What is hypnotherapy?

By Nathan Hook Dip.CBH  Dip.SMRB  MSc  MBPsS

This article is a short introduction to hypnosis in the context of therapy. There is good evidence that hypnotherapy is effective for treating a range of conditions. Hypnosis consists of two elements: induction into a trance state, and the use of suggestions.


Trance is an everyday mental state characterised by being more open, creative and receptive. Trance state includes having focused narrow attention, such as listening to the voice of the hypnotist and not noticing the sound of traffic going past. A good example is trance used for pain management, directing attention away from a painful experience such as dental surgery.

We naturally experience many different mental states in day-to-day life, such as the four different mental states during a good night’s sleep. Another example is ‘flow state’ which is experienced performing a rhythmic repetitive task such as long-distance driving, working on a production line or some computer games. Trance is simply another state comparable to these.

Some people use to think trance was a unique special state, but research with brain scanning technology has failed to find evidence for this. Evidence-based Hypnotherapists will still speak of trance but do not mean a special state as people did historically.

Despite being named after Hypnos (the Greek god of sleep) hypnotic trance is not sleep and while it can be relaxing it is not a state of relaxation. For example, hypnosis can be used to achieve peak sporting performance and clearly someone playing high level sport is not asleep or relaxed.


A hypnotist will use an induction technique to guide a client into a trance state.

All hypnosis is self-induced, in the same way that all meditation is induced by yourself. As with other activities and especially activities new to you, it’s useful to have a more experienced guide to talk you through the process.

There are lots of different kinds of induction, but some of the common examples include:

  • Counting, often downwards, with the client moving more deeply into trance with each number.
  • Eye fixation on a point, the modern version of using a pendulum or pocket watch.
  • Raising and dropping the arm, becoming relaxed with the movement.

There are even ‘rapid inductions’ that can work in only a few seconds, but these are generally used by stage or street hypnotists rather than hypnotherapists, and they tend to focus on working with people who respond highly to hypnosis.

The benefit of working directly with a hypnotherapist rather than a recording is that they can tailor the induction to you. Some people respond better to some inductions than others. A hypnotherapist can also read how deeply into trance someone is and modify the process accordingly, such as adding additional ‘deepeners’ to bring the client more deeply into trance.


Even under everyday circumstances humans are very open to suggestion. We take cues from others and the situation in how to respond. Advertising is a widespread example of the deliberate use of suggestion to influence behaviour. At a more personal level, someone suggesting that a room is too hot or cold can influence how the temperature of the room is perceived.

In a state of trance, suggestions become far more powerful and effective. It is possible to work using suggestion alone, but this can be less effective and would not be hypnosis due to the lack of trance.

Using suggestion a person can be guided through an imagined location, which might be termed a mindscape. These can be tailored to the client and the changes they are looking for. Suggestions can be used to directly achieve the desired changes or to give experiences that achieve the changes.

An important point is that all suggestions need to be positive. Suggesting someone is ‘no longer a smoker’ to help them quit is not effective, because it causes them to think of smoking. Suggestions to increase willpower would be more effective.


As with most skills some people have a talent for entering trance and accepting suggestions more easily than others, but everyone can get better at it with practice. The only time hypnosis would not work on a willing participant is if they are unable to follow the instructions, such as with a language barrier or severe learning difficulties.

Hypnotherapy is not suitable for people with psychosis or some personality disorders and could cause a bad reaction in these cases.

A client will usually remember almost all of what happens while in trance. However there is no evidence that hypnosis improves memory recall of past events, and if this is attempted there is a risk of creating false memories.

Cognitive Hypnotherapy (Hypno-CBT)?

Cognitive Behavioural therapy (CBT) is a different kind of therapy based on the idea of training a client to direct thinking and emotions more helpfully. A full discussion is beyond the scope of this article. Research has found good evidence that combining hypnotherapy with CBT makes the changes the client is seeking to make more effective for the majority of clients.

CBT can be used to unlearn bad mental habits, while hypnotherapy can be used to learn positive habits and helpful beliefs. Used by a therapist qualified to use both  is generally more effective than using one in isolation.

For example, to treat someone with a phobia (excessive fear of something), CBT might be used to train the client to better appraise the danger more accurately and channel any fear generated in a more helpful way to take proportionate precautions. Hypnotherapy might then be used to have the client safely visualise facing the source of their fear, learning to overcome it there before doing so in everyday life.


This short article has explained the core concepts of hypnotherapy and introduced the concept of Hypno-CBT.

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