There are over 40 controlled studies of variable methodologic quality on the use of hypnosis for treating acute pain in adult and pediatric populations. Hypnosis has been shown to be promising for periprocedural and perioperative pain in patients undergoing breast lumpectomy, excisional and core breast biopsy, bone marrow aspiration, pectus excavatum repair (Nuss procedure), percutaneous transluminal coronary angioplasty and other percutaneous vascular and renal procedures, burn wound care, dental procedures, and plastic surgery. Many studies also report less procedure-related anxiety and lower analgesic medication requirement. According to a 2013 meta-analysis, additional documented benefits include reduced recovery and surgical procedure times. A 2021 meta-analysis looked at the efficacy of hypnosis in 50 studies involving 4269 patients undergoing surgical procedures. The analysis found small to medium effects in favor of hypnosis on various surgery relevant outcomes, including mental distress, pain, medication consumption, recovery, and surgical procedure time; however, study heterogeneity limited the reliability of the findings.
For chronic pain, individual studies have shown efficacy for headache, orofacial pain, dyspepsia, low back pain, vulvodynia, sickle cell crisis, fibromyalgia, multiple sclerosis, and spinal cord injury. A 2021 meta-analysis of 45 trials found that hypnosis had moderate benefit for the treatment of chronic pain.
B. Cancer-Related Symptoms
There are at least 15 RCTs that have evaluated the efficacy of hypnosis for cancer-related pain, distress, fatigue, nausea, and hot flashes in adults. All trials showed benefit compared with no treatment or usual care. Three of four trials showed significant benefit of hypnosis for reducing anticipatory nausea and vomiting from chemotherapy. Other RCTs concluded that: (1) hypnosis decreased hot flash scores by 68% in breast cancer survivors; (2) self-hypnosis plus empathic attention was superior to empathic attention alone for reducing pain, anxiety, and medication usage patients undergoing percutaneous tumor treatment; (3) preoperative hypnosis reduced institutional costs for breast cancer patients; (4) hypnosis reduced the anesthesia medication requirements and reduced pain, fatigue, nausea, and emotional upset in breast cancer patients; and (5) a combined intervention of hypnosis with CBT reduced fatigue in one study of breast cancer patients undergoing radiation therapy and, in another study in a similar patient population, reduced negative affect and increased positive affect.
C. Irritable Bowel Syndrome
There are more than 20 studies of hypnosis for irritable bowel syndrome in adults, seven of which are controlled (placebo pill, CBT, or waitlist control). All seven controlled studies showed reduction in pain and bowel symptoms, and some showed improved quality of life and reduced anxiety. Five follow-up studies have found maintenance of benefits for 1–7 years. Two large studies (one RCT and one retrospective trial) found efficacy of hypnosis for patients with refractory irritable bowel syndrome. The American College of Gastroenterology includes hypnosis among its recommended behavioral therapies for the treatment of irritable bowel syndrome.
A 2012 Cochrane review of 11 trials that compared hypnosis to other interventions or no treatment in patients attempting smoking cessation could reach no definitive conclusions due to conflicting results and statistical weaknesses in head-to-head trials. Another 2012 meta-analysis found hypnosis may possibly aid smoking cessation, but a large CI in the final statistical analysis prevented the authors from stating any definitive conclusion. A 2016 three-arm RCT involving 164 hospitalized patients concluded that hypnotherapy was superior to nicotine replacement therapy for promoting smoking cessation, as measured by abstinence rates at 12 and 26 weeks, however, the statistical significance of this conclusion was questionable. A 2017 randomized controlled study of 140 veterans did not find significant improvements when hypnosis was used for smoking relapse prevention.
et al. Guided Imagery, Biofeedback, and Hypnosis: A Map of the Evidence [Internet]. Washington (DC): Department of Veterans Affairs (US); 2019.
et al. Efficacy of hypnosis in adults undergoing surgical procedures: a meta-analytic update. Clin Psychol Rev. 2021;85:102001.
et al. Hypnosis and the alleviation of clinical pain: a comprehensive meta-analysis. Int J Clin Exp Hypn. 2021;69:297.