Introduction to hypnotherapy and how it works

In this article we review some basics of hypnotherapy, some of the common techniques used and some ideas on why and how it works.

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What is hypnotherapy

Hypnosis is the process of making a subject enter a trance-like altered state, in which suggestions may be given to the subconscious of the person in trance, which may enable them to heal or improve some aspect of their lives when they return to the waking state. A kind of therapy using hypnosis is called hypnotherapy. Hypnotherapy can be used to help the subject overcome a range of problems such as high stress or depression, phobias (such as public speaking), addictions (such as smoking or over eating) and illnesses and become more confident, more fit, more assertive and so on.

Representation of the conscious, subconscious and unconscious mind. Our conscious mind is just like the tip of the iceberg. Hypnosis enables us to tap into our subconscious and make effective changes in our lives

The basic idea is that we all have a subconscious which is powerful but untapped, and its power can be tapped during hypnotherapy to make positive changes in our lives. All healing comes from the subconscious, which acts as a bridge between our waking selves and spiritual selves. Our subconscious carries imprints of both good and bad experiences and traumas from our past, that effect the way we behave or relate to others. Therefore, giving suggestions to our subconscious during a hypnotic trance has a more powerful effect in making effective changes in our waking states.

Hypnotherapy can be used either in isolation or in combination with other therapies such as Mindfulness based stress reduction (MBSR), Neuro Linguistic Programming (NLP), Cognitive Behavioral Therapy (CBT) etc to solve particular problems. Different kinds of therapies work in different ways and have their own complementary (and sometimes overlapping) strengths and weaknesses. Hypnotherapy works better when an issue in the subject’s life has a strong psychological or mind element to it, such as in getting extra confidence, combating an addiction such as smoking, or getting rid of a common phobia.

There are many other types of hypnosis, some of which are:

1. Self hypnosis is the process in which a person induces themselves in and out of a trance, for example by listening from a recorded script. They can perhaps record it themselves by reading from a written script.
2. Conversational hypnosis is bringing a person into a hypnotic trance state by simple conversation.
3. Stage hypnosis is what is performed on a stage or in front of a live audience, and is what most people associate as hypnosis

One important thing to keep in mind is that all hypnosis is self hypnosis. Nobody can make someone to enter a hypnotic trance or to make changes in their lives as a result of a hypnotherapy session. The hypnotist at best empowers or enables the subject to heal or change themselves. The hypnotherapist only gives suggestions when the subject is in trance, it is up to them to act upon those suggestions. So hypnotherapy works best when the subject wants to change some aspect of themselves willingly, rather than being coerced to visit the hypnotherapist by family or friends.

We form our own worlds through the mind. We cannot change what is external to us, but how our minds react to our problems is completely internal. We can train our minds through hypnotherapy and other techniques to react to everything in a more healthy manner.

Normally, in the first visit to the hypnotherapist, the subject is asked about their history and the aspect of their life they wish to change. One may need multiple hypnotherapy sessions to reach the desired change. Often, a problem the subject wants to improve (such as not getting sleep) may be a combination of multiple, smaller, problems (such as a traumatic event combined with stress about their job and lack of confidence). There are a range of techniques in a hypnotherapist’s toolbox to handle all such issues in one or multiple sessions. Also, hypnotherapists sometimes combine elements of hypnotherapy with methods borrowed from other therapies.

A good hypnotherapist has to empathize with the subject and use skillfully one or more of the available techniques. Often, the hypnotherapist themselves get in some kind of a light trance even as they are speaking to the subject, so that they can better relate to the subject’s state of mind.

Stages of a hypnotherapy session

Stages of a hypnotherapy session

A session at a hypnotherapist consists of a number of well defined stages. We broadly describe the stages below.

Stage 1: Induction

In the induction stage, the subject is led to a trance by using any of the available techniques for induction. Techniques for induction commonly use the the subject’s imagination, visualization, background and other aspects.

Induction might consist of techniques such as the following :

1. Paying attention to ambient sounds in the room
2. Performing a body scan, when the subject imagines each part of their body successively becoming heavier and more relaxed, from the top of the head to the toes of the feet.
3. It can include a physical element to it, such as rubbing their arms in a certain way or making head or eye movements in a specific pattern.

Stage 2: Deepener

In this stage the subject is led deeper and deeper into a more relaxed state. The objective is to deepen the trance, so that the suggestions by the hypnotherapist to the person’s subconscious are more effective. This too employs a combination of visualization and imagination related approaches. A common deepener is to imagine walking down a flight of stairs while counting from 1 to n (where n is the number of stairs) at each step, and at each step the relaxation becomes double of the previous step, such that the subject reaches the highest amount of relaxation once they have reached the last step.

Stage 3: Post Hypnotic Suggestions

Once the person has entered the hypnotic trance state and has also deepened their relaxation to the maximum extent, the hypnotherapist can choose to give suggestions to the person’s subconscious, related to the aspect of life they wish to improve. These suggestions are supposed to be acted upon in the daily life of the subject once they are out of trance, hence the name of post hypnotic suggestion.

The post hypnotic suggestions might be given in multiple ways, some of which are listed below:

1. Direct suggestions (such as tell the person directly to change the aspect of their life that needs changing, or to behave in a certain way once they encounter a trigger cue, such as a phobia)
2. Suggestions using visualization of the results (such as seeing themselves as more fit or confident once they are in the normal awake state, or visualizing certain cells or organs or parts of the body healing themselves)
3. Suggestions that employ some kind of metaphor (such as seeing a change from dark clouds in the sky to bright sunshine, where the sky can be a metaphor for the state of a person’s mind).
4. Suggestions given when the subject has regressed to a different time or place (such as a younger version of themselves, or before a particular traumatic event)

Here it is best for the hypnotherapist to employ clean language (not give any specific directions but speak in a way that the hearer can fit what they hear to their specific situation) to ensure that they are in tune with the subject’s current state of mind, considering the subject already knows which aspect of their life needs to change and by how much, what is the result of the change etc.

Stage 4: Wakening or Coming out of trance

In coming out of trance or wakening stage, the hypnotherapist gently guides the subject out of the trance state, by using similar techniques as were used during the induction and deepener phase. For example, they may visualize themselves ascending the same flight of stairs they descended during the deepener, and at each step they become progressively more energized and awake, and by the time they take the last step they are fully awake and ready to open their eyes.

Techniques of hypnosis

There are multiple available techniques of hypnosis that have been used by famous hypnotherapists till now. Examples include

1. Ericssonian hypnosis (after the style of Milton H Erickson)
2. Rossi technique (after Ernst Rossi, one of Erickson’s students)
3. Elman technique (after Dave Elman, uses a combination of physical and mental induction techniques)
4. Ideo motor technique (using the ideo motor reflex to enter a certain state of mind upon a certain trigger)
5. Psycho-sensory techniques (using a combination of thinking and touch to re-program the body and mind out of stressful or traumatic events, such as Havening technique and Tapping solution)

The (neuro)science of hypnotherapy

The hypnotic trance is what could be called an altered state. Scientists have studied the brains of persons when they are in a hypnotic trance and have identified some neural mechanisms and neural correlates for the hypnotic state.

The hypnotic state has an higher amount of theta and gamma oscillations in EEG (electroencephalography) measurement and could be said to have certain similarities with the sleep state, state under anesthesia or certain kinds of meditation. When the subject is in hypnotic trance, the left hemisphere of the brain is more likely to be activated.

Some books on hypnotherapy

Some hypnosis books and videos

For people wanting to learn more about hypnotherapy or pursuing a career in it, many hypnotherapy courses, such as in person diploma courses and online courses,are available from different providers in different countries.

Some useful videos and books are as follows:

1. Videos of hypnotic inductions on YouTube or Vimeo by famous hypnotherapists such as Milton Eriksson, Rossi, Dave Elman, Paul McKenna.
2. Apps related to hypnosis or hypnotherapy on the Google play store or Apple App store
3. Hypnotherapy for dummies
4. Self hypnosis for dummies
5. Change Your Life In Seven Days by Paul McKenna
6. Trancework by Michael D. Yapko
7. Handbook of Hypnotic Suggestions and Metaphors by D. Corydon Hammond
8. My Voice Will Go with You: The Teaching Tales of Milton H. Erickson by Sidney Rosen
9. Uncommon Therapy: The Psychiatric Techniques of Milton H. Erickson, M.D. by Jay Haley, Brian Arens, et al.
10. The Art of Hypnotherapy: Mastering client-centered techniques by C Roy Hunter