Can Hypnosis Help People Stop Smoking?
There have been many attempts to use hypnosis for habit control, however, hypnosis has no coercive power. That is, one cannot be hypnotized against his or her will, and even deeply hypnotized individuals cannot be made, by virtue of hypnotic suggestions, to do things that run against their own or others' interests. You cannot cajole a smoker to the local hypnotist and expect him or her to stop smoking. However, where the patient is appropriately motivated, as in the obesity study described earlier, hypnosis may offer a boost to treatment.
One popular hypnotic treatment for smoking involves a single session in which patients are taught to repeat a simple persuasive message during self-hypnosis. In one large-scale study of this technique, about 50% of patients stopped smoking immediately after treatment; at follow-up one and two years later, however, this figure had dropped to about 25%. Although this study did not include a nonhypnotic control group, this is about the same success rate as achieved with other cognitive-behavioral interventions. However, these other treatments are typically more intensive, so that the single-session hypnotic treatment may have some advantage in terms of efficiency. Interestingly, long-term abstinence was not related to traditional measures of hypnotizability, suggesting that the success of the treatment may have had more to do with the persuasive message than with hypnosis per se.
Caveats for Health Practitioners in the Use Hypnosis
with Patients An important but unresolved issue is the role played by individual differences in the clinical effectiveness of hypnosis. As in the laboratory, so in the clinic: a genuine effect of hypnosis should be correlated with hypnotizability.
It is possible that many clinical benefits of hypnosis are mediated by placebo-like motivational and expectational processes -- that is, with the "ceremony" surrounding hypnosis, rather than hypnosis per se. An analogy is to hypnotic analgesia, which appears to have a placebo component available to insusceptible and hypnotizable individuals alike, and a dissociative component available only to those who are highly hypnotizable. Unfortunately, clinical practitioners are often reluctant to assess hypnotizability in their patients and clients, out of a concern that low scores might reduce motivation for treatment. This danger is probably exaggerated. On the contrary, assessment of hypnotizability by clinicians contemplating the therapeutic use of hypnosis would seem to be no different, in principle, than assessing allergic responses before prescribing an antibiotic. In both cases, the legitimate goal is to determine what treatment is appropriate for what patient.
It should be noted that clinicians sometimes use hypnosis in non-hypnotic ways -- practices which tend to support the hypothesis that whatever effects they achieve through hypnosis are related to its placebo component. There is nothing particularly "hypnotic", for example, about having a patient in a smoking-cessation treatment rehearse therapeutic injunctions not to smoke and other coping strategies while hypnotized. It is likely that more successful use of hypnosis as an adjunct to the cognitive-behavioral treatment of smoking, overweight, and similar habit disorders would be to use hypnotic suggestions in order to control the patient's awareness of cravings for nicotine, sweets, and the like. Given the ability of hypnotic suggestions to control conscious perception and memory, such strategies might well have therapeutic advantage -- but only, of course, for those patients who are hypnotizable enough to respond positively to such suggestions.
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