Good Question

Is Hypnosis Real?

What research says about how it works in the brain — and the many conditions it may be useful for

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Welcome to my new column for Elemental. Each Tuesday, I’ll attempt to answer a thought-provoking health question with the help of one or two experts. If you’d like to suggest a topic, please email me at goodhealthquestion@gmail.com.

Hypnosis has long struggled with branding issues. For many, the term still conjures visions of swinging pocket watches and charlatans incanting, “Look into my eyes.” (No thank you.)

Jessie Kittle wants to dispel all those old associations and misconceptions. “The idea that you can take over someone’s brain and run them around like a puppet against their will — that doesn’t happen,” says Kittle, who is a doctor and a clinical assistant professor of medicine, psychiatry, and behavioral sciences at Stanford University.

Kittle has published several papers on hypnosis. When I spoke with her, she told me that she gets asked all the time whether hypnosis is real. During her early days as a hospital physician, she wondered this herself. To find the answer, she started digging through the published scholarship. “I found this ridiculous amount of medical literature going back decades and all of these clinical outcomes showing hypnosis to be effective for many different conditions,” she said. “It blew my mind.”

I asked her what hypnosis is, exactly, and she told me that it’s a brain state in which a person has the ability — usually with an administrator’s help — to assume some control over mental processes that we tend to think of as uncontrollable. “You can think of hypnosis as a way to align your conscious intention to feel better with your subconscious mind’s ability to make you feel better,” she explained.

The science-supported concepts that underlie hypnosis can be abstruse. But the basic idea is that conscious experience — what we each think of as reality — is an invention of the brain. That doesn’t mean it’s fake; the reality that the brain makes is usually based on objective information. But take 10 people and expose them to the exact same situation — whether it’s a needle poke, a public-speaking engagement, or a roller coaster ride — and each of their experiences will be different because each person’s brain is processing that situation using its own unique machinery. Hypnosis seems to allow people to access that mental machinery and to make some helpful adjustments. (When used as a form of medical or psychological treatment, hypnosis is often called hypnotherapy.)

Hypnosis begins with something called induction, which shifts the brain into a more suggestible state. “There are a variety of ways to do this, but many involve relaxation and focusing the mind inward,” Kittle explained to me. “You might have the person look up at the ceiling and then slowly close their eyes while relaxing their breathing.”

Imaging research in the American Journal of Clinical Hypnosis has found that hypnotic induction causes very specific and measurable changes in the brain’s electrical activity, and these changes seem to underlie its mechanism of action. “You can see differences in the ways that parts of the brain are working together that you don’t see when someone is out of hypnosis,” Kittle said. These differences aren’t supernatural. “We think this is a brain state that most humans are in and out of in daily life, like when you find yourself in a deep meditative state where you’re not aware of things around you,” she explained. “Hypnosis is capitalizing on that brain state and using it for therapeutic purposes.”

Once you’ve entered this hypnotized state — during which you’re still conscious, by the way — the person administering your hypnotherapy will suggest new ways of thinking about or engaging with the situation that’s giving you trouble. “The suggestions are different every time because people have different reasons or triggers for what they experience,” Kittle told me. For example, someone trying to overcome a phobia will require different suggestions than someone trying to quit smoking. For reasons that remain hazy, hearing these suggestions while in a hypnotized state somehow helps the brain absorb and assimilate them in ways that influence how it responds moving forward.

Kittle’s field is perioperative medicine, which is concerned with improving patient experiences before and after surgery. In a 2020 paper appearing in the American Journal of Medicine, she and her co-author argued that hypnosis is woefully underutilized as a treatment for pain — and also for headache, anxiety, and other common ailments or symptoms — despite the robust evidence backing its benefits.

“When it comes to clinical applications, it’s best to think of [hypnosis] as an adjunct to treatment,” says Irving Kirsch, PhD, a long-time hypnosis researcher and director of the Program in Placebo Studies at Harvard Medical School. “So it can help with medical pain reduction or in the context of trying to help someone overcome a phobia or some other anxiety disorder.”

Some aspects of hypnosis remind me of cognitive behavioral therapy (CBT), which is now a first-line treatment for anxiety disorders, phobias, and other mental health challenges. (Like hypnosis, CBT involves teaching people ways to helpfully reframe their thoughts and experiences.) And Kirsch tells me that hypnosis is often used to augment CBT and other therapies.

“Hypnosis is not deceptive,” he adds. “It’s not trying to trick people or get them to believe something that isn’t true. It’s helping them believe something that they want to experience.”

Kittle told me it’s her hope that the medical community — and the general public — will recognize and embrace hypnosis as an effective form of therapy. “We know that for a large percentage of the population, hypnosis can relieve pain and other symptoms that we normally treat with drugs,” she said. “So why not start there? Let’s start with this thing that can make you feel great and relaxed and with the fewest side effects, not with a drug.”

I write about health and science. I live in Detroit with my wife and kids. I’m trying to learn German, but my progress so far is nicht gut.

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