How hypnotherapy can help us make positive changes in our lives
As an occupational therapist, my focus is on doing. It may seem strange, then, that I have recently trained in cognitive behavioural hypnotherapy, which is more likely to be associated with thinking, or even entering a state of trance. In this short piece, I will explain why I believe that self-awareness, and using our imagination to practice new ways of thinking and feeling, can help us to do the things we want to do, make changes in our lives and be the best versions of ourselves.
Photo by Milad Fakurian on Unsplash
In the hot summer of 2022, I cured my arachnophobia and wrote about my experiences here. Terror of spiders had been a long-standing issue for me, so when I was able to overcome it at the London Zoo, Friendly Spider Programme I became curious about the methods that had been used. The programme incorporated a special blend of cognitive behavioural therapy (CBT), hypnotherapy, and exposure therapy, all bolstered by some excellent peer support from volunteers. As a result of this, I decided to undertake training in cognitive behavioural hypnotherapy, an approach that integrates these methods, at the UK College of Hypnosis and Hypnotherapy (UKCHH). I’m an occupational therapist and researcher, so it was important to me that this was an evidence-based approach, that focuses on enhancing CBT with hypnosis. There is a strong body of research showing that those who have hypnosis added to their CBT will generally have better outcomes than with CBT alone.
Various articles have summarised what hypnosis is and where it is supported by evidence. A final-year medical student writing for Inspire the Mind described their experience of shadowing an Irritable Bowel Syndrome (IBS) hypnotherapist here. Peter Whorwell, a prominent medical doctor and researcher, conducted research which found that of 1,000 people with hard-to-treat IBS, 76% experienced a positive effect with hypnotherapy, with symptom severity reduced by half.
I found that there was a lot of overlap between what I have learnt over the years about successful rehabilitation and the keys to successful hypnotherapy. In my professional training, I was influenced by Bandura’s concept of self-efficacy, which emphasises that our belief in our ability to do something is a key factor in whether we will be able to do it successfully. Self-efficacy can be improved by receiving positive feedback or observing others doing the task in question, but a more powerful way of improving self-efficacy is to have the opportunity to master the task by doing it ourselves. In rehabilitation, this concept is applied by educating people to understand their conditions, and empowering people with opportunities for ‘mastery experiences’. Although there are many models and approaches to hypnotherapy, the cognitive behavioural hypnotherapy approach encourages self-management and self-awareness, with self-hypnosis encouraged as a tool for clients to sustain positive changes that have been identified and agreed in the initial meeting. A key feature in cognitive behavioural hypnotherapy is an initial assessment that spends time gathering information about the problems a client is facing and understanding them in a cognitive behavioural model – which then helps identify how specifically the client can begin to solve those problems. At each stage, the client is highly involved in the process - including the hypnosis part which is not a passive experience for a client but an active directed involvement. Learning to use self-hypnosis enhances self-efficacy further, due to the sense of accomplishment gained by guiding oneself to develop a skill or manage challenges.Â
Real-life experience is always the best way to develop mastery and self-efficacy, but hypnotherapy is an excellent way to practice for the real thing. The second most potent way of developing self-efficacy is ‘vicarious experiencing’, which could be through observing others or through our own imagination. Far from the stereotype of a hypnotist embarrassing people by turning them into chickens or making them do silly dances, the reality of hypnotherapy is that it strategically uses the imagination to powerfully increase self-efficacy, as we imagine coping with and mastering our challenging situations. After an in-depth assessment to find out about a person’s issues and goals, hypnosis can be used to mentally rehearse situations, using the imagination to experiment safely with different thoughts, feelings and actions.
This is where the cognitive behavioural part comes in. Many people will be familiar with the principles of CBT as it has strong research evidence and is widely used, including in the NHS. It enables us to increase our self-awareness of the connections between our thoughts, feelings and actions. Once we can understand how these factors interact, we can test and challenge unhelpful assumptions and break unhelpful patterns. When I mentioned cognitive behavioural hypnotherapy to a retired psychologist friend, he was surprised. ‘Sounds a bit counterintuitive,’ he said. ‘CBT is all about awareness, so why would you send someone to sleep?’. Actually, the idea that hypnosis is the same as sleep or trance is a myth. It requires focused attention, imagination, absorption and positive expectation. It may not even involve relaxation, for example where the goal is to improve performance in sports. Whatever the goal, hypnosis is always something the person involved should be actively engaging in, and it does not require any relinquishing of control.
Photo by Chris Briggs on Unsplash
An example might help here. Jane (not her real name) had a fear of flying. It ruined holidays for her. She avoided travelling by plane, and if she knew she would have to fly home from a holiday the anxiety about this preoccupied her throughout the holiday. She had the opportunity to take a cruise to her holiday destination but would have to fly home afterwards. We spent a long time unpicking what the fears were about. I probed Jane about what sort of thoughts went through her head relating to the flight, and how she felt when she boarded a plane. We talked about what sort of things she would usually do in response to these thoughts and feelings. Then we used hypnosis to allow her to get into a relaxed, receptive mindset so that she could mentally rehearse the things that she feared in the knowledge that she was perfectly safe. We repeated the experiment until her anxiety lost its grip. Occupational therapy came in too, as we problem-solved different activities Jane could do on the flight to occupy her and bring a sense of pleasure and relaxation. Incidentally, Jane had no intention of making a habit of flying as she was also concerned about the environmental impact, and it is really important to consider a person’s wider values when setting goals together. She just wanted to be free of her phobia and able to enjoy the occasional holiday with flying involved when necessary.
This is just a little taster of how we can combine approaches to increase our self-awareness, desensitise ourselves to the things we fear, achieve a new sense of mastery (self-efficacy) and make positive changes in our lives. So far, I have successfully worked with people to overcome fears, break habits, build confidence and manage pain. I use self-hypnosis regularly to manage period pain, reset my motivation, rehearse situations or just to go to a positive place in my imagination. The evidence for hypnotherapy depends on what you are using it for. It has been found to be effective in helping people manage anxiety, asthma, irritable bowel syndrome, and pain. When combined with cognitive behavioural therapy it is effective for treating phobias and obesity. Other suitable goals include overcoming fears and inhibitions and improving self-esteem and self-confidence. The Royal College of Psychiatrists has published information about the conditions hypnotherapy can help, according to research evidence.
Although in theory, anyone can respond well to hypnosis, it helps if you are motivated, have a good imagination and have the patience to persevere. If you would like to see someone having significant dental work using only hypnosis to manage the pain, take a look at this video! It may seem inconceivable that the power of the mind could be so effective, but why should it? Have you ever had a thought that makes you feel sick, or causes you to flush or have a wave of sadness or fear? Our thoughts lead to physical responses all the time, sometimes on an obvious level and sometimes much more subtly. When you think of it that way, it’s only sensible to pay attention to the messages we give ourselves, take control, and re-programme any unhelpful patterns. Now, on the count of three, you will take a deep breath and feel ready to stop reading, smile to yourself and get on with the rest of your day. One… two… three!
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Photo by Yuyang Liu on Unsplash