During my recent forays exploring the evidence base for hypnosis and hypnotherapy, one of the discoveries that is found and demonstrated in masses of research is that just about anything that can be experienced with hypnosis, can also be experienced without it, often just using suggestion. This tends to be something that polarises the field of hypnosis and certainly gets juices flowing for many a hypnotist I have discussed this with.

Probably the best sources of this work are Hypnosis: A Scientific Approach by T.X. Barber in 1969 and Hypnotic Susceptibility by Hilgard in 1965. Though there are many others you can seek out too and almost no real empirical evidence to suggest that certain things can only be done in hypnosis.

Even some of the seemingly amazing and impressive phenomena such as anaesthesia creation and hallucinations can all be reproduced without hypnosis.

That said, many of the things that can be done without hypnosis may well also be used with hypnosis. In fact, the regular marriage of cognitive behavioural therapeutic techniques with hypnosis is perhaps because that much research tends to suggest that hypnosis enhances the therapeutic results gained when combining the two approaches.

So how do we choose if hypnosis is actually going to help or not? How do we decide whether hypnosis is best employed or not in therapy? How do we make the best decision?

I tend to think the simplest and most effective way to decide, is to ask the potential client.

Yes, ask them.

In fact, according to studies conducted by Devine and Fernauld in 1973 and Kanfer and Grimm in 1978, giving your clients a choice about which modality of therapeutic intervention to use enhances the therapeutic outcome!  The vast majority of people that come to see me have been referred, so often have heightened expectations of success due to the success of the person referring them… This is likely the case with many people who have been referred. However, I personally prefer my clients to have realistic expectations about what can and cannot be achieved rather than just ride the wave of incredibly high expectation… Although that expectation can often prove beneficial, it could potentially also set therapist and client up for a fall if they are not correctly educated.

Educate the client of the options available, then ask them.

A number of studies suggest that if the client is truly heard and paid attention to, they’ll achieve better results in therapy (you can look at Cooley and LaJoy, 1980 and Bohart et al. 2002). It may seem obvious, but not everyone does adhere to as much and many therapists I have encountered do impose their regime in therapy rather than truly listen to the needs of the client.

So aside from the posturing here today, I thought I would offer up a list of facts about hypnosis that actually truly aid any therapist in choosing whether hypnosis is the right way forward. It is a list I was initially introduced to by the brilliant book Essentials of Clinical Hypnosis, An Evidence Based Approach by Kirsch and Lynn. So armed with this information, the client and therapist can make an informed decision together as to whether hypnosis is best employed or not, rather than being used a panacea for everyone in any circumstances, and then if the decision is to choose hypnosis, your therapeutic outcomes are much more likely to be met, as research suggests.

– Hypnosis is not a dangerous procedure when practiced by qualified clinicians and researchers (see Lynn, Martin, & Frauman, 1996).

– The ability to experience hypnotic phenomena does not indi­cate gullibility or weakness (T. X. Barber, 1969).

– Hypnosis is not a sleeplike state (Bányai, 1991).

– Most hypnotized participants do not describe their experience as a trance but as focused attention on suggested events (McConkey, 1986).

– Hypnosis depends more on the efforts and abilities of the subject than on the skill of the hypnotist (Hilgard, 1965).

– Suggestions can be responded to with or without hypnosis, and the function of a formal induction is primarily to in­crease suggestibility to a minor degree (see T. X. Barber, 1969; Hilgard, 1965).

– A wide variety of hypnotic inductions can be effective (e.g., inductions that emphasize alertness can be just as effective as inductions that promote physical relaxation; Banyai, 1991).

– Direct, traditionally worded hypnotic techniques appear to be just as effective as permissive, open-ended, indirect suggestions (Lynn, Neufeld, & Mare, 1993).

– All of the behaviors and experiences occurring in hypnosis can also be produced by suggestions given without the prior induction of hypnosis (reviewed in Kirsch, 1997b).

– Participants retain the ability to control their behavior during hypnosis, to refuse to respond to suggestions, and even to oppose suggestions (see Lynn, Rhue, & Weekes, 1990).

– Hypnosis does not increase the reliability of memory (Lynn, Lock, Myers, & Payne, 1997) or foster a literal reexperiencing of childhood events (Nash, 1987).

– Spontaneous amnesia is relatively rare (Simon & Salzberg, 1985) and can be prevented by informing patients that they will be able to remember everything they are comfortable remembering.

There you go, some facts to be considered, which I have seen many a hypnotist and therapist suggest are not facts…. Heck, I don’t make the rules…