Is hypnosis an effective treatment for medical conditions?

Effectiveness of Hypnosis as a Medical Treatment

Clinical hypnosis is an effective adjunctive therapy for specific medical conditions, particularly functional abdominal pain, irritable bowel syndrome, procedural pain, and anxiety, with evidence showing superior outcomes compared to standard care alone. 1

What is Clinical Hypnosis?

Clinical hypnosis is a therapeutic technique characterized by:

• An altered state of consciousness involving intensified attention, decreased peripheral awareness, and enhanced responsiveness to suggestion 1, 2
• A skill set involving interpersonal communication designed to facilitate therapeutic change in maladaptive psycho-physiological reflexes 1
• A well-established therapeutic modality that should not be confused with entertainment hypnosis 1

Evidence for Effectiveness by Condition

Functional Abdominal Pain and IBS

• Randomized controlled trials show gut-directed hypnotherapy is highly effective for functional abdominal pain (FAP) and irritable bowel syndrome (IBS) in children 1
• A 5-year follow-up study demonstrated significantly higher remission rates in hypnosis group (68%) compared to standard care (20%) 1
• Systematic reviews confirm hypnosis has superior efficacy over standard care for FAP and IBS 1

Pain Management

• Effective for both procedural and chronic pain management 1
• Systematic reviews involving 528 children (ages 3-19) found hypnosis more effective than standard care for procedure-related pain 1
• Long-term studies show significant reduction in pain scores over 2 years when hypnosis is used as adjunctive therapy for chronic pain conditions 3
• Case studies demonstrate effectiveness for refractory neuropathic pain, even when first, second, and third-line treatments have failed 4

Anxiety and Perioperative Care

• Hypnosis alleviates preoperative anxiety in pediatric patients 1
• Significant reduction in anxiety scores measured by Hamilton Anxiety Rating Scale over 2-year follow-up compared to control groups 3

Other Applications

• May reduce medication requirements - studies show 4 times lower risk of increasing analgesic medications in patients using hypnosis as adjunctive therapy 3
• Potential benefits for attention-deficit/hyperactivity disorder when used as EEG biofeedback 1
• Effective for enuresis when used by appropriately trained pediatricians 1

Limitations and Considerations

• High-quality randomized controlled trials with clear methodologies remain lacking 1
• Clinical hypnosis requires establishing strong rapport with patients and individualizing therapy to specific goals 1
• Should only be used by appropriately trained providers who are already competent in managing the targeted condition 1
• Contraindications include psychosis (especially schizophrenia with delusions of influence) and prominent histrionic personality characteristics 2

Implementation Guidelines

1. Provider qualifications: Should be performed only by clinicians trained in the technique (psychiatrists, psychologists, or other healthcare providers with appropriate training) 2
2. Appropriate scope: Providers should only use hypnosis for conditions they are already licensed to treat 1
3. Collaborative approach: Mental health practitioners should not use clinical hypnosis for physical conditions without physician co-management, and physicians should not use it for psychological trauma without mental health collaboration 1
4. Treatment protocol: Often involves 6-12 sessions over several months, with home practice reinforcement 1, 3

Conclusion for Clinical Practice

Hypnosis represents a valuable adjunctive treatment for specific medical conditions, particularly pain and anxiety-related disorders. The strongest evidence supports its use for functional abdominal pain, IBS, procedural pain, and anxiety management. While more high-quality research is needed, existing evidence demonstrates meaningful improvements in morbidity and quality of life outcomes when properly implemented by trained clinicians.