How hypnosis works, according to science

When you think about hypnosis, what do you visualize? For many, it’s a clock-swinging magician or a comedy act that forces an unwitting volunteer to make embarrassing public admissions on stage.

But hypnosis has a surprisingly robust scientific framework. Clinical research has shown that it can help relieve pain and anxiety and aid smoking cessation, weight loss, and sleep.

It can help children and adolescents better regulate their feelings and behaviors. Some people can even use “self-hypnosis” to manage stress, cope with life’s challenges, and improve their physical and emotional health.

Hypnosis creates “a non-judgmental immersive experience,” says Dr. David Spiegel, a Stanford University psychiatrist and leading researcher of hypnosis.

It’s been used in various forms for centuries, but it wasn’t until 1843 that the Scottish surgeon Dr. James Braid popularized the term “hypnosis.

” Braid’s central discovery—that concentration can guide the brain toward a more suggestible state—was and remains controversial. But physicians have continued to test and teach the technique over the centuries with great success, Spiegel says.

Today, a psychologist, psychiatrist, or other healthcare professional certified in hypnotherapy will first screen a potential client for their ability to be hypnotized using a validated suggestibility scale. (Not everyone is equally susceptible to hypnosis, but research has found that about two-thirds of adults are.)

The hypnotherapist will talk with them about what sort of sensory experiences make them feel safe, like a lakeshore retreat or a beach vacation.

Then, the hypnotherapist will conjure that imagery—focusing, for example, on the salt spray of the ocean, seagulls calling overhead, and sun-kissed skin—to help the person go deeper into the calming visualization. If done right, the patient’s physical surroundings will melt away.

The result is a powerful combination of dissociation, immersion, and openness to new experiences, which culminates in what was once called a “trance,” but which modern hypnotherapists simply refer to as a “hypnotic state.” It can be achieved in just a few minutes, Spiegel says.

Such scene-setting techniques can create the ideal stage for positive transformation, says Binghamton University psychology professor Steven Jay Lynn. During hypnosis, people are more open to the suggestions of the hypnotherapist, whether those ask the patient to detach themselves from a past painful experience or visualize a solution to their problem.

For some people, these changes may be catalyzed in a one- or two-hour session. For others, hypnotherapy or self-hypnosis may be a regular part of their mental health care. “Hypnosis can modify consciousness in many ways,” Lynn says.

This state of deep relaxation isn’t particularly difficult for most people to dive into or emerge from. It’s similar to a “flow state,” Spiegel says, or an altered state of consciousness in which a person is so immersed in a given activity, their focus narrows and their sense of time shifts.

It’s also reminiscent of what happens during meditation, except instead of training people to tune into the present moment, hypnosis makes them more receptive to suggestion. Like meditation practice, many people are capable of doing hypnosis on their own, Spiegel says. In 2020, he co-founded Reveri, a subscription-based self-hypnosis app that’s structured a lot like Calm or Headspace.

A user can access recordings that guide them into a hypnotized state, after which they’re given suggestions or statements that lead them toward a goal the person selects before the session. “We do it all the time,” Spiegel says of entering and exiting these mental states, “but in hypnosis you do it more.”

Brain-imaging studies have helped to illuminate what happens inside the hypnotized brain, though much still remains a mystery. During hypnosis, activity in a brain region that helps people switch between tasks quiets down, Spiegel says.

This same region seems to disconnect from another area responsible for self-reflection and daydreaming—which may be why hypnotized people aren’t worried about who they are or what they’re doing.

Researchers have also found that hypnosis can calm brain regions that help control autonomic functions like heart rate, blood flow, and breathing. This is likely what leads to the physical relaxation that’s a hallmark of hypnosis, Spiegel says.

One of the most interesting modern applications of hypnosis is in the operating room, says Lorenzo Cohen, director of the Integrative Medicine Program at the University of Texas MD Anderson Cancer Center. For some localized breast cancer surgeries, namely lumpectomies, the center lets patients choose between general anesthesia or a localized anesthetic and hypnotherapy.

Those who choose the second option remain fully awake during their surgery, but a hypnotherapist first helps them enter a state of deep relaxation, or “hypnosedation,” Cohen says. “The local [anesthesia] should be doing its thing,” Cohen says. “The rest is in your head.”

More than 30 clinical trials have affirmed the use of hypnosedation, says Cohen (who is also researching the practice).

Studies have shown that people who received hypno-sedation experienced less preoperative anxiety, required less pain medication during surgery, and reported less post-operative pain intensity, nausea, fatigue, and discomfort than people who chose general anesthesia, Cohen says.

“The hypothesis is that the patients who are under general anesthesia, even though they’re not conscious, are having an intense stress response,” he says.

This can suppress an immune system that, in cancer patients, is already compromised by the disease and its treatments. When patients choose hypnosis, Cohen believes the body’s fight-or-flight response may be reduced.

Despite the mounting evidence, hypnosis is not without skeptics. Randomized controlled trials have found that hypnosis can help with pain and anxiety associated with a range of medical conditions, but even the best studies can’t meet the gold-standard of a double-blind design, Spiegel says.

While patients and practitioners can be kept in the dark about what pill they’re administering or receiving, it’s almost impossible to design a study where neither side knows hypnosis is being delivered, he adds.

And historically, the power of hypnosis hasn’t always been wielded responsibly. The imaginative potential of hypnosis has been shown to create false memories—sometimes with devastating effects. At least 27 states ban hypnotically-elicited testimony from appearing in court. Hypnotherapists should avoid using the technique to “recover” memories, Lynn says.

But when conducted by a trained professional and properly applied, modern hypnotherapy can provide powerful results. Susceptibility to suggestion is often “viewed as a liability or a weakness,” Spiegel says, “but it’s really a strength.”

by: Eleanor Cummings 

Beyond the Conventional

Beyond the Conventional

Among the wide array of alternative therapies, hypnotherapy has long been an interesting option for those seeking unconventional solutions to various issues like stress, anxiety, and habit breaking. In addition to the usual mainstream hypnotherapy options there are several applications of this meditative modality that extend beyond the conventional, delving into uncharted territories of inner thought.

Quantum Hypnotherapy

Picture a form of hypnotherapy that ventures into the quantum realm, blurring the lines between science and spirituality. Quantum hypnotherapy suggests that our consciousness is intricately linked with the universe’s fabric. Practitioners guide individuals through profoundly deep hypnotic journeys, uncovering the potential for healing and self-discovery at the quantum level.

Hypnotic Regression to Parallel Realities

Traditional regression hypnotherapy is typically a journey to past experiences, but what if we could explore not just our own past, but parallel realities? Some practitioners guide individuals into hypnotic states offering access to memories from alternate timelines. This unconventional approach invites a captivating exploration within the depths of the hypnotic mind.

Dream Integration Hypnotherapy

Dreams are considered windows to the subconscious, and dream integration hypnotherapy takes this notion to new heights. This approach guides individuals into a hypnotic state where they actively interact with and influence the content of their dreams. By subconsciously navigating the dream realm, individuals gain insights into their deepest fears, desires, and unresolved issues.

Hypnotherapy and Virtual Reality

In this age of advanced technology, some hypnotherapists incorporate virtual reality (VR) into their practice. This innovative approach creates immersive and personalized hypnotic experiences within virtual environments. Whether overcoming phobias or addressing trauma, the fusion of hypnotherapy and VR provides a unique and powerful avenue for therapeutic exploration.

Metaphysical Hypnotherapy

Metaphysical hypnotherapy goes beyond the conventional mind-body connection, exploring intricate relationships between the mind, spirit, and the unseen energies around us. Practitioners may guide individuals to connect with spirit guides, explore past lives, or tap into higher states of consciousness for profound healing and self-awareness.


These fascinating applications may stretch the boundaries of traditional hypnotherapy, yet they underscore the evolving nature of alternative therapies. As individuals continue to seek unconventional paths for personal growth and healing, hypnotherapy emerges as an effective gateway into the uncharted realms of the inner mind.

by P Gustafson

A Breakthrough for Hypnotherapy?

A Breakthrough for Hypnotherapy?

Hypnosis has long been used to treat and manage a host of psychiatric and neurologic symptoms. However, not all patients respond equally to this therapy type. About two thirds of the general adult population are estimated to be at least somewhat hypnotizable, and 15% are highly hypnotizable.

Through brain imaging, the Stanford team found that high hypnotizability is associated with greater functional connectivity between the left dorsolateral prefrontal cortex (DLPFC) and the dorsal anterior cingulate cortex.

“A novel aspect of this trial is that we used the person’s own brain networks, based on brain imaging, to target the right spot,” Co-senior author Nolan Williams, MD, with Stanford University, California, said in a news release.

The team chose patients with chronic pain because hypnosis has been shown to be a “highly effective analgesic that has a far better risk/benefit ratio than widely overutilized opioids that have serious fatal overdose potential,” Spiegel told Medscape Medical News.

The pre-to-post SHIFT change in hypnotic induction profile scores, a standardized measure of hypnotizability, was significantly greater in the active vs sham group after just 92 seconds of stimulation (P = .046).

Only the active SHIFT group showed a significant increase in hypnotizability following stimulation, an effect that lasted for about 1 hour.

“Increasing hypnotizability in people who are low-to-medium hypnotizable individuals could improve both the efficacy and effectiveness of therapeutic hypnosis as a clinical intervention,” the researchers wrote.

They note that because this was a “mechanistic study,” it did not explore the impact of increased hypnotizability on disease symptoms. They also note that further studies are needed to assess the dose-response relationships of SHIFT.

Transformative Research

“This line of research is fascinating,” Shaheen Lakhan, MD, PhD, neurologist, and researcher in Boston, told Medscape Medical News.

“We are nearing an era of personalized, noninvasive brain modulation. The ability to individually modulate the DLPFC opens new possibilities for brain health beyond hypnotizability for fibromyalgia,” said Lakhan, who wasn’t involved in the study.

“The DLPFC is involved in executive functions (and disorders) like attention (ADHD), emotional regulation (depression), motivation (schizophrenia), and impulse control (addiction),” he noted.

“Soon we may no longer need large expensive devices like transcranial magnetic stimulators as in this research study. Smartphones could deliver tailored digital therapeutics by engaging specific brain circuits,” Lakhan predicted.

“Imagine using an app to receive treatment customized to your unique brain and needs — all without anything implanted and delivered anywhere. The potential to precisely modulate the brain’s wiring to enhance cognition and mental health, without surgery or physical constraints, is incredibly promising. The possibilities are intriguing and could truly transform how we address brain diseases,” he added.

The study was supported by a grant from the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health (NIH). Williams is a named inventor on Stanford-owned intellectual property relating to accelerated TMS pulse pattern sequences and neuroimaging-based TMS targeting; has served on scientific advisory boards for Otsuka, NeuraWell, Magnus Medical, and Nooma as a paid advisor; and holds equity/stock options in Magnus Medical, NeuraWell, and Nooma. Spiegel is a cofounder of Reveri Health, Inc., an interactive hypnosis app (not utilized in the current study).


Hypnosis: The most effective treatment you have yet to prescribe

Despite robust evidence for myriad ailments and sound mechanistic data, hypnosis is underused by internists. Using hypnosis fulfills our pledge to abide by evidence-based treatments that alleviate suffering with the least collateral harm, but there is a discrepancy between its benefits and physicians who offer the treatment.

Although hypnosis may appear in the medical curricula at academic powerhouses like Baylor, Harvard, Columbia, and Stanford, hypnosis training is rare even at these institutions. Here is why a modern resurrection of the oldest Western form of psychotherapy should inspire internists to get trained and offer medical hypnosis broadly.

Hypnosis, and its myths and misconceptions, have evolved since the 18th century when Franz Mesmer inadvertently led hypnosis into obscurity with his theory about manipulating a force called “animal magnetism.” These claims were dispelled by the French Royal Academy of Sciences, and it took nearly 100 years for Scottish physician James Braid to first describe a mental and suggestive theory of hypnosis as a waking physiologic state.

The 2014 definition from the American Psychological Association’s Division 30 describes hypnosis as “a state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion.”

Long-standing empirical evidence demonstrates that hypnosis impacts perception, symptoms, and habits, which have recently been explained by advanced diagnostic modalities like functional magnetic resonance imaging (fMRI). Changes during hypnosis include reduced activity in the dorsal portion of the anterior cingulate cortex (a key component of the salience network) and connectivity between the prefrontal cortex and the insula (a pathway for mind-body control).

Augmented by data on neurotransmitter metabolism and genetics, the neurophysiologic basis of hypnosis is no longer mysterious. Though our understanding of the mechanism of action of hypnosis is more robust than that of even acetaminophen, this has not sufficed to enhance its use.

Skeptics describe hypnosis in 1 of 3 ways: dangerous mind control, an ineffective farce, or placebo. It is often viewed as a loss of control and, therefore, dangerous, when in fact it is a powerful means of teaching patients how to control mind and body. The ability to enter into hypnosis, termed hypnotizability, is a stable trait possessed by most people, which can be entered into or terminated by the patient.

It is not effective in the presence of conditions such as stroke or schizophrenia or impaired focused attention or language processing. Hypnosis is more powerful than placebo (though patient expectancy is a moderating factor), and placebo effect is blocked by administration of naloxone, while the hypnotic analgesia is not.

Reviews on hypnosis for internal medicine topics are impressive, with demonstrated efficacy for migraine headache,4 irritable bowel syndrome,5 and anxiety.6 Hypnosis improves procedural pain and emotional distress and reduces medication consumption up to 40%7—in short, if hypnosis were a drug, it would be standard of care. Internists should prescribe hypnosis particularly when it outperforms the current standard of care by safety and efficacy, as in the case of opioids and sedatives.

Patients have a strong appetite for taking charge of their symptoms; online hypnosis videos for anxiety and insomnia boast 15-19 million views, and medical hypnosis is quite acceptable by patients.8 But patients cannot be expected to differentiate between legitimate and manipulative sources of hypnosis online any more than if they bought pills off the street. This treatment modality falls under the purview of medicine, and our duty is to provide safe access. To do this, we must improve the supply.

Formal training for medical providers is offered through national societies, such as the American Society of Clinical Hypnosis (ASCH) and Society for Clinical and Experimental Hypnosis (SCEH). Trainings span 4 days and include ethics and informed consent in addition to practical skills. Hospital credentialing for the privilege of hypnosis may be required: If none exists, designing one to include formal training and mentorship requirement is advised. For institutional trailblazers, individuals in the hypnosis societies can provide mentorship.

Hypnosis training includes tools for helping our patients to help themselves, which benefits all our patients even outside a formal session. Telling a patient: “Don’t think about purple elephants” will assure that they do. Through the lens of hypnosis, one appreciates that even the common phrase “How bad is your pain” is fraught with negative associations.

With all their capacity to trust their physician, patients internalize “You have bad pain.” Contrast this with the phrase, “How comfortable are you right now?” The patient scans their body for comfort rather than pain and, if discomfort is reported, can be followed up with the 0-10 scale. These subtle adjustments acknowledge comfort without the disservice of anticipatory suffering. This is the healing art of medicine.

Additionally, the trained physician can practice self-hypnosis for stress management, insomnia, or performance anxiety, thereby avoiding medications that blunt their focus. Our patients, colleagues, trainees, and families stand to benefit.

Hypnosis research is funded by the National Center for Complementary and Integrative Health (NCCIH), and researchers are making inroads into the genetic aspects of hypnotizability and response to treatment and studying hypnosis for pain management for cancer and surgery, smoking cessation, and stress management in health care.

The automation of hypnosis using recordings, web-based applications, and smart-speaker devices is being tested to expand access to hypnosis interventions. From basic science to clinical efficacy to medical education, hypnosis research of all kinds has relevance for internal medicine.

Internists are the ambassadors of evidence. Our broad training and scope maximizes our effectiveness as healers, but we mustn’t lose sight of that which experiences illness: the human mind. When the technique of hypnosis is properly illuminated, its role will be welcomed and respected by our patients.

They will benefit from less pain, anxiety, insomnia, habits such as smoking, and the side effects that accompany many pharmacological treatments. We will benefit from the satisfaction of reacting nimbly to the best evidence for safer treatments and, perhaps, also enjoy a better night’s sleep. This is a call to action for broader use of hypnosis with intrepid internists leading the charge.

by: Jessie Kittle, MD and David Spiegel, MD

Smoker’s account of quitting

I see many smokers who are struggling to quit. Initially we talk about their smoking history, past attempts to quit and any health concerns for themselves or if they know someone whose health was compromised by smoking.

Smokers are very quick to say they hate smoking; they hate the smell, the cost and don’t like the fact that they have to go ‘somewhere else’ to smoke.

A recent client said she was at a family function and a couple of cousins were also smokers. The routine was for them to step outside and chat while they smoked.

The client had already come for her first of two office visits and had been listening to MP3 of her session daily at home. While recounting this particular smoke break story, she said it was very different from previous times. ‘We were standing in the cold next to the chimney to the back side of the house. I remember feeling so stupid because I was freezing to death and isolated from the rest of my family just to smoke.’

She spoke at length about how, in the past week, she became much more aware of the absurdity and certainly the health risk of smoking. I reminded her how hypnotherapy enhances mindfulness, we become very careful thinkers and impulsivity fades. This was likely why she saw this situation in a new light.

I asked her why she ever smoked in the first place, what was the upside? If she was so eager to condemn the cost, stink and health risk what could she possibly be getting from smoking.

She said ‘I guess I just want to smoke.’ To that I asked her to drill down into the ‘want’ a little more. Could she logically want something that checked off the cost, stink and health boxes? She paused and then responded with an emphatic ‘of course not’.

I asked if it made sense that the ‘want’ was just a habit that had taken on a life of its own out of simple repetition? That made sense to her.

Then I asked if it also made sense that by continuing to repeat the relaxing process that reinforced a comfortable smoke-free transition could fix the problem? She just smiled and nodded. After our chat we did her hypnotherapy session and she left the office feeling very focused and confident.

I routinely engage in these types of conversations with clients prior to initiating a hypnotherapy session because it helps them sort through all the details on a subconscious level. Once the session is concluded clients typically are much more focused and confident about moving forward to healthy change.

By: Paul Gustafson

12 Reasons a mentor is important

12 Reasons a mentor is important

1 Mentors support growth

Mentors encourage and enable another person’s professional or personal development. A mentor can help focus their efforts by setting goals and giving feedback. As a result, companies that want to build employees’ skills often create mentoring programs. The mentors’ knowledge can help train and create a high-quality and productive workforce. Employees appreciate workplaces that encourage development, as it can demonstrate that their employer values them and wants to see them grow.

2 Mentors serve as a source of knowledge

Mentors can provide specific insights and information that enable the mentee’s success. For example, they offer instructions on how to perform particular tasks or develop useful skills. Individuals starting their career can benefit from such guidance, as it helps them feel comfortable in the role more quickly. For example, a mentor can help a person starting a business learn how to develop their initial business plan and budgets.

3 Mentors can help set goals

A mentor can help their mentee set personal or professional development goals. For effective goal-setting, they can create SMART goals—specific, achievable, relevant and time-based. These goals can help focus the mentee’s efforts and make it easier for the mentor to track and assess progress. They may identify smaller tasks in pursuit of a larger objective to develop specific skills or meet particular priorities.

4 Mentors maintain accountability

A mentor helps hold their mentee accountable for their goals. By tracking progress, the mentor helps the mentee stay focused and on track towards completing them. It can also ensure that the mentee does not forget about the goals they have set. Knowing that someone else is watching can serve as motivation, as the mentee likely does not want to let the mentor down by failing to meet goals.

5 Mentors offer encouragement

When the mentee finds themselves struggling to perform their job or reach a goal, they can turn to their mentor for support. This encouragement can motivate them to keep moving forward despite challenges. A mentor can also identify and express their mentee’s strengths to instill confidence in them. Having a strong sense of confidence can make the mentee less likely to give up on their goals.

6 Mentors help make connections

A mentor can help build their mentee’s professional network. When the mentee identifies professional or personal goals, the mentor can connect them to potential opportunities or individuals who can help them. As the mentor typically has more industry experience or a higher-level career, these connections can be valuable for career advancement.

7 Mentors are willing to listen

When an individual has ideas, they can use a mentor as a resource to discuss or try them. The mentor can provide unbiased advice or opinions using their relevant knowledge and experience. With these insights, the mentee can better understand what steps to take and whether to pursue the idea or walk away. Similarly, a mentor can also listen and advise them on daily concerns, such as workplace conflicts.

8 Mentors serve as a trusted ally

Trust represents a core element of mentoring relationships. The mentee must trust that the mentor has their best interests in mind and will provide accurate and honest guidance. The business world can also be competitive, so they need to rely on one another to keep confidential information private when necessary. Communicating regularly and following through on their promises demonstrate two methods of establishing trust in these relationships.

9 Mentors can offer constructive feedback

A trusting mentorship relationship enables honest feedback. By establishing trust, the mentee understands that constructive criticism aims to build their professional growth rather than make them feel bad. Mentors can identify weaknesses and advise them on ways to improve. Because this is a professional relationship, the mentor plays an objective role. Meanwhile, a friend may hesitate to identify the mentee’s weaknesses because they do not want to appear critical.

10 Mentors provide guidelines

For individuals just starting their career, a mentor can help set guidelines on professional expectations. For example, they may clarify the priorities of the role and proper workplace behaviors. These guidelines can help the mentee establish appropriate work habits that enable them to focus and perform their job successfully. These effective work habits can help them be more productive and impress their supervisors.

11 Mentors have relevant experience

When possible, individuals should choose mentors who have the experience relevant to their profession or goals. When mentors convey their successes, the mentee can use them as an example to strive toward and copy the steps they took. Mentors can also share the mistakes they made along their journeys. The mentee benefits because they learn lessons about the mistakes’ negative impacts but do not have to suffer the consequences themselves. Learning about these experiences can also help prepare the mentee for the challenges they can expect to face and provide demonstrable advice on how to overcome them.

12 Mentors are a free resource

Mentorship typically occurs due to networking or company programs, so mentors do not seek payment. They offer to serve this role because they genuinely want to help the other individual grow and establish a more authentic and personal connection. The lack of payment also opens up mentorship for all types of people, rather than restricting this resource to only those who can afford it. (

Hypnotherapist Paul Gustafson RN CH offers a 6-class mentoring program for new certified hypnotherapists interested in taking the fast track to professional success. Paul incorporates high-end audio and video along with creatively effective sessions which offers eager clients consistently positive results. [more]

Paul’s multilevel approach includes a dynamic client office experience, digital recording of client sessions, MP3 file sharing, cable TV show production with search engine optimization, blogging and social media distribution. [contact]