Hypnotherapy – The power of trance

Hypnosis as a form of therapy – isn’t that a question of faith? Or even manipulation? Does it work for everyone? And can it not also cause harm? We all know pictures from television how a magician hypnotizes the ignorant spectator in a spectacular way and the spectator is under his power for the next minutes until he is finally released. Fascinating – but at the same time for many people certainly rather frightening.

When the term hypnotherapy comes up, most people think of patients losing control, doing embarrassing unwanted things and not being able to remember them afterwards. But fascinatingly, exactly the opposite happens: patients gain control, become more creative, find new ways of solving problems and have full power over their actions during the whole time. Hypnotherapy consequently has nothing to do with a stage show, but is a scientifically based form of psychotherapy.

Importantly, in 2006, hypnotherapy was officially recognized as a method by the Scientific Advisory Board of Psychotherapy, initially primarily as a therapeutic method for psychosomatic disorders and addiction disorders.

How does hypnosis work?

Worldwide, the process of hypnosis now enjoys a high level of attention and research. Magnetic resonance imaging (MRI) and electroencephalography (EEG) have demonstrated that the state of trance actually alters brain activity and cannot be compared to a waking state, nor to the state of sleep. Hypnosis has the function of directing attention to a specific idea or thought while simultaneously blanking out other internal (e.g., pain) as well as external perceptions (e.g., disturbing environmental factors), similar to meditation, praying, or even daydreaming.

Hereby it is possible to lower the blood pressure as well as the pulse rate and thus to stimulate the immune system as well as to influence brain waves. For example, in trance, areas responsible for perception are turned off, while at the same time the regions responsible for imagination and emotions are very active. The experience resembles that of actually feeling, seeing, or experiencing something at the moment. Areas that process fear and pain, on the other hand, are not active in the trance.

Measurements of brain waves have shown that although pain sensations are conducted into the brain under hypnosis, the stimulus is processed differently and is not consciously perceived. Scientists assume here that areas in the brain are not only differently active in trace, but also differently connected. Thus, there is the possibility to change or even delete learned sensations or thoughts.

Dialogue with the unconscious – Classical hypnosis and hypnotherapy

Classical Hypnosis

Classical hypnosis was the most common and only known technique of hypnosis until the 1980s. It works with uniform procedures by which each person is led into trance in the same way, with hypnotizability as an invariant personality trait. In the state of trance, standard suggestions, such as “You will never drink alcohol again,” are stated. These are given either as an assertion, “You are very calm,” or as a command, “Become calm now!” Classical hypnosis has the advantage of being easy to learn and needs no special preparation for the individual patient. However, this also results in the disadvantage that it only has a long-term effect on a small proportion of patients and for this reason is hardly ever used nowadays.


At the end of the 20th century, the techniques of the American hypnotherapist Milton Erickson became known in Europe. He followed the cooperative approach of working with the individual needs and inclinations of patients and addressed them with indirect suggestions, conscious confusion, and hypnotic metaphors and narratives. By his new procedure meanwhile almost every willing patient can be brought into trance.

Erickson understood his procedure as a special form of communication, which addresses the conscious and unconscious parts of the patient to use all available resources for problem solving. Consequently, during hypnotherapy, a person is completely absorbed in inner imaginings, such as ideas of physical healing processes, memories, or new behaviors. Due to the altered state of consciousness, the perception of oneself and everyday thinking completely fade into the background.

Judgmental thoughts such as “What do others think about me? Can I do this?” cannot occur and contents can be evaluated differently and linked in a new way. The advantage of hypnosis is that distant and non-present memories (e.g. from early childhood) are included in current thinking and can provide a new perspective on things

It is also particularly significant that the ideas in this state can condition physiological reactions and there is a special openness to the words of the hypnotherapist. Nevertheless, in modern hypnotherapy the patient’s own motivation is strictly respected, he is never pushed in a direction he dislikes, and he can interrupt the session at any time. The therapist leads and the patient decides where to go in the trance. Consequently, through the state of trance, behavioral patterns can be changed (e.g., drinking alcohol), emotional blocks can be released (e.g., fears), and improvement of somatic complaints can be triggered (e.g., chronic pain).

Techniques of modern hypnotherapy

Hypnotherapy is based on the principle that an incomplete style of speech triggers search processes in the patient and stimulates the action to add own content. The following tools are used in this process:

  • Freedom of choice: “You can enter the trance whenever you want.”
  • Nominalizations: Without the patient feeling addressed, a theme is introduced – “Relaxing can be beneficial.”
  • Analogical marking: prompts to the patient are conveyed via a change in volume or voice pitch.
  • Generalizations: “Everyone knows what is good for their own body.”
  • Pseudocausality: A real situation is linked to suggestions.
  • Ambiguity: Words used leave room for interpretation by the patient.
  • Substitute technique: The patient’s problem or the solution to it are described by a metaphor, for example, to avoid anxiety and facilitate processing.
  • Dissociative processes: Creating inner distance to, for example, traumatic experiences or pain treatments.

Designing a hypnotherapy session

As in any psychotherapeutic treatment, the design of the session and the patient-therapist relationship are enormously important. In hypnotherapy, the focus is on hypnosis-specific issues and fears. During a session, the patient is free to choose whether to sit or lie down, as well as whether to keep the eyes open or closed. Hypnosis always starts with focusing the attention, for example by directing the gaze to a fixed point in the room.

Subsequently, the trance is deepened. Here the patient can count from one to ten, imagine descending a staircase or focus on breathing. The emphasis is on calm and relaxation. In the following main part of the trance, the techniques already mentioned are used to work on the problematic issues. A brief reorientation is usually followed by a final debriefing. The patient has the opportunity to reflect on new findings. Here it becomes clear that the actual work with the trance takes only one part in the therapy session.

Fields of Application

Hypnotherapy has a very wide field of application:

  • Psychological disorders: Such as depression, specific phobias, anxiety disorders, post-traumatic stress disorders, personality disorders or psychosis.
  • Psychosomatic disorders: Such as irritable bowel syndrome, sleep disorders, chronic pain, or arthritis.
  • Somatic disorders: Such as autoimmune diseases, Crohn’s disease, tinnitus, carcinomas or central nervous system problems.

Especially the psychosomatic disorders are considered very treatable with hypnotherapy. In addition, there are other uses such as in emergency situations (eg burns, surgical procedures) and complicated diagnostic examinations or procedures (eg dental examinations, gastrointestinal endoscopies).

Hypnotherapy can be combined very well with other psychotherapeutic methods such as systemic therapy or behavioral therapy, as it represents a new approach to the patient and expands the scope of intervention. A combination shows to be even more effective. Often, hypnotherapy is also carried out as a guide to self-hypnosis, so that patients have the chance to help themselves in the long term, even outside the framework of therapy.

  • Burkhard, Peter; Dirk, Revenstorf: Hypnotherapy. Stuttgart, 2018.
  • Deutscher Ärzteverlag GmbH: https://www.aerzteblatt.de/archiv/145099/Moderne-Hypnotherapie-Im-Dialog-mit-dem-Unbewussten, accessed 13.05.2022.
  • German Society for Hypnosis and Hypnotherapy e.V.: https://dgh-hypnose.de/zur-behandlung-mit-hypnose, retrieved on 13.05.2022.
  • Milton Erickson Institut Köln e.V.: https://www.meik.de/hypnotherapie/, retrieved on 12.05.2022.
  • Schlarb, Angelika A.; Schweizer, Cornelie C.; Junker, Stefan: Hypnotherapy – Step by Step. Georg Thieme Verlag KG Stuttgart (2018), issue 4.
  • Signer-Fischer, Susy: Hypnotherapy – efficient and creative: proven recipes for daily practice. Heiligkreuzsteinach, 2019.

Categories: Therapy

Dr. med. Kjell R. Brolund-Spaether
Ärztlicher Direktor und Chefarzt Dr. med. Kjell R. Brolund-Spaether
Dr. med. Kjell R. Brolund-Spaether ist renommierter Facharzt für Psychiatrie und Psychotherapie, bei dem stets der Mensch im Mittelpunkt steht: Dank seiner individuell abgestimmten, ganzheitlichen Behandlungspläne verbessert und personalisiert er die psychiatrische Versorgung kontinuierlich. Seine umfassende Expertise in der psychotherapeutischen und medikamentengestützten Behandlung erlangte er durch sein Studium der Humanmedizin an der Christian-Albrechts-Universität in Kiel, spezialisierte Weiterbildungen sowie seine langjährige Erfahrung in führenden Positionen. Seit 2019 ist Dr. med. Brolund-Spaether als Chefarzt und seit 2023 als Ärztlicher Direktor der LIMES Schlosskliniken AG tätig. 2024 trat er unserem Vorstand bei.

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