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Research · Therapies

Hypnotherapy and clinical hypnosis

Gut-directed hypnotherapy relieved irritable bowel syndrome more than education, support or routine care in several meta-analyses and large trials, and about as much as CBT. It eased chronic and experimental pain and anxiety against controls. For quitting smoking it did not beat other behavioral support. Registered trials reported non-serious adverse events at a rate of 0.47%.

Checked 2026-11-13
Status
Rules for hypnotherapists are set state by state. Washington State, for example, registers hypnotherapists through its Department of Health under Chapter 18.19 RCW [1]. NCCIH states that hypnosis used in treating medical conditions has a good safety record [2].
Also called
hypnotherapy, hypnosis, clinical hypnosis, medical hypnosis, gut-directed hypnotherapy, self-hypnosis, hypnotherapist, hypnotic suggestion, hypnobirthing, hypnosis for smoking, hypnoanalgesia
Used for
irritable bowel syndrome, stomach pain in children, chronic pain, pain during surgery, labor pain, quitting smoking, anxiety, stress, phobias, sleep, weight loss, recovering memories

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help5

Reported risks2

What it is used for, and what was found

Shown to help5

Strong

Irritable bowel syndrome, compared with education, support or routine care

Shown to relieve irritable bowel syndrome more than education, supportive therapy or routine care, with adequate relief in about 33% to 41% against 17% in the largest trial.

Compared with education and/or support, or routine care [3]; control conditions the source abstract does not describe [4]; group educational supportive therapy [5]; online self-guided psychoeducation [6]

The numbers and sources
Effect
A network meta-analysis of 41 trials found gut-directed hypnotherapy reduced the chance of remaining symptomatic (RR 0.67, 95% CI 0.49 to 0.91), and in refractory IBS it beat education, support or routine care [3]. Across 8 trials, hypnosis gave adequate symptom relief more often than control at the end of therapy (RR 1.69, 95% CI 1.14 to 2.51, number needed to treat 5) and at long-term follow-up (RR 2.17, number needed to treat 3) [4]. In 354 adults referred from primary or secondary care, adequate relief at 3 months was 40.8% with individual hypnotherapy, 33.2% with group hypnotherapy and 16.7% with educational supportive therapy (OR 2.9, 95% CI 1.2 to 7.4), and 40.8%, 49.5% and 22.6% at 12 months [5]. In 230 people, an abdominal pain response was seen in 48% with in-person hypnotherapy, 33% with a smartphone program and 22% with psychoeducation [6]. The American College of Gastroenterology guideline states: "We suggest that gut-directed psychotherapy be used to treat global IBS symptoms" [7], a conditional recommendation based on very low-quality evidence according to NCCIH [2].
Population
4,072 adults in 41 trials of psychological therapies [3]. 464 adults in 8 trials, mostly with IBS that had not responded to usual treatment [4]. 354 adults in 11 Dutch hospitals [5]. 230 people aged 16 to 75 [6].
Sources
[3], [4], [5], [6], [7], [2]
Caveats
Trials were at high risk of bias, with funnel plot asymmetry suggesting effects are overestimated [3]. A 2007 Cochrane review of 4 small early trials judged their quality too poor for conclusions [8]. No trial can blind patients to receiving hypnotherapy.
Strong

Chronic pain

Shown to ease chronic pain moderately (Hedges' g -0.42) against control treatments, with larger effects after 8 or more sessions.

Compared with control interventions the source abstract does not describe [13]; standard care, and other psychological interventions [14]

The numbers and sources
Effect
In chronic musculoskeletal and nerve pain, hypnosis lowered pain intensity (Hedges' g -0.42 after treatment, -0.37 at short-term follow-up) and pain interference (-0.39). With 8 or more sessions the effect was g -0.555, and with fewer it was smaller and not significant [13]. An earlier meta-analysis found a moderate benefit over standard care, and a moderate benefit over other psychological treatments in people with pain other than headache [14].
Population
530 adults in 9 trials [13]. Trials in chronic pain [14].
Sources
[13], [14]
Caveats
Heterogeneity across trials was large [14].
Moderate

Pain in lab tests in healthy people

Shown to lower pain from lab pain tests in healthy volunteers (Hedges' g 0.54 to 0.76), mainly in people who respond strongly to suggestion.

Compared with no intervention [15]

The numbers and sources
Effect
Hypnosis lowered pain ratings and raised pain threshold and tolerance (g 0.54 to 0.76). With direct suggestions of pain relief, 42% of highly suggestible people and 29% of moderately suggestible people had clinically meaningful pain reductions, and people low in suggestibility gained little [15].
Population
3,632 healthy participants in 85 mostly crossover trials using experimentally caused pain [15].
Sources
[15]
Caveats
Pain was induced in a lab, and the authors call for clinical data to show the effect carries over to chronic pain [15].
LimitedStudied in women

Pain and side effects of breast surgery

One trial of 200 women found a 15-minute hypnosis session before breast surgery lowered pain at discharge from 48 to 22 on a 100-point scale against empathic listening.

Compared with nondirective empathic listening as an attention control [16]

The numbers and sources
Effect
Women given hypnosis needed less propofol and lidocaine during surgery and reported less pain (22.43 against 47.83 on a 100-point scale), nausea, fatigue, discomfort and emotional upset at discharge. Use of fentanyl, midazolam and recovery room pain medicine did not differ [16].
Population
200 women having breast biopsy or lumpectomy, mean age 48.5 [16].
Sources
[16]
Caveats
One trial. Patients knew which group they were in [16].
Moderate

Anxiety

Shown to reduce anxiety more than control conditions, with the average treated person improving more than 79% of controls, and more when combined with other psychological treatment.

Compared with control conditions the source abstract does not describe [18]

The numbers and sources
Effect
At the end of treatment, 17 trials gave a mean weighted effect size of 0.79, and at the longest follow-up 7 trials gave 0.99. Hypnosis reduced anxiety more when combined with other psychological interventions than when used alone [18].
Population
17 trials in 15 studies [18].
Sources
[18]
Caveats
The abstract does not describe the control conditions or the populations [18].

Mixed results2

ModerateStudied in children

Stomach pain and irritable bowel syndrome in children

Mixed results: pooled trials found more children treated successfully than with no intervention, while a primary care trial found no difference in relief at 12 months.

Compared with no intervention [9]; care as usual [10]

The numbers and sources
Effect
Hypnotherapy led to treatment success more often than no intervention (RR 2.86, 95% CI 1.19 to 6.83, number needed to treat 5), at low certainty [9]. In 152 children aged 7 to 17 treated in primary care, home-based guided hypnotherapy added to usual care did not change adequate relief at 12 months (79.5% against 74.3%, adjusted OR 1.47). More children had relief at 3 months (adjusted OR 2.74) and 6 months (4.26) [10].
Population
91 children in 2 trials of hypnotherapy against no intervention [9]. 152 children in Dutch primary care [10].
Sources
[9], [10]
Caveats
The pooled result rests on two small trials at risk of bias [9]. Relief was high in both groups by 12 months [10].
ModerateStudied in pregnancy

Labor pain

Mixed results: women taught hypnosis used pain medication less often, and satisfaction with pain relief, coping and spontaneous birth did not differ from control groups.

Compared with standard care, supportive counseling and relaxation training [17]

The numbers and sources
Effect
Women in the hypnosis groups were less likely to use pain medication (RR 0.73, 95% CI 0.57 to 0.94, 8 trials, 2,916 women), with no difference in epidural use, sense of coping (MD 0.22) or spontaneous vaginal birth (RR 1.12). Against standard care or relaxation, primary outcomes did not differ. Against supportive counseling, pain medication use was lower (RR 0.48, 95% CI 0.32 to 0.73, 2 trials) [17].
Population
2,954 women in 9 trials [17].
Sources
[17]
Caveats
Evidence for the main comparison was rated low quality, with heterogeneity that could not be explained [17].

Not shown to help2

Moderate

Irritable bowel syndrome, compared with other psychological therapies

Not shown to differ from cognitive behavioral therapy or other psychological therapies for irritable bowel syndrome in a network meta-analysis of 41 trials.

Compared with cognitive behavioral therapy in several formats, and other psychological therapies [3]

The numbers and sources
Effect
Self-guided or minimal-contact CBT (RR 0.61), face-to-face CBT (RR 0.62) and gut-directed hypnotherapy (RR 0.67) all reduced the chance of remaining symptomatic, and none was superior to another. CBT-based therapies and gut-directed hypnotherapy had the largest evidence base and the largest long-term effects [3].
Population
4,072 adults in 41 trials [3].
Sources
[3]
Caveats
Few trials compared therapies head to head, so most comparisons are indirect [3].
Moderate

Quitting smoking

Not shown to raise quit rates at 6 months or more compared with other behavioral support or medication. Group hypnotherapy and group CBT gave similar quit rates.

Compared with attention-matched behavioral treatments, intensive behavioral programs, brief behavioral advice, rapid smoking, quit-smoking medication and no intervention [11]; group cognitive behavioral therapy [12]

The numbers and sources
Effect
Against attention-matched behavioral treatment, quit rates did not differ (RR 1.21, 95% CI 0.91 to 1.61, 6 trials, 957 people). Nor did they differ against intensive behavioral programs (RR 0.93), brief behavioral advice (RR 0.98), rapid smoking (RR 1.00) or medication (RR 1.68, 95% CI 0.88 to 3.20). One trial of 40 people favored hypnotherapy over no intervention (RR 19.00) at very low certainty. Added to other treatment, hypnotherapy raised quitting (RR 2.10, 95% CI 1.31 to 3.35, 5 trials) in studies mostly at high risk of bias [11]. In 360 smokers, continuous abstinence over 12 months was 15.0% with group hypnotherapy and 15.6% with group CBT [12].
Population
1,926 smokers in 14 trials [11]. 360 smokers at two study sites [12].
Sources
[11], [12]
Caveats
Only one trial in the Cochrane review was at low risk of bias. The reviewers write that any benefit is small at most [11].

Protocols studied

IBS trials gave a median of 8.5 sessions over 12 weeks [4]. The largest trial gave six individual or group sessions [5], and a later trial gave 12 weeks of in-person or smartphone-guided hypnotherapy [6]. Chronic pain effects were larger with 8 or more sessions [13]. The breast surgery trial used one 15-minute session from a psychologist before surgery [16]. Labor trials mostly taught hypnosis before birth, with one giving it during labor [17]. The smoking trial gave six weekly 90-minute group sessions [12].

Risks

Reported risks2

ModerateUncommon

Adverse events in trials

Shown at a rate of 0.47% for non-serious adverse events in registered hypnosis trials, with no serious adverse event likely caused by hypnosis.

The numbers and sources
How common
Uncommon: between 1 in 1,000 and 1 in 100 people.
Effect
In trials registered on ClinicalTrials.gov, the rate of serious adverse events likely attributable to hypnosis was 0%, and the rate of other adverse events was 0.47% [19]. In 8 IBS trials, 1 of 238 people given hypnosis (0.4%) dropped out because of a panic attack [4]. In the largest IBS trial, eight serious adverse events, mostly cancer or inflammatory bowel disease, were judged unrelated to therapy [5]. The Cochrane smoking review found little data on harms, with no sign of any [11]. NCCIH notes it is possible that hypnosis could worsen symptoms in people with some mental health conditions [2].
Population
Hypnosis trials registered on ClinicalTrials.gov [19]. 464 adults with IBS [4]. 354 adults [5].
Sources
[19], [4], [5], [11], [2]
Caveats
Many registered trials did not report adverse events, and all those analyzed treated medical conditions or procedures, not psychiatric conditions [19].
LimitedHow often is not known

False memories during hypnotic recall

A 2025 review reports that using hypnosis to recall past events, called hypnotic regression, has been linked to the creation of false memories.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The review describes hypnotic regression as accused of favoring the creation of false memories, and finds the evidence that hypnosis enhances memory contradictory [20].
Population
A narrative review of laboratory and clinical studies [20].
Sources
[20]
Caveats
A narrative review, not a meta-analysis, and it gives no rate [20].

Claims tested and not found

  1. That hypnotherapy helps smokers quit more than other behavioral support. Quit rates did not differ from attention-matched behavioral treatment (RR 1.21, 95% CI 0.91 to 1.61) [11].
  2. That group hypnotherapy beats group CBT for quitting smoking. Continuous abstinence was 15.0% against 15.6% in 360 smokers [12].
  3. That home hypnotherapy raises relief from children's stomach pain at one year. Relief at 12 months did not differ from usual care in 152 children [10].
  4. That gut-directed hypnotherapy outperforms CBT for IBS. No psychological therapy was superior to another in 41 trials [3].

Related

Cognitive behavioral therapy

Sources

  1. Washington State Department of Health. Hypnotherapist: Registration Requirements. 2026. https://doh.wa.gov/ar/node/7480
  2. National Center for Complementary and Integrative Health. Irritable Bowel Syndrome: What You Need To Know. 2023. https://www.nccih.nih.gov/health/irritable-bowel-syndrome-what-you-need-to-know
  3. Black CJ, Thakur ER, Houghton LA, et al. Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis. Gut. 2020. https://doi.org/10.1136/gutjnl-2020-321191
  4. Schaefert R, Klose P, Moser G, Häuser W. Efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome: systematic review and meta-analysis. Psychosomatic Medicine. 2014. https://doi.org/10.1097/psy.0000000000000039
  5. Flik CE, Laan W, Zuithoff NPA, et al. Efficacy of individual and group hypnotherapy in irritable bowel syndrome (IMAGINE): a multicentre randomised controlled trial. The Lancet Gastroenterology & Hepatology. 2019. https://doi.org/10.1016/s2468-1253(18)30310-8
  6. Snijkers JTW, Bosman MHMA, Winkens B, et al. In-person therapist-delivered hypnotherapy versus smartphone-based self-guided hypnotherapy in IBS: a multicentre three-armed randomised controlled trial. Gut. 2026. https://doi.org/10.1136/gutjnl-2026-338385
  7. Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. American Journal of Gastroenterology. 2021. https://doi.org/10.14309/ajg.0000000000001036
  8. Webb AN, Kukuruzovic RH, Catto-Smith AG, Sawyer SM. Hypnotherapy for treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews. 2007. https://doi.org/10.1002/14651858.CD005110.pub2
  9. Gordon M, Sinopoulou V, Tabbers M, et al. Psychosocial Interventions for the Treatment of Functional Abdominal Pain Disorders in Children: A Systematic Review and Meta-analysis. JAMA Pediatrics. 2022. https://doi.org/10.1001/jamapediatrics.2022.0313
  10. Ganzevoort IN, Berger MY, de Boer MR, et al. Effectiveness of hypnotherapy for paediatric abdominal pain in primary care: a randomised controlled trial. British Journal of General Practice. 2026. https://doi.org/10.3399/bjgp.2025.0459
  11. Barnes J, McRobbie H, Dong CY, et al. Hypnotherapy for smoking cessation. Cochrane Database of Systematic Reviews. 2019. https://doi.org/10.1002/14651858.CD001008.pub3
  12. Batra A, Eck S, Riegel B, et al. Hypnotherapy compared to cognitive-behavioral therapy for smoking cessation in a randomized controlled trial. Frontiers in Psychology. 2024. https://doi.org/10.3389/fpsyg.2024.1330362
  13. Langlois P, Perrochon A, David R, et al. Hypnosis to manage musculoskeletal and neuropathic chronic pain: a systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews. 2022. https://doi.org/10.1016/j.neubiorev.2022.104591
  14. Adachi T, Fujino H, Nakae A, et al. A meta-analysis of hypnosis for chronic pain problems: a comparison between hypnosis, standard care, and other psychological interventions. International Journal of Clinical and Experimental Hypnosis. 2014. https://doi.org/10.1080/00207144.2013.841471
  15. Thompson T, Terhune DB, Oram C, et al. The effectiveness of hypnosis for pain relief: a systematic review and meta-analysis of 85 controlled experimental trials. Neuroscience & Biobehavioral Reviews. 2019. https://doi.org/10.1016/j.neubiorev.2019.02.013
  16. Montgomery GH, Bovbjerg DH, Schnur JB, et al. A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. Journal of the National Cancer Institute. 2007. https://doi.org/10.1093/jnci/djm106
  17. Madden K, Middleton P, Cyna AM, et al. Hypnosis for pain management during labour and childbirth. Cochrane Database of Systematic Reviews. 2016. https://doi.org/10.1002/14651858.CD009356.pub3
  18. Valentine KE, Milling LS, Clark LJ, Moriarty CL. The efficacy of hypnosis as a treatment for anxiety: a meta-analysis. International Journal of Clinical and Experimental Hypnosis. 2019. https://doi.org/10.1080/00207144.2019.1613863
  19. Bollinger JW. The Rate of Adverse Events Related to Hypnosis During Clinical Trials. American Journal of Clinical Hypnosis. 2018. https://doi.org/10.1080/00029157.2017.1315927
  20. Leo DG, Bruno D, Proietti R. Remembering what did not happen: the role of hypnosis in memory recall and false memories formation. Frontiers in Psychology. 2025. https://doi.org/10.3389/fpsyg.2025.1433762

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