ARC Blog

Understanding Hypnosis for Anxiety

Talking about hypnosis isn’t easy.

There hasn’t been common agreement on a definition, and there’s been ample disagreement on whether it’s better understood as an altered state of consciousness or as enactment of a social role. (My own understanding draws on both perspectives. Enacting social roles alters consciousness.) The worst popular writings on hypnosis resort to extravagant claims or reflexive skepticism. And those stage hypnosis comedy shows—although highly entertaining—foster impressions of hypnosis as something silly if not sinister. In fact, hypnosis amounts to a naturally occurring phenomenon (or collection of phenomena) that almost everyone has experienced, perhaps even daily, even if it wasn’t formally induced or explicitly labelled. Examples of everyday experiences that resemble hypnosis include daydreaming, intense concentration, strong emotion, meditative states, the placebo effect, conditioned reflexes, “losing track of time,” and—at the more troubling extreme—the effects of trauma.  (Some older literature refers to being “in shock” as a hypnoidal state, i.e., a state that resembles hypnosis.)  People experienced or exhibited all of these phenomena long before the 19th century when James Braid coined the term “hypnosis.”  

Hypnotherapy is a procedure in which qualified practitioners help clients achieve a state of focused attention in order to resolve an issue or reach a goal.

This state—also known as “trance” or being “in hypnosis”— is not sleep, but it usually involves deep relaxation.  Misconceptions about hypnosis abound, but its therapeutic effects have been amply documented. Two examples will suffice: Kirsch, Montgomery, and Sapirstein’s (1995) meta-analysis of 18 studies comparing cognitive-behavioral therapy (CBT) to the same therapy supplemented by hypnosis showed that adding hypnosis significantly enhanced treatment outcome with various clinical conditions, including chronic pain, insomnia, obesity, and phobia. A study by Ginandes, C. et al. (2003) reported in the American Journal of Clinical Hypnosis indicated “that use of a targeted hypnotic intervention can accelerate postoperative wound healing.” Still, therapeutic hypnosis remains an underutilized intervention. This is unfortunate. Hypnosis is a non-invasive procedure that requires no medication, has no detrimental side effects, and potentially empowers its recipients to discover their innate ability to use their minds for a change.

The dominant tendency in much present-day mental health care is to attribute psychological or emotional problems, including excessive or problematic anxiety, to hypothesized brain abnormalities or “chemical imbalances,” to view the mind reductively as “what the brain does,” and to prescribe medication to correct whatever neurotransmitters are thought to be “imbalanced.” I recognize that psychiatric medication helps some people sometimes with some things. But I also find it deeply troubling that many persons with mild to moderate anxiety “disorders” receive psychiatric medication as first-line treatment without first receiving encouragement to pursue psychotherapy, hypnotherapy, or healthy self-soothing practices. In my opinion, this runs the risk of disempowering people by removing their opportunity to discover and develop their natural capacity for effective self-care. There is also a risk that the diagnosis itself will become one’s conceptual identity and a self-fulfilling prophecy: “My anxiety disorder makes me worry.”

Hypnotherapy isn’t a magic fix, but it does help many people reduce and even eliminate problematic or excessive anxiety.

As noted above, it can do more than that, but even if promoting relaxation were its only beneficial effect, hypnosis would certainly have a role in anxiety reduction and addiction treatment. Through working in addiction treatment, I have encountered many clients with co-occurring anxiety. Many others have no idea how to relax in the absence of drugs and alcohol. For these persons, hypnotic relaxation training (whether or not they pursue further, issue-specific hypnotherapy) is empowering because it provides an actual experience of obtaining voluntary control over tension and autonomic arousal. In this sense it offers something that “talk therapy” alone cannot.

Hilgard (1970) found that the capacity for imaginative involvement is crucial for hypnotizability. Such involvement can be employed intentionally to induce or deepen hypnosis. One example is employing “favorite place imagery” to bring about feelings of relaxation and well-being: Intentionally engaging one or more sensory modality—e.g., sight, sound, sensation—to imagine as vividly as possible a scene, situation, or event that one associates with a desired physical or emotional state. Many people who struggle with anxiety seem to possess a remarkable capacity for imaginative involvement or absorption in their own thoughts, but they are misusing it in what Daniel Araoz, Ed.D. (1985) called “negative self-hypnosis.” After all, much anxiety involves vividly imagining everything that could wrong and then reacting emotionally as if it were already happening.

Your nervous system can’t tell the difference between what you actually experience and what you vividly imagine.

At least that’s what Maxwell Maltz (1960) said. Decades later, Winerman (2006) summarized fMRI research on hypnotized subjects that essentially confirmed Maltz’s assertion. When instructed to perceive gray-scale printed patterns in color, hypnotized subjects showed activation in the same area of the brain as when they viewed actual color prints. Hypnotically induced pain activated the same brain area as “real” pain. It would not be too much of an extrapolation to say that this research implies that, through hypnosis, it is possible to alter perceptions and sensations in either detrimental or beneficial ways. If we think of worrying as a form of negative self-hypnosis that instigates or exacerbates anxiety, then it becomes apparent that hypnotherapy could be used to redirect the same skill required to worry into reducing or relieving anxiety. What skill or ability does it take to worry? It takes a vivid imagination and sufficient absorption in one’s thoughts to produce changes in sensation, perception, and physical arousal.  In a sense, then, if you know how to worry, you already know something about how to meditate and how to use hypnosis!

I am not suggesting that misuse of the creative imagination is the only source of anxiety. Other contributors or causes include unprocessed trauma, blocking or “stuffing” one’s emotions, and anxiety sensitivity (AS). (Anxiety sensitivity refers to a tendency to over-interpret the bodily arousal associated with anxiety as threatening or harmful, thereby intensifying the anxiety or fear and the resulting arousal.) Arguably, each of these involves a feeling of being “out of control.” Like biofeedback, hypnosis or hypnotherapy promotes voluntary control of one’s sensations and perceptions, including those associated with anxious arousal. This behavioral understanding of hypnosis is not the only way to conceptualize it, but it might be the most readily understandable, accessible, and measurable way to experience its benefits and to use your mind—and body—for a desired change!

Michael K. Kivinen, MA, LLP, C.Ht. has a master’s degree in counseling psychology and a Michigan limited license as a psychologist. He is also a certified hypnotherapist. He works as a therapist at West Brook Recovery Center, a private addiction treatment program in Grand Rapids, Michigan, and he teaches psychology courses as an adjunct instructor at Grand Rapids Community College (GRCC) and Aquinas College.  If you have questions about hypnotherapy, anxiety- and trauma-related disorders, or addiction treatment, you may contact him at (616) 957-1200.

-Araoz, D. (1985). The New Hypnosis. New York, NY: Brunner/Mazel.
-Ginandes, C., Brooks, P., Sando, W.,  Jones, C., & Aker, J. (2003). Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial. American Journal of Clinical Hypnosis, 45(4), 333-51.
-Hilgard, J. (1970). Personality and Hypnosis: A Study of Imaginative Involvement. Chicago, IL: University of Chicago Press.
-Kirsch, I.,  Montgomery, G.&  Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis. Journal of Consulting and Clinical Psychology, 63(2), 214-20.
-Maltz, M. (1960). Psycho-Cybernetics: A New Technique for Using Your Subconscious Power.  N. Hollywood, CA: Melvin Powers Wilshire Book Co.
-Winerman, L. (2006). From the stage to the lab: Neuroimaging studies are helping hypnosis shed its ‘occult’ connotations by finding that its effects on the brain are real. Monitor on Psychology, 37(3), 26-27.


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