We investigated whether adding hypnosis to CBT (CBTH) improved treatment outcomes for MDD with a two-armed, parallel-treated, randomized-controlled trial using anonymous self-report and clinician-blinded assessments. Expectancy, credibility, and attitude to hypnosis were also examined. Participants ( = 66) were randomly allocated to 10-weekly sessions of group-based CBT or CBTH. LMM analyses of ITT and Completer data at post-treatment, six-month and 12-month follow-up showed that both treatments were probably efficacious but we did not find significant differences between them. Analyses of remission and response to treatment data revealed that the CBTH Completer group significantly outperformed CBT at 12-month follow-up ( = .011). CBTH also displayed significantly higher associations between credibility, expectancy and mood outcomes up to 12-month follow-up (all  < .05 or better), while attitude to hypnosis showed one significant association ( = -0.57,  < .05). These results suggest that hypnosis shows promise as an adjunct in the treatment of MDD but a larger sample size is required to fully test its merits.

This study presents the norms and psychometric properties for a shortened online adaptation of a French version of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). Assessment of involuntariness and subjective intensity was added to the traditional scoring. A total of 373 individuals completed an online hypnotizability screening test on their own computer. Participants received the HGSHS:A script through an audio recording lasting about 30 minutes. The results showed that the item difficulty and reliability of the short online HGSHS:A were consistent with the offline version of the scale and with the reference samples. Involuntariness and subjective intensity corrections improved significantly the accuracy in the measurement of the scale and helped to dissociate between different phenomenologies in hypnotic responding. These findings indicate that the short online HGSHS:A is a reliable tool for measuring hypnotizability. Moreover, we suggest that using complementary measures of involuntariness and subjective intensity helps to shed more light on hypnotizability as part of a multi-componential approach to hypnotic response.

Hypnosis has sometimes been described as an "altered state of consciousness," but what is "unaltered" consciousness? We approach the issue by first exploring the sense of free will, because it can be lost during hypnosis. However, the argument is developed that free will is an illusion, so should not be present in the waking state. Thus, in a sense, hypnosis is a more accurate state of consciousness. The sense of free will is shown to result from an experience of agency, which is often missing in hypnosis. We consider how hypnotic, illusory perceptions are developed, and plausible processes are discussed, but none throws clear light upon what the philosopher David Chalmers called the "hard problem" of consciousness. The paper concludes with a brief evaluation of the possibility that phenomenal consciousness is associated with feedback loops, which transform the simple registering of stimuli into experiences of which we are aware.

Studies have explored the impact of suggestion on the Stroop effect, aiming to understand how effective suggestion is in modulating this phenomenon. The suggestion effect has been replicated in multiple studies, supporting its robustness, but lacks systematic evaluation. We conducted a systematic review and meta-analysis of relevant English-language studies from PubMed, Web of Science, PsycINFO, Scopus, and ScienceDirect since databases inception until January 2023. Quality of included studies was evaluated using the Joanna Briggs Institute (JBI) appraisal checklist, and potential publication biases were assessed. Subgroup analyses were also performed, and effect sizes were estimated using Hedges' g and analyzed using random effects model. The systematic review was comprised of 19 studies. For the meta-analysis, 14 studies examined the suggestion effect on Stroop interference effect (SIE), while six studies investigated suggestion effects on accuracy. Results have revealed significant overall effects of suggestion on Stroop performance in participants, as evidenced by SIE and accuracy. Subgroup analysis based on types of suggestion demonstrated a significant effect on SIE. Six EEG/ERP studies have also been discussed in the context of the review.

Sleep disturbance is a public health problem among aging adults (age 45 and older). While aging adults are at an elevated risk for sleep disturbance, many also have high rates of mistrust toward psychological interventions, such as self-hypnosis, which may be beneficial for sleep. The purpose of the study was to assess factors that may impact utilization of self-hypnosis for sleep, including willingness, preferences, and access among informed aging adults. 244 aging adults were recruited. After reading an information sheet on self-hypnosis for sleep, participants completed questionnaires assessing sleep related worry, stress, and perceptions of self-hypnosis for sleep, including willingness, benefits, barriers, preferences, and access. The findings indicated that informed aging adults were willing to engage in self-hypnosis for sleep, regardless of their race or gender. Furthermore, they preferred technological delivery methods (i.e. telehealth or smartphone apps) with flexible scheduling options. However, very few participants endorsed having access to self-hypnosis.

The main objective of this systematic review is to comprehensively describe and evaluate the evidence on hypnotherapy for smoking cessation. Included studies were comprised of adults, had measurable objective/subjective data reflecting smoking cessation, hypnosis or hypnotherapy studied alone or as part of a multicomponent intervention, and at least ten participants. A total of 745 nonduplicate publications were screened, and 63 papers were included for analysis. Based on 33 of these studies, 66.7% reported a positive impact of the hypnosis intervention for smoking cessation. Positive impact studies had longer average treatment duration, greater number of hypnotherapy sessions, and utilized both self-report and objective measures of smoking cessation outcome (40.9% of positive studies using both vs 20% of no impact studies). The efficacy of hypnotherapy for smoking cessation is positive; however, more studies using biologically confirmed abstinence and reduction in the number of cigarettes smoked are needed. Hypnotherapy is a useful approach for smoking cessation that warrants additional inquiry. Future studies are needed that assess treatment fidelity and hypnotizability, provide information on race/ethnicity, and report on side effects and adverse events.

Non-Invasive Brain Stimulation (NIBS) stands as an advanced technology embraced by researchers and clinicians to influence thoughts, emotions, and behaviors. The prevalent NIBS methods include transcranial Direct Current Stimulation (tDCS) and Transcranial Magnetic Stimulation (TMS), both proficient in either exciting or depressing neural activities in specific cortical regions. Recently, NIBS has been integrated into hypnosis research with the goal of enhancing hypnotizability. Specifically, the limited existing studies have predominantly focused on the dorsolateral prefrontal cortex (DLPFC) due to its significant role in neutral hypnosis. Overall, these studies suggest the fascinating potential to alter hypnotizability and hypnotic phenomena, although the impact on responsiveness to suggestions remains modest. In contrast to psychological and pharmacological methods, NIBS enables alterations in hypnotic experiences that are independent of operators and noninvasive. This grants researchers the chance to employ a causal approach in investigating the brain-behavior relationship associated with suggestibility. The present paper evaluates existing NIBS studies in this domain, delving into the neurocognitive mechanisms at play and their potential implications for hypnosis research and practice.

Research into clinical hypnosis for sleep disturbances is an expanding with important implications for clinical practice and future research. This issue of the includes emerging research on clinical hypnosis to improve sleep quality and disturbances. While clinical hypnosis for sleep is very promising, the underlying mechanisms are largely unknown. To address this is an article that examines pre-sleep arousal and worry reduction as potential variables associated with the effects of clinical hypnosis in improving sleep quality. Related to this topic is an article entitled, "Aging adults' willingness, preferences, and access to self-hypnosis for sleep: A cross-sectional study," which identifies aging adults' preferences and access to self-hypnosis for sleep. This issue of the IJCEH also includes an important article on health care professionals' perceptions, knowledge and attitudes toward clinical hypnosis which considers the need for more training and education in clinical hypnosis among health care providers. Further, a scoping review of hypnotherapy for treatment of depression is presented, followed by an exploration of implicit rapport in hypnotherapy, and a case report on hypnotherapy in oral surgery with a highly hypnotizable patient.

When used separately, virtual reality (VR) and mind-body therapies (MBTs) have the potential to reduce pain across various acute and chronic conditions. While their combination is increasingly used, no study offers a consolidated presentation of VR and MBTs. This study aims to propose an overview of the effectiveness of VR combined with MBTs (i.e., meditation, mindfulness, relaxation, and hypnosis) to decrease the pain experienced by healthy volunteers or patients. We conducted a scoping review of the literature using PubMed, Science Direct and Google Scholar and included 43 studies. Findings across studies support that VR combined with MBTs is a feasible, well-tolerated, and potentially useful to reduce pain. Their combination also had a positive effect on anxiety, mood, and relaxation. However, insufficient research on this VR/MBTs combination and the lack of multidimensional studies impede a comprehensive understanding of their full potential. More randomized controlled studies are thus needed, with usability evaluation protocols to better understand the effects of VR/MBTs on patients wellbeing and to incorporate them into routine clinical practice.

The objective of this study was to determine the model fit of a standardized hypnotizability measure in a targeted clinical sample. The Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) was administered to 168 post-menopausal women aged 39 to 75 years. Confirmatory factor analysis was conducted, and comparative fit index (CFI) and root mean square error of approximation (RMSEA) were used to determine goodness of fit. Results indicated that the single-factor structure modeled with twelve indicators based on the individual items on the SHSS:C provided the best description of fit. Results of the present study demonstrate that the SHSS:C has a single-factor structure. These findings suggest that new scales of hypnotizability can be optimized by focusing on the use of items that correlate highly with the overall score representing the unidimensional construct of hypnotizability. The findings should be interpreted with caution due to the small sample size, and further research is needed with other populations to clarify generalizability.

Controlling acute pain for individuals undergoing orthopedic surgery is highly desirable as it is related to various treatment outcomes. Immersive, virtual reality hypnosis (VRH) is one potential treatment modality to aid in pain management. This three-arm, randomized clinical trial evaluated the efficacy of two hypnosis interventions for reducing post-surgical pain and anxiety in addition to evaluating the effects on sleep quality, mental health, and physical functioning. Results indicated no statistically significant main effects associated with intervention groups for pre-post change scores of pain intensity (F(3, 177) = 0.35,  = .71, partial η2 = .004), anxiety (F(3, 177) = 0.20, = .81, partial η2 = .002) or sleep quality (F(3, 175) = 0.81,  = .45, partial η2 = .009). Additionally, there were no statistically significant group effects of treatment condition on mental health (F(2, 162) = .71,  = .49, η2 = .009) or physical functioning (F(2, 165) = .43,  = .65, η2 = .005). Issues and future directions for this line of research are discussed.

The aim of this study was to test the clinical feasibility of hypnotherapy in the management of fatigue and sleep disturbances among multiple sclerosis (MS) patients in the south of Iran. Forty patients aged 25-47 were enrolled, and 22 (19 females, 3 males) completed eight 50-minute sessions of hypnotherapy for 10 weeks. Patients were required to practice the hypnotherapy sessions at home throughout the week. Participants completed the Multidimensional Fatigue Inventory (MFI) and Pittsburgh Sleep Quality Index (PSQI) at baseline and after the final hypnotherapy session. The mean MFI score was significantly reduced by 8.19 points following hypnotherapy ( < .05). The mean PSQI global score following hypnosis treatment significantly decreased from 7.4 ± 3.3 to 5.52 ± 3.12 ( < .05). Our results suggest that MS patients might benefit from hypnotherapy for controlling fatigue and sleep disturbance symptoms. Confirmative assessment is required in a randomized controlled trial after feasibility has been established.

For over a decade, the growing use of smartphone apps provided a way to make hypnotherapy more widely accessible. However, available apps vary widely in the quality of hypnosis provided to users. This study systematically reviewed apps delivering some form of hypnotherapy intervention and summarized their characteristics. Using hypnosis-related search terms, a list of apps was generated, yielding 679 unique hypnosis apps across both Android and iOS stores, and 168 apps met inclusion criteria for this review. The most common app targets were sleep ( = 94, 56.0%), relaxation/meditation ( = 92, 54.8%), and stress ( = 62, 36.9%). Only 34 (20.2%) of the apps indicated that the developer or person providing hypnosis was trained in hypnosis. Thirteen (7.7%) apps included some claim of evidence-based treatment. Only four apps reported inclusion in a clinical efficacy trial. Relationships between key app characteristics were explored using chi-square analysis. Though hypnotherapy apps have much potential in health care, apps based upon evidence-based protocols and empirical research are limited at this time.

Perceived stress is a significant problem among female college students that can impact psychological distress, sleep, and overall well-being. Mindful self-hypnosis (MSH) and resistance training (RT) have both been shown to reduce perceived stress. The rationale for the present study was to investigate whether MSH combined with RT could be more effective at reducing perceived stress as measured by the Perceived Stress Scale than RT alone due to synergistic effects achieved by combining the interventions. Forty-four female college students were randomized to one of the three groups: MSH+RT, RT only, or a wait-list control (WLC). Results indicated that, compared to RT only, the addition of MSH led to pronounced improvements in perceived stress which was significantly greater than WLC. Also, MSH+RT resulted in significant increases in mindfulness, sleep, strength, and well-being in comparison to WLC. MSH+RT was shown to be feasible with highly satisfactory participant ratings. Future research should examine the MSH+RT intervention with a larger population and with older women who are more at risk for stress and declining strength.

This article proposes a multicomponent hypnotherapeutic approach for obsessive-compulsive disorder (OCD) treatment. This new approach combines hypnosis with exposure and response prevention, cognitive reappraisal, principles of acceptance and commitment therapy, and other components. In the presented case study, the patient was treated for four months with both biological and psychological first-line therapy with minor effects; the patient was then treated with hypnotherapy. The patient listened to a recorded hypnosis session, which was constructed according to the new proposed principle. After three weeks of near-daily listening to the session, the patient's Yale-Brown Obsessive-Compulsive Scale score decreased by 38.5%, which helped achieve a 51.5% reduction from the initial score, suggesting that this method might have significantly contributed to the therapeutic outcome. In addition, this article discusses the differences between the proposed approach and previously published hypnotherapeutic methods for OCD treatment and the hypothetical use of such an approach for other disorders characterized by compulsive behavior. Further randomized controlled studies are needed to confirm the efficacy of hypnotic approaches for treating OCD.

Despite advancements in medication,managing inflammatory bowel disease (IBD) remains challenging, necessitatingalternative control methods. Gut-directed hypnotherapy, known for alleviating irritable bowel syndrome (IBS), is debated as an IBD management method. Anextensive search across PubMed, Cochrane Library, and Clinicaltrials.govuncovered five randomized trials and two case series involving IBD patients undergoing hypnotherapy. A small trial reported statistically significant remission at one year ( = .04), but larger trials, including one with 63 patients, showed no significant gastrointestinal improvements. The first case series noted post-intervention reduction in the mediators of inflammation in rectal mucosal, without long-term monitoring. The second case series observed the absence of flare episodes in 12 of 13 ulcerative colitis patients during follow-up, possibly influenced by the simultaneous use of two drugs alongside hypnotherapy. Psychological outcomes, demonstrated no significant differences between hypnotherapy and control groups. While current literature doesn't decisively support hypnotherapy for managing IBD symptoms, it underscores the importance of further research, including randomized clinical trials, to thoroughly assess its effectiveness in this context.

This paper explores the complex area of so-called unfolding processes and unfolding phenomena in hypnotherapy, emphasizing on unfolding movements and unfolding images, identified as complex involuntary phenomena, which emerge spontaneously without suggestions for these phenomena. Unfolding phenomena are examined as foundational elements of the unfolding process. On the one hand, the study unveils the macro-structure of the unfolding process by categorizing it into involuntary unfolding sets, phases, and unfolding subunits, all of which are analogous among patients and across different organizational levels. On the other hand, detailing the micro-structure aids in elucidating the functionality and elements of the unfolding phenomena. These elements encompass unfolding schemas and instruments. They are emphasized for their role in intrapsychic ideodynamics and responsiveness, aiding recurrent induction aligned and being promoted via an intuitive state of consciousness. Unfolding phenomena elucidate resource elicitation, and adaptation, contributing to the phenotypic organization and reorganization. In this context, the mechanisms of responsiveness, characterized by an unfolding process during hypnotherapy with distinct phases, are examined to help therapists and researchers understand how hypnotherapy can induce phenotypic changes, thereby facilitating treatment, personal growth, and the emergence of a new form of consciousness.

"The relationship" is often cited as an essential aspect of successful psychotherapy, but what is it about the relationship that contributes to positive outcomes in treatment? This article introduces the concept of implicit rapport, which, in the parlance of social psychology, is an element of influence. Influence represents those things to which people respond without awareness of what exactly they are responding. Implicit rapport is here defined as a category of behaviors or interventions that occur within the context of clinical encounters and are designed or intended to promote a sense of feeling known, understood, valued, and safe. It is characterized as implicit because the variety of interactions referred to are not likely to be overtly or explicitly recognized by the client but, nonetheless, influences their willingness to commit to the work of psychotherapy. Clinical vignettes are presented to provide examples of how implicit rapport is conceptualized and actualized.

This study compares two groups of university students with differing instructions participating in an object drawing task as a part of an art therapy-based self-help online intervention. The intervention aimed to help participants enhance positive mood and subjective feeling of self-control and reduce negative mood. The object task contained suggestive elements in the instructions similar to self-hypnosis with an indirect and a direct way of formulation. Quantitative (positive affect and negative affect scale and Self-Assessment Manikin scale) and qualitative methods (text and picture rating) were used to investigate the difference between the outcome effects on the two groups. The results found a significant decrease in negative mood for indirect suggestion, while a significant increase of positive mood for the direct suggestion condition. Based on qualitative analyses, findings indicated that hidden implications in the art-making instructions modified the chosen imaginary and emotional changes related to art-making. Suggestions in the instructions can make a difference in one's mood and this should also be considered while designing guidelines for self-hypnosis.

This scoping review aims to provide a comprehensive overview of studies that explore the use of hypnotherapy as a treatment for depression, adhering to the PRISMA-ScR guidelines. A total of 232 articles were identified through systematic search strategies in four databases. Following rigorous screening, 14 studies, varying from case studies to randomized controlled trials, were included in the final review. The age range of participants spanned from 18 to 70 years, and the number of female participants generally exceeded that of males in these studies. Hypnotherapy was found to be frequently used as an adjunct treatment alongside various types of psychotherapy such as cognitive behavioral therapy and often included techniques like hypnotic induction, ego strengthening, and self-hypnosis. The treatment duration varied from 3 sessions to as long as 20 weekly sessions. Most importantly, the majority of the studies found hypnotherapy to be effective in reducing symptoms of depression, with some studies suggesting it has superior effects to antidepressant treatment in areas such as overall health and vitality. This review highlights the potential of hypnotherapy as a viable treatment option for depression and highlights the need for further controlled studies to establish its efficacy.

This issue of the provides a systematic review of hypnotherapy for smoking cessation as well as a systematic review of hypnosis apps. These reviews are followed by articles that examine hypnotherapy for sleep disturbances in patients with multiple sclerosis, and provide results from a randomized clinical trial of immersive virtual reality to reduce pain and anxiety in individuals undergoing orthopedic surgery. In addition, an important new study, with findings that suggest a "general factor" may best account for hypnotizability is presented. Together, these articles address important emerging research on applications of clinical hypnosis and methods of intervention.