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Hypnotherapy as a Treatment for Depression:
Does It Work?
Meredith Murray

October 5, 2009




 

 

 

 

Depression and Hypnosis: A New Duo?
        Depression is an illness that affects the daily lives of millions of Americans. While depression is most often considered a mental illness, its progression can produce physical symptoms that weaken the body and make the individual more susceptible to other illnesses and can sometimes manifest into physical pain. People suffering from depression find it difficult to function in their routine tasks. Depression manifests itself differently in each patient, and the severity and duration depend on many contributing factors (http://www.associatedcontent.com/article/129176/combatting_depression_with_hypnotherapy.html).

        Depression is caused by a variety of factors, ranging from biochemical and genetic factors to psychological and environmental factors (http://www.altmd.com/Articles/Hypnotherapy-for-Depression). For years now, physicians have turned to medication for the treatment of depression in their patients, readjusting the biochemical functions of the individual. A segment of the population, however, is beginning to view cognitive behavioral and therapeutic approaches as more effective for the treatment of depression. Hypnosis as treatment for depression has been brought to the forefront of discussion by many clinicians.
 
What’s on the Web?
        There is a great deal of information online that suggests that hypnosis is a preferable and efficient treatment for depression. Online resources give a variety of different reasons for their opinion. One resource states that hypnosis results in greater outcomes than drug therapy. David Kato, a hypnotherapist, suggests on his website that prescription antidepressants can often mask underlying issues, and once the patient stops drug therapy, the depression is still evident. The author, David Kato, suggests that drug treatment lacks the long-lasting effectiveness against recurrences of hypnosis and fails to teach the skills of resolution and problem solving that are necessary to conquer the illness. Kato also believes that people falsely attribute depression symptoms to being purely biological and brings up the idea that the way people think is actually the more probable cause (http://www.depression-therapist.co.uk/index.html)

The Rationale:
        Pharmacotherapy has side effects and complications such the potential for dependency and tolerance, while proponents of hypnosis for the treatment of depression maintain that hypnosis counters depression by helping the patient build a foundation that creates constructive ways of dealing with the feelings associated with the illness, a sense of control over their condition, and decreased rates of relapse (http://www.hawaii.edu/hivandaids/Hypnosis and Depresison.pdf).

 

What is hypnosis – how does it work?
        During a hypnotherapy session, the depressed individual experiences a variety of relaxation stages. The hypnotherapist combines these states with imagery, and as the person moves into deeper, trance-like states of relaxation, the hypnotherapist is able to access the emotions and memories of the depressed individual that may have been repressed or forgotten. Once these memories are unveiled and learned behaviors are separated from the memories, the hypnotherapist reveals coping strategies and healthier, more productive thought processes directly to the subconscious mind of the depressed individual. While in this hypnotic state, the individual tends to accept the suggestions of the therapist. According to online resources, hypnosis helps patients identify the intrinsic causes of their depression and allows them to modify and refute their negative memories, feelings, and thoughts that contribute to the illness (http://www.altmd.com/Articles/Hypnotherapy-for-Depression).
WHO says so?
        The resources that tend to be proponents of hypnotherapy for the treatment of depression are authors of hypnosis books, people who have been trained in hypnotherapy (not necessarily people with degrees in clinical psychology), and some clinicians that use hypnotherapy in their therapeutic sessions and have found success.

Is Hypnotherapy Effective – What are the Risks?
        Online resources claim that hypnotherapy brings results (decrease in depression symptoms, better sleep, etc.) in four to ten sessions. Proponents of hypnotherapy for the treatment of depression believe that children are easier to hypnotize and may improve after one to two sessions (http://www.altmd.com/Articles/Hypnotherapy-for-Depression). One online resource cites a 2007 study in which hypnosis was found to be more effective than cognitive-behavioral therapy (http://www.naturalnews.com/024313_depression_hypnotherapy_hypnosis.html).
        While these people believe that hypnotherapy is more effective than some other treatments of depression, they do not ignore the risks and potential harmful effects of hypnotherapy. Much like dependency on antidepressants is a risk with drug therapy, hypnotherapy can cause the depressed individual to become dependent on the therapist and therefore affect the long-term personal growth of the depressed individual (http://www.hawaii.edu/hivandaids/Hypnosis and Depresison.pdf). Burrows, Stanley, & Bloom (2001) also suggest that revisiting painful or depressing memories, thoughts, and feelings may increase the risk of suicide in severely depressed individuals.

Science says…
         Alladin and Alibhai (2007) evaluated cognitive hypnotherapy as an effective treatment for depression. The effects of hypnosis and cognitive-behavioral therapy combined were of interest in this study. Eighty-four participants who were considered depressive individuals were randomly assigned to either a cognitive-behavioral therapy (CBT) group in which they were only treated using CBT, or a group in which both hypnotherapy and CBT were used as treatment. Baseline scores were measured in order to compare scores on the Beck Depression Inventory, Beck Hopelessness Scale, and the Beck Anxiety Inventory. The combined therapy (CT) group’s scores on their inventories significantly improved. Calculations of effect size were made, showing that there was a 8% reduction in hopelessness, a 6% reduction in depression, and a 5% reduction in anxiety in the combined therapy group. This was maintained over a 6-month and 12-month period. This study was very important; it was the first controlled analysis of hypnotherapy against an established psychotherapy technique for the treatment of depression. The results suggest that hypnotherapy does in fact provide effective treatment, compared to other psychotherapy techniques, for depression.
        Suzuki (2003) examined the effectiveness of hypnosis on lowering aggression and depression in depressed college undergraduates. Participants (13 depressed individuals, 13 non-depressed individuals) in the study were shown six frustrating situations. Participants were evaluated in both their waking states and in their hypnotic state after undergoing hypnosis. The method of measuring emotions involved open-ended questions and rating scales. The results of the study showed that depressed individuals reported being less depressed while in the hypnotized state. An interesting finding of the study related to the aggression of depressed and non-depressed individuals while in the trance state. Based on the open-ended questions, depressed individuals were indicated by two raters as being less aggressive while in the trance state. However, non-depressed individuals were indicated as being more aggressive in the trance state than their waking state. This seems to explain the repressive side of depression, suggesting that hypnotherapy may be able to help eliminate unwanted behaviors and thoughts of the individuals. The results of this study cannot be generalized, however, to the entire population of depressed individuals because of the small sample size with college undergraduates being the only participants.
         Dobbin, Maxwell, and Elton (2009) assessed whether a self-hypnosis treatment would be effective in the primary care setting. Patients were given the choice of being randomized to a treatment group or be assigned to the treatment group of their preference. These treatment groups were either self-help (self-hypnosis) or a drug therapy treatment consisting of antidepressant medications. Evaluations were given using the Beck Depression Inventory, Brief Symptom Inventory, and an evaluation called the SF-36. There were 58 patients recruited for the study: four patients choosing to be randomized, four patient choosing drug therapies, and the remaining 50 choosing self-hypnosis. Cognitive-behavioral therapy and counseling were benchmarked, and the preference groups were close to similarity with the benchmarked trials on baseline scores, demographic information, and outcome effects. The outcome of the study shed favorable light on the possibility of using self-hypnosis in primary care for the treatment of depression.
        Gonsalkorale, Miller, Afzal and Whorwell (2003) studied the role of hypnotherapy in long-term relief of irritable bowel syndrome, a common co-occurrence in depressed patients. The irritable bowel syndrome benefits in this study are, however, not as important in this discussion as the relief of depression symptoms also seen in the study. Therefore, discussion will be on the pre-hypnotherapy anxiety and depression evaluation scores and the post-hypnotherapy improvement in these evaluation scores. Gonsalkorale et al. (2003) recruited 204 patients who completed questionnaires assessing quality of life, symptoms, anxiety and depression at different times: before treatment, immediately after treatment, and up to six years after treatment using a validated IBS questionnaire, the Hospital Anxiety and Depression Scale, and a subjective assessment scale rating the effectiveness of hypnotherapy on symptoms in order to determine their responder status. Our measurement of interest is the Hospital Anxiety and Depression Scale. Scores post-hypnotherapy improved in both the responder and non-responder groups. The HAD scores were still improved from pre-HT scores at follow-up. The responder group had more improved scores overall immediately after hypnotherapy, but at follow-up this improvement was less evident. This suggests that the non-responder and responder groups became more similar as the time since hypnotherapy was performed increased. These results do not seem to strengthen the hypothesis that hypnotherapy is an effective long-term treatment for depression.
What is the answer?
        There are few experimental studies focusing solely on hypnotherapy for the treatment of depression. Aside from cognitive-behavioral therapy, psychotherapy seems to be a novel and shallowly explored idea in the clinical field of psychology. While the results of the studies previously mentioned are mostly favorable of hypnosis as a therapy for depression, the lack of evidence makes it impossible to confidently conclude that hypnotherapy is an appropriate, or effective, treatment for depressed individuals. Hypnotherapy does have therapeutic benefits, however, that may serve to improve the condition of the depressed individual, but permanent curing effects are not known. As for all illnesses, the appropriate therapy depends on the needs and desires of the individual, and it is critical that each person consult with his or her physician or therapist regarding treatment options. 

References:
Alladin, A. and Alibhai, A. (2007). Cognitive hypnotherapy for depression: an empirical
        investigation. The International journal of clinical and experimental hypnosis,  
        55(2):147-166

Burrows, G. D., Stanley, R., and Bloom, P. B. (2001). International handbook of clinical
        hypnosis, 129-142.

Dobbin, A., Maxwell, M., and Elton, R. (2009). A benchmarked feasibility study of a
        self-hypnosis treatment for depression in primary care. The International journal
        of clinical and experimental hypnosis
, 57(3): 293-318.

Gonsalkorale, W.M., Miller, V., Afzal and Whorwell. (2003). Long term benefits of
        hypnotherapy for irritable bowel syndrome.
Gut, 52(11): 1623–1629.
Suzuki, T. (2003). The effects of hypnosis on emotional responses of depressed students
        in frustrating situations. Shinrigaku kenkyu: The Japanese journal of psychology,
        73(6):457-463.

 

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