Integrating hypnosis into psychotherapy for mind-body health and wellness.
Eric Spiegel, Ph.D. specializes in psychological hypnosis and hypnotherapy, which allows for the treatment of challenging psychosomatic (mind-body) health areas such as anxiety/panic, pain management, Irritable Bowel Syndrome (IBS), headaches, insomnia, weight management, smoking and more.
Hypnosis is a tool in our psychological toolbox.
We don’t love the term hypnotherapy for several reasons. First, it is a term often used by ‘lay hypnotists’ (persons who practice hypnosis without a license in a mental health field), which can ethically blur the appropriateness and use of the treatment. A hypnosis center may advertise ‘hypnotherapy’ for weight loss, which implies a therapeutic modality, however, they may know nothing about the ‘therapy’ part of ‘hypnotherapy.’
Second, we believe that hypnosis is a ‘tool’ in our psychological ‘toolbox.’ We don’t consider hypnotherapy to be a stand-alone treatment. Hypnosis is simply a tool used in therapy – it is not THE therapy.
To fully understand hypnosis, it is important to distinguish between the terms trance, hypnosis, clinical hypnosis, and psychological hypnosis.
Trance is a naturally occurring state in which we focus our attention, defocus from other cues, and have a shift in sensory experience. This feels involuntary in that it “just happens” and of course, it feels entirely owned by the person. Trances occur in small ways such as vivid daydreaming, and larger ways such as virtuoso performances (such as . The latter is performing incredibly well (or incredibly poorly) at something that defies your usual range of ability). Most people have some experience with naturally unfolding trance states.
Hypnosis is a term that is closely aligned with trance. It can be used to reference the state of trance (e.g. “I was in a hypnotic trance”). In this application, there is very little difference between the two words. The term hypnosis can also be used to describe a more formal skill or procedure of trance. Hypnosis usually occurs with two people (e.g. the term ‘hetero-hypnosis’), someone who facilitates trance and someone who experiences it. However, hypnosis can also happen individually (e.g. ‘self-hypnosis’) with someone trained in initiating one’s own hypnotic experience. This is like trance, except it is a more deliberative process and a learned skill. Self-hypnosis in many ways overlaps significantly with meditation.
Clinical hypnosis is a term that refers to the ethical use of a trance state for the benefit of the patient. Sadly, there is very poor ethical regulation of hypnosis training and use in the United States (laws vary by state). Anyone can learn how to do hypnosis. Many individuals learn this skill and then use it for entertainment purposes or for service purposes. With the latter, there are multiple organizations that will train anyone who wants to learn hypnosis, then in turn start a business as a “hypnotherapist” to fix problems or reduce symptoms. Think of the “hypnosis centers” that advertise the therapy to stop smoking or lose weight. The problem with these centers is that there is no quality control. Some people who learn how to “do” hypnosis are quite talented at it, and may even have a background in health or mental healthcare (although they may not be licensed in their respective field). Others may have learned hypnosis at such a workshop and may be applying it inappropriately, and with complex issues.
Clinical hypnosis providers are licensed practitioners (such as a psychologist or doctor), and use hypnosis within the scope of their fields. There is no intervention – such as a language and/or imagery hypnotic suggestion – that we would offer to a patient in hypnosis that we would not utilize in regular therapy. We choose our hypnotic suggestions with specific diagnostic, contextual, and personality needs of our patients in mind. It is for this reason that careful initial evaluation/assessment is an important part of the process. Although there are empirically-supported hypnosis treatments, hypnosis is inherently a personal process.
Psychological hypnosis is a term quite similar to clinical hypnosis. Psychological hypnosis refers to clinical hypnosis in a psychological setting and treatment administered by a psychologist. We refer to these two terms interchangeably on this page.
What is hypnotherapy and what can I expect in a session?
The process of hypnotherapy generally has an induction phase, treatment phase, and re-alerting phase. An induction is a technique used to elicit the focused state of attention that is at the definition of hypnosis. Depending on the induction technique and response, this phase could be quite brief or possibly longer. The treatment phase involves hypnotic imagery and language (suggestions) that are personally tailored to you and your presenting concerns. Re-alerting is a phase in which your therapist re-alerts you to your previous waking state.
The percentage of hypnosis featured in a hypnotherapy treatment will vary depending on the person and the issue. On a more infrequent basis, we may work as an ‘adjunctive hypnotherapist’ when a patient is already in a treatment with a psychologist, therapist, or doctor and is referred specifically to us for hypnosis. In these cases, upon receiving a formal release from the patient, we communicate thoughtfully and collaboratively with the referring provider. Naturally, when we agree to such a role, it is our preference to have an established relationship with the other treatment provider.
Is hypnotherapy the same for every patient?
No. There are several different hypnotic interventions and approaches (e.g. Eriksonian hypnosis, alert-hypnosis). We strongly recommend hypnosis be incorporated into a larger psychotherapy treatment so that the approach can fit the unique person, history, and symptoms involved. For example, hypnotherapy with an athlete might involve ‘alert hypnosis’ in which eyes remain open during the hypnosis and kinesthetic movement is incorporated into the process. The process of hypnosis is also variable. For example, for certain types of trauma, clients may already be entering spontaneous trance on their own (e.g. PTSD). In these types of treatment, the main featured hypnotic phase may be re-alerting, to help clients manage dissociation and build anchoring skills.
Is everyone equally hypnotizable?
NO. There are two client-centered characteristics that influence the hypnotic experience. The first is hypnotizability. Hypnotizability refers to the extent of one’s capacity to enter a hypnotic state. This characteristic is understood to be trait-based (with some environmental/contextual influence) and most people fall in the “moderately” hypnotizable range, with outliers on each end in the “low” and “high” hypnotizable range.
The second client-centered characteristic that can influence the hypnotic experience is suggestibility. Suggestibility refers to one’s willingness to receive suggestion. A synonym could be gullibility. As you can infer, suggestibility does not just refer to a hypnotic state. How likely we are to believe things plays out in all facets of life. While there may be a trait-based component to suggestibility, this is obviously contextually and relationally influenced. Trust is an important factor and we believe it may be helpful to develop a therapeutic alliance at the outset of treatment prior to utilizing hypnosis
Can you control my mind in hypnotherapy?
NO. Clinical hypnosis is a collaborative, participatory process and we use it for therapeutic purposes while working as a team with our clients. We use what is called a permissive approach to hypnosis (rather than an authoritarian approach) that gives our clients the control by asking their permission when we make a suggestion in hypnosis. Hypnosis is meant to be used WITH someone, not DONE TO someone.
Will you use hypnosis to help me uncover memories?
NO. Memory is highly subjective and is not like a video that can be rewound. Hypnosis is a highly subjective process. While enhanced recall is possible, one is also more prone to believing the veracity of one’s hypnotic experiences. This is one reason that imagination can be used to such adaptive purposes in hypnosis. We are clear with our patients that we use hypnosis for therapeutic purposes rather than for retrieval purposes. For more information, we highly advise readers to reference the book Memory, Trauma Treatment, and the Law by Dan Brown, Cory Hammond, and Alan Scheflin.
What are some therapeutic applications of hypnotherapy?
Although we list below some ‘diagnoses’ that clinical hypnosis is often utilized to treat, we advise thinking in a more treatment-centered manner. There are generally three types of treatments that we utilize hypnosis with:
Symptom-focused: these are usually straightforward ‘medical’ presentations that do NOT have complex psychological origins or unconscious manifestations and thus are amenable to direct hypnotic suggestions. These types of treatments tend to feature direct hypnotic suggestion tailored to the symptom, and are short-term in duration.
Insight-oriented: these are treatments in which the emphasis is on reaching insight or self-understanding. Hypnosis might be used to help a person better access his/her unconscious mind and less accessible thoughts, feelings, and experiences. This is typically used with higher functioning clients. It also may be helpful with psychosomatic symptoms that do not respond to a symptom-focused method.
Developmental repair: in this type of treatment, the emphasis is on healing psychological ‘wounds’ from childhood experiences and building structural functioning associated with healthy attachment and personality organization. Hypnosis is used to help clients access positive internal resources that they can use adaptively in their lives. This tends to be longer-term psychotherapy which integrates hypnosis.
The following is a list of diagnoses/treatment focuses for which clinical hypnosis may be beneficially utilized:
- Anxiety Disorders
- Pain Management
- Chronic Headaches
- Health Psychology
- Irritable Bowel Syndrome (IBS), IBD, Crohn’s, Colitis
- Performance Enhancement (sports, test anxiety, arts, etc.)
- Smoking Cessation
- Obesity/Weight Management
*Please contact us if you are interested in working with us for an issue not listed.