Is self-hypnosis (autogenic training) backed by evidence for treating medical conditions, particularly for individuals with a history of mental health issues such as anxiety or depression?

Is Self-Hypnosis Backed by Evidence?

Yes, self-hypnosis is strongly backed by evidence for treating multiple medical conditions, particularly anxiety, procedural pain, chronic pain, and functional gastrointestinal disorders, with the most robust data supporting its use in cancer care and irritable bowel syndrome.

Evidence Quality and Strength

The evidence base for self-hypnosis (also called autogenic training or self-hypnotherapy) is substantial and comes from high-quality clinical practice guidelines:

• The 2023 Society for Integrative Oncology-ASCO guidelines provide the strongest recent evidence, recommending hypnosis (including self-hypnosis with training) for anxiety during cancer-related diagnostic and treatment procedures with moderate strength based on 9 RCTs 1
• The 2013 American College of Chest Physicians guidelines reviewed 69 studies with 2,831 patients and found hypnosis consistently effective for pain, fatigue, nausea/vomiting, anxiety, depression, and overall well-being in cancer care 1
• Effects have been documented with just one brief session, demonstrating rapid efficacy 1

Specific Conditions with Strong Evidence

Anxiety and Procedural Anxiety

• Hypnosis shows greatest effectiveness when applied during diagnostic or treatment procedures such as central venous port implantation, with sample sizes of 50-201 participants per study 1
• Digital delivery of self-hypnosis via pre-recorded MP3 formats has proven effective, improving accessibility 1
• Self-hypnosis represents a rapid, cost-effective, nonaddictive, and safe alternative to medication for anxiety-related conditions 2

Chronic Pain

• A 2-year follow-up study in palliative care showed patients using clinical hypnosis and self-hypnosis had VAS pain scores decrease from 81.9 to 38.9, compared to 78.5 to 57.1 in controls (P=0.0001) 3
• The hypnosis group had 4-times lower risk of requiring increased analgesic medications (adj.IRR: 4.36; 95% CI: 1.59-12.0) 3
• Inpatient chronic pain patients receiving self-hypnosis training showed significant improvement in Pain Disability Index (p=0.019) 4

Functional Gastrointestinal Disorders

• Gut-directed hypnotherapy (including self-hypnosis) is one of the most effective brain-gut behavioral therapies for IBS, with long-term efficacy demonstrated in systematic reviews 1
• Children with functional abdominal pain showed significantly higher remission rates at 5-year follow-up after hypnotherapy 5
• Self-hypnosis training for headaches in children and adolescents has proven effective 1

Cancer-Related Symptoms

• Hypnosis effectively addresses pain medication needs, pain intensity, procedural pain, postsurgical pain, fatigue, anticipatory and chemotherapy-related nausea/vomiting, and mood disturbances 1
• Physiological changes in stress and immune biomarkers have been documented following hypnotherapy interventions 5

Clinical Implementation Algorithm

Patient Selection

1. Appropriate candidates include those with:

   • State anxiety (pre-procedure, pre-surgery) 2
   • Chronic pain conditions requiring palliative care 3
   • Functional GI disorders (IBS, functional abdominal pain) 1, 5
   • Cancer-related symptoms during active treatment 1

2. Screen for contraindications:

   • History of dissociation or substantial trauma requires qualified mental health practitioner involvement 1
   • Psychosis or certain personality disorders (WHO caution) 1
   • Patients with severe comorbid depression or anxiety disorder may respond less well and require individualized mental health assessment first 1

Training and Delivery

• Self-hypnosis requires initial training from appropriately qualified practitioners who are licensed to treat the specific condition being addressed 5
• Healthcare providers should only use clinical hypnosis for conditions they are already licensed to treat 5
• Digital tools (apps, pre-recorded audio) can be used after initial professional training and assessment 1
• Typical training involves learning techniques for 15-30 minutes daily 4

Expected Outcomes and Timeline

• Anxiety reduction can occur within a single session 1
• Chronic pain improvements become significant at 1-year follow-up and continue improving at 2 years 3
• IBS symptom benefits persist long-term (5-year follow-up data available) 5

Safety Profile and Adverse Events

Self-hypnosis has minimal adverse effects when properly delivered:

• Only minor adverse events reported in cancer populations 1
• One study reported emotional upset in 3 participants, though they continued treatment 1
• Dizziness, nausea, or headache may occur if patients are brought out of trances by inexperienced practitioners 1
• Critical caveat: Hypnotherapy is not safe for all patients—screening by qualified clinicians is essential to identify risks like history of dissociation or trauma 1

Special Populations

Children and Adolescents

• Children are more in touch with innate imagery processes than adults and can learn self-hypnosis easily 6
• Effectiveness demonstrated across broad age range from preschool through adolescence 5
• Particularly useful for autonomic response control, habit disorders, and chronic conditions 6

Patients with Mental Health History

• Patients with anxiety or depression history can benefit, but require careful assessment 1
• Those with severe comorbid mental health conditions may need community-based psychotherapy before or concurrent with self-hypnosis training 1
• Coordination with qualified mental health experts is strongly recommended for patients with PTSD or abuse history 5

Common Pitfalls to Avoid

1. Do not recommend self-hypnosis apps or digital tools without prior professional assessment in medical, dietary, and psychosocial contexts 1
2. Do not confuse clinical hypnotherapy with entertainment hypnosis—this is a legitimate medical intervention 5
3. Do not use self-hypnosis as monotherapy for severe mental health conditions—it should augment, not replace, standard psychiatric care 1
4. Ensure interdisciplinary collaboration—mental health practitioners should not use hypnotherapy for IBS without physician co-management, and physicians should not use it for PTSD without mental health collaboration 5

Comparison to Other Interventions

Self-hypnosis compares favorably to other mind-body therapies:

• In meta-analyses of brain-gut behavioral therapies for IBS, cognitive behavioral therapy and gut-directed hypnotherapy were most effective long-term 1
• Unlike pharmacological approaches, self-hypnosis is nonaddictive and has minimal side effects 2
• Cost-effectiveness is superior to ongoing medication or repeated professional therapy sessions once initial training is complete 2