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Is hypnotherapy for addictions safe?

Hypnotherapy for substance abuse disorders

Are you looking for strategies to remain sober in your daily life? If you suspect that you need additional treatment to stay sober, maybe hypnotherapy can help.

Hypnosis, or hypnotherapy, is currently gaining credibility as an addiction treatment modality in the medical and psychiatric community. But what are its limitations? Who makes a good candidate for hypnotherapy and who needs be referred to psychiatric help?

We’ve asked a hypnotherapist

Here, we discuss the use of hypnotherapy in treating addiction with Heather Good, MSW, RSW, Clinical Hypnotherapist and Principal of Change for the Good. Heather Good has worked for many years as a mental health therapist and has dealt with many complex mental health difficulties including depression, anxiety, abuse, and trauma. She is a graduate of the Centre for Right Relationships’ Coaching Program. She has also completed training in the Hakomi method of psychotherapy which helps to resolve trauma through the wisdom of the mind-body connection.

In this interview, Heather explains to us:

  • How hypnotherapy is used in addiction treatment
  • What hypnotherapy includes and what a typical session is like
  • Whether or not hypnotherapy is best for everyone
  • How to avoid danger or risk in seeking hypnotherapy

At the end, if you still have questions about hypnotherapy and its safe use, please use the comments section below. We will do our best to send you a personal and prompt answer.

ADDICTION BLOG: What is the science behind hypnotherapy?

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HEATHER GOOD: How hypnosis actually works is still not completely understood by scientists, but we do know that the process of hypnosis accesses a level of the deeper mind (the subconscious) which can initiate long-lasting change. In the trance state, the client is highly suggestible, relaxed, and able to access the deeper mind and the imagination; the trance state is likened to the state between waking and sleeping. In the trance state, the conscious mind relaxes and all the memories stored in the subconscious are accessible. The client is a partner in the process and it is their goals and desires that are integrated and solidified.

The subconscious is like a store-house for all our experiences in the lifetime. People are able to let go of their addiction when (the subconscious mind and the conscious mind are on the same page). When this occurs, people are able to transform the trauma with positive support networks, self-compassion, and coping skills.

Time and time again; most often people leave hypnotherapy feeling a stronger sense of their own power and a sense of peace. Even if they don’t attain abstinence, or if they fall short of meeting the goal they set for themselves, the process of hypnosis helps to release stress that has been held in the body and mind and re-connects oneself to a sense of power and purpose.

What hypnotherapy can do – which is brilliant and needed – is to help to re-write the life story and to release the trauma of the past. As a sense of self-worth and empowerment arises, people begin to learn that they are resourceful and powerful. For some people it can make a huge difference, while for others, it can be an important aspect of their healing journey.

If you would like to learn more about hypnotherapy, or if you send me a message, I am happy to send you a document I wrote on the history of hypnosis!  Visit me at: http://changeforthegood.ca/services-view/hypnotherapy/#.Vfbx6I-FPIV

ADDICTION BLOG: What is the goal of hypnotherapy in the treatment of chemical and process addictions?

HEATHER GOOD: One might view the goal of hypnosis and counselling to be abstinence (and this may be necessary and needed). However, I view the goal of hypnosis to be the alleviation of suffering and the strengthening of self-love and self-compassion.

Although the goal of hypnosis varies, what is of the upmost importance is to help the person who is suffering to find freedom from decades or years of pain and to feel a sense of control and mastery over their lives. Addiction is a complex interplay of causes and conditions which results in a set of behaviors that oftentimes have detrimental results in a person’s life. Support systems and dedication to the recovery process are essential for long-term success for those with serious addiction issues.

Substance use or addictive behaviors arise in order to meet a need. In my view, the goal of hypnotherapy in the treatment of addictions is three-fold.

  1. To begin with, the client needs to have a clear picture of what they want their life to look like and they have to be ready for change.
  2. Secondly, helping people have greater self-control of their lives elicits greater control within themselves.
  3. Finally, through the hypnosis process we remove the energies that are associated with what you might call the “original trauma” so that there is more freedom and peace.

ADDICTION BLOG: In your opinion, what is the cause of addiction?

HEATHER GOOD: As noted earlier, there is not one single cause of addiction.

In his book, In the Realm of Hungry Ghosts, Dr. Gabor Mate shares that addiction involves a complex interplay between humans and their environments and that addiction is a chronic neurobiological disease. He suggests that early stress is a potent inducer of addiction as it impairs brain development. He shares in his research that drug addicts show a high likelihood of being victims of early abuse and childhood trauma.

Dr. Mate goes onto to write that there are three main systems involved in addiction. The attachment system involves a sense of belonging and connection with others that may have been disrupted early in life. Secondly, because of early trauma the reward and motivation centres of the brain are impacted. Finally, those with addictions may have difficulty with self-regulation and calming themselves in times of stress.

ADDICTION BLOG: How effective is hypnotherapy in the treatment of addiction?

HEATHER GOOD: Although much more rigorous research is required in the field of hypnotherapy to fully show the efficacy of hypnosis for addictions, based on randomized controlled trials, there is sufficient evidence to show that both relaxation techniques and hypnosis can effectively reduce anxiety, and help patients with chronic pain, insomnia and panic disorders.

As we also know, hypnosis helps people to become non-smokers. Additionally, hypnosis can help patients with cancer control anxiety, pain, nausea and vomiting. Hypnotherapy for trauma has also shown efficacy. Since hypnotherapy is regularly suggested and is used in many group scenarios for healing there is a need for large trials to establish its efficacy, specifically related to addiction.

In the International Journal of Clinical and Experimental Hypnosis (2000), Lynn et al., suggests that rarely, if ever, is hypnosis the sole form of treatment with a patient. In fact, the position of the Society for Clinical and Experimental Hypnosis is that hypnosis cannot and should not stand alone as the sole medical or psychological intervention for any disorder. Instead, hypnosis is used in addition to some recognized medical or psychological treatment protocol.

For years now, hypnosis has been recognized as a legitimate component of medical treatment by the American Medical Association and the American Psychiatric Association. This being said, I have had experiences where a single session of hypnosis has made a significantly positive impact on the people that I have seen.

ADDICTION BLOG: Can you describe a typical hypnotherapy session step-by-step? What is the expected outcome?

HEATHER GOOD: Hypnotherapy can be an amazingly powerful component of a treatment program but one thing is for certain – the person seeking the change has to be 100 % on board with the goal and they need to be ready for change.

When I first talk to people about hypnosis, I find out their goals and I explain how hypnosis works. I then use my voice and deepening techniques to help the client to relax. This is very similar to a guided relaxation process. The client is aware that they can speak to me the whole time, that they will remember everything, and that they are in control. The client will not say anything they don’t want to say and they are completely in control.

Once the client is in a relaxed state then we journey back to clear all the things that they experienced with a negative association in their lifetime. People imagine letting go of these experiences so that when they think about them from this point onwards they do so in a neutral manner. Letting go of what has caused pain and sadness results in a release of fear, anxiety, insecurity and self-doubt. The end result is that the person feels more connected to their true essence and power and feels more accepting of themselves. We integrate in their goals and they determine their action steps for change and we solidify these through anchoring and future visioning.

I believe that strong self-criticism lies at the base of every addictive behavior. Most people I see with addictions are very hard on themselves. As people learn to love themselves more they can choose behaviors that are more in line with self-care and self-nurturance.

ADDICTION BLOG: What license is required when practicing hypnotherapy?

HEATHER GOOD: This varies depending on the province, state, or country that you live in. Some provinces require advanced degrees to work in the field of hypnosis, while other places do not have such strict guidelines.

I have personally received very powerful sessions from practitioners who do not hold graduate or advanced degrees but who have years of experience and who are gifted in the art of hypnosis. Hypnosis is truly an art form and the hypnotherapist is a master of language. As most literature in the field of psychotherapy notes, the therapeutic relationship provides a significant vehicle for change so it is of the upmost important that you feel rapport, comfort, and safety with a practitioner you are seeing for hypnosis.

When looking for a practitioner, ensure you have looked into the credentials of the person you are considering seeing or ask for a testimonial or referral. Finally, use your intuition. If you have a good sense of the person and you are able to discern that they have a good motivation and are a fit with you – then ask questions and get to know them.

ADDICTION BLOG: What co-occurring conditions do you avoid treating as a hypnotherapist? In other words, who SHOULD NOT seek treatment via hypnotherapy?

HEATHER GOOD: In my opinion, it would not be wise for anyone who is experiencing psychosis or schizophrenia to seek out hypnotherapy – unless the person providing that therapy is a licensed psychiatrist who is trained in hypnotherapy and they have deemed and recommended that it is a safe adjunct to treatment.

I would also never treat anyone who is under the influence of drugs or alcohol and if someone is in the detoxification or withdrawal state – which can also be accompanied by symptoms of psychosis – I would also not provide hypnosis until the person has stabilized.

ADDICTION BLOG: Can we practice self-hypnosis in addiction treatment? How?

HEATHER GOOD: You don’t need a highly-trained hypnotist to induce hypnosis, however, it helps to meet with a hypnotherapist to learn how to hypnotize yourself and to set your goals. With the proper relaxation and focusing techniques people can accomplish relaxation, sleep improvements, and goal attainment through self-hypnosis.

When I am doing sessions with people, I sometimes tape a session for them to play back later on. Eventually, they can use the power of their breath and mind to induce hypnosis. By taking three long, slow, deep breaths, setting an intention to go to a relaxing and calm place in their minds (what I call their happy place) then they can settle deeply into the trance state. When people are ready to wake up – then they come out of that state easily and effortlessly.

If you are interested in having a skype session (which is safe and effective) and to receive a script you can later use for self-hypnosis you can email me at heather@changeforthegood.ca.

If you would like to listen to some FREE guided hypnosis inductions and visualizations that I have created you can access them at:  http://changeforthegood.ca/tools-resources/#.VfbtuY-FPIU

ADDICTION BLOG: Can hypnotherapy treat people’s psychological and physical condition?

HEATHER GOOD: Hypnotherapy can be an important and useful tool in treatment, but as stated earlier, it may just be one component of a treatment program for change to the health of the body mind and spirit.

One approach that I have come across that I found particularly interesting in the research is referred to as Urge Reduction by Growing Ego Strength (URGES) for Trauma/Addiction Treatment Using Alternate Bilateral Stimulation, Hypnotherapy, Ego State Therapy and Energy Psychology. The URGES approach was created to treat addiction and trauma as one inseparable condition and to reduce re-traumatization and abreaction during trauma resolution treatment. If this interests you there is some preliminary research that you may find interesting.

Furthermore, a meta-analysis explored the efficacy of hypnosis in the treatment of depressive symptoms. Six studies were analyzed and the results indicated that hypnosis appeared to significantly improve symptoms of depression (p < .001).

It is estimated that more than half a million individuals in the United States used hypnosis in the treatment of their illness (Barnes et al., 2007). In addition, a recent review evaluated meta-analyses published in the American Journal of Clinical Hypnosis, and the author reported 32 disorders for which hypnosis can be considered a possible treatment (Wark, 2008). Results of this study revealed that the beneficial effect of hypnosis in the treatment of depressive symptoms exceeded that of placebo. In another study on first-time mothers, there was a significant decrease in scores after weekly 30 minute hypnosis sessions for 6 weeks in a postnatal Depression Scale (EPDS) compared to a control group at 10 weeks.

In conclusion, hypnosis has also been researched for sleep disorders, chronic insomnia and also in a group of patients suffering from chronic combat-related PTSD. Hypnosis interventions consistently produce significant decreases in pain associated with a variety of chronic-pain problems. Also, hypnosis was generally found to be more effective than non-hypnotic interventions such as attention, physical therapy, and education.

Most of the hypnosis interventions for chronic pain include instructions in self-hypnosis. However,  “there is a lack of standardization of the hypnotic interventions examined in clinical trials, and the number of patients enrolled in the studies tended to be low and lacking long-term follow-up.” (Intl. Journal of Clinical and Experimental Hypnosis, 55(3): 275–287, 2007). Lastly, “Stanton (1989) conducted a controlled clinical study with 45 subjects matched on their baseline sleep-onset latency and then randomly assigned to one of three treatment conditions: hypnotherapy, stimulus control, and placebo treatment. A significant reduction in sleep-onset latency was found only in the hypnotherapy group” (Intl. Journal of Clinical and Experimental Hypnosis, 56(3): 270–280, 2008).

ADDICTION BLOG: What are the risks of hypnotherapy (in general) and how can someone in addiction recovery mitigate these risks?

HEATHER GOOD: Asides from the risks noted above, there are few other negative risks associated with hypnotherapy. That being said, hypnosis for healing and with this intention in mind, is very powerful and helpful.

Hypnosis is often experienced as a relaxing and pleasant experience. Finding a hypnotherapist, psychiatrist, or counsellor that you trust that uses hypnosis or another type of therapy that is very good for trauma called Eye Movement Desensitization and Reprocessing (EMDR) can help with deep healing. Other promising therapies include Brainspotting and Mindfulness-Based Relapse Prevention (MBRP).  If you struggle with addictions then having a plan and treatment team to help you will support your healing journey is necessary.

ADDICTION BLOG: How often is hypnotherapy used for addiction treatment as part of the Cognitive Behavioral Therapy (CBT)? What kinds of overlap exist?

HEATHER GOOD: Cognitive behavioral therapy (CBT) combined with hypnotherapy can be a part of healing for a wide arrangement of difficulties, including addictions. Although there is very little empirical data related to CBT and hypnotherapy, especially as it relates to addictions, the Journal of Clinical Oncology, Montgomery et al. (2014) determined that the results support Cognitive Behavioral Therapy and Hypnosis (CBTH) as an evidence-based intervention to control fatigue in patients undergoing radiotherapy for breast cancer.

CBTH is non-invasive, has no adverse effects, and its’ beneficial effects persist long after the last intervention session. Furthermore, Kirsch et al. (1995) conducted a more broad-spectrum meta-analysis of empirical studies that had compared the effectiveness of cognitive-behavioral treatments (CBT) with and without hypnosis across a number of disorders (e.g., obesity, insomnia, anxiety, pain, and hypertension). Patients receiving CBT with hypnosis showed greater improvement than at least 70% of patients who received standard CBT. Second, relaxation did not appear to be the mechanism. Third, there was a hint that the advantages of adding hypnosis to CBT might increase over time, though this was not definitive. Schoenberger’s review (2000) provides further evidence that hypnosis combined with cognitive behavioral methods, generally produce outcomes superior to wait-list and no treatment control conditions.

Although no hypnotically augmented cognitive behavioral treatment has as yet met the criteria for a well-established treatment, especially promising treatment gains have been observed in relation to obesity, anxiety disorders, and pain management. Given that many cognitive behavioral procedures can easily be conducted with hypnosis it seems that behaviorally oriented clinicians with training in hypnosis could readily establish a hypnotic context as a simple, cost-effective means of enhancing treatment efficacy. It is suggested that the reader explore the work of Dr. Michael Yapko (www.yapko.com) to learn more about mood disorders and how hypnosis can be helpful.

ADDICTION BLOG: You are trained in a unique combination of hypnotherapy and energy psychology. Can you explain to us your treatment philosophy?

HEATHER GOOD: I have been studying and practising mind-body practices for many years and I bring all my experiences to my sessions with clients.

Anytime I meet with someone, I find out their goals and desires and together we collaboratively determine a plan for the best possible outcome for them. Sometimes a counselling or hypnosis session is required, while at other times, I draw on my experience as a yoga instructor to help people learn how to use relaxation and meditation strategies to stay calm in difficult situations. People who are depressed may need to activate more energy in their body through a kundalini yoga or hatha yoga practice where people who have overactive minds may need balancing and grounding practices.

I am fascinated by the study of mind-body medicine and the field of energy and psychology. “The body as a complex energetic system is part of a new scientific worldview that is gradually gaining acceptance in modern medicine” (Gerber, 2000, p.10).

If you would like to learn more about my background, training, and how I work, please visit me at: http://changeforthegood.ca/about-us/#.VfbwwY-FPIU

If you are interested in learning how to use self-reflection practices and mindfulness to be an amazing leader – you can purchase my book Conscious Mindful Leadership: Your Path to Greatness in Work and Life at:  http://changeforthegood.ca/services-view/my-book/#.VfbxIY-FPIU

ADDICTION BLOG: Is Yoga Nidra part of your treatment? How is it related to hypnotherapy?

HEATHER GOOD: I am not a practitioner of Yoga Nidra but I have developed a style of yoga called Hypnoyoga which integrates and re-sets the body and system. I am told by my participants that the results they experience are similar to those they have experienced in Yoga Nidra classes. The deeper mind is involved and aspects of the subconscious mind are released and re-set to a more neutral framework.

Interested in Hypnoyoga- check it out!  http://changeforthegood.ca/services-view/hypnoyoga/#.VfbyqI-FPIU

ADDICTION BLOG: Is there anything else you would like to share with our readers?

HEATHER GOOD: I would like to dispel some of the myths about hypnosis.

To receive FREE hypnotic inductions you can follow me at ChangefortheGood on Facebook or you can access my newsletter through www.changeforthegood.ca. I post regularly and answer questions and provide research and updated information from the field of hypnosis.

People are either intrigued or frightened by the idea of being hypnotized. I like to let people know that it is an amazing tool for healing that can accomplish what might take decades in talk therapy.

People sometimes say to me – I cannot be hypnotized because I was at a stage show and would not be hypnotized there so why would this be different. I often tell that their intuition guided them correctly not to be hypnotized in a group setting, by a random stranger, in front of an audience. In the hypnosis session, you will not say anything you regret and you will not reveal any deep dark secrets as you are totally in control of what you say and do. Most people report the experience to be deeply relaxing.

In order to be a good candidate for hypnosis you must want to be hypnotized and be willing to follow the guidance of the therapist into a relaxed state. An ethical hypnotherapist will not ask you to do anything that you are not comfortable with. You should always know that you are completely in control of the process and that you can end the process at whatever time feels right for you. Here are some reports from people who have tried hypnosis and what they thought:  http://changeforthegood.ca/about-us/testimonials/#.VfbvU4-FPIU

It is never too late to change or to ask for help. I hope that you reach out for support – I thank you for taking the time to read this and I hope it helps you.

Reference Sources:  – Barnes, P. M., Bloom, B., & Nahin, R. (2007). Complementary and alternative medicine use among adults and children: United States. CDC National Health Statistics Report
– #12. Retrieved January 21, 2009 from http://www.cdc.gov/nchs/data/nhsr/nhsr012.pdf
 – Benor , D. J. (2004). Healing research, volume II consciousness bioenergy and healing self-healing and energy medicine for the 21st Century, Medford, NJ: Wholistic Healing Publications.
– Dickersin, K. (1990). The existence of publication bias and risk factors for its occurrence. Journal of the American Medical Association, 263, 1385–1359.
– Eitan, G. Abramowitz, E., Baraky,Y., Ben-Avi, I and Knobler, H. (2008).Hypnotherapy in the Treatment of Chronic Combat-Related PTSD: Patients Suffering from Insomnia: A Randomized, Zolpidem-Controlled Clinical Trial. Israel Defense Forces, Mental Health Department, Israel, International Journal of ClinExp Hypnosis, 56 (3), 270-80.
– Flammer, E., & Bongartz, W. (2003). On the efficacy of hypnosis: A meta-analytic study. Contemporary Hypnosis, 20, 179–197.
– Gerber , R. (2000). A practical guide to vibrational medicine, energy healing and spiritual transformation, New York: Harper Collins.
– Gholamrezaei, A., & Emami, M. H. (2008). How to put hypnosis into a placebo pill?
– Complementary Therapies in Medicine, 16, 52–54.
– Godoy, P., & Araoz, D. (1999). Use of hypnosis in PTSD, Eating disorders, Sexual difficulties, Addiction, Depression, and Psychosis. An 8 year review. Australian Journal of Clinical Hypnotherapy and Hypnosis, 27 (2), 35-43.
– Good, H. (2010). Conscious Mindful Leadership: Your Path to Greatness in Work and Life. Blitzprint: Calgary.
– Guse, T., Wissing, M., & Hartman, W. (2006). The effect of a prenatal hypnotherapeutic programme on postnatal maternal psychological well-being. Journal of Reproductive and Infant Psychology, 24, 163–177.
– Katz, N. (1980). Hypnosis and Addictions: A critical review. Addictive Behaviors, 5, 41-47.
– Kirsch, I.,Montgomery, G.,& Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: A Meta-Analysis. J. Consult Clin Psychol, 4, 63(2),214-20.
– Lenox, J., & Bonny, H. (1976). The hypnotisability of chronic alcoholics. International Journal of Clinical and Experimental Hypnosis, 24, 419.
– Liossi, C., & White, P. (2001). Efficacy of clinical hypnosis in the enhancement of quality of life of terminally ill cancer patients. Contemporary Hypnosis, 18, 145–160.
– Lipsey M. W., & Wilson, D. B. (2000). Introduction: Practical meta-analysis. Thousand Oaks, CA: Sage.
– Lynn, S., Kirsch, I., Barabasz, A., & Carden., E.,& Patterson, D. (2000). Hypnosis as an empirically supported clinical intervention: The state of the evidence and a look to the future. International Journal of Clinicaland Experimental Hypnosis, 48:2, 239-259.
– 48r Mamtani, R., & Cimino, R. (2010). Hypnotherapy for smoking cessation: A primer of Complimentary and Alternative Medicine and its Relevance in the Treatment of Mental Health Problems. Psychiatric Quarterly, 73:4, 367-81.
– Mate, G. (2011). In the Realm of Hungry Ghosts. Berkeley, CA: North Atlantic Books.
– Montgomery et al. (2014) Randomized Control Trial of a Cognitive Behavioral Therapy plus Hypnosis Intervention To Control Fatigue in Patients Undergoing Radiotherapy for Breast Cancer in Journal of Clinical Oncology, 22: 6, 557-563.
– Pilkington, K., Kirkwood, G., Rampes, H., & Richardson, J. (2005). Yoga for depression:
– The research evidence. Journal of Affective Disorders, 89, 13–24.
– Potter, G. (2004). Utilizing hypnosis in the treatment of substance abuse disorders. American Journal of Clinical Hypnosis, 47:1, 21-28.
– Stanton, H. (1989). Hypnotic relaxation and the reduction of sleep onset insomnia.Intl. Journal of Psychosomatics, 36 (1-4), 64-68.
– Wark, D. M. (2008). What we can do with hypnosis: A brief note. American Journal of Clinical Hypnosis, 51, 29–36.
– Wu, W., Lin, S., Wu, G. J., & Li, L. (2005). Influence of preoperative supportive psychotherapy on the postoperative mental state and sexual life in patients with uterine cervix cancer.
– Chinese Journal of Clinical Rehabilitation, 9, 42–43.
– Van der Kolk, B. A., McFarlane, A. C. & Weisaeth, L. (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society, New York: Guilford Press.
– Elkins, G., Jensen, M., and Patterson, D. (2007). Hypnotherapy for the management of chronic pain. Intl. Journal of Clinical and Experimental Hypnosis, 55(3): 275–287.

 

Websites
https://brainspotting.pro
www.mindfulrp.com
www.yapko.com
www.changeforthegood.ca

Leave a Reply

3 Responses to “Is hypnotherapy for addictions safe?
Elmer
11:00 pm October 10th, 2015

Good morning Heather,

In reading your published blog on hypnotherapy, I read that the process operates, takes place, in between the space time of waking and sleeping. As a Cultural Anthropologist, I have also been interesting in this space. I have written about the experience of being awake and falling asleep and being aware of being in this space of what you call the subconscious. I begin entering into a different experience of sometimes picking up where I had left off before waking up. In these Soul planes I live a life. Sometimes, I regret waking up from these dream Soul travel experiences. I accept that Soul is eternal thus our experiences are also eternal. From the little I know about you, I know you can relate to these experiences, as well, otherwise you would not blog about them.

I have often heard people say, I fell asleep last night at 10pm. My question is in the process of falling asleep where does one fall to? It is seems to me that sleep exists in a sleep Soul plane different from the awake Mother Earth Soul plane.

Heather
2:54 pm October 16th, 2015

Dear Elmer, thank you for your beautiful response. The subtle layers of ethereal energy when we tap into them send us into beautiful realms where much healing can be accomplished!
Sending you continuing positive energy as you navigate the mysteries of this beautiful land. Namaste.
Heather

Vishwas
1:48 pm December 2nd, 2015

Is Hypnosis can help you lose weight and keep it off ?

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