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Author: Robyn

4th Year Medical Student

Why Reflection Is Important For Your Medical Journey

What is Hypnotherapy?

Hypnotherapy is a concept not often discussed throughout the medical profession. It is frequently seen with doctors’ scepticism and comes linked with a tag of patients with symptoms “all in their head” – AKA hard work when a clear-cut treatment isn’t available!

However, many doctors and medical students do not even realise Hypnotherapy is a treatment option in my experience. Never mind licenced by NICE (National Institute of Health and Care Excellence) and occasionally used in the NHS. This article will explore what Hypnotherapy is, how it is used, and its potential for the future.

How does Hypnotherapy work?

When we think about hypnosis, we often imagine swinging clocks and the participant losing control of their body, doing whatever the hypnotist orders. However, medical Hypnotherapy is often very different!

The patient is fully in control and does not have to do the therapists suggestions unless they want to. The patient is mostly in a relaxed/hypnotic state, rather than fully hypnotised. This means they may be more open to suggestion, such as feeling or acting a certain way and generally feel calm and relaxed, but their mind is aware and very much their own.

It almost always begins with the patient having a chat with the doctor or therapist running the sessions and clarifying what the patient wants to gain from these treatments. They will decide on how many sessions they need, but this is often subject to change as every patient will respond differently to this type of therapy.

The Hypnotherapy session

During the session, the patient will lie/sit in a comfortable chair and be led into a deeply relaxed state. Often by the reassurance and repetition of the therapist. For something like smoking cessation, the therapist may spend most of the session suggesting that the patient stops the habit and repeats this while the patient is in a trance. At the end of the session, the hypnotist will bring the patient back round; they often feel extremely relaxed afterwards.

Hypnotherapy aims to change the way the patient thinks and feels, almost reprogramming them with these sessions. Their heart rate, breathing, and even pain decreases during the treatment. Over time, it can help them manage how they feel or react to pain and stressors in their daily lives.

However, hypnosis does not work unless the patient actually wants to be hypnotised, which is probably a huge factor to why it’s so successful for some patients and not others.

How is Hypnotherapy used currently? 

What is Hypnotherapy used for? We can use hypnosis as part of a treatment program for a huge range of conditions:

 

  • Menopausal symptoms – such as hot flushes 
  • Unpleasant behaviours – like insomnia, bed-wetting, over-eating 
  • Pain management – for patients suffering from cancer, burns, childbirth, fibromyalgia, headaches 
  • Symptom control – this may be to manage pain but also symptoms in conditions like irritable bowel syndrome
  • Mental health conditions – it may help manage some of the symptoms relating to anxiety, depression, obsessive-compulsive disorder, phobias, and post-traumatic stress disorder 
  • Lifestyle changes – it is often used privately for smoking cessation, alcoholism, weight management and gambling addiction 

How is it used in the NHS? 

Hypnosis doesn’t always work for everyone. For medical purposes, patients need to be able to enter a light trance. This is possible for almost 90% of the population.

Although some patients still aren’t hypnotised successfully. This may be because of the hypnotist’s skills or the patient needing to be relaxed enough for it to work; they need to co-operate to enter a fully hypnotic state and believe it will work for them.

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The effectiveness of Hypnotherapy

Hypnotism as a treatment can be hugely effective for some people and not at all for others. Although we don’t know exactly why this is, it’s probably because it’s unique and personal to the patient. When we prescribe medicine, we know its mode of action and the way the drug will interact with the body.

With Hypnotherapy, it is a completely different type of treatment. It is also hard to measure the effectiveness of Hypnotherapy. Especially because unlike most medications it can be used for a huge range of conditions and problems, so measuring a specific outcome for Hypnotherapy overall, may be difficult.

It is much easier to define Hypnotherapy’s effectiveness for a specific condition, not just as a treatment in general. For example, it is proven to be a treatment for IBS (irritable bowel syndrome) and is listed in the NICE guidelines but may not be as good for fibromyalgia, which is thought to have similar causes and pathology to IBS.

Why Hypnotherapy is often not recommended

The main point is, there is a huge amount we don’t know about it! That may be why it’s not always recommended as a treatment, even when it has been proven to work for some people.

Many of the conditions listed above have other alternative treatments that are advised to be trialled first. Hypnosis often is not even mentioned in the NICE guidelines which are what doctors used to guide them on their treatment plans.

For example, for mental health conditions hypnosis would seem like a good option. However, we often use cognitive behavioural therapy (CBT) as the gold-standard treatment, and it has the most evidence behind it. Therefore, even though Hypnotherapy may be much more effective for some specific patients, as the previous data and evidence we have suggests CBT is better for the majority of patients we opt for those treatments first.

What is the future of Hypnotherapy?

Although Hypnotherapy has been around for decades, I feel like it is not used as effectively as it could be within healthcare. This may be because of the doubt and scepticism that clinicians seem to associate with it.

However, we know that hypnosis is an effective treatment or many psychological and psychosomatic illnesses (illnesses that relate the mind and body, such as IBS and fibromyalgia). In fact, the British Medical Journal wrote “It regards hypnotism as a proper subject for scientific inquiry”, during their paper in April 1955. Sadly, it has been more than 65 years since that was written. Ultimately Hypnotherapy has not been utilised as much as it may have been hoped for.

As hypnosis is not used often in medicine, there does not seem to be a huge effort to investigate how it could develop further. There have been small trials that show amazing results, such as Hypnotherapy being a tool in aiding cancer patients to cope with their illness. But it is not used often in daily patient care.

It is also being used currently as a treatment in the UK, in a hospital in Manchester, for severe IBS patients. Here it has shown to have very effective outcomes. In one trial, 83% of patients that originally responded to Hypnotherapy were still well 1-5 years later. Not only that but their consultations with doctors and medications were reduced, ultimately reducing their need and cost to the NHS.

Although Hypnotherapy may be time-consuming and costly originally, it could be something to investigate. It may be very cost-effective when calculating the cost it could save the NHS for these types of patients over many years.

Ultimately there is so much we do not know about Hypnotherapy. We need more research into the area to even touch on how it could be used more wildly within the NHS. As it is currently being used as a treatment for IBS, I hope there will be more research into that area as well as into other medical conditions as it has a huge promise to be an excellent treatment.

Sources used: 

  1. https://www.mayoclinic.org/tests-procedures/hypnosis/about/pac-20394405
  2. https://www.ahcp.pt/wp-content/uploads/2019/09/3.-HIPNOSE-E-CANCRO.pdf 
  3. http://markhypnotist.com/index.php/2017/10/22/aimofhypnotherapy/
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