Can hypnosis really help with anxiety, depression, pain management and obesity?

In the 1770s, a German physician named Franz Mesmer made a splash when he said he could cure physical and mental ailments by putting people in a trance to realign their magnetic fields. “Mesmerism” was popular for about a decade until it was publicly discredited in 1784, but some elements of the practice persisted.

In 1841, the Scottish surgeon James Braid started using a similar technique of fixed attention to cure headaches, alleviate pain and anesthetise patients. He called it hypnosis, after Hypnos, the Greek god of sleep.

Today, hypnosis, also called hypnotherapy, has a lot more data to back up its use for mental health conditions like anxiety and depression. It can also be an effective treatment for sleep problems, pain, irritable bowel syndrome and quitting smoking, studies show. And it’s still occasionally used as a way to sedate patients for surgery with little (or no) medication.

Despite all of these varied applications, hypnosis can’t seem to shake its reputation as a stage gag – in which you might stare at a pocket watch and then cluck like a chicken – or a way to retrieve lost memories and probe “past lives.” (The former can be misleading and the latter is pseudoscience.)

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The simplest way to describe hypnosis is as a state of both deep relaxation and focused attention, where your mind is more receptive to making subtle changes in feelings and behaviours.

The intense concentration and focus of hypnosis may sound foreign, but it’s not unlike “being absorbed in a good book or movie, getting lost on the internet or scrolling on your phone,” said Dr Elvira Lang, a radiologist and founder of Comfort Talk, a service that trains medical staff to reduce anxiety and pain in hospital patients using hypnotic language (named that way since people are often afraid of what she calls “the H word”). You are absorbed, less aware of your physical or sensory surroundings, rapt and yet at ease.

The aim is for the suggestions you hear in that trance-like state to shift your perspective, feelings and eventually behaviours.

Formal therapeutic hypnosis has a few more steps. First a hypnotist will try to induce a hypnotic state by getting you to relax and focus on their words. Once you are induced, they will talk you through suggestions based on your goals for the session. If you’re trying to get over a fear of flying, they might tell you that the plane is an extension of your body and get you to imagine floating with the plane through the sky.

The patient should become so focused on the hypnotist’s words that everything else falls away, said Dr David Spiegel, a psychiatrist at Stanford University and a leading hypnosis researcher. The aim is for the suggestions you hear in that trance-like state to shift your perspective, feelings and eventually behaviours.

In addition to traditional in-person hypnosis, there are hypnosis sessions online and a crop of apps with prerecorded video and audio; some will also connect you with hypnotists remotely. Those are usually generic and work on common issues like insomnia and smoking.

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Tonja Langis, 47, was diagnosed with complex post-traumatic stress disorder, which, for her, is accompanied by chronic pain, anxiety and a loss of self-confidence. She’s been in individual and group therapy for trauma for the past 11 years and has tried a range of therapies. Langis started small-group hypnosis therapy sessions almost a year ago, and now does one-on-one sessions once a week with her psychologist in Nashville, Tennessee.

During sessions, Langis said there’s a “detachment from the pain sensations” that she normally feels, and that she feels “really comfortable” in her body. “It feels like a deeper state of relaxation than meditation,” she said.

Everyone’s pain is individual, with different causes and reactions to treatment. But “it’s very clear by now” that hypnosis can be effective for pain, said Afik Faerman, a postdoctoral researcher in clinical neuropsychology who has done work with hypnosis. Pain management is one of the most-studied applications of hypnosis, he said, with research suggesting that it’s effective for helping people deal with both acute and chronic pain.

People with extreme mental illness, schizophrenia and other forms of psychosis are not good candidates for hypnosis.

Langis said that hypnosis has helped her with irritable bowel syndrome. Since starting, “I’ve only had two flares, which is a huge reduction for me.”

The conditions Langis deals with – chronic pain, inflammatory bowel syndrome, stress and anxiety – are some of the ones hypnosis is most commonly used for. It’s also frequently used for insomnia and addiction. But it won’t work for everyone.

People with extreme mental illness, schizophrenia and other forms of psychosis are not good candidates for hypnosis, Dr Lang said, in part because they tend not to be hypnotisable, and also because the treatment can be emotionally difficult for people with these conditions.

Hypnotisability itself is another limitation. One person might go under immediately and readily take suggestions, while another will never feel themselves slip into a hypnotic state.

The ability to be hypnotised lies on a bell-shaped curve, Dr Spiegel said. Research suggests that 10 to 15 per cent of people are incredibly hypnotisable, while another 10 to 15 per cent either struggle to be hypnotised or can’t experience it at all. The rest, the majority of us, are somewhere in between – mildly to moderately hypnotisable.

It’s hard to tell how hypnotisable you are without a formal screening. Dr Lang said she has seen extremely skeptical people turn out to be very hypnotisable, and people who are excited to try hypnosis discover it doesn’t work for them.

“I view hypnosis as a talent or an ability,” like a good ear for music, said Mark P Jensen, a health psychologist at the University of Washington School of Medicine. “Some people are Mozarts, but most of us aren’t.”

Hypnosis is best used when combined with different types of therapy, like cognitive behavioural therapy, Dr Faerman said. “Hypnosis plus CBT is more effective than either of them individually,” he said, as evidenced by research on its effectiveness for treating obesity, pain and distress in people with fibromyalgia and acute stress disorder.

For Lindsey C McKernan, a clinical psychologist at Vanderbilt University Medical Center who uses hypnosis in her practice, training in the practice came with her training as a clinical psychologist. But not every clinical psychologist will necessarily have such training. To find a hypnotist, first seek out therapy with a licensed therapist who can either work with you on hypnosis or direct you to someone who can. (Experts recommend first seeing a licensed professional before starting with apps or recordings.)

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As a hypnotist, Dr Spiegel said, “my job is to identify your ability to be hypnotised, and stimulate and teach you how to use this ability to solve a problem.” Like with other therapies, seeing results with hypnosis will take time and practice. If you’re dealing with a chronic condition, that will require regular treatment.

Rachael Howe, 32, has been dealing with chronic pain in her back since she herniated three disks between 2013 and 2016. Both her physical pain and mental distress prevented her from getting restful sleep. Howe, who lives in Auburn, Wash, tried years of physical and talk therapy in addition to medication, but they didn’t help very much, she said.

It’s not like it works 100 per cent of the time, but the more you do it, the more you get out of it.

About a year and a half ago she tried a remote hypnosis session after a referral through a previous therapist. In an early session for relaxation and sleep, her psychologist took her on an imagined walk through the Cascade Mountains, where she had gotten married. He described arrows on the ground that would each lead her to deeper levels of relaxation.

As she walked, Howe recalled, she felt her pain fade away as her body loosened its tension. “I actually ended up falling asleep,” she said – her therapist ended the session and they rescheduled. “I can’t believe I actually got a couple of hours.”

Howe has done many sessions since, focusing on increasing calm, managing pain and reframing negative thoughts. “The ideal scenario is for patients to work with a hypnotist and learn the skills to go through these sessions themselves,” said David Patterson, a pain specialist and clinical psychologist at the University of Washington School of Medicine who is Howe’s clinician. Practicing this way is especially important for conditions “like chronic pain, where you need relief over a long period of time.”

Langis noticed that the immediate relief from pain and fatigue she gets through hypnosis wanes after a few days. She regularly re-ups, going through recordings of her previous sessions. She said she feels herself going deeper into the hypnotic state over time. “As I practice more, I’m seeing more and more benefit, and so I’m becoming more encouraged to practice more,” she said.

After re-listening to sessions and practicing staying in a hypnotic state, Howe said she feels she now has the discipline and skill to calm her body and mind when pain flares.“It’s not like it works 100 per cent of the time,” she said, but “the more you do it, the more you get out of it.”

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By Hannah Seo© The New York Times Company

The article originally appeared in The New York Times.

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