Hypnotherapy can Help
Hypnotherapy has been proven to be effective as a treatment for a wide range of issues, as documented in a significant body of international research, some of which is outlined on this page.
Hypnotherapy has been examined as a standalone therapy and as a complementary therapy, and compared to other means of treatment.
There have been reports of hypnotherapy being as effective as other established treatments for conditions, and on other cases being more effective than even pharmacological interventions.
Hypnotherapy Research for Mental Health Issues
Anxiety
Studies have shown that hypnotherapy can be an effective treatment for anxiety.
Summary
Anxiety is something everyone experiences at times, and feeling anxious is a perfectly natural reaction to some situations. But sometimes feelings of anxiety can be constant, overwhelming or out of proportion to the situation and this can affect your daily life.
Evidence
Hammer et al., (2021) demonstrated that hypnotherapy significantly reduced anxiety symptoms, including lack of confidence, in a group of medical students with exam anxiety.
Brooker (2018) demonstrated that hypnotherapy significantly reduced performance anxiety in a group of advanced pianists.
Anllo et al., (2020) demonstrated hypnotherapy alleviated anxiety and improved respiratory rates in patients with severe COPD and anxiety.
Depression
Studies have shown that hypnotherapy can be an effective treatment for Depression.
Summary
Depression affects people in different ways and can cause a wide variety of symptoms. They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety. There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains. The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.
Evidence
Alladin & Alibhai (2007) compared the effectiveness of hypnotherapy as a treatment for depression with the effectiveness of CBT as a treatment for depression. Patients in both groups improved but the hypnotherapy treatment group had significantly better improvements, demonstrating that hypnotherapy is more effective than CBT for the treatment of depression.
Smith (2004) presented a case of 30-year-old woman with severe depression linked to trauma. The symptoms were resistant to anti-depressant medications, but responded well to hypnotherapy which resulted in alleviating all her depression symptoms.
Panic Disorder
Studies have shown that hypnotherapy can be an effective treatment for Panic Disorder.
Summary
Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear.
Evidence
Abramowitz & Lichtenberg, (2010) presented a case of a 37-year-old male suffering from panic disorder and agoraphobia who was on medication treatment. Hypnotherapy was effective in alleviating the agoraphobia and he was able to discontinue using medication.
Phobias
Studies have shown that hypnotherapy can be an effective treatment for Phobias
Summary
A phobia is an overwhelming and debilitating fear of an object, place, situation, feeling or animal. Phobias are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object. If a phobia becomes very severe, a person may organise their life around avoiding the thing that’s causing them anxiety. As well as restricting their day-to-day life, it can also cause a lot of distress.
Evidence
Noble (2002) presented a case of a 61-year- old female client with an extreme case of haematophobia (Blood Phobia) which inhibited her from undergoing needed dental work. Hypnotherapy was effective in helping her to undergo dental work and to eliminate the blood phobia.
Iglesias & Iglesias (2014) presented a case of a man with social phobia and debilitating panic, that dated back to a gathering for upper management executives wherein he felt panic when he was introduced to the president of the company. From then the discomfort generalized to situations where he met new acquaintances. He proceeded to employ avoidance of social situations as a defence. Hypnotherapy was effective in alleviating his social phobia.
Obsessive Compulsive Disorder
Summary
Obsessive compulsive disorder (OCD) is a common mental health condition where a person has obsessive thoughts and compulsive behaviours. OCD can affect men, women and children. Some people start having symptoms early, often around puberty, but it usually starts during early adulthood. OCD can be distressing and significantly interfere with your life, but treatment can help you keep it under control.
Evidence
Husain & Mat (2014) presented a case of a 37-year-old male who presented with excessive worries about his health for one year. The worries were accompanied by somatic symptoms such as shortness of breath, chest discomfort, abdominal discomfort, tremors and unstable feeling while walking; leading to compulsive behaviour. He also had intrusive thoughts about his wife having ill intentions towards him. A Physical examination revealed no abnormalities. It was demonstrated that hypnotherapy was effective in helping him to reduce anxiety and control compulsive behaviour; and to control the persecutory ideas he had about his wife.
Hypnotherapy Research for Stress
Studies have shown that mindful hypnotherapy can be an effective treatment for Stress
Summary
Stress is the body’s reaction to feeling threatened or under pressure. It’s very common, can be motivating to help us achieve things in our daily life, and can help us meet the demands of home, work and family life. But too much stress can affect our mood, our body and our relationships – especially when it feels out of our control. It can make us feel anxious and irritable, and affect our self-esteem. Experiencing a lot of stress over a long period of time can also lead to a feeling of physical, mental and emotional exhaustion, often called burnout.
Evidence
Olendzki et al., (2020) demonstrated that mindful hypnotherapy was effective in significantly reducing stress and increasing mindfulness.
Hypnotherapy Research for Effects of Trauma
Grief
Studies have shown Hypnotherapy can be an effective treatment for the effects of Trauma
Summary
Bereavement, grief and loss can cause many different symptoms and they effect people in different ways. As well as bereavement, there are other types of loss such as the end of a relationship or losing a job or home. These feelings may not be there all the time and powerful feelings may appear unexpectedly.
Evidence
Gupta & Sidana (2020) presented a case of a 47 year-old male, who had lost a son to suicide 4 years prior. The patient was experiencing a prolonged and complicated grief reaction. After 4 years of hospitalisations and treatment, including psychotherapy and pharmacotherapy, the patient was still experiencing extreme distress. He was then introduced to hypnotherapy which was an effective treatment for him.
PTSD
Studies have shown Hypnotherapy can be an effective treatment for the effects of Trauma
Summary
Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very stressful, frightening or distressing events. Someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt. They may also have problems sleeping, such as insomnia, and find concentrating difficult. These symptoms are often severe and persistent enough to have a significant impact on the person’s day-to-day life.
Evidence
Abramowitz et al., (2008) In a random controlled trial using hypnotherapy as a treatment for insomnia in a group of chronic combat-related PTSD patient, hypnotherapy was found to be an effective treatment for insomnia. The researchers also found a significant main effect from the hypnotherapy treatment with a reduction in all PTSD symptoms, as well as the sleep improvement, demonstrating hypnotherapy to be an effective treatment for PTSD.
Brom et al., (1989) demonstrated that hypnotherapy was an effective treatment for PTSD in a group of mixed genders from both a military and a non-military background, using a randomised controlled trial. There was a significant reduction in severity of symptoms in the hypnotherapy treatment group.
Shakiaei et al, (2008) demonstrated that hypnotherapy significantly reduced the re-experiencing of trauma in a group of patients that had been hospitalised for burn care.
Abramowitz & Lichtenberg (2009) presented a case of an ex military 51-year old man with combat-induced PTSD. At the start of hypnotherapy treatment he was on a high level of medication that enabled to sleep for 4 hours a night and led to a slight reduction in symptoms of anxiety, but he remained distressed and non-functional. By the end of the hypnotherapy, his functioning and well-being had improved greatly and his medication was minimal, demonstrating the effectiveness of hypnotherapy for PTSD.
Hypnotherapy Research for Sleep
Studies have shown Hypnotherapy can help in the treatment of insomnia.
Insomnia
Summary
Insomnia means you regularly have problems sleeping. It usually gets better by changing your sleeping habits. If you have insomnia for a short time (less than 3 months) it’s called short-term insomnia. Insomnia that lasts 3 months or longer is called long-term insomnia.
Evidence
Lam et al., (2015) conducted a systematic review and meta-analysis of 13 studies (six trials of Hypnotherapy and seven on autogenic training or guided imagery). Meta-analyses found that overall, hypnotherapy significantly shortened latency in sleep compared to autogenic training or guided imagery.
Hypnotherapy Research for Unwanted Behaviours
Bruxism
Summary
Teeth grinding and jaw clenching (also called bruxism) is often related to stress or anxiety. It does not always cause symptoms, but some people get facial pain and headaches, and it can wear down your teeth over time. Most people who grind their teeth and clench their jaw are not aware they’re doing it. It often happens during sleep, or while concentrating or under stress.
Evidence
Dowd (2013) presented a case of hypnotherapy benefiting a 33-year-old woman who reported to have been suffering from nocturnal bruxism for over 20 years, causing a sore jaw most mornings and consistent sleep interruption. She sought psychological help with hypnotherapy which resulted in a complete eradication of her symptoms. Hypnotherapy was an effective treatment for teeth grinding.
Eating Problems
Summary
An eating disorder is a mental health condition where you use the control of food to cope with feelings and other situations. Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape. Anyone can get an eating disorder, but teenagers between 13 and 17 are mostly affected. With treatment, most people can recover from an eating disorder.
Evidence
Roy (2014) presented a case of hypnotherapy benefiting a 22-year-old female with anorexia nervosa. The onset of her condition was at 14 years old, with symptoms becoming aggravated at age 18. Before onset she was fussy about food and had significant anxiety associated with examinations. Cognitive Hypnotherapy was effective in significant symptom reduction, including moderating her eating attitude and in preparation for relapse prevention.
Smoking Cessation
Evidence
Hasan et al., (2014) compared the effectiveness of hypnotherapy and nicotine replacement therapy (using nicotine patches) in a randomised controlled trial. It was demonstrated that hypnotherapy was more effect than NRT and also that combining hypnotherapy and NRT resulted in the most effective long term outcome for smoking cessation.
Weight Loss
Summary
Excessive weight is generally caused by consuming more calories, particularly those in fatty and sugary foods, than you burn off through physical activity. The excess energy is stored by the body as fat. Obesity is an increasingly common problem because for many people modern living involves eating excessive amounts of cheap high-calorie food and sedentary lifestyles.
Evidence
Greetham et al (2016) Conducted a pilot investigation of a virtual gastric band hypnotherapy intervention over 24 weeks on 30 participants of mixed gender with a BMI over 27kg/m2 with the aim of determining if a virtual gastric band hypnotherapy (VGB) had an effect on weight loss in overweight adults compared to relaxation hypnotherapy and a self-directed diet.
Participants in each group were given 1-hour sessions once a week for 4 weeks, then returned at week 8 for a further 1-hour refresher session.
Results: Levels of weight gain and weight loss in the VGB group ranged from -17kg to +4.7kg, and in the relaxation group, weight gain and loss ranged from -9.3kg to +7.8kg. There was no significant difference between VFB and hypnotherapy as a main effect on weight loss (p = .41) or difference in groups over time (p = .64). Although there was a trend in results in favour of VGB as a stronger weight loss technique, no significant results were found in this pilot study.
Bo et al., (2018)55 conducted a randomised controlled trial evaluating if self hypnosis, added to lifestyle interventions, contributed to weight loss. Furthermore, if hypnosis could elicit changes in metabolic and inflammatory variables, and quality of life improvement (the secondary outcomes) in severe obesity. 120 participants were equally divided into the hypnosis group (n = 60) or the control group. All of the participants received exercise and behavioural recommendations and individualised diets. The intervention consisted of three hypnosis sessions, during which self-hypnosis was taught to increase self-control before eating. Diet, exercise, satiety, quality of life anthropometric measurements, and blood variables were collected and measured at enrolment and at 1 year (the trial end).
Results: A similar weight loss was observed in the intervention (−6.5 kg) and control (−5.6 kg) groups ( p = 0.79). However, habitual hypnosis users lost more weight (−9.6 kg, p < 0.001) and greatly reduced their caloric intake (−682.5 kcal; p = 0.005) in linear regression models. At the trial end, the hypnosis group showed lower C-reactive protein values (p < 0.001), higher satiety (p = 0.001), and better quality of life (p = 0.01).
Hypnotherapy Research for Tinnitus
Summary
Tinnitus is sound in the head with no external source. For many, it’s a ringing sound, while for others, it’s whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.
Evidence
A Maudoux et at (2007) conducted a research study to evaluate the effect of Ericksonian hypnotherapy on tinnitus. It was demonstrated that Ericksonian hypnotherapy was effective in helping to significantly modulate tinnitus intensity, in particular using self-hypnosis
Hypnotherapy Research for Gastrointestinal Issues
Crohn’s Disease
Summary
Crohn’s disease is a lifelong condition where parts of the digestive system become inflamed. It’s one type of a condition called inflammatory bowel disease (IBD).
Evidence
Emami, Gholamreaei & Daneshgar (2009) presented a case study of two patients diagnosed with Crohn’s Disease. Patient 1 was an 18-year-old female with mild symptoms. She was undergoing pharmacological treatment but complained of anxiety, depression, and poor quality of life. Her HADS score showed mild levels of depression (score = 4) and for anxiety (score = 4). Patient 2 was a 24-year-old female with moderate symptoms. She was also undergoing pharmacological treatment for her physical symptoms. Patient 2’s HADS score revealed significant depression (score = 15) and anxiety (score = 12).
Treatment: Both patients participated in 12 weekly one-hour sessions of hypnotherapy on a one-to- one basis. They were given regular 45-minute audio exercises to carry out between sessions as homework.
Results: Both patients completed the course, although they did not follow their homework completely. The patients could clearly visualize gut-directed, immune-related, and ego- strengthening suggestions. After the hypnotherapy course, symptoms, psychological state, and quality of life significantly improved for patient 1. After 6 months follow-up, symptoms and quality of life were the same as at the end of hypnotherapy. In this follow-up period, patient 1 was practicing a relaxation technique, but rarely used the compact disk (because its length of 45 minutes was too long). Corresponding physicians stated that the most significant change was improvement in the patient’s mood. For patient 2, symptoms, depression, anxiety, and quality of life were not improved after the hypnotherapy course. However, she reported that she could cope better with her disease. Six month follow-up did not demonstrate any improvement, though she participated in three additional sessions. Both patients reported that the greatest benefit of hypnotherapy was in helping them to cope better with their disease and also improved psychological state.
Irritable Bowel Syndrome
Summary
Irritable bowel syndrome (IBS) is a common condition that affects the digestive system. It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time. It’s usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life. There’s no cure, but diet changes and medicines can often help control the symptoms. The exact cause is unknown – it’s been linked to things like food passing through your gut too quickly or too slowly, oversensitive nerves in your gut, stress and a family history of IBS.
Evidence
Peters et al., (2016)2 compared the efficacy of Hypnotherapy and the low FODMAP diet for the treatment of IBS using a randomised clinical trial. 74 IBS patients were randomised to receive hypnotherapy (n = 25), the low FODMAP diet (n = 24) or a combination of treatments (n = 25).
Observations were made over 6 weeks, then at a 6-month follow-up. Recipients of Hypnotherapy received gut-directed hypnotherapy for one session a week, lasting an hour, over the 6-week period. The diet group were provided education of a low FODMAP diet at the beginning of week 1, then reviewed at week 6. The combination group received both treatments at the same time. After 6 months, all participants were given a questionnaire to fill out to provide data on symptoms (and upkeep of diet if applicable). All of the participants were requested to refrain from alternative treatments during this time.
Results: For gastrointestinal symptoms, significant improvements were made from the baseline to the 6-week and six-month time points, (p < .001; p < .001 respectively). Furthermore, no significant differences were found across treatment groups at the six-week or six-month intervals (p = 0.62; p = 0.32 respectively), which indicates that Hypnotherapy was as effective as the low FODMAP diet. For psychological status, gut-directed hypnotherapy was found to significantly reduce trait anxiety (p <.001) and depression (p = .011) for participants from baseline to 6 months post-treatment. This was distinguished from the diet and combination groups who found no significant improvements.
Miller et al., (2015)3 conducted an audit on one thousand patients suffering from refractory IBS, with participants of mixed age and gender. Participants all received a maximum of 12 one-hour sessions of gut-focused hypnotherapy over the course of 3 months. To measure data, the experimenters examined scores on the IBS-SSS with a primary outcome of a 50-point reduction in scores, with scores for non-colonic symptoms, quality of life and anxiety or depression recorded as secondary outcomes. All participants had been previously undergone conventional management strategies (i.e. dietary manipulation, pharmacological treatment). The audit used data between 2007 and 2011 on patients with suitable pre-and post- data.
Results: Overall, 76% of participants scores for the IBS Symptom Severity Score met the primary outcome (p < .001), with the greatest success with females (p <.001) and those with anxiety (p <.010). The mean reduction in IBS-SSS was 129 points (p < .001). The mean reduction in non-colonic symptoms was 65 points (p <.001). The mean reduction in Quality of Life score was 66 (p < .001). By the end of the treatment, patients with anxiety and depression fell from 63% to 34% and 25% to 12% respectively (p < .001).
Gonsalkorale et al., (2003)4 examined the long term benefits of hypnotherapy for irritable bowel syndrome. 204 patients who had received hypnotherapy for treatment of IBS within the last 6 years before the experiment completed questionnaires examining quality of life, anxiety, and depression at 3 time points of before, immediately after and up to the 6 year limit following the hypnotherapy treatment. Patients had been asked to complete 3 questionnaires; a validated IBS questionnaire, the HADS Scale, and a subjected assessment questionnaire. At the time of pre- and post- treatment, all participants had filled in these questionnaires so all data will have been within similar respective time-frames before being given the follow-up survey.
Results: Surveys indicated that 71% of patients initially responded to the therapy, with 81% of these recipients maintaining improvement over time. The remaining 19% claimed that deterioration over time since the treatment had been only slight. With respect to symptom scores, all items at the time of the experiment were significantly improved compared to self-reported pre-hypnotherapy levels (p< .001), with little change between post-hypnotherapy values which indicates a stable improvement to symptoms over time. Furthermore, there were no significant differences in scores of patients assessed at 1, 2, 3, 4 or 5+ years following treatment. Quality of life, anxiety and depression scores were still at improved levels in comparison to pre-treatment (p < .001), but did show some deterioration over time. Lastly, patients also reported a reduction in consultation rates and medication use following the completion of hypnotherapy.
Hasan et al., (2019)5 examined the outcomes of gut-directed hypnotherapy in 26 children and adolescents with severe refractory IBS, seeking an alternative treatment to anti-depressants due to safety concerns of their use in young people. Patients received 12 sessions of gut-focussed hypnotherapy at weekly intervals using the Manchester Protocol. All participants completed the Tellgen Absorption Scale before treatment, and all completed the IBS-SSS as well as the HADS , non-colonic symptom score and the QoL score. The primary outcome measure was defined by a minimum 50 point reduction in IBS-SSS scores.
Results: The scores before and after treatment were compared. The mean IBS-SSS score at baseline was 321.5. After the hypnotherapy treatment, there was a success rate of 88% with an overall mean reduction in IBS-SSS scores of -160.9 (p < .001). 19 out of 26 patients (73%) achieved a >30% reduction in abdominal pain scores. Hypnotherapy also improved other symptoms: the mean non- colonic symptom score was improved by 102.1 (p < .001). Mean HADS- anxiety scores improved by -3.0 (p < .001) and mean HADS- depression improved by -2.1 (p = .002). Lastly, The mean QoL score in patients improved by +89.7 (p <.001).
Hegade et al., (2012)6 examined different types of hypnotherapy in 34 patients with refractory IBS. Based on symptom severity from an IBS Symptom Score sheet, patients were sorted into groups of either general hypnotherapy, gut-directed hypnotherapy, or both. Patients also completed a HADS score. Measurements were taken at baseline, then at the end of the hypnotherapy. They analysed the data of all suitable patients from their records between 2009 and 2011. Follow-up questionnaires were sent to all patients at variable periods after the completion of their hypnotherapy treatment to score their symptoms at the time of the study.
Results: of the 34 patients, 15 received general hypnotherapy, 8 received GDH and 11 patients received a combination. The average number of hypnotherapy sessions was 4.7 sessions for 1 hour a week. 50% of patients returned their follow-up questionnaires. The results showed a significant improvement to HADS scores immediately after hypnotherapy (p = .025), with mean scores dropping from 26.13 to 16.42. For patients receiving general hypnotherapy, there was a significant improvement both immediately after and after a delay to scores (p = .026) as well as for recipients of GDH and a combination (p = .008).
Peter et al., (2018)7 used gut-directed hypnotherapy and measured its effects on the gut microbiome in 38 patients with refractory IBS. The majority of the patients suffered with severe refractory IBS (IBS-SSS > 300 points). They focused on microbial composition, IBS symptoms and psychological distress before and after GDH. Faecal samples were collected before and after 10 weekly group sessions of GDH, and underwent microbial 16S rRNA analysis. They measured psychological changes using the HADS-D and PSQ scales, as well as the IBS-SSS to measure symptoms in patients.
Results: No significant differences were found in the before-after groups concerning relative microbial abundances, but trends were identified in a reduced abundance of Lachnospiraceae and Firmicutes. For scores on the IBS-SSS, there were significant reductions in mean scores of symptom severity (p = .001) from baseline (323) versus post-treatment (264). Furthermore, a significant reduction in psychological distress (p = .001) was found between baseline scores (17.0) and post- treatment scores (12.0). Overall, adequate relief was reported by 84% of patients.
Galovski & Blanchard, (2002)8 presented a case study on a 55-year-old male patient suffering from refractory IBS and Generalised Anxiety Disorder. The subject had suffered from IBS for 30 years and had unsuccessfully pursued multiple psychological and pharmacological treatments. At the initial assessment, The therapist administered the SUNY IBS structured interview then determined that the client met the Rome Criteria for a diagnosis of IBS. He completed the Beck Depression Inventory to assess for his current level of depressive symptomatology and the State Trait Anxiety Inventory.
Treatment: After establishing a symptom baseline through a week of symptom monitoring, the client began treatment. The treatment consisted of 6 weekly sessions lasting approximately 50 minutes each. All sessions began with a review of the previous week’s diaries and included discussing any problems, questions, or concerns that may have arisen. All sessions were taped, and the client was able to access the recordings for practise at home.
(IBS): The subject’s CPSR score was calculated as a 53 following 6 sessions of hypnotherapy. With continued practice, the CPSR score continued to improve at the six-month follow-up point and was calculated at 70. Finally, at the two-year follow-up point, the CPSR score was calculated at 38. Therefore, the subject can be considered to have improved 53% following treatment, 70% at the six month follow-up, and 38% at the two year follow-up in overall IBS symptomatology.
Results (Generalized Anxiety Disorder): The therapist administered the BDI and the STAI at the six- month and two-year follow-up points. The subject’s level of depressive symptomatology, as measured by the BDI decreased from a pre-treatment score of 13 to a post-treatment score of 10 at six months, and to a score of 6 at the two-year point. Furthermore, the subject’s anxiety levels decreased as indicated by STAI scores. Prior to treatment, the subject scored a 49 on the state anxiety index. This score decreased to a 38 at post-treatment and to 36 at the two-year follow-up point. Trait anxiety showed similar decreases from a pre-treatment score of 68 to a post-treatment score of 52 and finally to a 42 at the two-year follow-up point.
Ulcerative Colitis
Summary
Ulcerative colitis is a long-term condition where the colon and rectum become inflamed. The colon is the large intestine (bowel) and the rectum is the end of the bowel where stools are stored. Small ulcers can develop on the colon’s lining, and can bleed and produce pus.
Evidence
Study 1: Keefer et al., (2013)9 explored the feasibility of Hypnotherapy on clinical remission status on a 1-year period in 54 UC patients with a historical flare rate of 1.3 times a year. The patients were split into two groups: gut-directed hypnotherapy (n = 26) or attention control (n = 29). Both Groups were given seven sessions of their respective interventions, then followed for 1 year. The primary outcome as the proportion of participants in each condition that had remained clinically asymptomatic through 52 weeks post treatment.
Results: The hypnotherapy group reported a greater amount of days in remission than the control group (p = .03). A comparison of the groups on maintaining remission at 1 year was also significant ( p = .04), with 68% of the hypnotherapy condition and 40% of the control condition maintaining remission for 1 year.
Hypnotherapy Research for Pain Management
Evidence
See Also: Depression Study 3 and PTSD Study 5.
Prasetya, Kusumawati & Wardiyatmi (2021)20 examined the effectiveness of hypnotherapy in reducing pain in patients with cervical cancer. The experiment used a random controlled trial over 8 months in 2019. A sample of 90 patients were used, with half of the patients (n = 45) receiving hypnotherapy and half of the patients being assigned to the control group who received standard care. Levels of pain experienced by patients were measured by a numerical pain scale ranging from 0 to 10. Hypnotherapy was delivered to patients once a day over seven consecutive days.
Results: the mean pain scores from patients after hypnotherapy (m = 0.8) were lower than the control group (m = 3.2), with this difference being statistically significant (p < .001).
Jones et al., (2006)21 examined the efficacy of hypnotherapy in a group of 28 patients with non-cardiac chest pain. After a four week baseline period, Patients were randomly sorted into one of two groups: The hypnotherapy group (n = 15) or the supportive therapy plus placebo medication group (n = 13). Both groups received the treatment over a 17 week period. The primary outcome measure was global assessment of chest pain improvement. Secondary variables were score changes in quality of life, pain severity, pain frequency, anxiety and depression, as well as any alteration in medication use.
Results: 80% of hypnotherapy patients compared with 23% of control patients experienced a global improvement in pain (p = .008), which was associated with a significantly greater reduction in pain intensity (p = 0.46), however not frequency. Hypnotherapy also resulted in a significantly greater improvement in overall well being in addition to a reduction in medication usage.
Spiegel and Bloom (1983)22 assigned 54 women with chronic cancer pain from breast carcinoma to either standard care (n = 24) or weekly expressive-supportive group therapy (n = 30) for up to 12 months. The hypnosis intervention was directed toward enhancing patient competence and mastery in managing pain and stress related to cancer. Hypnotic training included suggestions to “filter out the hurt” of any sensations by imagining competing sensations in affected areas. Patients were also given instructions for using self-hypnosis outside of the group-therapy sessions.
Results: Both treatment groups demonstrated significantly less pain and suffering than the control sample. Hypnosis was not the main focus of the expressive-supportive group-therapy sessions, however, patients who received hypnosis in addition to group therapy reported significantly (p < .05) less increase in pain over time (as cancer progressed) compared to patients who did not receive the hypnosis intervention.
Elkins et al. (2004)23 conducted a prospective, randomized study of the benefits of hypnotherapy on 39 advanced-stage cancer patients with malignant bone disease. Patients were randomized to receive either weekly sessions of supportive attention or a hypnosis intervention. Patients assigned to the hypnosis intervention received at least four weekly sessions in which a hypnotic induction was completed following a standard transcript. The transcript included suggestions for relaxation, comfort, mental imagery for dissociation and pain control, and instruction in self-hypnosis. In addition, patients in the hypnosis intervention were provided with an audiocassette tape recording of a hypnotic induction and instructed in home practice of hypnosis.
Results: The hypnosis intervention group demonstrated an overall decrease in pain (p < .0001) for all sessions combined. The mean rating of the effectiveness of self-hypnosis practice outside the sessions was 6.5 on a 0-to-10 scale.
McCauley et al. (1983)24 conducted a prospective trial comparing hypnosis and relaxation training for chronic low-back pain. Seventeen outpatients were assigned to either self-hypnosis (n = 9) or relaxation (n = 8). The baseline was an EMG-assessment session and 1 week later the patients began eight individual weekly sessions.
Results: No significant change in any outcome measure was observed during the 1-week baseline period. Patients were assessed 1 week after the completion of treatment and then again 3 months after the treatment ended. Patients in both groups were found to have significant reductions in pain as measured by the McGill Pain Questionnaire and visual analogue ratings.
Gay et al. (2002)25 compared the effectiveness of hypnosis and Jacobson relaxation for the reduction of osteoarthritis pain. Thirty-six patients with osteoarthritis pain were randomly assigned to one of three conditions: hypnosis, relaxation training, and a no-treatment/standard-care control condition. The hypnosis intervention consisted of eight weekly sessions that began with a standard relaxation induction followed by suggestions for positive imagery, as well as a memory from childhood that involved joint mobility.
Results: Patients in the hypnosis treatment showed a substantial and significant decrease in pain intensity after 4 weeks of treatment, which was maintained through 3 months and 6 months of follow-up. In comparison, patients in the no-treatment control condition reported little change in pain during the 6 months of this trial. However, although significant differences between the hypnosis and the standard-care control condition were found mid-treatment (4 weeks after treatment started), post-treatment, and at follow-up, the differences between the effects of the hypnosis intervention and the relaxation control on pain reduction were not statistically different.
Simon and Lewis (2000)26 examined the effectiveness of hypnosis on temporomandibular pain disorder in 28 patients. Measures of pain symptoms (pain intensity, duration, and frequency) were assessed on four separate occasions: during wait list, before treatment, after treatment, and at 6-month follow-up. Patients were also instructed to practice self-hypnosis daily with audiotaped recordings of the hypnotic treatment.
Results: The results indicated a significant decrease in pain frequency (p < .001), pain duration (p <
.001), and an increase in daily functioning. Analyses also suggested that the treatment gains were maintained for 6 months after treatment with reduced pain and improved daily functioning.
Haanen et al. (1991)27 randomly assigned 40 patients with fibromyalgia in a controlled study into groups that received either eight 1-hour sessions of hypnotherapy with a self-hypnosis home- practice tape over a 3-month period, or physical therapy (that included 12 to 24 hours of massage and muscle relaxation training) for 3 months. Outcome was assessed pre- and post-treatment and at 3-month follow-up. The hypnosis intervention included an arm-levitation induction and suggestions for ego strengthening, relaxation, improved sleep, and “control of muscle pain.”
Results: Compared with patients in the physical therapy group, the patients who received hypnosis showed significantly better outcomes on measures of muscle pain, fatigue, sleep disturbance, distress, and patient overall assessment of outcome. These differences were maintained at the 3- month follow-up assessment and the average percent decrease in pain among patients who received hypnosis (35%) was clinically significant, whereas the percent decrease in the patients who received physical therapy was marginal (2%).
Case Study 1: Artimon (2015)28 used hypnotherapy to treat a 53-year-old female with no psychiatric history but a high medical-surgical background due to her chronic pain symptoms. These started in October 2006 with stabbing and stinging pain in the left shoulder, radiating down the left arm to the elbow, increasing with movement but with no numbness. The pain apparently started because of a psycho-physical overload. After onset the patient received a litany of medical investigations and treatments. Psychological tests revealed high scores on depression and anxiety scales: a 37 on the Hamilton Depression scale and 33 on the Hamilton Anxiety scale.
Treatment: The patient agreed to a treatment plan that included pharmacological treatment (Alprazolam 1 mg/day) and hypnosis, initially for 4 to 6 weeks (for controlling anxiety and to enable the psychotherapeutic approach) and psychotherapy, which included mainly Ericksonian hypnosis and hypnoanalysis in combination with cognitive-behavioural techniques. The therapy was conducted over 1 year and 3 months, with sessions twice a week in the first month, then once a week, with a break of about 1 month approximately 1 year after initiating therapy, when the patient was abroad to visit her daughter (a total of 65 sessions).
Results: The therapy goals were achieved entirely, resulting in a complete resolution of the anxious- depressive mood and of painful symptoms. At follow-ups made at 3 and 6 months post treatment, it was found that these results were maintained; the patient no longer had any somatoform rebound and continued to have a good social and family functioning.
Case Study 2: Ramachanrada & Chaturvedi (2006)29 presented a 42-year-old female who reported psychosomatic body aches, pain, anxiety, depression, and disturbed sleep. She covered much of her face to conceal eczema and it had spread to her face, hands, and feet. Avoided mixing with others as she believed that it drew negative attention. Duration was 6 years with an insidious onset. Initially medical treatment helped her but subsequently dosage had to be increased including steroids resulting in unbearable side effects. Feelings of depression became more pronounced. At this stage she opted for hypnotherapy as a possible intervention.
Treatment: Psychological assessment revealed her to be an having difficulty in interpersonal relationships, anxiety and depression with occasional suicidal ideas, and poor self-concept. Excessive worry about the body-image, (thought her face not the same as it used to be) loss of beauty due to eczema seemed to be the core factors for her manifested complaints. Therapeutic strategy consisted of trance induction, deepening the trance, suggestions with enhanced positive imagery to counter the negative feelings and poor self-concept and posthypnotic suggestions.
Results: Each successive hypnotherapy session resulted in better eye contact, tone of talking, and expressing herself confidently. Dark patches on her face were visibly lighter after 7−8 sessions. A total of 1 sessions were held with appreciable improvement and the level of medication was gradually reduced to a bear minimum. Steroids were completely withdrawn. 6 months’ follow up showed the level of improvement was maintained.
Case Study 3: Thomson (2022)30 presented a case of a 17-year-old female with complex regional pain syndrome. The patient also had a history of juvenile idiopathic arthritis (JIA) that was in remission. Four years prior to treatment, during her parents disputatious divorce, the patient received a mild injury to her right foot during a game of field hockey. Over time, she experienced similar symptoms in her left foot, then her knees and both her hands. The patient had been a dancer and an athlete, all of which she gave up due to her significant symptoms. She was evaluated,
diagnosed, and treated at the Children’s Hospital. There she received both occupational and physical therapy along with corticosteroids and anaesthetic creams. The patient explained her treatment techniques for desensitization to temperature, vibration and impact. She had also been seeing a mental health counsellor. When she returned for her well child check, hypnosis was recommended as she had already been routinely using all of these modalities with limited success for 4 years.
Treatment: The patient was provided four sessions of hypnosis used strategies such as distancing, distraction, redirection and hypnotic dissociation. The therapist also utilized time distortion, symptom substitution and displacement of the sensation to a less bothersome area. Another technique was to selectively attend to the painful sensation and then alter it with switches, dials, colours and shapes.
Results: After four sessions of clinical hypnosis, the patient’s condition improved dramatically with nearly complete resolution of her symptoms. With hypnosis, the patient was able to make new associations by directly impacting her behavioural inhibition system and behavioural activating system. She was age regressed to hypnotically remember and re-experience a time before the injury
Case Study 4: Elkins, Koep & Kendrick (2012)31 presented a case study detailing hypnotherapy as an intervention for loin pain haematuria in a 17-year-old female patient. The patient complained of unilateral, uncontrolled loin pain and had been resistant to previous treatments that included pharmacotherapy and renal denervation. The symptoms were so severe that the patient had to withdraw from school and seeking the emergency room 9 times in as little as 2 months. The patient’s only remaining options were a surgery that carried a risk of the inability to carry a child to term, so the patient was offered hypnotherapy as an alternative treatment.
Treatment: The patient received eight 1-hour sessions total of hypnotherapy over the course of 5 months, with a follow-up given at 12 months. She was given questionnaires including the LF-MPQ and HADS scale at baseline, endpoint and at follow-up.
Results: At the time of the follow-up, the results from the scales that the patient filled out indicated a clinically significant reduction in pain, anxiety and depression as well as a nearly complete remission of the presenting symptoms. The patient’s scores on the HADS scale went from 28 at pre- treatment, to 14 post-treatment, to 0 at the follow-up. The patient’s scores on the LF-MPQ went from118 at pre-treatment, to 31 post-treatment and then to 0 at the 12-month follow-up.