Not every person is hypnotizable to the same degree; some aren’t hypnotizable at all. “Hypnotizability … is modestly correlated with absorption, a personality construct reflecting a disposition to enter states of narrowed or expanded attention and a blurring of boundaries between oneself and the object of perception,” writes John F. Kihlstrom, a psychologist at the University of California, Berkeley, in a 2013 paper in Cortex. “Absorption, in turn, is related to ‘openness to experience,’ one of the ‘Big Five” dimensions of personality.”
More than 200 years later, research in neuroscience is confirming at least parts of Mesmer’s outlandish theory. No, there is not magnetic fluid coursing through our bodies. But the power of mere suggestion — of imagination, as Franklin phrased it — is a more effective treatment than many modern skeptics might expect, causing real, measurable changes in the body and brain. Hypnotism has been shown to be an effective treatment for psychological problems, like phobias and eating disorders, but the practice also helps people with physical problems, including pain — both acute and chronic — and some gastrointestinal diseases. Physicians and psychologists have observed this with their own eyes for decades; now, many of them say that brain-imaging studies (not to mention the deep respect people tend to have for all things prefixed by “neuro”) are helping them finally prove their point.
But for the comparison between PHA and functional amnesia to be most meaningful, we need to know that they share underlying processes. One way to test this is to identify the brain activity patterns associated with PHA. In a groundbreaking study published in Neuron, neuroscientist Avi Mendelsohn and colleagues at the Weizmann Institute in Israel did just that using functional magnetic resonance imaging (fMRI). They carefully selected 25 people to participate in their experiment. Although all were susceptible to hypnosis, earlier testing had shown that half could respond to a PHA suggestion (labelled “the PHA group”) and half could not (the “non-PHA group”). In the Study session of their experiment, participants watched a 45-minute movie. One week later, in the Test session, participants returned to the laboratory and were hypnotized while they lay within the fMRI scanner. During hypnosis, people in both the PHA and non-PHA groups received a suggestion to forget the movie until they heard a specific cancellation cue.
Poor regulation of hypnosis and deeper relaxation techniques is more serious. Although several professional organizations exist, these groups do not regulate or certify practitioners in hypnotherapy or relaxation. Hypnotherapists with a conventional health care background (such as psychologists, physicians, dentists, and nurses) are regulated by their professional regulatory bodies. Psychotherapists who use hypnotherapy as an adjunctive treatment modality require appropriate training. Individuals who have received a master's degree in counseling or social work or a doctorate in clinical or counseling psychology will be likely to have received appropriate training and supervision.
Hypnosis is not a dangerous procedure. It is not mind control or brainwashing. A therapist cannot make a person do something embarrassing or that the person doesn't want to do. The greatest risk, as discussed above, is that false memories can potentially be created and that it may be less effective than pursuing other, more established and traditional psychiatric treatments.
Hypnosis or deep relaxation can sometimes exacerbate psychological problems—for example, by retraumatizing those with post-traumatic disorders or by inducing “false memories” in psychologically susceptible individuals. Evidence, although inconclusive, has raised concerns that the dissociation necessary to participate in relaxation or hypnosis can lead to the manifestation of the symptoms of psychosis. Only appropriately trained and experienced practitioners should undertake hypnosis. Its use should be avoided in patients with borderline personality disorder, dissociative disorders, or with patients who have histories of profound abuse. Competent hypnotherapists are skilled in recognizing and referring patients with these conditions.
“That study changed the whole landscape,” said Dave Patterson, a psychologist at the University of Washington in Seattle, who has been using hypnosis since the 1980s to help burn victims withstand the intense pain that comes with the necessary but excruciating bandage removal and wound cleaning. Since the ’90s, other well-designed, controlled studies have been published showing similar changes in brain activity. In another slightly trippy example, researchers suggested to people in a hypnotic state that the vibrant primary colors found in paintings by Piet Mondrian were actually shades of gray. “Brain-scan results of these participants showed altered activity in fusiform regions involved in color processing,” notes psychologist Christian Jarrett.
Hypnotherapy employs the use of hypnosis—an altered state of consciousness caused by little more than the power of suggestion—to help facilitate behavioral and emotional change. A trained hypnotherapist can cause a trancelike state in clients by using auditory, visual, or other perceptual cues. Once the person enters the hypnotic state, he or she is much more suggestible, making it easier to discuss memories, gain insight, and alter behavior.
Depending on the purpose of the hypnotherapy (i.e., smoking cessation, weight loss, improvement in public speaking, or addressing some deep emotional turmoil), follow-up may be advisable. When trying to eradicate unwanted habits, it is good practice to revisit the therapist, based upon a date prearranged between the therapist and the patient, to report progress and, if necessary, to obtain secondary hypnotherapy to reinforce progress made.
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The American Psychological Association published a study comparing the effects of hypnosis, ordinary suggestion, and placebo in reducing pain. The study found that highly suggestible individuals experienced a greater reduction in pain from hypnosis compared with placebo, whereas less suggestible subjects experienced no pain reduction from hypnosis when compared with placebo. Ordinary non-hypnotic suggestion also caused reduction in pain compared to placebo, but was able to reduce pain in a wider range of subjects (both high and low suggestible) than hypnosis. The results showed that it is primarily the subject's responsiveness to suggestion, whether within the context of hypnosis or not, that is the main determinant of causing reduction in pain.
Psychiatric nurses in most medical facilities are allowed to administer hypnosis to patients in order to relieve symptoms such as anxiety, arousal, negative behaviours, uncontrollable behaviour, and to improve self-esteem and confidence. This is permitted only when they have been completely trained about their clinical side effects and while under supervision when administering it.
We have, however, come a long way from the days of Mesmer’s animal magnetism. The increasing interest in mindfulness meditation suggests that mainstream acceptance of the mind-body connection is growing. This year, two well-received books by serious science journalists, Marchant’s Cure, out in January, and Erik Vance’s Suggestible You, out this month, explore this territory — the demonstrable results of hypnosis, faith, and even magic — long dismissed as pseudoscience or explained away as the placebo effect. Just last month, NPR reported that placebo pills work even when people know they’re taking a placebo. “Those are real, biological changes underlying those differences in your symptoms,” Marchant told Science of Us earlier this year. It’s all in your mind. But that doesn’t mean it’s not real.
Modern hypnotherapy is widely accepted for the treatment of certain habit disorders, to control irrational fears, as well as in the treatment of conditions such as insomnia and addiction. Hypnosis has also been used to enhance recovery from non-psychological conditions such as after surgical procedures, in breast cancer care and even with gastro-intestinal problems, including IBS.