A forty-seven-year-old by the name of Tonja has been going to various therapy sessions for the past eleven years. After being diagnosed with post-traumatic stress disorder, Tonja has suffered from a myriad of health problems. Unfortunately for her, none of these therapy sessions seemed to yield the results she wanted. In search of mental and physical healing, she turned to hypnotherapy (Seo). No, this did not involve a swinging pocket watch and a mysterious doctor whispering words and controlling her actions. However, it did lead to Tonja feeling reduced levels of pain and stress as well as increased confidence (Seo). Hypnotherapy, although relatively unfamiliar to most, has cultivated interest in recent years with an increasing prevalence of mental health disorders such as depression. This report aims to shed light on the possible positive effects of hypnotherapy for treating depression as well as current concerns and uncertainties. Where hypnotherapy could have a place in modern treatments will also be considered.
What Defines Depression and Why is it a Problem?
Depression is a term often used today, but it is not always clear what it is referring to. For example, you most likely have heard someone respond to a friend’s failed attempt at a task with the phrase, “that was depressing.” Or maybe you yourself have experienced a tragic event and remarked, “well, now I’m feeling a little depressed.” Thus, the definition of depression can be convoluting depending on the circumstance and context in which it is used. Clarification is needed. For this article, the use of the word depression will refer to what the Mayo Clinic, one of the US’s leading hospital organizations, defines as “a mood disorder that causes a persistent feeling of sadness and loss of interest.…it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living,” (Mayo Clinic Staff). The differentiating words in this definition are the words disorder and persistent. Disorder as defined by the Oxford English Dictionary refers to “an illness or condition that disrupts normal physical or mental functions” (Oxford English Dictionary). Persistent is a more familiar term and refers to a condition that reoccurs or lasts over an extended period of time. Going back to the two examples above, neither of these uses of the word depression are either ongoing or a hindrance to normal physical and mental function. That is not to say that one of these examples could lead or contribute to depression as described above.
While most people understand what depression is, some may not acknowledge how prevalent it is in our society today. According to Michael Yapko, a clinical psychologist with a doctorate in professional psychology, the number of Americans diagnosed with depression, as of 2009, is 20 million and continues to increase (12). Furthermore, he adds, “Realistically, we are all affected by depression, even if only indirectly, by having to share in the hurtful consequences of the many antisocial behaviors (such as child abuse and drug abuse) that often have their origin in badly managed depression” (12). Depression, although most directly affecting the afflicted, is a shared burden and should be handled with sensitivity to all parties. Additionally, as Yapko states, it is a growing problem; because of this, there is an increasing importance and necessity of treatments. Some of these treatments will be briefly considered here, with the main focus being on hypnotherapy and its place within the realm of psychology as a treatment for depression.
Why Should Hypnotherapy be Considered in Treatments for Depression?
As the circumstances are right now, the most common forms for treating depression are medicines, such as SSRIs (Selective Serotonin Reuptake Inhibitors), and psychotherapy treatments, such as CBT (Cognitive Behavioral Therapy) (Mayo Clinic Staff). Unfortunately, neither of these are foolproof treatments and not everybody responds to these well. On SSRIs, Assen Alladin, a clinical psychologist and professor at the University of Calgary Medical School, has reported, “Selective serotonin reuptake inhibitors (SSRIs) have been found to be very effective in relieving severe depression, but 40% to 50% of depressed patients do not respond adequately to these drugs, and a substantial number of the remainder is left with residual symptoms of depression” (246). If a perfect drug had been invented, then depression would not be the growing problem that it is. Concerning psychotherapy, Michael Yapko has said, “The disadvantages of psychotherapy include the greater reliance on the level of clinician competence, the greater time lag between the initiation of treatment and the remission of symptoms compared to medications, the lesser effect in reducing vegetative symptoms, and the potential detrimental side-effects of client exposure to a clinician’s particular theoretical or philosophical stance” (14). This is in no way to say that these methods are bad or ineffective. These methods are often deemed first-line treatments because they have proven their effectiveness. All of this is just to demonstrate that there is room for treatments such as hypnotherapy to fit in. An overview of what hypnotherapy is will be given next in order to better understand how this treatment could be beneficial.
What is Hypnotherapy?
It should first be noted that hypnotherapy and psychotherapy have a lot of similarities and share techniques at a fundamental level (Yapko, 17). Because of this, it can sometimes be difficult to distinguish the two and assign certain methods, and results, to one category or the other. This essay, in an attempt to maintain clarity, will solely focus on hypnotherapy and all methods that may fall under that category. In turn, this allows for a broad view of the positive and negative effects of hypnotherapy which can later be scrutinized and researched in more depth.
According to Psychology Today, a magazine publisher overseen by psychology professionals, hypnotherapy is defined as “a therapeutic practice that uses guided hypnosis to help a client reach a trance-like state of focus, concentration, diminished peripheral awareness, and heightened suggestibility” (“Hypnotherapy”). This is usually accomplished through forms of hypnosis such as mental imagery. A patient may be asked to close their eyes and picture themselves in a calming or familiar setting. The patient would then be guided by a clinician to focus their thoughts and acknowledge physical or mental pains. The main difference between psychotherapy and hypnotherapy is that the latter causes the patient to enter a hypnotic state, which allows the clinician to reach the subconscious directly. Psychotherapy, on the other hand, reaches the subconscious by asking questions and performing mental exercises with a fully conscious patient. Considered below, will be some of the positive and negative effects of hypnotherapy as well as research that has been done on it. Furthermore, we will look at case studies to form a broader perspective on the topic.
What are the Positive Effects of Hypnotherapy?
One of the key tools used in hypnotherapy is helping the patient relax and experience a calming state. This is accomplished by putting the patient into a hypnotic state and having them imagine a setting in which they find calming. Some examples of this could be imagining the forest, the beach, or any other secluded area. In his article “Use of Hypnosis in Psychotherapy with Major Depressive Disorders,” Elliott H. Schreiber cites a case study of a forty-year-old single woman who had been medically diagnosed with depression. After seven sessions of hypnotherapy, all about a week apart, Schreiber reports that the patient “revealed less depressive moods and a better self-concept about her environment” (47). In another case study using similar techniques and a similar timeline, a twenty-eight-year-old single woman “displayed less anxiety and less depressive moods with respect to her environment and her relationships” after treatment (Schreiber, 50). Thus, when hypnotherapy has been applied on an individual basis, the results have been positive, suggesting that hypnotherapy could be helpful in the treatment of depression. It is important to consider that this only applies to using relaxation methods and other methods could produce better or worse results.
Another study was conducted where researchers divided eighty-four participants, who had been diagnosed with depression, into two groups. One group was only treated with Cognitive Behavioral Therapy while the other was treated with hypnotherapy. This lasted over the course of sixteen weeks, and at the end each group was evaluated on their level of depression. According to researchers Alladin and Alibhai, “Effect size calculations showed that the [Cognitive Hypnotherapy] group produced 6%, 5%, and 8% greater reduction in depression, anxiety, and hopelessness, respectively, over and above the CBT group” (147). While each group had improved regarding their levels of depression, the hypnotherapy group proved to be slightly more effective. This suggests once again the possible benefits of hypnotherapy used as a method to treat depression.
What are Some Concerns or Remaining Questions?
One of the biggest concerns with hypnotherapy is the lack of empirical evidence. Empirical evidence is evidence that is supported by “observation or experience rather than theory of pure logic” (Oxford English Dictionary). While individual clinicians have integrated hypnotherapy into their practice, there has been very little experimentation on the therapy itself. This means that even though there might be positive results from individual cases, they cannot be generalized to support hypnotherapy as a treatment method in the field of psychology (Alladin, 257). Although many of the case studies above resulted in positive outcomes, they cannot be used to predict the outcomes of future occurrences. Other established researchers have agreed with this statement. After conducting a study on the last twenty years of clinical research regarding hypnotherapy, Felipe Souza and her colleagues concluded that “There is not enough evidence to indicate that hypnosis-based interventions may reduce the severity of depression, which precludes the clinical recommendation of this intervention for patients in the real world” (Souza). Because hypnotherapy is not well-supported with evidence as of now, it makes it difficult to obtain more evidence in the future due to a lack of clinical practice to conduct studies. This only becomes increasingly difficult when studying its effect on depression since depression, as with most illnesses, has varying levels of intensity.
There is also some criticism concerning the study of the eighty-four participants diagnosed with depression as mentioned in the section above. In regards to this, writers of the Harvard Mental Health Letter, which consists of a variety of doctors from Harvard Medical School, pointed out that even though, “The hypnosis group made greater improvements than the CBT group…The gains were small,” (6). In other words, the difference was not significant enough, suggesting that the slight variation could be accounted for by other variables such as participants’ underlying health problems or their expectancy of the treatment to work. This creates uncertainty as to whether hypnotherapy is a more effective treatment for depression. In general, if a treatment does not show its superiority over another treatment or solve a specific problem, it will likely not be tested and experimented on further.
Conclusion
Hypnotherapy, up to this point, has had its application in a relatively small amount of clinical cases. Although it has proven effective in most of those cases, the experimental evidence has not yet been significant enough to establish hypnotherapy as an empirically supported practice. That being said, there is some encouragement to continue research in this field due to the insufficiencies of current medicinal and psychological treatments. Depression is not a withering problem that will disappear in a couple of years. It is acute and the pursuit of more effective treatments must continue. Concerning hypnotherapy, more research is required before it can find a place among current practices to treat depression. Until then, the individuals who have received aid from this treatment method, such as Tonja, can appreciate the healing effect that hypnotherapy had and continues to have on them.
Works Cited
Alladin, A. “Cognitive Hypnotherapy for Depression: An Empirical Investigation.” International Journal of Clinical and Experimental Hypnosis, vol. 55, no. 2, Apr. 2007, pp. 147–66.
Alladin, A. “Evidence-Based Cognitive Hypnotherapy for Depression.” Contemporary Hypnosis, vol. 26, no. 4, 2009, pp. 245–262. John Wiley & Sons, Inc., https://doi.org/10.1002/ch.391.
“Hypnosis as Mental Health Therapy.” Harvard Mental Health Letter, vol. 24, no. 9, 2008, p. 6. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip&db=asn&AN=30733423&site=ehost-live&scope=site.
Filipe Luis Souza, G., Mazzoni, M., Landry, M., et al. “Hypnosis for Depression: Systematic Review of Randomized Clinical Trials with Meta-Analysis.” Complementary Therapies in Clinical Practice, 2 Oct. 2024, https://www.sciencedirect.com/science/article/abs/pii/S1744388124000860#:~:text=There%20is%20not%20enough%20evidence%20to%20indicate%20that,no%20evidence%20of%20significant%20adverse%20effects%20was%20found.
“Mayo Clinic Staff. ‘Depression (Major Depressive Disorder).’” Mayo Clinic, 14 Oct. 2022, https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007.
“Hypnotherapy.” Psychology Today, accessed 1 Nov. 2024, https://www.psychologytoday.com/us/therapy-types/hypnotherapy?msockid=0bc675238742651b0f5761fe86c164a6.
Seo, H. “What Can Hypnosis Do for Your Health?” The New York Times, 8 Feb. 2023, https://www.nytimes.com/2023/02/08/well/mind/hypnosis-therapy-mental-health-depression.html.
Schreiber, E. H. “Use of Hypnosis in Psychotherapy with Major Depressive Disorders.” Australian Journal of Clinical and Experimental Hypnosis, vol. 38, no. 1, 2010. https://lib.byu.edu/remoteauth/?url=https://search-ebscohost-com.byu.idm.oclc.org/login.aspx?direct=true&AuthType=ip&db=asn&AN=57961907&site=ehost-live&scope=site.
Yapko, Michael. “Hypnosis in Treating Symptoms and Risk Factors of Major Depression.” Australian Journal of Clinical Hypnotherapy & Hypnosis, vol. 30, no. 2, 2009, pp. 12–25. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip&db=asn&AN=47076930&site=ehost-live&scope=site.
“Oxford English Dictionary.” Oxford English Dictionary, Oxford University Press, https://www.oed.com/?tl=true.
Should Hypnotherapy be Considered as a Treatment for Depression?
I have been one acquainted with the night. /I have walked out in rain—and back in rain. /I have outwalked the furthest city light. /I have looked down the saddest city lane. /I have passed by the watchman on his beat /And dropped my eyes, unwilling to explain. (Frost, lines 1-6).
This excerpt comes from the poem “Acquainted with the Night” by Robert Frost and encapsulates the feelings of isolation and despair often felt by those suffering from depression. While Frost is mostly known for his eloquent poems about nature, this poem hits on a much deeper, more personal topic, and one that is very relevant today. The imagery used in this excerpt paints a picture of what many who are struggling with depression feel. I too have felt as though I have looked down “the saddest city lane” and outwalked “the furthest city light.” Thankfully, depression does not have to be left untreated, with current treatments ranging from SSRIs (Selective Serotonin Reuptake Inhibitors) to Cognitive Behavioral Therapy (CBT). These treatments have assisted many in their battle with depression and are invaluable. But, the question can and should be asked, are these treatments enough? And if not, should other treatment options such as hypnotherapy be considered?
In response to the first question, Assen Alladin, a clinical psychologist and professor at the University of Calgary Medical School, would probably answer no, claiming that current common treatments are insufficient. Concerning SSRIs specifically, he has stated that “40% to 50% of depressed patients do not respond adequately to these drugs, and a substantial number of the remainder is left with residual symptoms of depression” (246). That is quite a significant number considering the estimated 5% of adults worldwide who suffer from depression (WHO). When we then look at other common treatments, namely psychotherapy treatments, they also have disadvantages according to clinical psychologist Michael D. Yapko. Some of these disadvantages of psychotherapy include having to rely on a clinician’s competence, having a longer wait time before the treatment takes effect (compared with medicine), and the possibility of treatments being influenced by a clinician’s personal beliefs. Additionally, psychotherapy is usually less effective in treating the physical effects of depression such as fatigue, a lack of appetite, and weight changes (Yapko 14). Once again, this shows that there are a lot of uncertainties for such a delicate and pressing problem. While I am not advocating for the removal of such treatments, I am trying to display the need to consider other treatments such as hypnotherapy.
You may be asking yourself, why hypnotherapy? To be frank, I probably would have been asking the same questions a couple of months ago. I can even say that my initial reaction to learning of this treatment was not positive. I heard the word “hypno” and my thoughts rushed immediately to some guy standing on a stage, dangling a pocket watch, and controlling another person’s actions through his words. Needless to say, I was very wrong in my prejudgment. Hypnotherapy is somewhat similar to psychotherapy in the sense that it involves a clinician asking questions and guiding the patient through mental exercises. The main difference is that hypnotherapy uses mental imagery to induce the patient into a hypnotic state, while psychotherapy is performed on a fully conscious patient. Because most mental conditions are usually a combination of conscious and unconscious factors, having access to the unconscious mind provides new possibilities for aiding in the treatment of depression.
Although current experimentation on this method of treatment is limited, there have been very positive findings in the studies conducted. One study, consisting of eighty-four participants diagnosed with depression, showed that hypnotherapy was 5–8% greater at reducing depression compared to a group treated with CBT (Alladin and Alibhai 147). Apply this on a larger scale and 5–8% makes a significant difference. In addition to this, there have been many case studies of depressed patients treated with hypnotherapy that yielded positive results. One of these was a twenty-eight-year-old woman who, after a variety of treatment options (including therapy and medicine), experienced inadequate results. She was then referred to a clinician trained in hypnotherapy and after several sessions reportedly “displayed less anxiety and less depressive moods with respect to her environment and her relationships” (Schreiber 50). This suggests that hypnotherapy can be of use to those who don’t respond well to current common treatments.
Going back to Robert Frost’s poem, there are many who are “acquainted with the night.” The millions of people who struggle with the agonizing effects of depression deserve viable treatment options. While the most common current methods are in no way bad, they are not one hundred percent effective. Thus, hypnotherapy, which has shown positive results in multiple studies, should also be considered when treating depression. Although it will not fill in all the gaps, it has the potential to make a positive difference in many individuals’ lives. Therefore, the question that should be asked is, why not consider hypnotherapy?
Works Cited
Frost, Robert. “Acquainted with the Night.” The Poetry of Robert Frost, edited by Edward Connery Lathem, Henry Holt and Company, 1969, pp. 169-170.
World Health Organization. “Depression.” World Health Organization, 17 Mar. 2023, www.who.int/news-room/fact-sheets/detail/depression. Accessed 11 Nov. 2024.
Schreiber, E. H. “Use of Hypnosis in Psychotherapy with Major Depressive Disorders.” Australian Journal of Clinical and Experimental Hypnosis, vol. 38, no. 1, 2010, https://lib.byu.edu/remoteauth/?url=https://search-ebscohost-com.byu.idm.oclc.org/login.aspx?direct=true&AuthType=ip&db=asn&AN=57961907&site=ehost-live&scope=site.
Yapko, Michael. “Hypnosis in Treating Symptoms and Risk Factors of Major Depression.” Australian Journal of Clinical Hypnotherapy & Hypnosis, vol. 30, no. 2, 2009, pp. 12–25, https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip&db=asn&AN=47076930&site=ehost-live&scope=site.
Alladin, A., and Alibhai. “Cognitive Hypnotherapy for Depression: An Empirical Investigation.” International Journal of Clinical and Experimental Hypnosis, vol. 55, no. 2, Apr. 2007, pp. 147–66.
Alladin, A. “Evidence-Based Cognitive Hypnotherapy for Depression.” Contemporary Hypnosis, vol. 26, no. 4, 2009, pp. 245–262, John Wiley & Sons, https://doi.org/10.1002/ch.391.
