Hypnotherapy, hypnosis
Various forms of hypnosis, trance, and altered states of consciousness have played roles across cultures throughout history. Hypnosis-like prac...

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Theory

The way hypnosis works is not well understood. Some changes in the body have been associated with hypnosis, including changes in skin temperature, heart rate, intestinal secretions, and immune response. During hypnosis, decreases have been noted in heart rate, blood pressure, body temperature, and brain wave patterns (alpha waves). Similar changes have been reported with other forms of relaxation.

Some scientists suggest that neuroendocrine pathways in the brain such as the hypothalamic-pituitary-adrenal axis or the limbic system (emotional center of the brain) are central to connecting body functions with the mind, memory, and emotions. Hypnosis is thought to activate these pathways. Various parts of the brain and spinal cord have been proposed as important in the pain-relieving properties of hypnotherapy. It has been suggested that the release of endogenous opioid peptides may play a role, although early evidence suggests that endorphins (chemicals in the brain) may not be involved in the mechanism of action.

Hypnosis is associated with a deep state of relaxation. Whether this represents a specific altered state of consciousness is the subject of scientific debate. There are reports that suggestion alone, without the process of hypnosis, can achieve many of the same results, although research in this area is not conclusive. It is not known why some individuals are more susceptible to hypnotic suggestion than others.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Adjunct to Cognitive Behavioral Therapy (CBT): Hypnotherapy techniques may be combined with cognitive behavioral therapy for the treatment of conditions such as anxiety, insomnia, pain, bed-wetting, post-traumatic stress disorder, or obesity. Better-quality study is necessary before a strong recommendation can be made.
Grade: B

Anxiety: Several studies report hypnosis to reduce anxiety, particularly prior to dental or medical procedures, or in the management of phobias. Early evidence suggests that these effects may last for up to three years with benefits reported in children and adults. Additional evidence is necessary before a strong recommendation can be made.
Grade: B

Dental anxiety: Several promising studies in adults and children report that anxiety related to dentist visits can be reduced with the use of hypnotherapy. Benefits may be long-standing (measured at up to three years). However, some research reports that hypnosis may be less effective for this use than group therapy or systematic desensitization therapy.
Grade: B

Irritable bowel syndrome (IBS): Early research suggests hypnotherapy may lower the sensory and motor component of the gastrocolonic response in patients with irritable bowel syndrome. Better studies are necessary to make a conclusion.
Grade: B

Pain (various causes): Hypnotherapy has been studied in the management of pain, including low back pain, surgery-related pain, cancer-related pain, dental procedure-related pain, burn pain, repetitive strain injury, temporomandibular joint disorders, sickle cell disease-related pain, irritable bowel syndrome, oral mucositis, tension headache, and chronic pain from various causes. Various hypnotherapy approaches have been used, and it is not clear what technique or duration of treatment is optimal. Therefore, although the existing research is promising, better-designed trials are necessary before a strong recommendation can be made.
Grade: B

Psychosomatic disorders: Hypnosis appears effective in the treatment of psychosomatic disorders. Additional research is needed to support this finding.
Grade: B

Tension headache: Several studies report improvements in the severity and frequency of tension headaches following several weekly hypnosis sessions. Early research suggests that hypnosis may be equivalent to other relaxation techniques, biofeedback, or autogenic training. Better quality studies are necessary before a strong recommendation can be made in this area.
Grade: B

Academic performance: There is conflicting evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Alcohol dependence: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Allergy/hay fever: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Alopecia areata (hair loss): Based on early study, hypnosis may help psychological well-being and physiological outcome in patients with hair loss. Larger, well-designed studies are needed before a firm conclusion can be drawn.
Grade: C

Asthma: Preliminary research for the use of hypnosis in management of asthma symptoms does not provide clear answers. Anxiety associated with asthma may be relieved with hypnosis. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Bed-wetting (nocturnal enuresis): There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Bone fractures: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Chemotherapy side effects: There are several studies of hypnosis for cancer-related conditions, including pain, anxiety, and quality-of-life. Limited research reports mixed effects of hypnotherapy for chemotherapy-related nausea/vomiting or mouth sores. Additional research is necessary before a conclusion can be drawn.
Grade: C

Conversion disorder: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Drug addiction: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Duodenal ulcer: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Eating disorders: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Erectile dysfunction: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Fertility: Based on early evidence, hypnosis may improve the in vitro fertilization-embryo transfer cycle. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Fibromyalgia: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Gastric disorders (gastric emptying): Early research indicates that gut-oriented hypnosis may have a beneficial effect on shortening gastric emptying both in dyspeptic and in healthy subjects. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Heartburn (dyspepsia): There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Hemophilia: There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Herpes: A small study showed potential benefit of a hypnotherapeutic treatment program for patients suffering from recurrent orofacial herpes infections. Further research is needed to confirm these results.
Grade: C

High blood pressure: Early study suggests that hypnosis may have short and long-term effects for patients with mild high blood pressure. Additional research is needed to confirm these findings.
Grade: C

Insomnia: Several early studies report that hypnosis may decrease the amount of time it takes to fall asleep, increase the duration of sleep, and improve sleep quality. However, this research is not well designed or reported, and cannot be considered definitive.
Grade: C

Jaw clenching: Preliminary research suggests jaw clenching may be related to hypnotic susceptibility. Better-designed research is necessary to make a strong recommendation.
Grade: C

Labor: Several studies report the effects of pre-natal hypnotherapy on duration of labor and pain medication use. Additional evidence is necessary before a clear conclusion can be drawn.
Grade: C

Menopausal disorders: Early evidence shows that hypnotherapy may be beneficial in the treatment of hot flashes and may improve quality of life in women who are experiencing menopausal symptoms. Further research is needed to make a recommendation.
Grade: C

Nausea/vomiting: Several studies report on the use of hypnotherapy in people with nausea/vomiting related to cancer chemotherapy, pregnancy (hyperemesis gravidarum), and surgical recovery. Results are mixed and there is no reliable comparison to anti-nausea medications or other relaxation techniques. Better research is needed before a firm conclusion can be drawn.
Grade: C

Post-surgical recovery: Research suggests that hypnosis may be helpful for pain and anxiety in various situations, including after surgery. Early research reports that length of hospital stay and psychological well-being may be improved after surgery with the use of hypnotherapy. However, most studies in this area are not well designed, and updated high-quality investigations are needed before a firm conclusion can be drawn.
Grade: C

Rheumatoid arthritis: Although multiple trials report diminished pain levels or requirements for pain-relieving medications after hypnotherapy, there is limited research for rheumatoid arthritis pain specifically. Other signs of rheumatoid arthritis, such as joint mobility or blood tests for rheumatoid factor, have not been adequately assessed.
Grade: C

Schizophrenia: There is currently not enough evidence to suggest for or against the use of hypnotherapy in this condition. High-quality studies are needed to determine the effect and safety of hypnosis in schizophrenia.
Grade: C

Skin conditions (eczema, psoriasis, atopic dermatitis): There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Tinnitus (ringing in the ears): There is inconclusive evidence from preliminary research in this area. Additional study is needed before a firm conclusion can be drawn.
Grade: C

Vascular damage: Preliminary study results suggest a protective role of hypnosis against vascular damage. Further research is needed to confirm these results.
Grade: C

Warts: There is promising early evidence to support the use of hypnosis in the treatment of warts. Larger well-designed trials are needed to further assess the use of hypnosis for warts, and to determine the most effective methodology.
Grade: C

Weight loss: Research suggests that hypnosis may be valuable as an adjunct to cognitive behavioral therapy for weight loss. However, it is not clear if hypnotherapy used alone is beneficial in this area.
Grade: C

Cancer (radiotherapy side effects): Hypnosis did not reduce anxiety or improve quality of life in cancer patients undergoing curative radiotherapy in early high-quality studies.
Grade: D

Smoking cessation: Hypnosis is a popular therapy used by people trying to quit smoking, and it is often included as part of smoking cessation programs. The available evidence suggests that hypnotherapy does not have significant effects in this area. Better-designed research is necessary before a strong conclusion can be drawn.
Grade: D

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