August 15, 2013
Maybe you’ve seen a hypnotist on TV make unsuspecting audience members cluck like chickens and bark like dogs. Funny as that might be, there's a much more serious side to hypnosis. In fact, clinical hypnosis, or hypnotherapy, is a legitimate tool for the treatment of clinical depression, also known as major depressive disorder (MDD). Depression experts who are trained in hypnotherapy use it as an attention-focusing tool that also helps their patients learn new skills, relax or adopt new perspectives that complement MDD therapies.
A review published in the International Journal of Clinical and Experimental Hypnosis pointed out that hypnosis can help:
But the same review noted that there's little clinical trial evidence to back up the experiences of clinical hypnosis experts.
As the American Psychological Association explains it: “When using hypnosis, one person (the subject) is guided by another (the hypnotist) to respond to suggestions for changes in subjective experience, alterations in perception, sensation, emotion, thought or behavior. Persons can also learn self-hypnosis, which is the act of administering hypnotic procedures on one’s own.”
There are a number of different styles of hypnosis, such as the narrative approach developed by Milton Erickson, M.D., but style is not the important factor, according to California-based hypnosis expert Michael Yapko, Ph.D., author of Treating Depression With Hypnosis: Integrating Cognitive-Behavioral and Strategic Approaches. "There are very different viewpoints on hypnosis, but the key aspect is not which model is used but how the hypnosis is integrated into the longer therapy," Yapko said.
From a patient’s perspective, explained psychiatrist Philip Muskin, M.D., a professor of clinical psychiatry at Columbia University Medical Center in New York City, the state of being hypnotized is something like a deep, experiential daydream in which the attention is fully focused. Some people achieve this state relatively easily, while others have a more difficult time doing so.
“Hypnosis is a tool for delivering information,” Yapko said. For people struggling with depression, focus, concentration and relaxation are all challenges that hypnosis can help with. During hypnotherapy, a therapist can help a patient learn a new skill or view a situation slightly differently. For example, the therapist might want to help the patient sleep more deeply, which can often help with depression. Or hypnosis can be used to help MDD patients change the way they respond to triggers for anxiety or other negative emotions.
Chances are that if you’re going to embark on having hypnotherapy, you’ll have some homework. This could involve learning how to self-hypnotize and strengthen the skills learned during your sessions.
“There are 227 different symptom combinations that can lead to a depression diagnosis,” Yapko pointed out. As a result, hypnosis could potentially be used in a number of different and creative ways in your depression treatment. Dr. Muskin also noted that creativity comes into play in helping someone who is less easily hypnotized experience the same results. For example, a therapist who wants to teach a patient to relax by using a hypnotic experience of floating peacefully in a warm bath might give the less hypnotizable patient a homework assignment of actually floating in warm water so they can repeat that sensation as needed.
However, both Yapko and Muskin stressed that hypnosis is only part of a depression treatment plan. You might, for example, still need to take antidepressants or participate in cognitive behavioral therapy or talk therapy as you cope with MDD.
Even with all the insight from clinical hypnosis experts, people new to hypnosis may still be coming to terms with strong notions about hypnosis, often based on the mesmerizing Hollywood images of hypnotic events on screens big and small. Here are a few myths, busted:
Unless you want to, that is. Muskin pointed out that even people who easily enter a hypnotic trance won’t do something that they don’t want to do, at some level. In addition, he emphasized that a reputable practitioner would not give you bizarre commands when the purpose is to treat an aspect of depression.
Muskin said some patients, especially women, express concern about being in a hypnotic state and alone with a male therapist. Reputable practitioners of hypnotherapy should be able to talk with you about ways to alleviate this concern, including taping the session so you can hear it later, offering to have someone else in the room with you or even (as with one of his patients) calling a loved one to be on the phone during the first session.
While hypnosis can be used in MDD treatment to relax you, ease anxiety, enhance sleep or help you learn another skill that could help with depression, your therapist cannot—while you are hypnotized—simply give you commands that will make you stop feeling anxious or sad and start feeling cheery. That's not how clinical hypnosis works.
Yapko emphasized that you must first find mental health professionals with expertise in treating depression and then look for one who has been trained in clinical hypnosis. “If they can’t treat depression without hypnosis, then they won’t be able to do so with hypnosis,” he pointed out.
He recommended getting referrals for depression treatment and then contacting the American Society of Clinical Hypnosis (www.asch.net) to find an appropriately trained clinical hypnotherapist.
By Madeline Vann, M.P.H.