Therapist speaks to a client under hypnosis

Hypnotherapy is an evidence-based psychological intervention that uses hypnosis—an altered state of consciousness characterized by focused attention and enhanced suggestibility—to facilitate therapeutic change in thoughts, feelings, and behaviors. According to APA Division 30 (Society of Psychological Hypnosis), hypnosis is defined as a "state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion" (Elkins et al., 2015, p. 6). This definition was finalized after several iterations due to the challenges of defining hypnosis when the mechanisms are complex and have been found in biological (e.g., functional connectivity, brain states), psychological (e.g., expectancy, hypnotizability), and social (e.g., rapport, demand characteristics) domains with no primary factor and variable combinations of factors across applications (Jensen et al., 2015). As a therapeutic modality, hypnotherapy has received endorsement from multiple medical associations and demonstrates robust clinical effectiveness across diverse mental and physical health conditions.

The documented use and investigation of hypnosis spans centuries, and its therapeutic use has received endorsement from multiple medical associations (British Medical Association, 1955; Council on Mental Health, 1958; Palsson et al., 2023). Today, hypnotherapy represents a sophisticated, evidence-based treatment approach with a comprehensive body of meta-analyses examining the efficacy of hypnosis to provide a foundational understanding of hypnosis in evidence-based healthcare, insight into the safety of hypnosis interventions, and identification of gaps in the current research literature.

Table of Contents

  • History of Hypnotism
  • How Does Hypnotherapy Work?
  • Clinical Applications of Hypnotherapy
  • Effectiveness & Research Evidence
  • Safety & Risks of Hypnotherapy
  • Digital & App-Based Hypnotherapy
  • Frequently Asked Questions
  • Find a Hypnotherapist

History of Hypnotism

In the mid-19th century, as psychology was emerging as its own field, hypnotism became a prominent method of study among neuropsychiatrists investigating psychological conditions. Pioneers in the field of hypnotherapy include Hippolyte Bernheim, Jean Martin Charcot, Ambroise Auguste Liébeault, and Pierre Janet, who laid the groundwork for understanding hypnotic phenomena.

Hypnotism was one of the earliest psychoanalytic techniques employed by Sigmund Freud, who was introduced to the technique by physician Josef Breuer. Freud and Breuer believed that traumatic memories that were not accessible to the waking mind could be revealed while a person was under hypnosis, thus facilitating a "cure." Freud eventually abandoned hypnosis in favor of forced association, and then free association, after he found that not all of his patients responded to hypnotism.

The contemporary evidence base for hypnotherapy is substantial and growing. Recent meta-analytic reviews encompassing hundreds of primary studies have documented effect sizes comparable to established psychological interventions, with particularly robust findings for pain management, depression, and anxiety disorders. Modern clinical hypnosis has evolved significantly from these early roots, incorporating neuroscientific understanding and evidence-based protocols.

How Does Hypnotherapy Work?

Neurobiological Mechanisms

Recent advances in neuroscience have provided unprecedented insights into how hypnosis affects the brain. Neuroimaging studies have elucidated the neural substrates of hypnotic analgesia and emotional regulation, demonstrating modulation of the anterior cingulate cortex, default mode network, and pain matrix. These findings reveal that hypnosis produces measurable changes in brain activity and connectivity.

Several years ago, Spiegel led a team that used brain imaging to uncover the neurobiological basis of the practice. They found that highly hypnotizable people had stronger functional connectivity between the left dorsolateral prefrontal cortex, which is involved in information processing and decision making, and the dorsal anterior cingulate cortex, involved in detecting stimuli. This enhanced connectivity appears to facilitate the focused attention and reduced distractibility characteristic of hypnotic states.

Studies using fMRI, EEG, and magnetic resonance spectroscopy reveal distinct changes in brain connectivity and neurochemical states at different hypnosis depths. Theta brainwaves increase, indicating profound relaxation without sleep. These neurobiological changes help explain hypnotherapy's broad therapeutic effects across diverse conditions.

The Hypnotherapy Process

In a typical hypnotherapy session, the practitioner begins by identifying client goals and explaining how the session will proceed. Induction of a state of deep relaxation and intense focus occurs. It is not a question of sleep, but rather of a state of altered consciousness, where the mind is more open to suggestions. There are several techniques to induce this state, such as gaze fixation, verbal suggestion, and visualization (Spiegel, 2013).

The therapist uses guided imagery and soothing speech to help the person feel relaxed and safe. Once the recipient has achieved a more receptive state, the practitioner provides therapeutic suggestions tailored to help the person reach their specific goals. Throughout the process, the person in the hypnotic state remains aware and typically can return to a more alert state independently once the session concludes. Some people find that just one hypnotherapy session is sufficient, while others may benefit from several sessions.

Clinical Applications of Hypnotherapy

Pain Management

A 2025 systematic review found that medical hypnosis decreased acute pain by 0.54 standard deviations compared to standard care, a medium and statistically significant effect. The evidence for hypnotherapy in pain management is particularly robust, with applications spanning:

  • Chronic pain conditions: Hypnosis adjunctive to usual care had a small additional analgesic effect (chronic pain: −8.2 [−11.8, −1.9])
  • Surgical and procedural pain: medical procedures/surgical pain: −6.9 [−10.4, −3.3]
  • Burn wound care: burn wound care: −8.8 [−13.8, −3.9]
  • Cancer-related pain
  • Fibromyalgia

The first assessed 85 controlled studies of experimentally evoked pain and found hypnosis delivered meaningful pain relief for most people, with the greatest effects in those who rated high on hypnotic suggestibility (Thompson, T., et al., Neuroscience & Biobehavioral Reviews, Vol. 99, 2019). In a separate analysis, researchers assessed 42 controlled studies of hypnosis for treating clinical pain. They concluded that hypnosis is "very efficacious," with a mean weighted effect size in the medium range (Milling, L. S., et al., International Journal of Clinical and Experimental Hypnosis, Vol.

Mental Health Conditions

Depression:

Efficacy of hypnotherapy compared to cognitive behavioral therapy for mild to moderate depression - Results of a randomized controlled rater-blind clinical trial. Research demonstrates that hypnotherapy achieves outcomes comparable to or exceeding cognitive behavioral therapy for depression, with sustained benefits. Long-term follow-up studies show maintenance of therapeutic gains.

Anxiety Disorders: Hypnotherapy has shown effectiveness for various anxiety conditions including:

  • Generalized anxiety disorder
  • Social anxiety disorder
  • Phobias
  • Panic disorder with agoraphobia

The experimental group showed significant reductions in P1, N170, N2pc, and late positive potential (LPP) brain wave activities during attention sensitivity and disengagement conditions. This indicates that hypnotherapy modulates early-stage face processing and later-stage emotional evaluation of threat-related stimuli in SAD patients.

Post-Traumatic Stress Disorder (PTSD):

A meta-analysis of hypnotherapeutic techniques in the treatment of PTSD symptoms. J. Trauma. Stress. 29, 97–100. doi: 10.1002/jts.22077, demonstrating effectiveness for trauma-related conditions when delivered by trained professionals.

Medical Applications

Irritable Bowel Syndrome (IBS):

Hypnotherapy has been shown to be effective at relieving global gastrointestinal symptoms (GGS) in irritable bowel syndrome (IBS). This review suggests that high volume hypnotherapy is more beneficial than low and should be adopted for GDH. Both high frequency and group interventions are effective in reducing GGS in IBS. Digital gut-directed hypnotherapy apps have shown comparable effectiveness to traditional in-person treatment.

Smoking Cessation: Clinical hypnosis helps individuals quit smoking by addressing both the physical addiction and psychological habits associated with tobacco use. Preliminary survey data from an app-delivered hypnosis intervention for smoking cessation shows promise for both traditional and digital delivery methods.

Hot Flashes & Menopausal Symptoms:

In one trial, menopausal women received five weekly sessions of clinical hypnosis or a structured-attention control intervention. Those in the hypnosis group reported hot flashes were reduced by more than 74%, whereas the control group reported a 17% reduction in hot flashes. Objective physiological monitoring of hot flashes supported their reports, showing a 57% reduction in hot flashes for women who had hypnosis compared with a 10% reduction for control participants.

Effectiveness & Research Evidence

Meta-Analytic Evidence

In January 2024, researchers from Jena University Hospital in Germany and Baylor University in the United States published a comprehensive overview of hypnosis research in the peer-reviewed journal Frontiers in Psychology. Their approach was methodical: they analyzed every meta-analysis of hypnosis published between 2003 and 2022. The result? They identified 49 meta-analyses encompassing 261 distinct randomized controlled trials.

Recent meta-analytic evidence reveals effect sizes ranging from medium to large (d = 0.5 to 2.72) for various conditions, with particularly robust evidence for chronic pain management, depression, anxiety disorders, and perioperative care. These effect sizes are comparable to or exceed those of many established psychological and medical interventions.

Factors Affecting Outcomes

Hypnotizability:

What's particularly interesting is how hypnotic suggestibility affects outcomes. The 2019 meta-analysis found that optimal pain relief occurred for people with high hypnotic suggestibility (42% clinically meaningful reductions in pain) and medium suggestibility (29% reductions). Those with low suggestibility showed minimal benefits. However, recent research shows that even individuals with lower hypnotizability can benefit from certain applications.

Treatment Intensity:

Compared to programs with minimal hypnotherapy sessions, efficacy rates were significantly better among more intensive hypnotherapy programs that had greater length and frequency of sessions, personalized hypnotic suggestions, educational materials, and support through counseling.

Safety & Risks of Hypnotherapy

Excellent Safety Profile

Although some research has pointed out potential unwanted effects associated with hypnosis (Gruzelier, 2000), the authors' conclusion regarding hypnosis as a safe intervention is consistent with a 2018 analysis of frequencies of adverse events in registered clinical trials which reported that there was zero report of a serious adverse event attributable to hypnosis and that the rate of "other adverse events" was 0.47% across 429 participants included in the studies (Bollinger, 2018). Further evidence of this is provided in a large meta-analysis on hypnosis for pain relief which included 3,632 patients across 85 trials concluding that hypnosis is both a safe and effective alternative to pharmaceutical approaches (Thompson et al., 2019).

The safety of hypnotherapy has been documented across diverse populations and conditions. In fibromyalgia patients receiving eight weekly hypnotherapy sessions, no adverse events were induced despite significant therapeutic effects (Dorta et al., 2024). Similarly, in depression trials comparing hypnotherapy to CBT over extended follow-up periods, no safety concerns emerged (Acharya et al., 2023; Fuhr et al., 2023). For surgical patients receiving perioperative hypnosis, the intervention was well-tolerated and produced beneficial effects without complications (Rosenbloom et al., 2024). Systematic reviews examining hypnosis for depression and pain management have consistently noted the absence of significant adverse effects (Jones et al., 2024; Souza et al., 2024).

Professional Standards

So long as the therapist is trained and follows basic ethical norms, hypnotherapy is safe. A recent international survey that included nearly 700 hypnosis practitioners (Palsson et al., 2023) provides a general view of how hypnosis is utilized in clinical settings.

Some people may experience minor effects such as:

  • Temporary dizziness or nausea during or after hypnosis
  • Headaches or drowsiness (typically mild and brief)
  • Emotional reactions when discussing traumatic memories

People who discuss traumatic memories may be subject to feelings of panic, flashbacks, or general feelings of anxiety, and the clinician or client may elect to discontinue treatment when symptoms are severe.

Historical Concerns About False Memories

When therapists attempt to uncover so-called repressed memories, they may inadvertently create false memories in their patients. In the 1980s and 1990s, the notion of uncovering repressed memories via hypnotherapy was very common. Because people are highly suggestible while they are under hypnosis, they may be more likely to "remember" things that did not actually occur. Modern clinical practice emphasizes suggestion-based therapeutic interventions rather than memory recovery to avoid these issues.

Digital & App-Based Hypnotherapy

Emerging Evidence

Stress and stress-related chronic illness are increasing worldwide while mental health care access remains limited. Recent neurophysiological advances support the effectiveness and safety of hypnosis for stress management. In this retrospective observational study, we studied app-delivered hypnosis in 84,395 users across 282,893 stress reduction sessions. Pre-to-post stress reduction occurred consistently in each of the first 10 sessions (Cohen's d values ranging from −0.71 to −0.78), demonstrating significant improvement in stress management.

Clinical Applications

Digital hypnotherapy apps are now available for:

  • Stress management
  • Sleep improvement
  • Pain management
  • Smoking cessation
  • IBS symptom management
  • Menopausal hot flashes

Scheffrahn, K., Alldredge, C. T., Snyder, M. & Elkins, G. R. Hypnosis apps: a systematic review. Int. J. Clin. Exp. Hypn. 73, 79–95 (2025). The systematic review found that well-designed apps can provide effective self-hypnosis training and therapeutic support between sessions.

Frequently Asked Questions

How many sessions of hypnotherapy will I need? The number of sessions varies by individual and condition. Some people experience significant improvement after just one session, while others benefit from a series of 4-12 sessions. When patients were taught self-hypnosis techniques, positive effects on pain, fibromyalgia symptoms, depression, and anxiety persisted at six-month follow-up (Aksoy et al., 2023). These findings suggest that hypnotherapy, particularly when combined with self-hypnosis training, equips patients with enduring self-regulation skills that support long-term symptom management.

Can everyone be hypnotized?

Hypnotic suggestibility varies among individuals. As TIME Magazine noted, research suggests about 60% of people are hypnotizable to some degree, with an additional 15% being highly hypnotizable. However, recent advances show that even those with lower natural hypnotizability can benefit from certain techniques or enhanced approaches.

Is hypnotherapy covered by insurance? Coverage varies by insurance plan and provider. Hypnotherapy provided by licensed healthcare professionals (psychologists, physicians, clinical social workers) for specific medical or mental health conditions may be covered. Check with your insurance provider about specific coverage details.

What's the difference between hypnosis and hypnotherapy?

Hypnotherapy is the use of hypnosis within a therapeutic context to help people change patterns of thought, feeling, or behavior. Clinical hypnosis is typically provided by licensed healthcare professionals (psychologists, physicians, nurses, social workers) who have additional training in hypnotic techniques.

Can hypnotherapy be done online or through apps? Yes, research shows that digital delivery of hypnotherapy can be effective. Pre-to-post stress reduction occurred consistently in each of the first 10 sessions (Cohen's d values ranging from −0.71 to −0.78), demonstrating significant improvement in stress management. Across the first 10 sessions, greater stress reduction was observed with interactive and regular-length sessions, higher hypnotizability, older age groups, and paying members.

Is hypnotherapy safe for trauma survivors? When delivered by trained professionals who understand trauma-informed care, hypnotherapy can be safe and effective for trauma survivors. However, it's important to work with a therapist experienced in treating trauma who can provide appropriate support if difficult emotions arise during treatment.

Find a Hypnotherapist

If you're interested in exploring hypnotherapy, it's important to work with a qualified professional. Look for practitioners who are:

  • Licensed healthcare professionals (psychologists, physicians, clinical social workers, nurses)
  • Certified by recognized hypnotherapy organizations
  • Experienced in treating your specific condition
  • Following evidence-based protocols

Use our therapist directory to find qualified hypnotherapists in your area who can help you achieve your therapeutic goals. Many therapists now offer both in-person and teletherapy options to meet your needs.

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