Hypnosis, Placebo and Healing

By Eric Greenleaf PhD

Hypnosis and hypnotherapy have long been considered as placebo treatments. In the narrow meaning, that is to say physically inert substances or physically neutral manipulations or interventions which, nevertheless, effect the patient in positive ways. The classic “sugar pill” is one such placebo, “a mother’s kisses” another famous example of healing without physico-chemical or biological substances entering the body.

 A more modern and more medically correct view of placebo holds that placebo effects are a major portion of all medical and psychological interventions that help patients heal. As Kirmayer says [Journal of Mind Body Regulation 2011, 1, #3] “Placebo responses may be understood as social phenomena that depend on embodied experience, socially distributed or embedded knowledge, and situated practice.” In this sense, placebo refers to a social, healing situation, not to a chemical substance.

What does this imply? Well, we know that we can feel better with more compassionate and responsive medical care. We know too that hypnotic “rapport,” the relationship with the hypnotherapist, is of the essence of hypnotic effectiveness with patients. We know, as with hypnosis, that much of healing is outside of conscious awareness and control.

 In the social context of healing, or the interpersonal “container” of hypnotic psychotherapy, our own brain, though affected, is not the agent of change; nor, is our therapeutic “technique” the healing item. Rather, placebo effects – recognizable, measurable, brain and body effects of healing - result from the unselfconscious rituals of medical and psychotherapeutic practices. These practices are metaphorical [meanings “carried” in symbolic acts], narrative [what we are told], and persuasive [“You are getting better already.”]

Research shows both that metaphors emerge from bodily experience and that metaphor and ritual and persuasive speech and expectation affect and change bodily experience, thought and action. When we go to a dance, we dress to dance, expect to dance and mentally practice the steps. We prepare to enjoy ourselves. When we are ill or troubled, we expect caring treatment and individual concern for our pains and methods to ease those pains and resolve the ills we suffer, physical or emotional.

 In the common practices of hypnotherapy there are situated practices which ritually invite states of trance, persuasive speech to encourage change and healing, and appeals to experience, both embodied and embedded, as well as “unconscious,” to effect healing in the patient. As in the ancient dream incubation practices of Asclepian Athens, so in modern hypnotic practice, the patient is led through a ritual, allowed to rest comfortably, and encouraged to reassess and rearrange experience to induce change, growth and recovery. With good placebo outcomes come self-value and approval – the healthier person esteems his own life more easily than does the troubled one. As a hypnotherapy patient of mine wrote, “Thank you again for what-ever-the-hell-it-is that you do – as I have benefited greatly. Most notably in my improved assessment of self.”

 The “whatever” is hypnotic conversation, hard to grasp consciously because its meanings are distributed through relationships; metaphorical and allusive, so, hard to pin down as “technique.” The benefit is clear; the means are ritualized, murky. And, without discussion of “self,” the treatment eventuates in improved self-valuation. A placebo without sugar pills or sugar-coating can help with all manner of medical and therapeutic goals.