Medical Hypnosis: Two Comprehensive Guides

A Story-Driven Guide for General Readers and an Evidence-Based Reference for Clinicians

This document contains two complete blog posts about medical hypnosis: one written for general readers focusing on real-world applications and personal relevance, and another for healthcare professionals emphasizing clinical evidence, integration strategies, and practice guidelines.

═══ PART 1: FOR GENERAL READERS ═══

Hypnosis in Modern Medicine: What It Really Does (And Doesn’t) Do

When most people hear “hypnosis,” they picture swinging watches or stage shows where people cluck like chickens. In hospitals and clinics, though, hypnosis looks very different. It is used as a serious, research-backed tool to help with pain, medical procedures, and certain chronic conditions.

Clinical (or medical) hypnosis is a guided state of focused attention where you become more responsive to helpful suggestions. You are not asleep, unconscious, or under anyone’s “control.” Instead, your mind is narrowed in on inner experience, which makes it easier to change how you feel pain, stress, or physical symptoms.

How a Medical Hypnosis Session Works

A typical session with a trained health professional is calm and structured. The clinician first explains what will happen and answers questions. Then you are guided into a comfortable position, asked to focus on breathing or a point in space, and led through imagery or sensations that help your attention narrow and relax.

Once you are in this focused state, the clinician uses tailored suggestions: for example, imagining turning down a “pain dial,” feeling warmth and comfort in an injured area, or seeing your gut muscles become calm and steady. You may also be taught short self-hypnosis exercises to practice at home between visits.

Where Hypnosis Helps the Most

Research over the last few decades shows that hypnosis can be genuinely helpful in several areas of health care.

Pain and Medical Procedures

Hypnosis can reduce pain and anxiety during surgeries, dental work, cancer treatments, and other procedures, and often cuts down how much pain medication people need. Some hospitals now routinely offer hypnosis or hypnotic communication before and during procedures to help patients stay calmer and more comfortable.

Real-world impact:

• Studies show that 89% of trials using hypnosis in surgical patients demonstrated positive outcomes in physical or psychological recovery
• Hypnosis reduces pain, anxiety, nausea, and recovery time after surgery
• Some patients have even undergone major surgery with hypnosis as the sole anesthetic agent

Chronic Pain and Long-Term Conditions

People living with ongoing pain (for example, from back problems, arthritis, cancer, or nerve pain) can learn hypnosis to change their perception of pain and feel more in control. Studies show meaningful drops in reported pain levels and improvements in quality of life when hypnosis is added to regular care.

The numbers tell the story:

• People who respond well to hypnosis can experience pain reductions of 29-42%
• The average person receiving hypnosis reduces pain more than about 73% of people who don’t receive it
• Benefits last over time, with many people maintaining improvements months or years later

Irritable Bowel Syndrome (IBS) and Gut Issues

Gut-focused hypnosis, often delivered over several sessions plus home audio, has helped many patients with IBS reduce pain, bloating, and bowel irregularity, while also improving daily functioning and well-being.

The results are impressive:

• 71% of IBS patients respond well to hypnotherapy
• Of those who respond, 81% maintain their improvement for at least five years
• Many patients no longer need medication after completing treatment
• The American College of Gastroenterology recommends gut-directed hypnotherapy in their clinical guidelines

There are also promising but more early-stage uses in skin problems (itching, certain chronic rashes), cancer-related symptoms, sleep problems, and anxiety or low mood. In all these, hypnosis is used alongside—not instead of—standard medical care.

How Effective Is It Really?

Large research reviews looking at hundreds of studies find that hypnosis has small to large benefits depending on what is being treated, with some of the strongest results in reducing pain and distress around medical procedures. This means it is not magic, but it is more than a placebo or “just relaxation,” especially when guided by a skilled clinician.

One key point: hypnosis works differently than placebo. Scientists can measure specific changes in brain activity during hypnosis that differ from placebo responses. Hypnotic pain relief isn’t blocked by naloxone (a drug that blocks placebo effects), proving it uses distinct pathways in the nervous system.

Importantly, hypnosis has an excellent safety profile. Across clinical trials, serious side effects are extremely rare, and mild temporary effects (like brief dizziness, headache, or feeling emotional) are uncommon and usually pass quickly. The bigger risks come from unqualified practitioners or unrealistic promises, which is why it matters who you work with.

Is Hypnosis “Approved” by Medicine?

Major professional bodies now recognize hypnosis as a valid clinical tool. The American Medical Association formally approved hypnosis as a legitimate medical treatment in 1958, followed by the American Psychological Association in 1960. Medical and psychological associations in the United States and United Kingdom have acknowledged hypnosis as a legitimate procedure for trained professionals, especially in pain and functional disorders.

In 2017, the U.S. Veterans Administration included clinical hypnosis in its complementary and integrative health approaches, recognizing it as safe with sufficient evidence of benefit for the veteran population. Hospitals and cancer centers increasingly integrate hypnosis or hypnotic communication into standard supportive care.

This does not mean hypnosis replaces drugs, surgery, or psychotherapy. Instead, it sits beside them as a mind-body tool that can improve comfort, reduce medication needs, and give patients a sense of active participation in their care.

How to Find a Qualified Practitioner

If you are considering hypnosis as part of your care:

• Look for a licensed health professional (doctor, psychologist, nurse, dentist, or therapist) with formal training in clinical or medical hypnosis from a recognized organization such as the American Society of Clinical Hypnosis (ASCH) or the Society for Clinical and Experimental Hypnosis (SCEH)
• Ask how hypnosis will fit into your existing treatment plan and whether they will coordinate with your other clinicians
• Be cautious of anyone who claims hypnosis can cure serious illnesses on its own or advises you to stop prescribed treatment
• Trust your comfort level—like any healthcare provider, you should feel at ease with your hypnotherapist

Used thoughtfully, hypnosis can be a powerful ally: helping you hurt less, cope better, and feel more in control while still keeping the best of modern medicine on your side.

═══ PART 2: FOR CLINICIANS ═══

Clinical Hypnosis in Medical Practice: Indications, Efficacy, and Integration

Clinical hypnosis has evolved from a marginal practice to an evidence-supported adjunct across multiple medical domains, especially perioperative care, pain management, and functional gastrointestinal disorders. Over the last two decades, meta-analytic work has clarified effect sizes, safety, and appropriate indications, providing a stronger basis for informed integration into routine practice.

Defining Clinical Hypnosis and Hypnotic Communication

Contemporary definitions describe hypnosis as a procedure involving focused attention and reduced peripheral awareness, accompanied by an increased responsiveness to suggestion. This is operationalized clinically via an induction (eye fixation, relaxation, or other focusing strategy) followed by therapeutic suggestions (cognitive, sensory, affective, or behavioral), often combined with imagery and post-hypnotic cues.

A useful distinction in medical contexts:

• Formal medical hypnosis: structured sessions with induction, deepening, symptom-focused suggestions, and self-hypnosis training
• Hypnotic communication: deliberate use of suggestion, framing, and expectation management by clinicians (even without a formal trance) to modulate pain, anxiety, and cooperation during routine care and procedures

Evidence Base: Overview and Key Indications

A 2024 synthesis of 49 meta-analyses comprising 261 primary randomized controlled trials concluded that hypnosis shows statistically and clinically significant benefits across multiple somatic and mental health outcomes, with particularly robust effects for perioperative distress and pain. Earlier systematic work on medical hypnosis similarly highlighted perioperative and procedural applications, chronic pain, and IBS as leading indications.

Perioperative and Procedural Applications

Meta-analyses of adults undergoing surgery and invasive procedures indicate that hypnosis reduces pain, anxiety, emotional distress, procedural time, and perioperative drug requirements compared with standard care or attention controls. Benefits have been reported in oncologic surgery, breast surgery, interventional radiology, cardiac procedures, and various minor procedures, with effect sizes often in the moderate range for pain and anxiety.

Key findings:

• A 1991 review found 89% of trials using hypnosis in surgical patients showed positive outcomes in facilitating physical or psychological recovery
• A 2002 meta-analysis concluded hypnosis as adjunct to surgery was successful for the majority of individuals, with benefits including decreased pain, anxiety, nausea, and recovery time
• Multiple sessions prior to procedures produced higher percentages of significant results
• A 2024 meta-analysis found hypnosis decreased acute pain by 0.54 standard deviations compared to standard care (p = 0.0024)

Acute and Chronic Pain

Across musculoskeletal pain, cancer pain, burn pain, and other pain conditions, hypnosis demonstrates clinically meaningful reductions in pain intensity and pain-related distress, often comparable to or augmenting other psychological interventions. Protocols commonly involve 4-10 sessions plus self-hypnosis, integrating sensory modulation (“numbing,” “cooling,” “turning down the pain dial”), cognitive reframing, and coping imagery.

Meta-analytic evidence:

• A comprehensive 2019 meta-analysis of 85 controlled trials with 3,632 participants found moderate to large pain-reducing effects (g = 0.54-0.76, all p < .001)
• High and medium hypnotic suggestibles demonstrated 42% and 29% clinically meaningful pain reductions respectively with direct analgesic suggestions
• A 2021 meta-analysis focused on musculoskeletal/neuropathic chronic pain found moderate effect sizes for pain intensity (Hedge’s g: -0.42) and interference (g: -0.39)
• Interventions ≥8 sessions showed significantly larger effects (g: -0.555, p = 0.034) compared to shorter programs
• A 2021 comprehensive meta-analysis of 42 clinical trials found mean weighted effect sizes of 0.60 post-treatment and 0.61 at follow-up, indicating hypnosis reduced pain more than 73% of control participants

Neurophysiological studies reveal that hypnotic analgesia produces measurable effects on brain and spinal-cord functioning that differ as a function of specific hypnotic suggestions, with distinct patterns in somatosensory cortex (pain intensity) and anterior cingulate cortex (pain unpleasantness). Hypnotic analgesia is not blocked by naloxone, unlike placebo responses, providing evidence for specific mechanisms.

Functional Gastrointestinal Disorders

Gut-directed hypnotherapy is one of the better-documented non-pharmacologic interventions for IBS, improving abdominal pain, bowel habit abnormalities, and quality of life, with sustained benefits at follow-up in some trials. Treatment typically entails structured scripts focusing on normalization of gut motility and sensitivity, delivered over multiple sessions (typically 7-12) with home audio supports.

Clinical trial results:

• A landmark audit of 1,000 IBS patients found 76% achieved clinically significant symptom improvement with gut-focused hypnotherapy
• Long-term follow-up demonstrated 71% initial response rate, with 81% of responders maintaining improvement up to 6 years
• A 2024 two-year follow-up of nurse-administered gut-directed hypnotherapy found stable response rates: 64.3% post-treatment, 62.8% at 6 months, 64.7% at 1 year, and 61.8% at 2 years
• The American College of Gastroenterology clinical guidelines recommend gut-directed hypnotherapy for IBS management
• Meta-analyses report Numbers Needed to Treat (NNT) of 3-5 for adequate symptom reduction

Additional Domains

Additional domains with promising but more heterogeneous evidence include:

• Dermatology: itch, chronic urticaria, some inflammatory dermatoses (eczema, psoriasis, warts)
• Oncology symptom management: pain, nausea, fatigue, procedure-related distress. High-confidence evidence for anxiety in cancer patients
• Women’s health: menopause-associated vasomotor symptoms (recommended by North American Menopause Society 2023), fertility support
• Anxiety disorders: A 2019 meta-analysis of 17 trials found effect size of 0.79 at end of treatment and 0.99 at follow-up. More effective when combined with other psychological interventions
• Sleep disturbance, headaches/migraines, asthma symptoms
• Integration with psychotherapy for depression and PTSD

Effect Sizes, Moderators, and Safety

The 20-year meta-analytic overview notes effect sizes ranging from small to large depending on outcome cluster, with particularly strong support for procedure-related distress, pain, and IBS-related symptoms. Hypnotic suggestibility appears to moderate response in some, but not all, indications, suggesting that formal pre-screening may be helpful when resources are limited but is not obligatory in all contexts.

Responder analyses:

Rather than relying solely on group averages, responder analyses identify clinically meaningful improvements (typically ≥30% pain reduction or 50-point reduction in IBS symptom severity). This approach reveals that while not everyone benefits equally, a substantial proportion of patients experience meaningful relief that persists over time.

Safety profile:

From a safety standpoint, systematic reviews and trial registries report no serious adverse events directly attributable to hypnosis and low rates of minor transient effects such as headache, dizziness, or increased emotionality, generally under 1% across samples. The primary clinical risks are indirect: inadequate preparation or debriefing, unrealistic promises, or use by unqualified providers who discourage evidence-based medical or psychological treatments.

Contraindications:

• Not effective in conditions affecting focused attention or language processing (stroke, schizophrenia)
• Use discouraged in paranoia, psychosis, borderline personality disorder, dissociative characteristics
• Requires appropriate clinical judgment in complex or high-risk patients

Institutional Acceptance and Training Considerations

Medical and psychological associations in the US and UK have formally recognized hypnosis as a legitimate clinical tool when used by appropriately trained professionals. The American Medical Association approved hypnosis in 1958, followed by the American Psychological Association in 1960. The British Medical Association endorsed hypnosis in 1955. These historical endorsements have been reinforced by more recent guidelines emphasizing value in pain, anesthesia adjuncts, and functional disorders, while emphasizing training and ethical use.

Best-practice recommendations:

• Restricting therapeutic hypnosis to licensed health professionals (medicine, dentistry, psychiatry, psychology, social work, nursing) or those working under appropriate clinical supervision, with formal training in clinical or medical hypnosis
• Training available through American Society of Clinical Hypnosis (ASCH) and Society for Clinical and Experimental Hypnosis (SCEH), typically 4-day programs covering ethics, informed consent, and practical skills
• Integrating hypnosis as an adjunct to standard care, not a replacement, with clear communication to patients about realistic goals and the ongoing role of pharmacologic and procedural treatments
• Documenting indications, consent, session content, and outcomes as with other behavioral interventions
• Coordinating with the broader care team, especially in complex or high-risk patients

Practical Integration into Clinical Workflows

For clinicians, feasible points of integration include:

• Pre-procedure consultations: brief hypnotic preparation to reduce anticipatory anxiety and modulate expected pain, even in 10-20 minute formats
• Perioperative care: intra-procedural hypnotic communication or formal hypnosis, particularly in settings where reducing sedative or opioid dose is desirable
• Chronic disease management: structured short-term hypnotherapy referrals for refractory pain, IBS, or functional symptoms, with emphasis on self-management and self-hypnosis skills
• Group protocols and audio-guided hypnosis: nurse-administered group sessions and audio files improve cost-effectiveness and accessibility without significant loss of efficacy

Medical hypnosis requires initial investment of uninterrupted time (typically 30-60 minutes per session initially), but this investment can save physician time later through improved patient outcomes, reduced medication use, and enhanced self-management capabilities.

Overcoming Barriers to Adoption

Despite robust evidence and professional endorsement, hypnosis remains underutilized. Key barriers include:

• Misconceptions perpetuated by entertainment hypnosis leading to views of hypnosis as either dangerous mind control or ineffective farce
• Limited curriculum integration in medical and psychological training programs
• Upfront time investment and need for specialized practice
• Need for appropriate hospital credentialing processes

Addressing these barriers through education, expanded training opportunities, workflow optimization, and institutional support can facilitate broader integration of this evidence-based modality.

Future Directions

The automation of hypnosis using recordings, web-based applications, and smart-speaker devices is being tested to expand access. However, patients cannot reliably differentiate between legitimate and manipulative sources online, making it essential to maintain medical oversight while improving accessibility.

Research priorities include larger, high-quality RCTs with adequate control conditions, investigation of mechanisms through neuroimaging and psychophysiology, development of predictive models for treatment response, and comparative effectiveness studies examining hypnosis relative to other evidence-based interventions.

Clinical Bottom Line

Clinical hypnosis represents an evidence-based, safe, and effective adjunctive intervention for multiple medical conditions, particularly perioperative care, pain management, and functional gastrointestinal disorders. With appropriate training, integration into standard care workflows, and realistic expectation-setting, hypnosis can meaningfully reduce symptom burden, enhance patient self-efficacy, and potentially reduce reliance on pharmacologic interventions.

Given current challenges with opioid dependence, chronic disease management costs, and patient demand for participatory care approaches, clinical hypnosis deserves serious consideration as part of comprehensive treatment strategies. Internists and other primary care clinicians are well-positioned to lead broader adoption of this underutilized but well-validated therapeutic modality.

References and Further Reading

Key Meta-Analyses and Systematic Reviews:

Zech, N., Hansen, E., Bernardy, K., & Häuser, W. (2024). Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: A 20-year perspective. Frontiers in Psychology, 14, 1330238. https://doi.org/10.3389/fpsyg.2023.1330238

Häuser, W., et al. (2016). The efficacy, safety and applications of medical hypnosis: A systematic review of meta-analyses. Deutsches Ärzteblatt International, 113(17), 289-296. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873672/

Thompson, T., Terhune, D. B., Oram, C., et al. (2019). The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials. Neuroscience & Biobehavioral Reviews, 99, 298-310. https://doi.org/10.1016/j.neubiorev.2019.02.013

Milling, L. S., Valentine, K. E., McCarley, H. S., & LoStimolo, L. M. (2021). Hypnosis and the alleviation of clinical pain: A comprehensive meta-analysis. International Journal of Clinical and Experimental Hypnosis, 69(3), 297-322.

Valentine, K. E., Milling, L. S., Clark, L. J., & Moriarty, C. L. (2019). The efficacy of hypnosis as a treatment for anxiety: A meta-analysis. International Journal of Clinical and Experimental Hypnosis, 67(3), 336-363.

Schnur, J. B., et al. (2008). Hypnosis to manage distress related to medical procedures: A meta-analysis. Contemporary Hypnosis, 25(3-4), 114-128. https://doi.org/10.1002/ch.364

Pain Management:

Jensen, M. P., & Patterson, D. R. (2014). Hypnotic approaches for chronic pain management: Clinical implications of recent research findings. American Psychologist, 69(2), 167-177. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465776/

Langlois, P., Perrochon, A., David, R., et al. (2022). Hypnosis to manage musculoskeletal and neuropathic chronic pain: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 135, 104591.

Jensen, M. P., Adachi, T., Gertz, K. J., et al. (2024). Adjunctive use of hypnosis for clinical pain: A systematic review and meta-analysis. PAIN Reports, 9(1), e1221.

Jong, M., et al. (2020). Hypnosis for acute procedural pain: A critical review. International Journal of Clinical and Experimental Hypnosis, 64(1), 75-115. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120961/

Irritable Bowel Syndrome:

Gonsalkorale, W. M., Miller, V., Afzal, A., & Whorwell, P. J. (2003). Long term benefits of hypnotherapy for irritable bowel syndrome. Gut, 52(11), 1623-1629.

Miller, V., Carruthers, H., Morris, J., et al. (2015). Hypnotherapy for irritable bowel syndrome: An audit of one thousand adult patients. Alimentary Pharmacology & Therapeutics, 41(9), 844-855.

Lee, H. H., Choi, Y. Y., & Choi, M. G. (2014). The efficacy of hypnotherapy in the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Journal of Neurogastroenterology and Motility, 20(2), 152-162.

Lindfors, P., Unge, P., Arvidsson, P., et al. (2012). Effects of gut-directed hypnotherapy on IBS in different clinical settings: Results from two randomized, controlled trials. American Journal of Gastroenterology, 107, 276-285.

Adler, E. C., et al. (2025). Gut-directed hypnotherapy for irritable bowel syndrome: A systematic review and meta-analysis. Neurogastroenterology & Motility, 37(7), e70037.

Historical and Professional Endorsements:

American Medical Association. (1958). Medical use of hypnosis. Journal of the American Medical Association, 168(2), 186-189.

American Psychological Association, Division 30. (1960). Statement on hypnosis. American Psychologist, 15, 86-89.

Veterans Health Administration. (2017). VHA Directive 1137: Provision of complementary and integrative health. U.S. Department of Veterans Affairs.

British Medical Association. (1955). Medical use of hypnotism: Report of a subcommittee appointed by the Psychological Medicine Group Committee. British Medical Journal, Supplement, 190-193.

Training and Professional Organizations:

American Society of Clinical Hypnosis (ASCH): https://www.asch.net/

Society for Clinical and Experimental Hypnosis (SCEH): https://sceh.us/

British Society of Clinical Hypnosis: https://www.bsch.org.uk/

Additional Reading:

Patterson, D. R., & Jensen, M. P. (2003). Hypnosis and clinical pain. Psychological Bulletin, 129(4), 495-521.

Montgomery, G. H., DuHamel, K. N., & Redd, W. H. (2000). A meta-analysis of hypnotically induced analgesia: How effective is hypnosis? International Journal of Clinical and Experimental Hypnosis, 48(2), 138-153.

Elkins, G., Johnson, A., & Fisher, W. (2012). Cognitive hypnotherapy for pain management. American Journal of Clinical Hypnosis, 54(4), 294-310.

Rainville, P., Duncan, G. H., Price, D. D., Carrier, B., & Bushnell, M. C. (1997). Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science, 277(5328), 968-971.

Whorwell, P. J., Prior, A., & Faragher, E. B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet, 324(8414), 1232-1234.

Palsson, O. S., et al. (2023). Current practices, experiences, and views in clinical hypnosis: Findings of an international survey. International Journal of Clinical and Experimental Hypnosis, 71, 92-114.Medical Hypnosis: Two Comprehensive Guides

A Story-Driven Guide for General Readers and an Evidence-Based Reference for Clinicians

This document contains two complete blog posts about medical hypnosis: one written for general readers focusing on real-world applications and personal relevance, and another for healthcare professionals emphasizing clinical evidence, integration strategies, and practice guidelines.

═══ PART 1: FOR GENERAL READERS ═══

Hypnosis in Modern Medicine: What It Really Does (And Doesn’t) Do

When most people hear “hypnosis,” they picture swinging watches or stage shows where people cluck like chickens. In hospitals and clinics, though, hypnosis looks very different. It is used as a serious, research-backed tool to help with pain, medical procedures, and certain chronic conditions.

Clinical (or medical) hypnosis is a guided state of focused attention where you become more responsive to helpful suggestions. You are not asleep, unconscious, or under anyone’s “control.” Instead, your mind is narrowed in on inner experience, which makes it easier to change how you feel pain, stress, or physical symptoms.

How a Medical Hypnosis Session Works

A typical session with a trained health professional is calm and structured. The clinician first explains what will happen and answers questions. Then you are guided into a comfortable position, asked to focus on breathing or a point in space, and led through imagery or sensations that help your attention narrow and relax.

Once you are in this focused state, the clinician uses tailored suggestions: for example, imagining turning down a “pain dial,” feeling warmth and comfort in an injured area, or seeing your gut muscles become calm and steady. You may also be taught short self-hypnosis exercises to practice at home between visits.

Where Hypnosis Helps the Most

Research over the last few decades shows that hypnosis can be genuinely helpful in several areas of health care.

Pain and Medical Procedures

Hypnosis can reduce pain and anxiety during surgeries, dental work, cancer treatments, and other procedures, and often cuts down how much pain medication people need. Some hospitals now routinely offer hypnosis or hypnotic communication before and during procedures to help patients stay calmer and more comfortable.

Real-world impact:

• Studies show that 89% of trials using hypnosis in surgical patients demonstrated positive outcomes in physical or psychological recovery
• Hypnosis reduces pain, anxiety, nausea, and recovery time after surgery
• Some patients have even undergone major surgery with hypnosis as the sole anesthetic agent

Chronic Pain and Long-Term Conditions

People living with ongoing pain (for example, from back problems, arthritis, cancer, or nerve pain) can learn hypnosis to change their perception of pain and feel more in control. Studies show meaningful drops in reported pain levels and improvements in quality of life when hypnosis is added to regular care.

The numbers tell the story:

• People who respond well to hypnosis can experience pain reductions of 29-42%
• The average person receiving hypnosis reduces pain more than about 73% of people who don’t receive it
• Benefits last over time, with many people maintaining improvements months or years later

Irritable Bowel Syndrome (IBS) and Gut Issues

Gut-focused hypnosis, often delivered over several sessions plus home audio, has helped many patients with IBS reduce pain, bloating, and bowel irregularity, while also improving daily functioning and well-being.

The results are impressive:

• 71% of IBS patients respond well to hypnotherapy
• Of those who respond, 81% maintain their improvement for at least five years
• Many patients no longer need medication after completing treatment
• The American College of Gastroenterology recommends gut-directed hypnotherapy in their clinical guidelines

There are also promising but more early-stage uses in skin problems (itching, certain chronic rashes), cancer-related symptoms, sleep problems, and anxiety or low mood. In all these, hypnosis is used alongside—not instead of—standard medical care.

How Effective Is It Really?

Large research reviews looking at hundreds of studies find that hypnosis has small to large benefits depending on what is being treated, with some of the strongest results in reducing pain and distress around medical procedures. This means it is not magic, but it is more than a placebo or “just relaxation,” especially when guided by a skilled clinician.

One key point: hypnosis works differently than placebo. Scientists can measure specific changes in brain activity during hypnosis that differ from placebo responses. Hypnotic pain relief isn’t blocked by naloxone (a drug that blocks placebo effects), proving it uses distinct pathways in the nervous system.

Importantly, hypnosis has an excellent safety profile. Across clinical trials, serious side effects are extremely rare, and mild temporary effects (like brief dizziness, headache, or feeling emotional) are uncommon and usually pass quickly. The bigger risks come from unqualified practitioners or unrealistic promises, which is why it matters who you work with.

Is Hypnosis “Approved” by Medicine?

Major professional bodies now recognize hypnosis as a valid clinical tool. The American Medical Association formally approved hypnosis as a legitimate medical treatment in 1958, followed by the American Psychological Association in 1960. Medical and psychological associations in the United States and United Kingdom have acknowledged hypnosis as a legitimate procedure for trained professionals, especially in pain and functional disorders.

In 2017, the U.S. Veterans Administration included clinical hypnosis in its complementary and integrative health approaches, recognizing it as safe with sufficient evidence of benefit for the veteran population. Hospitals and cancer centers increasingly integrate hypnosis or hypnotic communication into standard supportive care.

This does not mean hypnosis replaces drugs, surgery, or psychotherapy. Instead, it sits beside them as a mind-body tool that can improve comfort, reduce medication needs, and give patients a sense of active participation in their care.

How to Find a Qualified Practitioner

If you are considering hypnosis as part of your care:

• Look for a licensed health professional (doctor, psychologist, nurse, dentist, or therapist) with formal training in clinical or medical hypnosis from a recognized organization such as the American Society of Clinical Hypnosis (ASCH) or the Society for Clinical and Experimental Hypnosis (SCEH)
• Ask how hypnosis will fit into your existing treatment plan and whether they will coordinate with your other clinicians
• Be cautious of anyone who claims hypnosis can cure serious illnesses on its own or advises you to stop prescribed treatment
• Trust your comfort level—like any healthcare provider, you should feel at ease with your hypnotherapist

Used thoughtfully, hypnosis can be a powerful ally: helping you hurt less, cope better, and feel more in control while still keeping the best of modern medicine on your side.

═══ PART 2: FOR CLINICIANS ═══

Clinical Hypnosis in Medical Practice: Indications, Efficacy, and Integration

Clinical hypnosis has evolved from a marginal practice to an evidence-supported adjunct across multiple medical domains, especially perioperative care, pain management, and functional gastrointestinal disorders. Over the last two decades, meta-analytic work has clarified effect sizes, safety, and appropriate indications, providing a stronger basis for informed integration into routine practice.

Defining Clinical Hypnosis and Hypnotic Communication

Contemporary definitions describe hypnosis as a procedure involving focused attention and reduced peripheral awareness, accompanied by an increased responsiveness to suggestion. This is operationalized clinically via an induction (eye fixation, relaxation, or other focusing strategy) followed by therapeutic suggestions (cognitive, sensory, affective, or behavioral), often combined with imagery and post-hypnotic cues.

A useful distinction in medical contexts:

• Formal medical hypnosis: structured sessions with induction, deepening, symptom-focused suggestions, and self-hypnosis training
• Hypnotic communication: deliberate use of suggestion, framing, and expectation management by clinicians (even without a formal trance) to modulate pain, anxiety, and cooperation during routine care and procedures

Evidence Base: Overview and Key Indications

A 2024 synthesis of 49 meta-analyses comprising 261 primary randomized controlled trials concluded that hypnosis shows statistically and clinically significant benefits across multiple somatic and mental health outcomes, with particularly robust effects for perioperative distress and pain. Earlier systematic work on medical hypnosis similarly highlighted perioperative and procedural applications, chronic pain, and IBS as leading indications.

Perioperative and Procedural Applications

Meta-analyses of adults undergoing surgery and invasive procedures indicate that hypnosis reduces pain, anxiety, emotional distress, procedural time, and perioperative drug requirements compared with standard care or attention controls. Benefits have been reported in oncologic surgery, breast surgery, interventional radiology, cardiac procedures, and various minor procedures, with effect sizes often in the moderate range for pain and anxiety.

Key findings:

• A 1991 review found 89% of trials using hypnosis in surgical patients showed positive outcomes in facilitating physical or psychological recovery
• A 2002 meta-analysis concluded hypnosis as adjunct to surgery was successful for the majority of individuals, with benefits including decreased pain, anxiety, nausea, and recovery time
• Multiple sessions prior to procedures produced higher percentages of significant results
• A 2024 meta-analysis found hypnosis decreased acute pain by 0.54 standard deviations compared to standard care (p = 0.0024)

Acute and Chronic Pain

Across musculoskeletal pain, cancer pain, burn pain, and other pain conditions, hypnosis demonstrates clinically meaningful reductions in pain intensity and pain-related distress, often comparable to or augmenting other psychological interventions. Protocols commonly involve 4-10 sessions plus self-hypnosis, integrating sensory modulation (“numbing,” “cooling,” “turning down the pain dial”), cognitive reframing, and coping imagery.

Meta-analytic evidence:

• A comprehensive 2019 meta-analysis of 85 controlled trials with 3,632 participants found moderate to large pain-reducing effects (g = 0.54-0.76, all p < .001)
• High and medium hypnotic suggestibles demonstrated 42% and 29% clinically meaningful pain reductions respectively with direct analgesic suggestions
• A 2021 meta-analysis focused on musculoskeletal/neuropathic chronic pain found moderate effect sizes for pain intensity (Hedge’s g: -0.42) and interference (g: -0.39)
• Interventions ≥8 sessions showed significantly larger effects (g: -0.555, p = 0.034) compared to shorter programs
• A 2021 comprehensive meta-analysis of 42 clinical trials found mean weighted effect sizes of 0.60 post-treatment and 0.61 at follow-up, indicating hypnosis reduced pain more than 73% of control participants

Neurophysiological studies reveal that hypnotic analgesia produces measurable effects on brain and spinal-cord functioning that differ as a function of specific hypnotic suggestions, with distinct patterns in somatosensory cortex (pain intensity) and anterior cingulate cortex (pain unpleasantness). Hypnotic analgesia is not blocked by naloxone, unlike placebo responses, providing evidence for specific mechanisms.

Functional Gastrointestinal Disorders

Gut-directed hypnotherapy is one of the better-documented non-pharmacologic interventions for IBS, improving abdominal pain, bowel habit abnormalities, and quality of life, with sustained benefits at follow-up in some trials. Treatment typically entails structured scripts focusing on normalization of gut motility and sensitivity, delivered over multiple sessions (typically 7-12) with home audio supports.

Clinical trial results:

• A landmark audit of 1,000 IBS patients found 76% achieved clinically significant symptom improvement with gut-focused hypnotherapy
• Long-term follow-up demonstrated 71% initial response rate, with 81% of responders maintaining improvement up to 6 years
• A 2024 two-year follow-up of nurse-administered gut-directed hypnotherapy found stable response rates: 64.3% post-treatment, 62.8% at 6 months, 64.7% at 1 year, and 61.8% at 2 years
• The American College of Gastroenterology clinical guidelines recommend gut-directed hypnotherapy for IBS management
• Meta-analyses report Numbers Needed to Treat (NNT) of 3-5 for adequate symptom reduction

Additional Domains

Additional domains with promising but more heterogeneous evidence include:

• Dermatology: itch, chronic urticaria, some inflammatory dermatoses (eczema, psoriasis, warts)
• Oncology symptom management: pain, nausea, fatigue, procedure-related distress. High-confidence evidence for anxiety in cancer patients
• Women’s health: menopause-associated vasomotor symptoms (recommended by North American Menopause Society 2023), fertility support
• Anxiety disorders: A 2019 meta-analysis of 17 trials found effect size of 0.79 at end of treatment and 0.99 at follow-up. More effective when combined with other psychological interventions
• Sleep disturbance, headaches/migraines, asthma symptoms
• Integration with psychotherapy for depression and PTSD

Effect Sizes, Moderators, and Safety

The 20-year meta-analytic overview notes effect sizes ranging from small to large depending on outcome cluster, with particularly strong support for procedure-related distress, pain, and IBS-related symptoms. Hypnotic suggestibility appears to moderate response in some, but not all, indications, suggesting that formal pre-screening may be helpful when resources are limited but is not obligatory in all contexts.

Responder analyses:

Rather than relying solely on group averages, responder analyses identify clinically meaningful improvements (typically ≥30% pain reduction or 50-point reduction in IBS symptom severity). This approach reveals that while not everyone benefits equally, a substantial proportion of patients experience meaningful relief that persists over time.

Safety profile:

From a safety standpoint, systematic reviews and trial registries report no serious adverse events directly attributable to hypnosis and low rates of minor transient effects such as headache, dizziness, or increased emotionality, generally under 1% across samples. The primary clinical risks are indirect: inadequate preparation or debriefing, unrealistic promises, or use by unqualified providers who discourage evidence-based medical or psychological treatments.

Contraindications:

• Not effective in conditions affecting focused attention or language processing (stroke, schizophrenia)
• Use discouraged in paranoia, psychosis, borderline personality disorder, dissociative characteristics
• Requires appropriate clinical judgment in complex or high-risk patients

Institutional Acceptance and Training Considerations

Medical and psychological associations in the US and UK have formally recognized hypnosis as a legitimate clinical tool when used by appropriately trained professionals. The American Medical Association approved hypnosis in 1958, followed by the American Psychological Association in 1960. The British Medical Association endorsed hypnosis in 1955. These historical endorsements have been reinforced by more recent guidelines emphasizing value in pain, anesthesia adjuncts, and functional disorders, while emphasizing training and ethical use.

Best-practice recommendations:

• Restricting therapeutic hypnosis to licensed health professionals (medicine, dentistry, psychiatry, psychology, social work, nursing) or those working under appropriate clinical supervision, with formal training in clinical or medical hypnosis
• Training available through American Society of Clinical Hypnosis (ASCH) and Society for Clinical and Experimental Hypnosis (SCEH), typically 4-day programs covering ethics, informed consent, and practical skills
• Integrating hypnosis as an adjunct to standard care, not a replacement, with clear communication to patients about realistic goals and the ongoing role of pharmacologic and procedural treatments
• Documenting indications, consent, session content, and outcomes as with other behavioral interventions
• Coordinating with the broader care team, especially in complex or high-risk patients

Practical Integration into Clinical Workflows

For clinicians, feasible points of integration include:

• Pre-procedure consultations: brief hypnotic preparation to reduce anticipatory anxiety and modulate expected pain, even in 10-20 minute formats
• Perioperative care: intra-procedural hypnotic communication or formal hypnosis, particularly in settings where reducing sedative or opioid dose is desirable
• Chronic disease management: structured short-term hypnotherapy referrals for refractory pain, IBS, or functional symptoms, with emphasis on self-management and self-hypnosis skills
• Group protocols and audio-guided hypnosis: nurse-administered group sessions and audio files improve cost-effectiveness and accessibility without significant loss of efficacy

Medical hypnosis requires initial investment of uninterrupted time (typically 30-60 minutes per session initially), but this investment can save physician time later through improved patient outcomes, reduced medication use, and enhanced self-management capabilities.

Overcoming Barriers to Adoption

Despite robust evidence and professional endorsement, hypnosis remains underutilized. Key barriers include:

• Misconceptions perpetuated by entertainment hypnosis leading to views of hypnosis as either dangerous mind control or ineffective farce
• Limited curriculum integration in medical and psychological training programs
• Upfront time investment and need for specialized practice
• Need for appropriate hospital credentialing processes

Addressing these barriers through education, expanded training opportunities, workflow optimization, and institutional support can facilitate broader integration of this evidence-based modality.

Future Directions

The automation of hypnosis using recordings, web-based applications, and smart-speaker devices is being tested to expand access. However, patients cannot reliably differentiate between legitimate and manipulative sources online, making it essential to maintain medical oversight while improving accessibility.

Research priorities include larger, high-quality RCTs with adequate control conditions, investigation of mechanisms through neuroimaging and psychophysiology, development of predictive models for treatment response, and comparative effectiveness studies examining hypnosis relative to other evidence-based interventions.

Clinical Bottom Line

Clinical hypnosis represents an evidence-based, safe, and effective adjunctive intervention for multiple medical conditions, particularly perioperative care, pain management, and functional gastrointestinal disorders. With appropriate training, integration into standard care workflows, and realistic expectation-setting, hypnosis can meaningfully reduce symptom burden, enhance patient self-efficacy, and potentially reduce reliance on pharmacologic interventions.

Given current challenges with opioid dependence, chronic disease management costs, and patient demand for participatory care approaches, clinical hypnosis deserves serious consideration as part of comprehensive treatment strategies. Internists and other primary care clinicians are well-positioned to lead broader adoption of this underutilized but well-validated therapeutic modality.

References and Further Reading

Key Meta-Analyses and Systematic Reviews:

Zech, N., Hansen, E., Bernardy, K., & Häuser, W. (2024). Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: A 20-year perspective. Frontiers in Psychology, 14, 1330238. https://doi.org/10.3389/fpsyg.2023.1330238

Häuser, W., et al. (2016). The efficacy, safety and applications of medical hypnosis: A systematic review of meta-analyses. Deutsches Ärzteblatt International, 113(17), 289-296. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873672/

Thompson, T., Terhune, D. B., Oram, C., et al. (2019). The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials. Neuroscience & Biobehavioral Reviews, 99, 298-310. https://doi.org/10.1016/j.neubiorev.2019.02.013

Milling, L. S., Valentine, K. E., McCarley, H. S., & LoStimolo, L. M. (2021). Hypnosis and the alleviation of clinical pain: A comprehensive meta-analysis. International Journal of Clinical and Experimental Hypnosis, 69(3), 297-322.

Valentine, K. E., Milling, L. S., Clark, L. J., & Moriarty, C. L. (2019). The efficacy of hypnosis as a treatment for anxiety: A meta-analysis. International Journal of Clinical and Experimental Hypnosis, 67(3), 336-363.

Schnur, J. B., et al. (2008). Hypnosis to manage distress related to medical procedures: A meta-analysis. Contemporary Hypnosis, 25(3-4), 114-128. https://doi.org/10.1002/ch.364

Pain Management:

Jensen, M. P., & Patterson, D. R. (2014). Hypnotic approaches for chronic pain management: Clinical implications of recent research findings. American Psychologist, 69(2), 167-177. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465776/

Langlois, P., Perrochon, A., David, R., et al. (2022). Hypnosis to manage musculoskeletal and neuropathic chronic pain: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 135, 104591.

Jensen, M. P., Adachi, T., Gertz, K. J., et al. (2024). Adjunctive use of hypnosis for clinical pain: A systematic review and meta-analysis. PAIN Reports, 9(1), e1221.

Jong, M., et al. (2020). Hypnosis for acute procedural pain: A critical review. International Journal of Clinical and Experimental Hypnosis, 64(1), 75-115. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120961/

Irritable Bowel Syndrome:

Gonsalkorale, W. M., Miller, V., Afzal, A., & Whorwell, P. J. (2003). Long term benefits of hypnotherapy for irritable bowel syndrome. Gut, 52(11), 1623-1629.

Miller, V., Carruthers, H., Morris, J., et al. (2015). Hypnotherapy for irritable bowel syndrome: An audit of one thousand adult patients. Alimentary Pharmacology & Therapeutics, 41(9), 844-855.

Lee, H. H., Choi, Y. Y., & Choi, M. G. (2014). The efficacy of hypnotherapy in the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Journal of Neurogastroenterology and Motility, 20(2), 152-162.

Lindfors, P., Unge, P., Arvidsson, P., et al. (2012). Effects of gut-directed hypnotherapy on IBS in different clinical settings: Results from two randomized, controlled trials. American Journal of Gastroenterology, 107, 276-285.

Adler, E. C., et al. (2025). Gut-directed hypnotherapy for irritable bowel syndrome: A systematic review and meta-analysis. Neurogastroenterology & Motility, 37(7), e70037.

Historical and Professional Endorsements:

American Medical Association. (1958). Medical use of hypnosis. Journal of the American Medical Association, 168(2), 186-189.

American Psychological Association, Division 30. (1960). Statement on hypnosis. American Psychologist, 15, 86-89.

Veterans Health Administration. (2017). VHA Directive 1137: Provision of complementary and integrative health. U.S. Department of Veterans Affairs.

British Medical Association. (1955). Medical use of hypnotism: Report of a subcommittee appointed by the Psychological Medicine Group Committee. British Medical Journal, Supplement, 190-193.

Training and Professional Organizations:

American Society of Clinical Hypnosis (ASCH): https://www.asch.net/

Society for Clinical and Experimental Hypnosis (SCEH): https://sceh.us/

British Society of Clinical Hypnosis: https://www.bsch.org.uk/

Additional Reading:

Patterson, D. R., & Jensen, M. P. (2003). Hypnosis and clinical pain. Psychological Bulletin, 129(4), 495-521.

Montgomery, G. H., DuHamel, K. N., & Redd, W. H. (2000). A meta-analysis of hypnotically induced analgesia: How effective is hypnosis? International Journal of Clinical and Experimental Hypnosis, 48(2), 138-153.

Elkins, G., Johnson, A., & Fisher, W. (2012). Cognitive hypnotherapy for pain management. American Journal of Clinical Hypnosis, 54(4), 294-310.

Rainville, P., Duncan, G. H., Price, D. D., Carrier, B., & Bushnell, M. C. (1997). Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science, 277(5328), 968-971.

Whorwell, P. J., Prior, A., & Faragher, E. B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet, 324(8414), 1232-1234.

Palsson, O. S., et al. (2023). Current practices, experiences, and views in clinical hypnosis: Findings of an international survey. International Journal of Clinical and Experimental Hypnosis, 71, 92-114.