In my 20-plus years as a hypnotherapist, I think I’ve heardall the jokes, misconceptions and weird ideas people have about what I do, but todayI’m going to look at something that is often used to dismiss hypnosis asirrelevant, “It’s just a placebo”. Usually, when this is said, the implicationis that hypnosis (and by extension placebo) just don’t work. But in fact, that’svery unfair to both approaches. 

What is a Placebo?

This is a blog for hypnotherapists, so I’m going to assume thatyou know what hypnosis is. But knowing more about placebos will be useful.

Placebos are substances or treatments that shouldn’t haveany physical effect because they have no active ingredients. But they do, becauseour minds make them effective via the power of suggestion. An example would begiving someone a sugar or starch pill with no active ingredients and tellingthem it was for headaches. If the placebo is effective, their headache willsubside. The word “placebo” means “I will please” in Latin and refers to thispositive psychological effect.

Placebos are often dismissed as being for placatinghypochondriacs or patients for whom there is no effective treatment. However, multiplestudies have demonstrated that placebos have an observable effect. When new medicationsare tested, they are measured against both a control group (who receive notreatment), and a placebo group (who, obviously enough, receive placebotreatments). This indicates how effective the medication is, compared to both.

Placebos tend to work best on self-observed symptoms andmental health conditions, rather than physical conditions. For example, while aplacebo is unlikely to make a cancer tumour disappear, it is very likely toreduce the associated pain, alleviate the fear of the illness worsening, andlessen the side effects of chemotherapy. The benefits of these effects can’t beunderestimated. Reductions in pain, anxiety or depression can lower bloodpressure and stress hormone levels, which in turn improve the immune response.This can also help the patient adopt a healthier mindset, making it easier forthem to care for themselves and follow doctors’ instructions, thus leading to adomino effect towards easier recovery. [1]

In most cases, the person being given the placebo is nottold that’s what they’re getting, in case it reduces their belief in the treatment.However, recent studies have shown that placebo treatments can work even whenthe patients involved know they are receiving a placebo. [2]. How this works is not yet clearbut, probably, renewed hope and the feeling that they are taking steps towards dealingwith their illness, cause a reduction in stress and an increase in endorphins,which are natural painkillers and stress reducers.

We do need to be careful when using placebos, because of the“nocebo” effect. This is when negative symptoms appear with no physical cause.If a patient is warned to expect side effects, for example, they mayspontaneously develop them as a response to the suggestion.

 

Comparing Hypnosis and Placebo

Both hypnosis and placebos are subject to widespread misconceptionsabout how and whether they work; but, as described above, both have real,tangible benefits in the treatment of many conditions.

Both work with the power of suggestion and affect the mindrather than having direct physical effects on the body. By changing someone’sexpectations, they change the outcome. Responding to hypnosis or a placebodoesn’t mean you are weak-willed or gullible; both can work on anyone.

However, there are differences. As I’ve mentioned, placebo istypically presented deceptively; the person receiving it usually believes it isan effective remedy. Hypnosis, on the other hand, arguably works best whenpresented honestly and when the hypnotherapist and client are working togethertowards the goals.

 

Ethical Considerations in Hypnosis and Placebo Use

Whether you are using either hypnosis or placebos, ethicsare important.

As hypnotherapists, we’re encouraged to work cooperatively andtransparently with our clients and to obtain informed consent. Clients shouldbe fully aware of the process and have realistic expectations.

Traditionally, a placebo has been delivered with a built-inlevel of deception. The client or patient can’t give informed consent becausethey don’t have all the facts. This is defended by arguing that the placeboworks better that way – broadly, the end justifies the means - but it’s often difficultto find the ethical line between getting the best results for your patient or clientand being honest with them.

 

Long-term Effects of Hypnosis and Placebo

It’s also worth looking at the issue of whether hypnosis andplacebo have a comparable effect over the longer term.

Although both rely on the power of suggestion, studies haveshown that placebo effectiveness is only moderately connected to hypnoticsusceptibility. [3] Hypnoticsuggestion tends to produce more stable and consistent results than a placebo.

So, while placebos are good for short-term relief, thismight not be true over longer periods because they address only symptoms andnot any underlying issues. Hypnotherapy tends to have better long-termoutcomes.

When used by suitably qualified individuals, both placeboand hypnotherapy can have clear, measurable, positive effects. They can be usedtogether, or separately to help your clients.

How much do you think placebo plays a part in hypnotherapy? Doyou use it consciously in your practice? Let me know in the comments below.

 Interested in learning more about the effects of placebo in therapy? Look at my article on Mood Freezing.

References

[1] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect

[2] https://www.health.harvard.edu/blog/placebo-can-work-even-know-placebo-201607079926

[3] https://psycnet.apa.org/record/2016-41344-073

 

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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of Anxiety to Calm: a Practical Guide to a Laid-Back Life, The Hypnotherapist's Companion, Their Worlds, Your Words, and The Metaphor Toolbox, all available from Amazon or direct from the author. Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi-accredited hypnotherapy practitioner training, taster days and foundation levels.
CPD Expert - accredited CPD and other therapy training (online and workshops options), expert and qualified hypnotherapy supervision

Researcher for this article: Rae Waller