38              62
pain (birth)            5                   36              64

Table 2. Results of a meta-analysis of hypnotherapy (after Bongartz et al., 1999).

In a new meta-analysis (2002), Bongartz et al. again confirmed the effectiveness of hypnotherapy. The abstract recapitulates:

From 193 studies published until 1998 that investigated the efficacy of hypnosis 43 randomized clinical studies were selected that compared a patient group treated exclusively by hypnosis with an untreated control group (or with a group of patients treated by conventional medical procedures).The 43 studies were integrated into a meta-analysis that yielded a weighted average post-treatment effect size of d=.60 (medium effect size) for hypnotic treatment of ICD-10 coded disorders (24 studies; average treatment period: 5.1 weeks) and d=.38 (small effect) for hypnosis as an adjunct for supporting medical procedures (19 studies).These estimates are conservative since all variables of a given study were used. Most of the studies employed methods of the classical approach to hypnosis. In order to obtain an estimate to which extent non-clinical factors (design-quality, way of comparison of dependent variables) have an influence on the effect sizes, effect sizes were computed for all studies of the original 193 studies that reported the necessary statistical information (N=89). For those studies with an average effect size of d=.80 a mas- sive influence of non-clinical factors was demonstrated with a range from d=.51 for randomized studies with group comparisons to d=2.0 for non-randomized studies using pre-post-comparisons.

A table listing all 43 analyzed studies and their area of application ("Störungsbild/Anwendungsbereich"), number of patients ("Patientenzahl"), type of hypnosis ("Hypnoseart"), treatment period in weeks ("Behandlungszeitraum") and effect sizes ("Effektstärke") is included in the publication which is available online at http://bscw.rediris.es/pub/bscw.cgi/d4416025/Bongartz-Effektivitat_hypnose.pdf (in German). It gives a more discriminating view and shows the large variance in effect sizes among the studies, but does not add anything new to this overview.

All the studies included in the meta-analysis used a control group, randomized assignment of patients to the groups, and used hypnotherapy as the only psychotherapeutic treatment (and not in conjunction with other forms of psychotherapy), but sometimes in conjunction with the medical standard therapy. As such, from my point of view, the meta-analysis is quite flawless. Some of the studies included measurements taken some time after the end of the treatment, but these were not considered in this meta analysis, because the 193 studies from which the ones included in the meta-analysis were selected are all the studies that the authors could find in relevant databases and literature ("footnote chasing") between 1974 and 1998, and the number of studies including "longer-term" effects were apparently not enough for a separate analysis. Thus, the authors of the meta-analysis considered only the immediate post-treatment measures of all studies.

In summary, it seems to me that the effectiveness of hypnotherapy has been shown especially for behavioral, anxiety and (psycho)somatic disorders and symptoms, while it seems not to have been applied, or not successfully, to psychotic, affective, dissociative, sexual, eating, sleep, impulse control, adjustment and personality disorders.

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Footnotes:

¹ Sometimes. An attempt by a clinical psychologist and trained hypnotist to hypnotize me did not lead to any trance.

² In an analysis of 302 meta-analyses of psychologica, pedagogical and behavioral therapies, Lipsey and Wilson (1993) found 90% of effect sizes to be above 0.10, and 85% above 0.20. A more methodically severe selection of 156 meta-analyses returned a mean effect size of 0.47.

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Sources:

• Bongartz, W., Flammer, E., & Schonke, R. (1999). Die Effektivität der Hypnotherapie: Eine meta-analytische Studie. Vortrag auf der Jahrestagung der M.E.G., Bad Orb.
• Bongartz, W., Flammer, E., & Schonke, R. (2002). Die Effektivität der Hypnose: Eine meta-analytische Studie. Psychotherapeut, 47, 67-76.
• Brown, D. P., & Fromm, E. (1986). Hypnotherapy and Hypnoanalysis. Hillsdale, NY: Lawrence Erlbaum.
• Burrows, G. D., & Dennerstein, L. (Eds.) (1980). *Handbook of hypnosis and psychosomatic medicine. Amsterdam: Elsevier.
• Cheek, D. B., & LeCron, L. M. (1968). Clinical hypnotherapy. New York: Grune & Stratton.
• Crasilneck, H. B., & Hall, J. A. (1985). Clinical Hypnosis: Principles and Applications* (2nd ed.). New York: Grune & Stratton.
• Erickson, M. H. (2007-2010). Collected Works (10 vols.). Milton H. Erickson Foundation Press.
• Hammond, D. C. (ed.) (1990). Handbook of Hypnotic Suggestions and Metaphors. New York: Norton.
• Kossak, H. C. (1989). Hypnose: Ein Lehrbuch. Weinheim: PVU.
• Kroger, W. S., & Fezler, W. D. (1976). Hypnosis and Behavior Modification: Imagery Conditioning. Philadelphia: Lippincott.
• Lynn, S. J., Kirsch, I., & Rhue, J. W. (eds.) (1996) *Casebook of Clinical Hypnosis. Washington, DC: APA.
• Lipsey, M, L., & Wilson, D. B. (1993). The efficacy of psychological, educational, and behavioral treatment: Confirmation from meta-analysis. American Psychologist, 48, 1181-1209.
• O'Hanlon, W. H., & Hexum, A. L. (1990). An Uncommon Casebook: The Complete Clinical Works of Milton H. Erickson. New York: Norton.
• Peter, B., Kraiker, C., & Revenstorf, D. (eds.) (1991). Hypnose und Verhaltenstherapie. Bern: Huber.
• Revenstorff, D. (1993). Klinische Hypnose (2nd ed.). Heidelberg: Springer.
• Rominger, M. (1995). Metaanalyse der Hypnotherapie (Diploma thesis). University of Tübingen.
• Rosenthal, R. (1984). Meta-Analytic Procedures for Social Research*. London: Sage.
• Wester, W. C., & Smith, A. H. (1984). Clinical Hypnosis: A Multidisciplinary Approach. Philadelphia: Lippincott.