Hypnosis can be helpful in relation to pain, psychological distress and healing during and after surgical procedures, but it can also be used as a means of relaxation.
Hypnosis is an ancient healing method. Today, it is a recognized treatment method for certain diseases and can even sometimes be used as an alternative to anesthesia. Nevertheless, it is hardly known how hypnosis works exactly.
A young woman on a treatment table. Her left hand is resting on her leg, her right hand is slightly raised. She has closed her eyes. The woman seems calm, as if she were asleep. She has not been given anesthesia. Her dentist uses medical hypnosis techniques to ease her patients’ fear of treatment – or, as in this case, even to dispense with anesthesia.
After the treatment, the patient makes a relaxed impression. “Normally, yes, dentistry is an uncomfortable subject, and now I just feel like I’ve done something good for myself,” she says. “I’ve managed to have a treatment, and I think that’s what makes it special.”
Ancient healing method of priests and shamans
According to estimates by the “German Society for Dental Hypnosis,” hypnosis techniques are used in around five to ten percent of dental practices in Germany. This is new to many patients. Yet hypnosis is one of the oldest healing methods of mankind.
Shamans as well as priests in ancient Egypt or ancient Greece used forms of hypnosis in ritual or religious ceremonies to drive out evil spirits and to cure diseases. Records from Egypt, dating back to around 1500 B.C., attest to this and speak of the so-called “temple sleep”.
Native Americans, yogis in India, and fakirs in Islamic Sufism also seem to have used trance states since time immemorial – for example, to block out massive pain stimuli. Hypnotic states are an integral part of mystical religious rituals in all faiths and at all times.
The supposed supernatural and supernatural created respect. Fears and hopes were and are not seldom ideologically exploited. But even if the basis for all these states is difficult to explain: What happens in the brain are natural and everyday processes in every human being.
Mechanisms of action not fully explainable
Hypnosis now has a certain relevance – in the treatment of patients with physical and also psychological problems. Milton H. Erickson is partly responsible for this. Erickson was an American psychiatrist, psychologist and psychotherapist. He lived from 1901 to 1980 and is considered formative for modern hypnosis and hypnotherapy, which, among other things, uses unconscious abilities of the person to use them in the conscious state.
Erikson assumed that every human being has abilities within him or herself to cope with certain physical and psychological problems. According to his concept, the therapist is a kind of guide through the states of consciousness and resources.
However, although some of the techniques of hypnosis are thousands of years old, the mechanisms of action between the conscious and unconscious are still not clearly explainable today. “We know a few states of consciousness very well, for example sleeping, being awake,” says psychologist Barbara Schmidt. She conducts research on hypnosis at the Institute for Psychosocial Medicine, Psychotherapy and Psychooncology at Jena University Hospital. “Hypnosis is another state of consciousness that simply says: we are very focused on a certain thing, we are also more receptive to so-called suggestions. These can come from the person himself or from the hypnotist.”
Fear of having no will of one's own
This is also the point of departure for thrillers and detective novels, which cause considerable skepticism about hypnosis. They also play with the supernatural and force fears and horror. Fritz Lang’s classic “The Testament of Dr. Mabuse” from 1933 is a classic example. Mabuse sits in a mental hospital and writes down murder and terror plans that mysteriously leak out and are carried out by a criminal organization – police and neurologists are baffled.
The idea of hypnosis is shaped by cinema and television, show hypnosis on stage and even cartoons like The Jungle Book. As a result, many still think hypnosis renders people will-less. “I have conversations all the time that people are afraid of it,” says Lea Badenhoop, a hypnotherapist from Hamburg. But Burkhard Peter, co-founder of the Milton Erikson Society for Clinical Hypnosis, reassures, “You can’t hypnotize someone against their will.”
Lea Badenhoop also supports clients via the Internet. She uses audios to help her clients switch off, take a break from everyday life and relax.
Badenhoop came into contact with hypnosis by chance during her training in medical Thai massage at a temple in Bangkok. Those around her were skeptical when she told them she wanted to try it. “Many people said to me beforehand, ‘You’d better watch out, you might not come out of hypnosis,'” she says. “But it was completely different, because you’re completely there. But you just go deeper and are very, very relaxed in hypnosis.”
The Hamburg native was inspired by her own experience – a short time later, she took a six-month hypnosis training course in the U.S., as well as various continuing education courses. Since then, she has been active as a hypnotherapist. “Mindbreak” is what Badenhoop calls her platform – where by “break,” she means a break for the mind, not the breaking of one’s will, which some fear. Many people are afraid because they only know hypnosis from movies and television and don’t know what hypnosis really is, Badenhoop says.
An elevator to go into ones inside
“For me, that was the feeling of letting go of everything for the first time, that inner tension. I was also excited,” says Sarah Peters about her experience. She suffered from a severe anxiety disorder for more than four years, hardly ever left her apartment. Hypnosis cured her, she says herself.
Today she is a non-medical practitioner for psychotherapy and hypnotherapy. “Heart hypnosis” is what she calls her practices in Berlin and Potsdam. Peters knows both sides and can remember her first hypnosis session well.
“That image from TV: One, two, three, someone flicks it, and the victim on stage is running around there cackling. You can read up on it beforehand, but it’s not like that.” Nevertheless, a residual skepticism resonates, even with her at the time. “And then: I was lying on the couch. I heard everything, but it was less important. I heard the voice of the therapist next to me, accompanying me. But all the stimuli, all the trappings, and this voice that we all have in our heads, chattering and chattering all day and what else we have to do and somehow justifying and rationalizing everything, this critical mind, it was quieter. That was there. I already realized, okay, he’s protecting me here and he’s also making sure that everything is going as I imagine it, but he was calmer. It was as if I took the elevator to my inner experience, to my inner world.”
With the recognition as a healing method for certain physical and psychological symptoms, it is theoretically also possible for health insurance companies to cover the costs of hypnotherapy. However, in practice this is decided on a case-by-case basis. Patients should not count on this.
A very direct access
Trance instead of anaesthesia
Berlin Hermsdorf. Even at first glance, Ute Stein’s dental practice does not correspond to the cliché of a sterile, cold practice geared only to functionality. Many photos hang on the walls: Rainbows, temples, nature photos. There is no smell of disinfectants – there is a hint of incense in the air and quiet music comes from loudspeakers.
Despite a kind of living room atmosphere, the central point in the room is a modern treatment chair. Computer monitors show X-ray images, drills, suction cups, medication and filling material are ready – but not only. “Among other things, I work with hypnosis as a communication technique in the dental practice,” Stein says. “Fear of pain, fear of the injection, gag reflex – there are very many indications for dental hypnosis, psychosomatic complaints, atypical facial pain. In pediatric treatment, we can work well with hypnotic techniques.”
Various studies suggest that 35 to 70 percent of patients show anxiety symptoms before dental treatment. Hypnosis techniques can be used to calm patients, relieve anxiety, and also as a supplement and occasionally even an alternative to traditional anesthesia, putting patients in a trance. According to Wikipedia, trance is a collective term for altered states of consciousness with an intense mental experience. In distinction to ordinary waking consciousness, these states are characterized by the following features: A high degree of concentration on a process with simultaneous very deep relaxation and a shutdown of the logical-reflective mind.
“When we wake up in the morning, we are still in such a trance-like state. When we fall asleep in the evening, we are in a trance-like state that just occurs naturally,” explains hypnosis researcher Barbara Schmidt. “And when I’m with the hypnotist, I’m in an artificially induced trance state, which we then call hypnosis. The suggestion is now the content. For example, I say, every time you exhale, you become even more relaxed.”
Pain stimuli are damped
Probably every person has experienced how he or she has let the external world flow into this trance state. The alarm clock ringing, which is unconsciously incorporated into the dream world, for example. Something similar is also done in hypnosis, because the sounds and pain stimuli that occur during dental treatment, for example, reach the patient despite the trance.
Barbara Schmidt compares this to a hotel. “A stimulus in the form of a person comes into a house. There are quite a few departments, they can all do certain things quite well. And he comes to the reception desk. Then it’s decided how to proceed. And there are usually cascades that follow each other pretty closely in time.” These could be interrupted by hypnosis. “We call that dissociation: things that actually cascade one after the other can simply not happen all at once. Then the simply isn’t allowed to continue. That one stays at the front desk, maybe sits in the waiting room, but he doesn’t move on to any department.”
In the dental office, this means: In hypnosis, the patient perceives everything that happens in the treatment, but reactions such as fear and pain do not occur, or they are muted, because the stimulus does not penetrate, or does not penetrate as strongly, into the familiar brain areas in the cerebrum. The patient is mentally in a different place, feeling, for example, in nature, perhaps on the beach, her so-called safe place.
Brain responds to hypnosis
In her brain, areas are active during hypnosis that would also be active if she were actually in nature – this has been proven by studies. Other areas in the prefrontal cortex, normally responsible for planning, reason and rationality, and in the precuneus, which controls ego perception, are shut down.
“Since the so-called imaging techniques have been available, i.e. positron emission tomography or functional magnetic resonance imaging, it has been possible to look inside the brain, so to speak,” says Burkhard Peter, a psychologist and psychological psychotherapist from Munich. You can see: Is something happening in the brain, and does it make a difference if someone hypnotically changes something in their brain there – or is the brain the same? “And we know today: it makes a difference.”
“When you tell someone in hypnosis, you see a rose now, the same part of the brain lights up as when they actually see a rose,” adds Bernhard Trenkle, psychotherapist, instructor of the “Milton Erikson Society” and on the board of the “International Society of Hypnosis.”
Hypnosis in dental practice
In Ute Stein’s practice, you get the impression that time is ticking more slowly. Already during her studies, the future dentist became aware of the possibilities of hypnosis in everyday dental work – and was quickly convinced of the method. “Because I noticed that the profession of working as a dentist is on the one hand the physical stress, but on the other hand also the constant non-verbal encounter with fear and tension.” Via hypnosis, he says, this can be counteracted very well. A win-win situation for the patient and for the treating team. The dentist did her doctorate on the subject and has now been using hypnosis in her practice for around three decades.
The patient on this day is used to hypnosis. She has been coming to the practice since her first dental visits as a child. She knows the procedures and seems to be doing well at letting go.
It takes around 40 minutes before the patient is in the state that makes treatment possible – time that both the dentist and the patient take, and time that is not usually paid for by health insurance. In Germany, dental hypnosis costs between 70 and 150 euros an hour.
Drilling without anesthesia
In principle, the techniques of hypnosis can be used with anyone, but the effects vary greatly from person to person. “They can’t prove hypnosis in an evidence-based way because it’s just an individual relationship,” Stein says. “It has a lot to do with empathy, with trust.” So science usually relies on subjects’ descriptions more than measurement data. Scientists can draw conclusions about physical reactions from them, however.
Thomas Wolf, a private lecturer at the University of Bern and president of the “German Society for Dental Hypnosis,” illustrates this with the example of anesthesia: “Patients often report that when they have only been treated with hypnosis, for example during a tooth extraction, that if they have already had the comparison themselves, they often heal more quickly. This may have something to do with the fact that there are various substances in the local anesthetic, such as adrenaline. Adrenaline leads to vasoconstriction, i.e., to a narrowing of the blood vessels – and where there is less blood, there is logically less nutrient for healing. That could be an explanation, for example. What we often see in hypnosis and also in hypnosis research is that we can represent the phenomena. But the mechanism behind it and why it happens is often unknown to us at the moment. And that’s where we need to do further research.”
Simply hide certain things
The goal of hypnosis can be calming, relaxation or even the reduction of pain. The method is also recognized for phobias such as the fear of spiders or crossing bridges.
Barbara Schmidt studies the processes in the brain during hypnosis at the University Hospital of Jena using brain wave measurements. She says she has done three studies in which she said: “You don’t see anything anymore, you don’t hear anything anymore and you don’t feel anything anymore – in other words, no more pain stimuli. And that’s where we used such a paradigm, that’s been used for, 60, 70 years. Everybody knows how that works. So, for example, there’s always as a sound like this: Beep, beep, beep, toot – and that is, so to speak, the tone that deviates, to which one always reacts with very, very high amplitudes. You know exactly where and how and when everything happens. I can just make it go away. I just say, you don’t hear the sound anymore. Then there are no more brain reactions to that sound, which is deviating there, but which we always see. That’s one of the most stable effects ever measured in EEG.”
The subject becomes focused. This also happens again and again in fearful situations, for example, and is extremely useful there. Someone who runs out of fear will be able to run faster and longer than they could if they simply wanted to run fast and long. The transmission of exhaustion signals from the body to the cerebrum is slowed down in this example.
“In the listening, the subjects gave me partial feedback: The sound was there and also at the same time it was not there. That is exactly this concept of dissociation. The stimulus is at the reception, but it doesn’t get anywhere. They report that to me in their own words. I always found that so blatant. They don’t know my theories and my hypotheses and explain to me: Yes, maybe it sounds strange, but somehow it was there and not there at the same time or something. It was somehow still there on the horizon, but somehow it was ignored. It didn’t matter.”
The fact that subjects reported hearing the sound can be seen as evidence that the outside world is very much perceived, but without being aroused by it – electrical brain activity does not spike as much under hypnosis in response to the sound as it does while awake.
In another study, the scientist examined how people responded to an electrical pain stimulus on their hand when they were hypnotically given the suggestion that they were wearing a cooling glove – the brain responses were significantly different from those in the control session without hypnosis. In the hypnotized state, subjects felt the pain significantly less. “It’s also called salience, importance.
Something that deviates is important, and something that hurts is important. That means it is definitely processed more strongly. You can see that in the EEG. They are just huge spikes. If I induced hypnosis beforehand and said: You have earplugs in your ears or you have a glove that makes your hand numb and cold, then there is simply no longer this reaction to these salient stimuli.”
Beware of charlatans!
Hypnotherapist is not a protected term in Germany. Anyone can call themselves one, including charlatans. Hypnosis societies such as the “Milton Erikson Society for Clinical Hypnosis” therefore recommend that therapists with an academic background be consulted. With serious psychological problems, a psychotherapist experienced in hypnosis should be consulted.
The clients of alternative practitioner Sarah Peters see the great advantage of their therapist in the fact that she does not only have theoretical knowledge due to her own experience with a severe anxiety disorder. “I was indeed able to walk through Berlin at the end of the first session. That was an amazing experience after years of anxiety at home,” she says. An experience that Sarah Peters now shares with clients* such as music manager Julia Gröschel.
The tall, heavily tattooed woman appears tough, calm and positive – but, as she says, that wasn’t always the case. “Just being me was just never enough in my perception, and that has changed 100 percent” since she tried hypnosis. This was preceded by talk therapies, but they were unsuccessful. The manager describes herself as a very analytical person.
She was well aware of her weak points – and yet she could not get rid of the self-doubt. “And then I somehow came across hypnosis in a really classic way through Google and had a fifteen-minute conversation with Sarah,” and booked the first hypnosis session.
Wide range of applications
Hypnosis techniques are used as a way of relaxation or self-relaxation, as well as in everyday medical practice, where they are used complementarily and in some cases even as an alternative. A 2021 meta-analysis by the University Hospitals of Jena and Leipzig shows the benefits of hypnosis in relation to pain, psychological distress and healing during and after surgical procedures.
Hypnosis has multiple applications, but it is not a panacea. There is little scientific evidence for many applications. It does not work the same for all people, and if not used properly, it has risks and side effects, just like virtually all treatments or even medications. But at least one thing is certain: the image that show hypnosis and Hollywood have created is certainly wrong.