How to know if hypnosis is for you

Need to know

In 2009, Jack Watkins, a psychologist and early practitioner of clinical hypnosis, wrote an article: ‘Hypnosis: Seventy Years of Amazement, and Still Don’t Know What It Is!’ His title says it all – even the experts have had a hard time agreeing on an exact definition of hypnosis. I’m an experienced clinical psychologist who uses hypnosis in my work, and in this Guide I will help you understand what hypnosis involves, give you an idea of the kinds of difficulties it can address, and show you how to try self-hypnosis, as well as how to find a suitably qualified therapist if you want to take things further. My hope is that you will come away feeling well-informed about whether hypnosis might be right for you and the people close to you – and what to do next to get started.

Hypnosis is a state and a procedure

Part of the confusion about hypnosis lies over the fact that the term ‘hypnosis’ can refer to a state or a procedure. What’s more, there has long been disagreement over how to understand the state of hypnosis, and about what the procedural process of doing hypnosis looks like.

Hypnosis is a state of focused or heightened attention (known as ‘absorption’) that is reflected in changes in key brain networks involved in mental focus and control. For example, when athletes say they are ‘in the zone’, they are describing a hypnotic state. Intuitively, if you’re going to be focused in on something, you have to be focused out of something as well. For this reason, when there is absorption, there is also dissociation. In this case, the dissociation refers to what you aren’t paying attention to anymore. In fact, ‘getting hypnotised’ involves a state shift or deepening – something happens to your level of attention that subjectively feels different from what it was a moment or two ago.

You don’t need someone to do something to make this state of hypnosis occur. Natural states of hypnosis (often referred to as ‘trance states’) – whether happening through intense focus and/or performance; tribal, spiritual, religious, and/or meditative experiencing; or even by accident (eg, daydreaming) – can occur naturally without guided intervention. They can also be elicited through a formal hypnosis procedure: this is often referred to as clinical hypnosis or hypnotherapy.

Hypnosis as a procedure involves different methods for eliciting – and, as necessary, deepening – a state of hypnosis. This skill in and of itself is not particularly difficult to master. Many people ‘do’ this to themselves when they meditate.

Suggestion plays an important role

Once in a hypnotic state, people are typically more open to suggestion. The process of offering hypnotic suggestion is where more skill and training on the part of a therapist are necessary – that is, knowing how best to present someone with language describing something they could imagine and/or experience. This could be anything from a statement, to an image or scene in the past, present or imagined future, to a bodily or somatic sensation, to the utilisation of an internal resource (your favourite teddy bear as a child, or something kind someone used to tell you), to a self or ego state (eg, bringing to mind a particular part of yourself that you feel good or confident about).

Here’s an example of a suggestion: ‘In a moment from now… I don’t know just when… but you will notice it when it happens… you may find yourself becoming aware of something that will make you feel more ____.’

Notice that this is a permissive suggestion rather than an authoritarian one. Decades ago, hypnotists were typically more authoritarian and they used more definitive and command-based suggestions. This was reflective of the cultural zeitgeist, but it can also be a way to cater to certain personality types (eg, some people might prefer being told directly what to do). In general, however, hypnotists today have shifted to a more permissive approach. You can think of this as pacing and subtly leading, while allowing the client to have a spontaneous experience that belongs to them. Not only is this a more collaborative and respectful process, but I would argue it is a more successful one.

This suggestive style builds trust and does not make presumptions about what will unfold. It also increases the likelihood of something called trance ratification. This refers to a subjective experience in hypnosis – ‘Wow, this is working!’ – that, in and of itself, deepens the perception of being hypnotised. Part of the skill of a hypnotherapist is knowing how to utilise language and pacing; having an intuitive and informed understanding of who they are working with; and responding to the ‘here and now’ in order to craft suggestions that lead their client in a therapeutically helpful direction, while also lending them agency to shape the experience.

Notice too how I left a blank space at the end of the above example suggestion. This was to demonstrate that a good clinician who uses hypnosis will choose language that fits their clients’ needs, background, goals and psychological disposition.

The importance of hypnotisability and suggestibility

Before we dive into to some examples of the practical ways hypnosis can help you, there are two more concepts it’s important to understand. Hypnotisability refers to a person’s ability to enter a state of hypnosis. On the other hand, suggestibility refers to a person’s willingness to accept a suggestion. Both of these characteristics are trait-based qualities, meaning that they follow a bell-shaped distribution curve in the population. For example, about 15 per cent of the population have high degrees of hypnotisability, 15 per cent have low degrees of hypnotisability, and everyone else falls in the middle. People who are highly hypnotisable are more prone to deeper states of hypnosis; people with low hypnotisability may be able to experience only states of light hypnosis or none at all.

High hypnotisability is especially helpful where suggestions of hypnotic analgesia are being used – for pain reduction and numbing. While you don’t need to be highly hypnotisable to benefit, it can be helpful in circumstances where hypnosis is being used in place of anaesthesia or pain medication, such as during childbirth or surgery. However, with many applications of clinical hypnosis, such as in the case of anxiety or stress management, hypnotisability is not as important.

Suggestibility can also play a role in the hypnotic process. If we think in conventional non-hypnosis terms, someone who is highly suggestible might be referred to as gullible; someone who has low suggestibility might be referred to as cynical. Just as in these ‘waking state’ contexts, people also vary in their degree of suggestibility during hypnosis.

But suggestibility is more than a trait; for most people, their relationship with the person doing the suggesting and the context make a huge difference, too. You could be someone who is generally less suggestible, but you might be more inclined to accept the suggestions of someone you trust, such as a therapist with whom you have a relationship and who provides you with clinical hypnosis. I recently worked with a client for short-term smoking cessation hypnotherapy. (In keeping with the ethical guidelines of the American Psychological Association, I take steps to hide client identifying information when writing about clinical anecdotes.) She described herself as a rebellious type who questioned authority. This would fit the description of someone with low suggestibility. But she also had lung cancer, and was highly motivated to stop smoking. Additionally, we had good rapport. Given this, she responded well to the personally tailored hypnotic suggestions that I gave her in the hypnosis session.

A client’s relationship with their hypnotherapist has a significant role in predicting how effective hypnosis and hypnotic suggestions will be. I chaired a panel discussion on this subject in 2018, which we wrote up as a paper arguing that it makes no sense to focus only on the state of hypnosis and the procedural techniques of hypnosis. Arguably the most important ingredient is the relationship. This isn’t just about ‘Do you trust your hypnotherapist?’ The very process of how hypnotic suggestions are given – the timing, the vocal prosody, the synchrony of experience between therapist and client – is based on a deeply relational process of attunement that happens on a non-verbal level. Part of what can make a hypnosis experience feel intense and curative is the intuitive sense that your hypnotherapist is ‘in the zone’ with you.

If you’re curious about whether hypnosis could help you, and what it would be like to work with a clinical hypnotherapist, in the next section I’m going to walk you through several concrete examples of how it can be used to improve mental health and wellbeing. I will give you a sense of the kind of exercises that are involved, including taking you through a process of self-hypnosis so you get a first-hand feel for the experience.

What to do

Hypnosis can be used to relieve anxiety

At its core, anxiety is an anticipation of a negative outcome and a subsequent emotional, cognitive and somatic (bodily) response. Clients of mine with anxiety will often ask me if hypnosis can help them, to which I reply: ‘Would you agree that your anxiety is a suggestion?’ Almost all of them say ‘Yes’, which makes sense because, regardless of whether it is conscious or subconscious, on some level they are suggesting/predicting/expecting/bracing for a negative outcome. I tell them: ‘We know that you are hypnotisable because you have demonstrated that you can give yourself a (negative) hypnotic suggestion. Now imagine how much you can help yourself as you learn how to use this skill to create positive suggestions.’

One area of anxiety treatment for which hypnosis is particularly helpful is in providing grounding or anchoring. This can involve focusing on a stabilising detail, such as the sensation of having your feet on the floor, or your thumb moving in a circular rhythm as it gently presses on the forefinger. It can also involve pairing suggestions related to multiple sensations to create a containing ‘layering’ effect. For example, I might begin by asking a client to notice the sensation of their belly moving with their cycle of breathing (out when they breathe in, in when they breathe out). After confirming their awareness of this experience, I might use a parallel metaphor of ocean waves that move in a similar cycle. Next, I might ask them if they would be OK with imagining themselves on a beach while watching the repetitive cycle of the waves as they feel their breath moving in a similar fashion. From there, we could integrate other helpful sensory aspects of being at a beach (tactile sensations of temperature, dryness/moisture, and malleability of sand; auditory sensations of waves crashing; visual sensations of sunlight glistening on water).

Hypnosis-based grounding of this kind helps alleviate anxiety by emphasising the suggestion of self-constancy across changing experience. It means that even as you feel change or experience change around you, you can maintain an experience of constancy and cohesiveness across such changes. This is a reassuring realisation that buffers against the fear of annihilation, which often underpins many anxieties. Although the processes of breathing and the tide contain various highs and lows (deep breathing and high tide, shallow breathing and low tide, rapid breathing and stormy surf, slow breathing and peaceful surf), there is always a constant rhythm that underpins these change states: ‘The tide always goes out and in, just as you always breathe out and in.’ To reinforce the message, I might say at this point that ‘No matter how the pace of your breathing may change from moment to moment, your breath breathes itself… you don’t have to do anything at all, it just happens all by itself… and you’ve been breathing from the moment you were born, and you will continue to breathe your whole life.’ This is a type of hypnotic suggestion called a truism – a reassuring statement that is undeniably true.

Hypnosis can be used to manage pain

Significant evidence demonstrates that hypnotic analgesia (the decreased ability or inability to feel pain) can meaningfully reduce the experiencing of pain for people coping with conditions involving chronic and acute pain. Many integrated neural networks involving activity at cortical and subcortical sites are relevant to the perception and experiencing of pain. Different hypnotic suggestions appear to target different aspects of these networks.

For instance, if I was working with a client to help alleviate their pain, I might give them direct suggestions to imagine analgesia (decreased pain), numbness, or symptom substitution – for instance, imagining that a stabbing pain is transformed into a pulsing sensation. This might include suggestions to imagine ‘flipping switches’ for the purpose of inhibiting – ‘turning off’ – pain signals. Alternatively, if I wished to help a client alter (rather than simply reduce) their pain experience, I might propose suggestions for cognitive or perceptual change, or dissociation, for example by suggesting that they imagine warm or cool sensations. If I was seeking to help a client distance themselves from their pain experience, I would use a different approach again, such as developing suggestions that emphasise distraction or an alternative and pleasurable form of experience, including fantasy, being in a different place, or time distortion. For instance, I might suggest they imagine being in a ‘safe place’ that provides them with feelings of calm and security.

In contrast, if I was helping a client seek a more mindful awareness of their pain experience, I might give hypnotic suggestions for increased sensory information or awareness. I might even suggest a temporary increase in pain sensation to help illustrate to a client that they can use hypnosis to change the experience of a sensation simply through the power of suggestion. This might sound counterintuitive, but it’s an example of ‘trance ratification’ that I mentioned earlier. Usually, seeing the power of suggestion to increase pain makes it easier for a client to subsequently decrease pain phenomena through suggestion in hypnosis.

Hypnosis can help to break bad habits

A therapist cannot treat an unhealthy habit without understanding and treating the person who has the habit. This is where hypnosis can be most helpful. To show why, I’ll use the example of using hypnosis to help a person stop smoking where the best results come from personalising the approach to the individual client. For instance, I might use my hypnosis suggestions to modify specific aspects associated with the habit, such as the so-called ‘setting’ and ‘context’. So, I might have them imagine a movie with a beginning, middle and end, which shows them smoking in the same setting over time, as the context generally changes from positive to negative. This could be seeing themselves initially smoking in a social setting when younger, then the setting becomes more isolated over time as they age and smoking becomes less socially acceptable. Or we could play imaginatively with the appeal of smoking as a ‘break time’, and imagine themselves still taking the break but going for a refreshing walk around the block instead.

Alternatively, I might provide hypnotic cues for ‘being a non-smoker’, for example by focusing on strengthening a person’s connection to their future as a non-smoker. The best example of this is to modify the perception of time in hypnosis. As the person becomes more hypnotised and begins to confirm being able to experience positive sensory suggestions – such as deep, slow and pleasant breathing – I might tell them that they can imagine the experience of time slowing down in trance. It can feel like they’ve been breathing healthily for even longer than the time they’ve been in trance. Then I’ll simply observe that they have been a non-smoker for every moment that has passed in the trance and, now that they know this is possible, it will become easier to be a non-smoker when they become alert again after the trance. I’ll give them a truism, which is that the body is designed to heal itself and, every moment that they don’t smoke, the red blood cells bring restorative oxygen to the lungs to help them begin to heal. When they ‘re-alert’ post-trance, it will be easier and easier to allow this process to continue to occur on its own, without the interference of smoking, since they are no longer a smoker.

Some clients need help making their ‘reasons for stopping’ more viscerally tangible. Imagine a client tells me they want to give up vaping so that they can lead a healthier, more active life. In this case, I might ask them to imagine themselves jogging in a park on a sunny day and feeling the wind on their skin, and the ease of their healthy lungs providing nourishing oxygen to their body as they feel their legs and arms moving back and forth. To strengthen the suggestion, I might use prompts such as: ‘Isn’t it nice to know that your lungs and the rest of your body can work so seamlessly together… just as the different parts of your mind can feel integrated in working to maintain your growing good health?’

Hypnosis can relieve unexplained medical problems

Hypnosis can also be used to relieve physical symptoms that have no clear medical cause or pathology (also known as ‘functional disorders’ in some medical contexts). For example, more than a dozen randomised controlled trials have shown that hypnosis has strong efficacy in the treatment of irritable bowel syndrome (IBS), including providing significant and lasting gut pain relief and the alleviation of other symptoms in clients. In contrast, traditional medical and conventional treatments have often proved ineffective for IBS clients.

Hypnosis scripts for IBS typically emphasise calming scenes in natural settings. The therapist will also use hypnotic suggestions to decrease their clients’ attention to their gastric symptoms, to alter their perceptual experience of these symptoms, to increase their subjective sense of their health and wellbeing, the normalcy of bowel functioning, and to increase their immunity to unpleasant stimuli such as intestinal pain, bloating and diarrhoea. One of my favourite naturalistic hypnotic metaphors that demonstrates this comes from the work of the pioneer of IBS hypnosis, Olafur Palsson. Following his procedure, clients are encouraged to feel safe and calm by asking them to imagine being inside a secure mountain log cabin. There are a series of suggestions about the thickness, strength and insulation of the logs from the unpleasantness of the winter storm outside.

Self-hypnosis can give you a feel for what’s involved

Self-hypnosis is one-person hypnosis and it’s often most effective after you’ve worked with a hypnotherapist. However, I’ve provided a self-hypnosis practice exercise below so that you can get a modest feel for what hypnosis involves. The wording is inevitably generic (rather than personalised to your needs), and it is not intended as therapy or as a replacement for therapy. Please use it at your own discretion, as you feel is appropriate. It is permissively structured and, as with all hypnosis suggestions, you can modify it to fit what intuitively feels right for you.

This exercise draws upon certain principles of anxiety treatment to foster an implicit sense of safety, and thus can be helpful for anxiety or stress management, as well as conditions such as IBS and pain.

Self-hypnosis practice exercise:

• Focus on a point ahead of you. As you draw your attention to this point, allow your gaze to become soft and relaxed.
• As this happens, you can either continue to maintain eyes open or allow your eyelids to close.
• Bring your attention to your breath and imagine it gently slowing. Take a few moments to bring your breath to a 10-second cycle (4 seconds inhalation, 6 seconds exhalation). As this happens, you may begin to notice yourself slowing down and feeling more calm.
• After a few cycles of breathing like this, you can just let your breath go to its natural pace and continue in the background.
• Take a moment to focus on sensory aspects of feeling somatically grounded (eg, notice the feel of your feet on the floor, the support of a chair against your back and legs, and your hands in your lap or by your side). It can even be helpful to silently repeat statements about this somatic grounding as it happens (eg, ‘I’m sitting in the chair… with my feet on the floor… and my hands by my side…’).
• Allow your mind to drift naturally to a place that feels safe, either one that you have been to before or that your mind spontaneously imagines. You can let your mind connect with various sensory aspects of being present in this place (eg, imagine its sights, sounds, tactile sensations, smells and taste). Some people prefer to imagine being immersed or engaged in such a place – for instance, fantasising about enjoying themselves in the safe space. Others prefer to enjoy imagining themselves as being protected from external events, such as arguments, storms or whatever comes to mind. If nothing comes to mind, you can simply imagine being ensconced in a protective bubble and bask in a feeling of internal peace.
• As you experience this wellbeing, notice whether an affirming self-statement that is subjectively right for you comes to mind. This might be specifically related to why you are practising self-hypnosis (eg, how you wish to feel, how you wish to relate with yourself) or it might be a more general positive affirmation. If nothing comes to mind, you could select two words to match your inbreath and outbreath (for example, ‘strong… calm’) and repeat these words as you focus on your breath and being in this safe place.
• Optional: you could give yourself a post-hypnotic suggestion, and a cue to elicit that suggestion, to remember and allow you to re-experience this self-hypnotic state automatically after the exercise is over. For example, you could notice your thumb and forefinger gently circling (this would be the cue), and tell yourself that when this happens – either subconsciously (ie, you just find yourself doing it), or when you consciously choose to do it – that you will once again feel the physical and emotional calm and peace of being in this safe space.
• Finally, to end the exercise, count up from one to 10. With each number in the count, give yourself the suggestion that you will feel more alert, aware and present in the room, culminating in a state of full alertness by the time you reach the number 10. If for some reason you do not feel fully alert, take a few more moments to take in the experience of feeling fully present. You can additionally wiggle your fingers or toes, or run your hands along your face if this is helpful in feeling more alert and aware.

While this exercise can give you a modest sense of what hypnosis is like, it is important to emphasise that it is not a substitute for working with a therapist. Hypnosis with a therapist (eg, clinical hypnosis, hypnotherapy) has more techniques and approaches available than practising self-hypnosis on yourself. It can also feel more robust because it involves a mental health clinician trained in hypnosis subjectively creating hypnotic suggestions for you based on their understanding of your personality, diagnosis, symptoms and needs. In particular, the experience of your hypnotherapist utilising vocal prosody (eg, pacing, tone of voice) and synchrony of suggestions, paired with your unfolding physiological experience in trance, is often experienced as particularly therapeutic. Additionally, there are certain types of hypnotic language and suggestions that serve to ratify and deepen states of hypnosis, and/or are used with specific therapeutic intent. These require training and expertise, and are often more difficult to incorporate into self-hypnosis. Finally, because the state of hypnosis undertaken with a therapist involves frontal cortex disinhibition – meaning it bypasses the part of the brain responsible for conscious cognition and planning – it is inherently different from self-hypnosis, which to varying extents involves a self-directed, and thus more conscious, experience. In this respect, self-hypnosis, depending on how it is practised, can more closely resemble mindfulness meditation.

As I mentioned, self-hypnosis is most useful, generally speaking, when practised after working with a therapist. You might work with your therapist on a few self-hypnosis exercises to practise, based on the therapeutic work the two of you have been doing together. In this same vein, I will also periodically, in consultation with my clients, record our hypnosis sessions with the specific intent and purpose of their being used for self-hypnosis practice. This is often a great transition to self-directed self-hypnosis practice. One advantage of listening to a recording is that it allows people practising self-hypnosis to experience something akin to hypnosis without devoting conscious mental resources towards ‘guiding’ the hypnosis, which can make it easier to go into a deeper state of trance. The same is true of more recently emerging smartphone hypnosis apps, although great care should be used in researching and selecting ones that use evidence-based interventions.

I hope by now you have a good sense of what hypnosis involves, how it works, and the kind of difficulties it can be used to treat. The examples I’ve given of how hypnosis is used therapeutically are far from exhaustive – for instance, it can also be used to help people cope with childhood attachment difficulties; build self-esteem and confidence; and manage depression symptoms. One application of hypnosis that is especially important in mental health is as an adjunct to many different types of therapy for trauma. Hypnosis can be applied in trauma treatment in multiple ways, from helping to manage dissociation, to working through traumatic memories, to helping clients develop greater emotional self-regulation.

If you believe that undertaking hypnosis with a therapist might be beneficial to you or someone you know, in the final section of this Guide (Learn More) I give some advice on finding a suitable therapist to work with.

Links & books

In this blog post at Attune Philadelphia Therapy Group (my clinical practice), I provide a basic introduction to hypnotherapy.

On the episode ‘Modern Hypnosis 101’ of the We’re All Crazy! podcast, the clinical psychologist Stephanie Heck and I discuss how hypnosis is practised in modern times.

The book Affect Regulation Toolbox: Practical and Effective Hypnotic Interventions for the Over-reactive Client (2007) by Carolyn Daitch is geared towards practitioners, but can be understood by the general public. It’s a very readable book about using hypnosis for anxiety disorders.

The book Trancework: An Introduction to the Practice of Clinical Hypnosis (5th ed, 2018) by Michael Yapko is a broader book, aimed at practitioners, about the general practice of clinical hypnosis but another one that’s easy for all to read and understand.