How does hypnotherapy work?
Hypnotherapy is usually considered an aid to psychotherapy (counselling), rather than a treatment in itself. It helps with psychotherapy because the hypnotic state allows people to explore painful thoughts, feelings and memories they might have hidden from their conscious minds. In addition, hypnosis enables people to perceive some things differently, such as blocking an awareness of pain.
Hypnotherapy can be used in two ways, as suggestion therapy or for patient analysis.
Suggestion therapy: The hypnotic state makes the person better able to respond to suggestions. Therefore, hypnotherapy can help some people change certain behaviour, such as to stop smoking or nail-biting. It can also help people change perceptions and sensations, and is particularly useful for treating pain.
Analysis: This approach uses the relaxed state to find the root cause of a disorder or symptom, such as a traumatic past event that a person has hidden in unconscious memory. Once the trauma is revealed, it can be addressed in psychotherapy.
What are the benefits of hypnotherapy?
The hypnotic state allows a person to be more open to discussion and suggestion. It can improve the success of other treatments for many conditions, including:
- Phobias, fears and anxiety
- Sleep disorders
- Depression
- Stress
- Post-trauma anxiety
- Grief and loss
It can also be used to help with pain control and to overcome habits, such as smoking or overeating. It may also be helpful for people whose symptoms are severe or who need crisis management.
What are the drawbacks of hypnotherapy?
Hypnotherapy might not be appropriate for a person who has psychotic symptoms, such as hallucinations and delusions, or for someone who is using drugs or alcohol. It should only be used for pain control after a doctor has assessed the person for any physical disorder that might require medical or surgical treatment.
Some therapists use hypnotherapy to recover repressed memories they believe are linked to the person's mental health disorder. However, hypnosis also poses a risk of creating false memories -- usually as a result of unintended suggestions by the therapist. For this reason, the use of hypnosis for certain mental health disorders, such as dissociative disorders, remains controversial.
Is hypnotherapy dangerous?
Hypnotherapy 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 be created.
Who performs hypnotherapy?
Hypnotherapy is performed by a licensed or certified mental health professional who is specially trained in this technique. It is not routinely available on the NHS.
There are several good treatments for anxiety disorder, but there are no quick fixes and no cures.
Key points about treating anxiety disorder
- A talking treatment called cognitive behaviour therapy can work well for anxiety disorder, for adults, teenagers, and children.
- Drug treatments (including some antidepressants and a drug called buspirone) can also help.
- We don't know which works best: cognitive behaviour therapy or drug treatment. Different treatments suit different people.
- Your doctor may recommend a combination of cognitive behaviour therapy and drugs.
- A talking treatment called applied relaxation also works well.
- All drug treatments have side effects. You should discuss them with your doctor.
How anxiety disorder is treated
If you've got anxiety disorder, you won't usually need to go to hospital. You'll be cared for mainly by your GP. You may also be referred to another GP in your practice who specialises in treating anxiety disorder, or to a hospital doctor. We can't say exactly how you'll be treated. But we can give you some idea about the way anxiety disorder is treated in general.
You and your doctor should decide together the best way to treat your anxiety disorder. And you should be given all the information you need to understand the different types of treatment that your doctor may suggest.
As a first step, you may be offered some of these.
- Your GP may provide support and advice about how you can help yourself (self-help). For example, your GP may recommend working from a book or a computer program for about five to 14 weeks. Self-help typically involves little contact with a health care professional. However, you may meet with or talk on the phone with a health care professional for a short time every week or fortnight.
- Your doctor may recommend attending a course with other people to learn about the symptoms of anxiety and how to manage them. You may meet every week for about six weeks.
- If your anxiety is very bad, your doctor may prescribe a benzodiazepine drug for a short time to help you relax and feel less worried. But you should only use this drug for two to four weeks.
If the treatments above don't help, you may be offered one or both of these.
- Psychological treatment. This can be cognitive behaviour therapy or applied relaxation. Both involve weekly meetings with a health care professional for about three to four months.
- Drug treatment. You'll first be offered a type of antidepressant drug called a selective serotonin reuptake inhibitor (SSRI for short). Two examples are sertraline (brand name Lustral) and paroxetine (brand name Seroxat). If the first SSRI doesn't help you, your doctor may prescribe a different one or another type of antidepressant called a serotonin noradrenaline reuptake inhibitor (SNRI). Two examples are venlafaxine (Efexor) and duloxetine (Cymbalta). If antidepressants don't work for you, you may be offered a different type of medication called pregabalin.
If you don't seem to be getting better despite these treatments, your GP should refer you to a specialist. You may also be referred to a specialist if your symptoms are severe (for example, if you're at risk of self-harm or suicide), or you have other problems, such as drug or alcohol misuse.
While you are being treated for anxiety disorder you should see a doctor regularly, to check how you are getting on. If a medication is working, you should carry on taking it for at least a year, as this can help you stay well.
How does psychotherapy help?
Psychotherapy helps people with a mental health disorder:
- Understand the behaviours, emotions, and ideas that contribute to his or her problem.
- Understand and identify the life problems or events -- like a major illness, a death in the family, a loss of a job, or a divorce -- that contribute to their problem and help them understand which aspects of those problems they may be able to solve or improve.
- Regain a sense of control and pleasure in life.
- Learn coping techniques and problem-solving skills.
Types of therapy
Therapy can be given in a variety of formats, including:
- Individual: This therapy involves only the patient and the therapist.
- Group: Two or more patients may participate in therapy at the same time. Patients are able to share experiences and learn that others feel the same way, and have had the same experiences.
- Marital/couples: This type of therapy helps spouses and partners understand why their loved one has a mental disorder, what changes in communication and behaviours can help, and what they can do to cope.
- Family: Because the family is a key part of the team that helps people with mental health problems get better, it is sometimes helpful for family members to understand what their loved one is going through, how they themselves can cope, and what they can do to help.
Approaches to therapy
While therapy can be done in different formats -- like family, group, and individual -- there are also several different approaches that mental health professionals can take to provide therapy. After talking with the patient about their disorder, the therapist will decide which approach to use based on the suspected underlying factors contributing to the condition.
Different approaches to therapy include:
Psychodynamic therapy
Psychodynamic therapy is based on the assumption that a person has a developed a mental health problem because of unresolved, generally unconscious conflicts, often stemming from childhood. The goal of this type of therapy is for the patient to understand and cope better with these feelings by talking about the experiences. Psychodynamic therapy is administered over a period of three to four months, although it can last longer, even years.
Interpersonal therapy
Interpersonal therapy focuses on the behaviours and interactions a patient has with family and friends. The primary goal of this therapy is to improve communication skills and increase self-esteem during a short period of time. It usually lasts three to four months and works well for depression caused by mourning, relationship conflicts, major life events, and social isolation.
- Loss (grief)
- Relationship conflicts
- Life and role transitions (such as becoming a mother, or a carer)
Cognitive-behavioural therapy
Cognitive-behavioural therapy helps people with mental health problems to identify and change inaccurate perceptions that they may have of themselves and the world around them. The therapist helps the patient establish new ways of thinking by directing attention to both the "wrong" and "right" assumptions they make about themselves and others.
Cognitive-behavioural therapy is recommended for patients:
- Who think and behave in ways that trigger and perpetuate mental health problems.
- With mild-to-moderate depression as the only treatment or in addition to treatment with antidepressant medication
- Who refuse or are unable to take antidepressant medication.
- Of all ages who have mental health problems that causes suffering, disability, or interpersonal problems.
Therapy tips
Therapy works best when you attend all the appointments you have booked. The effectiveness of therapy depends on your active participation. It requires time, effort and regular sessions.
As you begin therapy, establish some goals with your therapist. Then spend time periodically reviewing your progress with your therapist. If you don't like your therapist's approach or if you don't think the therapist is helping you, talk to him or her about it and seek a second opinion if both you and your therapist agree, but don't discontinue therapy abruptly.
Tips for starting therapy
Here are some tips to use when starting therapy for the first time:
- Identify sources of stress: Try keeping a diary and note stressful as well as positive events.
- Restructure priorities: Emphasise positive, effective behaviour.
- Make time for recreational and pleasurable activities.
- Communicate: Explain and assert your needs to someone you trust; write in a diary to express your feelings.
- Try to focus on positive outcomes and finding methods for reducing and managing stress.
Remember, therapy involves evaluating your thoughts and behaviours, identifying stresses that contribute to your condition, and working to modify both. People who actively participate in therapy recover more quickly and have fewer relapses.
Also, keep in mind, therapy is treatment that addresses specific causes of mental illness; it is not a "quick fix". It takes longer to begin to work than medication, but there is evidence to suggest that its effects last longer. Medication may be needed immediately in cases of severe mental illness, but the combination of therapy and medicine is very effective.
This information is for people who have irritable bowel syndrome. It tells you about hypnotherapy, a treatment used for irritable bowel syndrome. It is based on the best and most up-to-date research.
Does it work?
We're not sure. The research on hypnotherapy for people with irritable bowel syndrome (IBS) isn't very good. So we can't say whether it works or not.
What is it?
If you have hypnotherapy, a hypnotherapist helps you to focus your attention at the same time as making you feel more relaxed. He or she then focuses on your symptoms, why you might have them and what you can do about them. The idea is that you'll be able to control symptoms on your own by making use of what you have learned under hypnosis.
You need to make sure you go to a qualified professional if you want to try this treatment. How much hypnotherapy helps may depend on how good the therapist is.
Hypnotherapy for IBS might include several weekly sessions with a therapist. The sessions will probably last for half-an-hour to an hour. In some of the research, people also used tapes or CDs at home as part of their treatment.
Hypnotherapy takes up a lot of time and can be expensive. But some doctors think it might be worth trying if your symptoms are bad and other treatments haven't worked.
How can it help?
We don't know whether hypnotherapy can help. Most of the studies weren't done very well, or didn't look at very many people. This makes it hard to know if the results are reliable.
One study found that people who had hypnotherapy had less severe symptoms of IBS after three months. But the benefits didn't last.
How does it work?
Feeling stressed makes IBS worse for some people. Hypnotherapy aims to help people relax and worry less about their symptoms. This could help them get on with their lives or even have fewer symptoms. But the research isn't good enough to say whether hypnotherapy helps in this way or not.
Can it be harmful?
Hypnotherapy is likely to be safe. People in the studies didn't report any serious side effects.
How good is the research on hypnotherapy?
The research on hypnotherapy for irritable bowel syndrome (IBS) isn't very good. There are only a few studies, and most of them weren't done very well or didn't look at many people. We found one study that collected together the findings from three small clinical trials (a systematic review). The poor quality of the trials, and the small number of people on which hypnotherapy has been tested means we can't say whether hypnotherapy helps people with IBS or not.
Does it work?
We don't know whether hypnotherapy can help if you have post-traumatic stress disorder (PTSD). That's because not enough research has been done for us to know for certain.
What is it?
If you have hypnotherapy, a trained therapist helps you get into a state of mind where you feel relaxed and secure. But at the same time, you're alert and able to talk about your feelings. The idea is that this state of mind helps you to talk about your experiences and make sense of them.
This treatment isn't usually given on its own. It is often used together with other talking treatments. For example, it may be used with cognitive behaviour therapy.
When hypnotherapy is used to treat people with PTSD, it may:
- Help you relax and feel safer (and maybe help you deal with upsetting memories or dreams even when you aren't in your therapist's office)
- Make it easier to cope with memories of what happened to you by letting you work at your own pace without feeling overwhelmed
- Help you find ways of getting on with your life.
How can it help?
One small study compared hypnotherapy with other treatments for PTSD. It found that hypnotherapy can help. For example, it can help them stop avoiding doing certain things that they might not want to do because of their PTSD.
How does it work?
When you are hypnotised, it's easier to focus your attention. This means your doctor or therapist can help you think about things in ways that will stop you from being so anxious about the memories of what you've been through.
Hypnotherapy may also help you remember things about the traumatic event. And this may play an important part in helping you get better.
Can it be harmful?
We didn't find any information on side effects in the study we looked at.
How good is the research on hypnotherapy?
We found one review that looked at the results from one small study on hypnotherapy for PTSD. It found that it did help with some of the symptoms of PTSD. For example, it helped some people stop avoiding doing things because of PTSD.
Even so, we need more research on hypnotherapy before we can know for certain if it can help treat PTSD.