How Does Hypnosis Work? Here’s What the Science Says

WWhen you think about Hypnosis, how do you imagine it? For many, it’s a clock-swinging magician or a comedy act that forces an unwitting volunteer to make embarrassing public admissions on stage.

Hypnosis is supported by a solid scientific foundation. It has been shown to relieve anxiety, help with weight loss and smoking cessation. This can be used to assist children and teenagers in regulating their moods and emotions. Some people can even use “self-hypnosis” to manage stress, cope with life’s challenges, and improve their physical and emotional health.

Hypnosis creates “a non-judgmental immersive experience,” says Dr. David Spiegel, a Stanford University psychiatrist and leading researcher of hypnosis. It’s been used in various forms for centuries, but it wasn’t until 1843 that the Scottish surgeon Dr. James Braid popularized the term “hypnosis.” Braid’s central discovery—that concentration can guide the brain toward a more suggestible state—was and remains controversial. Spiegel says doctors have used the technique with great success over the years.

A psychologist, psychiatrist or any other qualified healthcare practitioner in hypnotherapy will screen potential clients for their abilities to be hypnotized by a validated suggestion scale. Although not all people are equally vulnerable to hypnosis research shows that around two thirds of adult hypnotists are. They will be able to talk with the hypnotherapist about which sensory experiences they feel most comfortable, such as a vacation on the beach or lakeshore. Then, the hypnotherapist will conjure that imagery—focusing, for example, on the salt spray of the ocean, seagulls calling overhead, and sun-kissed skin—to help the person go deeper into the calming visualization. If done right, the patient’s physical surroundings will melt away.

The result is a powerful combination of dissociation, immersion, and openness to new experiences, which culminates in what was once called a “trance,” but which modern hypnotherapists simply refer to as a “hypnotic state.” It can be achieved in just a few minutes, Spiegel says.

Steven Jay Lynn from Binghamton University says that such scenes-setting techniques can help create an atmosphere for positive transformation. Hypnosis can open people up to suggestions from the hypnotherapist. These changes can be achieved in one or two hours for some. Hypnotherapy and self-hypnosis can be an integral part of a person’s mental health care. “Hypnosis can modify consciousness in many ways,” Lynn says.

This state of deep relaxation isn’t particularly difficult for most people to dive into or emerge from. It’s similar to a “flow state,” Spiegel says, or an altered state of consciousness in which a person is so immersed in a given activity, their focus narrows and their sense of time shifts. It’s also reminiscent of what happens during meditation, except instead of training people to tune into the present moment, hypnosis makes them more receptive to suggestion. Spiegel states that hypnosis can be done by anyone, just like meditation. In 2020, he co-founded Reveri, a subscription-based self-hypnosis app that’s structured a lot like Calm or Headspace. A user can access recordings that guide them into a hypnotized state, after which they’re given suggestions or statements that lead them toward a goal the person selects before the session. “We do it all the time,” Spiegel says of entering and exiting these mental states, “but in hypnosis you do it more.”

While brain imaging studies have provided some insight into the brain activity of those hypnotized, many things remain a mystery. Spiegel suggests that during hypnosis activity in the brain area that allows people to switch tasks slows down. This same region seems to disconnect from another area responsible for self-reflection and daydreaming—which may be why hypnotized people aren’t worried about who they are or what they’re doing. Research has also shown that hypnosis may calm the brain and help regulate autonomic functions such as heart rate, blood flow, breathing, and blood pressure. This is likely what leads to the physical relaxation that’s a hallmark of hypnosis, Spiegel says.

Lorenzo Cohen is the director of the University of Texas MD Anderson Cancer Center’s Integrative Medicine Program. This program allows for hypnosis to be used in many different settings. The center allows patients to choose from general or local anesthetics and hypnotherapy for some breast cancer surgery, such as lumpectomies. Those who choose the second option remain fully awake during their surgery, but a hypnotherapist first helps them enter a state of deep relaxation, or “hypnosedation,” Cohen says. “The local [anesthesia] should be doing its thing,” Cohen says. “The rest is in your head.”

Cohen is also working to research the effectiveness of hypnosedation. Cohen says that there have been more than 30 clinical studies supporting the idea. Cohen states that hypnosedation patients had less anxiety before surgery and required less pain medication afterward. They also reported less discomfort, pain, nausea and fatigue post-operatively than those who were given general anesthesia. “The hypothesis is that the patients who are under general anesthesia, even though they’re not conscious, are having an intense stress response,” he says. In cancer patients with compromised immune systems, this can reduce their ability to fight or flight. When patients choose hypnosis, Cohen believes the body’s fight-or-flight response may be reduced.

There are still many people who doubt hypnosis despite the growing evidence. Randomized controlled trials have found that hypnosis can help with pain and anxiety associated with a range of medical conditions, but even the best studies can’t meet the gold-standard of a double-blind design, Spiegel says. While patients and practitioners can be kept in the dark about what pill they’re administering or receiving, it’s almost impossible to design a study where neither side knows hypnosis is being delivered, he adds.

And historically, the power of hypnosis hasn’t always been wielded responsibly. The imaginative potential of hypnosis has been shown to create false memories—sometimes with devastating effects. At least 27 states ban hypnotically-elicited testimony from appearing in court. Hypnotherapists should avoid using the technique to “recover” memories, Lynn says.

Modern hypnotherapy is effective when it’s done by trained professionals and applied correctly. Susceptibility to suggestion is often “viewed as a liability or a weakness,” Spiegel says, “but it’s really a strength.”

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