Self-Hypnosis
by Florin Onighi for GuardYourEyes
Self-hypnosis for addictive behaviors. A rapid review of available evidence
Summary
Does self-hypnosis help people who are trying to stop addictive behaviors?
Background
Self-hypnosis refers to intentional hypnotic induction that is self-directed, without therapist presence, with or without the use of audio recordings (Elkins et al., 2018). Potential rationale for self-hypnosis as a useful aid for addictive behavior treatment is that, by acting on underlying impulses, it may weaken the desire to smoke, strengthen the wil lto stop, or improve the ability to focus on a treatment programme by increasing concentration (Spiegel et al., 1993).
Study characteristics
MEDLINE, PsycINFO and PubMed databases were searched using the terms ‘self-hypnosis’, ‘self-hypnotic’, ‘autosuggestion’, and ‘autohypnosis’ and ‘guided imagery’. Only publications in English were considered. Studies published up to September 2020 in peer-reviewed journals comparing self-hypnosis to no treatment or other clinical applications were included.
The search for studies examining the efficacy of self-hypnosis as a clinical treatment returned 23 studies, of which 4 were conducted in the context of addictive behaviors and are included in this review. Studies lasted at least two months.
Key Results
| Study | Audio? | No. of practice sessions | Active control group? | Participant number | Is there an effect?
(control type) |
Limitations |
| Pekala et al., 2004 (chronic drug/alcohol us) | Yes. | 4 x 50 min. sessions
Daily self-practice (suggestedt) for the next 3 months. 4 hypnosis protocols: self-esteem enhancement, relapse prevention, serenity enhancement, and anxiety and anger management/reduction. |
Yes.
Relaxation/stress management or transtheoretical cognitive-behavioral program. |
41 (self-hypnosis)
35 (control group) 178 (relaxation and transtheoretical interventions) |
Yes.
15% of the variance in abstinence was due to self-hypnosis. Self hypnosis increased self-esteem and serenity and decreased anger/impulsivity in severely addicted individuals practicing at least 4 times a week (no such effects were found for relaxation/stress management or the transtheoretical interventions). |
46% of the study participants could not be contacted at follow-up.
No significant differences at 2 months follow-up between the self-hypnosis practice and control groups (probably due to hypnotic susceptibility or other variables). |
| Tindle et al., 2006 (smoking) | Yes. | 6 x in-person weekly group sessions + daily home study (1 workbook and 4 audio CDs) | No. | 17 (self-hypnosis)
17 (control group) |
Yes.
Intervention participants had greater readiness to quit (Readiness to Quit Ladder, 8.3 vs. 7.2) and lower state anxiety (Spielberger Index, 32 vs. 38) at end of treatment than the control group. Abstinence rates in the intervention versus control groups were 36% versus 18% at 6 weeks and 30% versus 12% at 12 weeks, respectively. 94% found the technique helpful for smoking cessation. At a 1 year follow-up, 24% of intervention participants remained abstinent. |
Small sample size (pilot study).
No active (treatment) control group. |
| Lloret et al., 2014 (gambling addiction) | No. | 2 x 1h practice sessions and 7 x 1h intervention sessions | Yes. (CBT) | 21 (CBT)
28 (Self-Hypnosis) |
Yes.
Self-Hypnosis = CBT Abstinence at 6 months follow up was 61.9% for the CBT group and 60.72% for the self-hypnosis group. |
The dropout rate was slightly higher for the self-hypnosis group.
Small sample size. The study excluded a control group (authors’ decision based on ethical reasons.) |
| Spiegel et al., 1993 (smoking) | No. | Single, 50 min. session | No. | 226 | Yes. Abstinence rates at six-months and 1 year were 30% and 25%. | No control group. |
Conclusions and discussion
Combined, the results of four studies (with a total of 305 people) show a success rate (abstinence) for self-hypnosis in the range of 24% to 61.9%. However, there were no differences at follow-up between the interventions in the audio self-hypnosis with active controls (Pekala et al., 2004). Therefore, we can conclude that there is no evidence that self-hypnosis helpes people who are trying to stop problematic behaviors more than behavioral interventions, when delivered over the same amount of time.
As self-hypnosis can be used at will by the person trying to quit, this intervention can have some advantages over behavioral programs in terms of higher compliance and lower costs, as even a small number of sessions can prove effective (Spiegel et al., 1993; Pekala, 2017). In terms of effectiveness conditions, it is recommended that participants complete a minimum of 3 to 5 self-hypnosis sessions per week to expect improvements (Pekala et al., 2004). Practice sessions facilitated by a self-hypnosis expert before participation in an intervention might also be helpful.
In terms of self-hypnosis program content, an audio self-hypnosis program with different protocols (e.g. self-esteem enhancement, relapse prevention) might prove more effective than a generic protocol as it can target multiple mechanism of behavior change and counteract habituation (i.e. from listening to the same program many times). Self-hypnosis protocols targeting negative affect (e.g. stress reduction, serenity enhancement) might prove highly effective in the case of problematic sexual behaviors as negative affect leads to craving which in turn predicts engagement in addictive behaviors (Enkema et al., 2020).
References to studies included in this review
Lloret, D., Montesinos, R. and Capafons, A., 2014. Waking self-hypnosis efficacy in cognitive-behavioral treatment for pathological gambling: An effectiveness clinical assay. International Journal of Clinical and Experimental Hypnosis, 62(1), pp.50-69.
Pekala, R.J., Maurer, R., Kumar, V.K., Elliott, N.C., Masten, E., Moon, E. and Salinger, M., 2004. Self-hypnosis relapse prevention training with chronic drug/alcohol users: Effects on self-esteem, affect, and relapse. American Journal of Clinical Hypnosis, 46(4), pp.281-297.
Tindle, H.A., Barbeau, E.M., Davis, R.B., Eisenberg, D.M., Park, E.R., Phillips, R.S. and Rigotti, N.A., 2006. Guided imagery for smoking cessation in adults: a randomized pilot trial. Complementary health practice review, 11(3), pp.166-175.
Spiegel, D., Frischholz, E.J., Fleiss, J.L. and Spiegel, H., 1993. Predictors of smoking abstinence following a single-session restructuring intervention with self-hypnosis. American Journal of Psychiatry, 150, pp.1090-1090.
Additional references
Elkins, G.R., Roberts, R.L. and Simicich, L., 2018. Mindful self-hypnosis for self-care: An integrative model and illustrative case example. American Journal of Clinical Hypnosis, 61(1), pp.45-56.
Enkema, M.C., Hallgren, K.A., Neilson, E.C., Bowen, S., Bird, E.R. and Larimer, M.E., 2020. Disrupting the path to craving: Acting without awareness mediates the link between negative affect and craving. Psychology of Addictive Behaviors.
Pekala, R.J., 2017. Addictions and relapse prevention. Chapter in Handbook of medical and psychological hypnosis: Foundations, applications, and professional issues, pp. 443-451.