The Standing of Hypnotherapy

Hypnosis was first developed as a therapeutic discipline by the Scottish physician James Braid. Braid, who coined the term ‘hypnotism’, categorically rejected any supernatural explanations of trance and grounded the study of hypnotherapy on a firm empirical and scientific basis, publishing his research in Neurypnology (1843).

Hypnosis, Medical Research & the BMA
In 1892, the British Medical Association (BMA) responded to growing interest in hypnotherapy by commissioning a special committee of eleven doctors ‘to investigate the nature of the phenomenon of hypnotism, its value as a therapeutic agent, and the propriety of using it.’ Their report was received and published by the BMA, it opens with a clear recognition of the phenomenon of hypnotic trance:

‘The Committee, having completed such investigation of hypnotism as time permitted, have to report that they have satisfied themselves of the genuineness of the hypnotic state.’ (BMA, 1892)

The BMA Committee proceeded to outline a detailed and accurate account of the physical and mental characteristics of hypnotic trance, concluding with a summary of its principal therapeutic benefits,

‘The Committee are of opinion that as a therapeutic agent hypnotism is frequently effective in relieving pain, procuring sleep, and alleviating many functional ailments.’ (BMA, 1892)

In 1955 the Psychological Medicine Group of the BMA commissioned a Subcommittee of experts to a deliver second report which was published in the British Medical Journal (BMJ) the same year under the title of ‘Medical use of hypnotism’. Its terms of reference were:

‘To consider the uses of hypnotism, its relation to medical practice in the present day, the advisability of giving encouragement to research into its nature and application, and the lines upon which such research might be organised.’ (BMA, 1955)

The 1955 Subcommittee endorse the previous 1892 report, republishing it in the appendix to their work, they comment that its conclusions ‘showed remarkable foresight and are mainly applicable today.’ They also provide a more extensive statement on the medical uses of hypnosis and conclude that it is definitely an effective technique in the psychotherapy of neurosis, psycho-somatic conditions and in the alleviation of physical pain:

‘The Subcommittee is satisfied after consideration of the available evidence that hypnotism is of value and may be the treatment of choice in some cases of so-called psycho-somatic disorder and psychoneurosis. It may also be of value for revealing unrecognised motives and conflicts in such conditions. As a treatment, in the opinion of the Subcommittee it has proved its ability to remove symptoms and to alter morbid habits of thought and behaviour. […]

 In addition to the treatment of psychiatric disabilities, there is a place for hypnotism in the production of anaesthesia or analgesia for surgical and dental operations, and in suitable subjects it is an effective method of relieving pain in childbirth without altering the normal course of labour.’ (BMA, 1955)

Following this report the British Society of Medical & Dental Hypnosis (BSMDH) was formed and its training officially approved by the BMA. The BSMDH was subsequently recognised by the General Medical and Dental Councils, the Medical Protection Society and the Medical Defence Union. The Royal Society of Medicine now has a section devoted to the dissemination of research on ‘Hypnosis and Psychosomatic Medicine’.

Hypnosis & Current Medical Research
Over its 150 year history, hypnotherapy has been subject to innumerable research studies which lend clear support to its various therapeutic applications. For example, one of the most recent clinical reviews of hypnosis and ‘relaxation therapies’ published in the BMJ reports the following evidence:

· ‘There is good evidence from randomised controlled trials that both hypnosis and relaxation techniques can reduce anxiety, particularly that related to stressful situations such as receiving chemotherapy.’

· ‘They are also effective for panic disorders and insomnia, particularly when integrated into a package of cognitive therapy,’

· ‘A systematic review has found that hypnosis enhances the effects of cognitive behavioural therapy for conditions such as phobia, obesity, and anxiety.’

· ‘Randomised controlled trials support the use of various relaxation techniques for treating both acute and chronic pain,’

· ‘Randomised trials have shown hypnosis to be of value in asthma and in irritable bowel syndrome,’

· ‘There is strong evidence from randomised trials of the effectiveness of hypnosis and relaxation for cancer related anxiety, pain, nausea, and vomiting, particularly in children.’

[BMJ 1999;319: 1346-1349 ‘Hypnosis and relaxation therapies,’ Vickers & Zollman]

However, these conclusions would be considered by many hypnotherapists to be extremely conservative in their scope as they deal primarily with the use of rather basic therapeutic techniques and with a narrow range of conditions. More and more benefits to hypnotherapeutic treatment are being established as new methods are introduced from current research in psychology and clinical psychotherapy.

Hypnosis, Hypnotherapy & Hypno-Psychotherapy
More recently there has been a shift toward classifying the profession of hypnotherapy as a branch of psychotherapy, rather than complementary medicine. Whereas the BSMDH is mainly composed of doctors and dentists, there are many hypnotherapists who approach their practice from a background in psychology or psychotherapy.

In 1992 the UK Council for Psychotherapy (UKCP) was formed to act as an ‘umbrella body’ for psychotherapy organisations of all orientations. A section was established for ‘hypno-psychotherapy’, i.e., the practice of hypnosis as a technique integrated within a broader programme of psychotherapy.

‘Hypno-psychotherapy is the branch of psychotherapy which uses hypnosis. It rests on an extensive body of work and publications over the last three hundred years, leading to that of Milton Erickson and those influenced by him. It understands that we have a learned model of the world which can restrict the way we feel, what we understand, our attitudes and behaviour. Hypnosis is a state of relaxation which people enter voluntarily, during which there occurs an altered state of conscious awareness. The therapist can intervene to draw the individual’s attention to new possibilities, to alternative patterns of thought, emotions and behaviour. The methods and strategies used in therapy are designed to make use of the resources and capabilities that reside within all people, and do not require the individual to fit into a standardised pattern. Hypnotherapy may be invaluable for anyone seeking to resolve specific problems, or for personal development.’ (UKCP, 1999)

Techniques employed in hypno-psychotherapy may range from analytic methods aimed at achieving personal insight, such as regression or dream interpretation, to future-focused techniques aimed at directly removing symptoms or modifying behaviour. It seems increasingly likely that in the future the hypno-psychotherapy profession will be regulated so that only practitioners trained in psychotherapy will be qualified to practice.