The crucial effect of hypnosis is not on observable behaviour per se, but on subjective experience. The hallmark of the hypnotic phenomena is the nature and quality of the subjective experience. (Orne 1971). True hypnotic responses have an essential quality of involuntariness or non- volition. Regardless of how vividly a perception is imagined, it is not a hypnotic response unless it is experienced as real. (Tellegen 1978/1979).
Kihlstrom (2006) characterizes hypnosis as involving two essential qualities. “Involuntariness bordering on compulsion’ and ‘conviction bordering on delusion’. He explains two parallel streams of processing as an overt-cognitive rout and a covert affective route, which are subsequently integrated. Hypnotic suggestions exert their effects by altering the covert, affective components of behaviour.

It would seem that the motivational system engaged by hypnosis has the automatic effect of entrainment, which from an evolutionary point of view is valuable for survival. Hypnotic control can be therefore understood in relation to the social influences that engage at a primitive level and the mental representations that motivate, direct and monitor behavioural actions.

With hypnotherapy, most importantly are the awareness of the hypnotist and the nature of the hypnotist-subject interaction. (Social neurophysiological mechanisms). The hypnotherapist observes and experiences the patient’s mode of communication on as many different levels as possible. Verbal, nonverbal, emotional, styles of imagery and cognitive functioning, and entering the patient’s frame of reference, i.e., his interpretation of reality, internal, and external.

As young children we learn the meaning of words largely through careful attention to the perspective and intention of the parent. Forming a representation of the parent’s intention is an elementary process that is formative in the development of verbal thought. Attunement and reciprocity are aspects of this attachment process that reflect mutual awareness and emotional resonance. Early emotional regulation establishes via mother-infant synchrony that contributes to the eventual self-regulation development in the child. Mirror neurons found in Broca’s area in the brain suggest that shared actions and turn taking may have been the genesis of proto-conversation and semantic language. Facial expressions, gestures and posture of another, will activate circuits in the observer similar to for empathy. Out internal emotional state can become our intuitive ‘theory ‘of the internal state of another.
Research has shown that this representation of others’ mental states continues throughout life for the development of self. The mechanisms of self-regulation are tightly coordinated with the mechanisms of social influence. This would suggest that for hypnotherapy to have an enduring effect there needs to be more than direct suggestions without the attunement and synchronicity with the therapist. Our brains are inescapably social, their structure and functioning deeply embedded in the family, tribe and society. While the brain has many shortcomings and vulnerabilities, our ability to link with, attune to and regulate each other’s brains provides us with a way of healing. Hypnotherapy is therefore more than just words, as Erickson demonstrated so brilliantly.