Institutes of Health is supporting clinical trials of complementary and
alternative medicine, which includes hypnosis. To determine whether hypnosis
has a role in present-day medicine, this review evaluates relevant clinical
trials involving hypnosis. ....studies using PET (positron emission tomography)
support the occurrence of distinct changes in the brain with hypnosis.
By using electroencephalography, changes were seen during hypnosis that
could not be evoked by waking imagination.
TRIALS OF HYPNOSIS
FOR PAIN RELIEF
Hypnosis with direct suggestions for pain relief produced significant
pain relief compared with placebo...and gave the best results of all the
A 1999 review of more than 1650 surgical cases using hypnosis combined
with other methods for conscious sedation promoted the safety and patient
comfort afforded by hypnosis....The authors concluded that hypnosis prevents
pharmacological unconsciousness, allows patient participation, and may
allow a faster recovery and a shorter hospital stay...Other studies support
the multiple benefits of hypnosis as an adjunct to conscious sedation
for many types of surgery.
Hypnosis has been used successfully for other (than warts) conditions.
Patients with atopic dermatitis noted decreased pruritus, scratching,
sleep disturbance, and tension after treatment with hypnosis. In many
patients, improvements persisted at follow-up evaluations up to 18 months
later. A review of the use of hypnosis in dermatology supports its value
for many skin conditions not believed to be under conscious control.
Hypnosis for irritable bowel syndrome (IBS) has been studied extensively...all
patients in the hypnosis group had significant improvements...with no
relapses at 3-month follow-up.
The positive results with hypnosis
for IBS have been confirmed in several other trials. It was concluded
that "in addition to relieving the symptoms of irritable bowel syndrome,
hypnotherapy profoundly improves the patients' quality of life and reduces
absenteeism from work." Use of audiotapes for self-hypnosis at home, used
in many IBS studies, was considered important for success. Patients with
peptic ulcer disease have benefited from hypnosis.
In 1 study of 44 patients, the hypnosis group had a significant decrease
in blood pressure compared with the control group. At 6 months, the hypnosis
group had mean decreases...below their baseline blood pressures.
Hypnosis has been
used successfully for treatment of headaches. Patients with chronic...tension
headaches were assigned randomly to hypnosis or a control group. The hypnosis
group had a significant reduction in the number, duration, and intensity
of headaches. Instruction in self-hypnosis produced significant benefit
for tension headaches...
Hypnosis as anesthesia
for childbirth has a long, successful history supported by several trials.
The hypnosis group reported
less discomfort and shortened labor. At delivery, the hypnosis group had
a significant decrease in complications, fewer surgical interventions,
and a shorter hospital stay.
is associated with nausea and vomiting. Hypnosis has been studied for
reducing these and other adverse effects.
Hypnosis has been used successfully
in other areas of oncology. Patients undergoing bone marrow transplantation
treated with hypnosis experienced significantly less oral pain than control
patients. Patients with metastatic breast cancer benefited from self-hypnosis
and from participation in group support....benefited with significantly
less pain and an increased duration of survival. An untapped potential
for hypnosis for cancer treatment is the reported ability to alter regional
blood flow, which offers the prospect of increasing the delivery of chemotherapy
to a tumor or reducing blood flow to it.
Patients with chronic tinnitus treated with hypnosis improved significantly
in 7 of 10 disturbing symptoms compared with a group treated with masking
techniques or supportive measures.... These results support the findings
from other trials.
Several trials have evaluated hypnosis for asthma. A study of 55 patients
with asthma noted that patients assigned randomly to the hypnosis group
used bronchodilators less frequently and experienced less wheezing than
controls.... A large multicenter trial of patients with asthma reported
a significant decrease in the number of treatment failures and a larger
number of patients deemed "much improved" by independent assessment in
the group taught self-hypnosis. A retrospective study of asthmatic patients
reported similar benefit, with 54% of patients treated with hypnosis having
an "excellent" result and 21% becoming symptom free and discontinuing
Decreased rates of hospital
admissions, length of stay, and use of corticosteroids were attained with
hypnotherapy during the year of study in patients with refractory asthma
who served as their own controls.
A few cases have been reported
of success with hypnosis in weaning dependent patients from ventilators.
The report indicates a potential benefit of hypnosis when other techniques
Numerous studies have reported
various techniques and outcomes in the use of hypnosis for SMOKING CESSATION,
many with beneficial results. A 1970 study used a single 12-hour group
session for volunteer smokers who had unsuccessfully tried other methods
of smoking cessation. The program achieved an 88% 1-year abstention rate.
In a 1992 meta-analysis of
633 smoking-cessation studies involving almost 72,000 participants, hypnosis
was the most successful cessation method...
A 2000 review of 59 studies
using various techniques for smoking cessation indicated that,...several
showed a greater than 50% success rate, with 3 studies (200 participants
total) documenting 12-month abstention rates of 63% to 88%. In another
report, an experienced practitioner of hypnosis reviewed his experience
and techniques with 4355 patients, citing an 81% success rate for smoking
Patients with refractory fibromyalgia (mean duration, 8.5 years) who were
randomly assigned to receive hypnosis obtained significant improvement
compared with those assigned randomly to physical therapy alone. Benefits
included improvements in morning fatigue... sleep ... muscle pain... overall
assessment... and use of pain medications, with results persisting for
at least 6 months.
More recently, it has been emphasized again that health care personnel
should be aware that patients under anesthesia have unconscious auditory
perception and tend to interpret comments negatively. The report also
stressed that, along with the potential deleterious effects of this awareness,
came the opportunity for using "semantics of positive suggestion" (emphasizing
comfort, safety, and success) that should be "an integral part" of surgical
and obstetrical care. It appears appropriate to consider the use of suggestions
for patients in the perioperative period as a part of the practice of
Postoperative hypnosis demonstrated
significant...recall of material from the audiotape (as well as events
during surgery) that was not recalled consciously.
Preoperative hypnosis is less
controversial than the idea of awareness during anesthesia, with benefit
noted in many trials. Significant benefits include less anxiety and decreased
blood pressure...reduced blood loss...enhanced postoperative well-being...improved
intestinal motility...shorter hospital stay...reduced postoperative nausea
and vomiting...and reduced need for analgesics.
A 1991 review of clinical trials
using hypnosis, suggestion, or relaxation in the care of surgical patients
found that 89% of the trials showed that these techniques produced a positive
outcome in facilitating physical or psychological recovery from surgery.
Hypnosis as an adjunct to surgery was believed to be "successful for the
majority of individuals," with benefits such as decreased pain, anxiety,
nausea, and recovery time.
The medical literature from the 1960s indicated a strong potential for
the use of hypnosis for impotence, and support for this assertion has
come from recent clinical trials. A review of the personal experience
and techniques of an experienced practitioner cited an 88% success rate
using hypnosis for impotence in almost 3000 patients. Review of developments
in hypnosis reported its efficacy in augmenting other treatment methods
for sexual dysfunction and its potential for exploring contributing psychological
In a trial of hypnosis for
chronic (mean, 7 years) urinary incontinence, 50 women served as their
own controls. At 1 month, 58% were symptom-free and another 28% were improved,
with cystometric testing at 3 months objectively confirming the benefits.
The acceptance of hypnosis as a mode of treatment in medicine is increasing
as a result of "careful, methodical, empirical work of many research pioneers.”
Many important trials reviewed here have helped to establish the role
of hypnosis in contemporary medicine. These trials have established the
utility and efficacy of hypnosis for several medical conditions, either
alone or as part of the treatment regimen. Through greater awareness and
acceptance of hypnosis, additional training and research can be inspired
in pursuit of improved techniques and new areas of potential benefit.