Does hypnosis work for anxiety or depression?

I've written here in the past about the use of meditation for reducing anxiety and as part of comprehensive treatment for depression. Another technique that may help some people is hypnosis.

One of the oldest forms of psychotherapy in the Western world, hypnosis may also be the most misunderstood. Although long associated with charlatans or performers, all true hypnosis is, by definition, self-hypnosis. In spite of the prevailing myth, nobody can be hypnotized against his or her will. Instead, hypnosis is generally induced by focusing attention on positive mental imagery.

A number of hypnotic techniques exist, combining relaxation with imagery. There's no magic to this technique. It relies mainly on a patient's ability to concentrate and the trust he or she has in a therapist.

People who undergo hypnosis may achieve a trancelike state, similar to what happens when they daydream or meditate. But hypnosis is actually a heightened state of concentration. The aim is to focus the mind to eliminate distractions and make someone more open to suggestions, such as those that promote the aims of treatment.

The American Medical Association approved hypnosis as a therapy in 1958, and the American Psychiatric Association followed in 1961. Since then, published reviews and papers in peer-reviewed journals have provided guidance about when this therapy is effective.

Hypnosis is sometimes used in conjunction with cognitive behavioral therapy to treat anxiety. It can help patients to focus their attention, rethink problems, relax, and respond to helpful suggestions.

This technique has been studied most as a treatment for anxiety related to surgery. Many studies have reported that hypnosis reduced anxiety levels and lowered blood pressure in patients before surgery, and enhanced recovery afterward by shortening hospital stays and reducing complications like nausea and vomiting.

In a 2006 study, for example, patients who underwent hypnosis received suggestions of well-being before surgery. Upon entering the operating room, they reported anxiety levels 56% lower than anxiety levels before hypnosis. Patients in a comparison group, who received the normal presurgical standard of care, reported a 47% increase in anxiety.

There is less evidence for the use of hypnosis in treating depression, but it may help some patients.

One study involving 84 people with depression, who were randomly assigned to 16 weeks of treatment with either hypnosis or cognitive behavioral therapy, found that both groups improved with treatment. The hypnosis group made greater improvements than the cognitive behavioral group when symptoms were rated on standard symptom scales, but the gains were small.

If you are interested in hypnosis, discuss it first with your doctor or clinician, who may be able to provide a referral to a qualified therapist. Just be aware that many states do not regulate hypnotherapy.

To find a qualified therapist, ask if the person is licensed to practice as a mental health professional (that is, not just "certified" as a hypnotist). Or check for membership in the American Society of Clinical Hypnosis or the Society for Clinical and Experimental Hypnosis, two nationally recognized organizations for licensed professionals in this field.

Have you ever used hypnosis to help with anxiety or depression? Did you find it helpful?

Dr. Michael Miller has been on staff of the Beth Israel Deaconess Medical Center, a large teaching hospital in Boston, for more than 25 years. He is also an Assistant Professor of Psychiatry at Harvard Medical School.

Anxiety and Phobias
Anxiety disorders—which include panic attacks, post-traumatic stress disorder, obsessive-compulsive disorder, and phobias—are among the most common mental illnesses, affecting about 23 million American adults. Thankfully, never before have there been so many therapies to help control anxiety. Coping With Anxiety and Phobias is a special report from Harvard Medical School that provides up-to-date information on these treatments, as well as information on the many types of anxiety disorders, their symptoms, causes, and getting a proper diagnosis.

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