Does Hypnosis have an Effect on Psychosomatic Disorders?
Hypnotic suggestion can have psychosomatic effects, a matter that should be of some interest to psychophysiologists and psychoneuroimmunologists. A famous case study convincingly documented the positive effects of hypnotic suggestion on an intractable case of congenital ichthyosiform erythroderma, a particularly aggressive skin disorder. Carefully controlled studies have shown that hypnotic suggestions can have a specific effect on the remission of warts. However, the same effects can be achieved by suggestions administered nonhypnotically. The mechanisms by which these "psychosomatic" effects are produced are theoretically interesting, and possibly clinically significant, but it is not yet clear that they have anything to do with hypnosis.
Can Hypnosis be used in Psychotherapy?
Hypnosis has been used in psychotherapy—both in psychodynamic or cognitive-behavioral oriented therapy. In the former case, hypnosis is used to promote relaxation, enhance imagery, and generally loosen the flow of free associations (some psychodynamic theorists consider hypnosis to be a form of adaptive regression or regression in the service of the ego). However, there is little evidence from controlled outcome studies that hypnoanalysis or hypnotherapy are more effective than nonhypnotic forms of the same treatment. By contrast, a 1995 meta-analysis by Kirsch and colleagues showed a significant advantage when hypnosis is used to complement cognitive-behavioral therapy for a number of problems, including anxiety and hypertension. In an era of evidence-based mental health care, it will be increasingly important for practitioners who use hypnosis to document, quantitatively, the clinical benefits of doing so.
Can Hypnosis help with Weight Control?
In the Kirsch study (mentioned above in the Psychotherapy section), the prospects for hypnosis appeared to be especially favorable in the treatment of obesity, where individuals in the hypnosis group continued to lose weight even after formal treatment had ended. In one study, for example, women who received personally tailored hypnotic suggestions for specific food aversions, in the context of a traditional self-monitoring and goal-setting treatment, lost approximately twice as much weight as a comparison group. This comparison group received the behavioral treatment alone (no hypnotic suggestion). However, the actual weight lost by the hypnosis group was only about 14 lb. on average. Given that the patients were approximately 50% overweight at the outset, it is not clear that the treatment actually improved their clinical status. Studies that document the clinical efficacy of hypnosis should pay careful attention to the terms in which outcome is assessed. While hypnosis may seem to offer an advantage over some other treatments, it is not clear that the statistical significance or experimental results translates into meaningful clinical significance or real results for individuals.
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