Hypnosis and Hypnotherapy: A Comprehensive Review of Therapeutic Impact, Neurobiological Mechanisms, and Evidence-Based Outcomes (2018-2026)

1. Introduction

Hypnosis, defined as a state of focused attention, heightened suggestibility, and enhanced capacity for response to suggestion, has evolved from a controversial practice to an evidence-based therapeutic intervention supported by rigorous scientific research.

Hypnotherapy—the clinical application of hypnosis for therapeutic purposes—has demonstrated remarkable efficacy across diverse medical and psychological conditions, offering patients a non-pharmacological pathway to healing that addresses both mind and body.

The period from 2018 to 2026 has witnessed unprecedented growth in hypnosis research, characterized by sophisticated neuroimaging studies, large-scale meta-analyses, and rigorously designed randomized controlled trials. This body of evidence has not only validated the clinical effectiveness of hypnotherapy but has also illuminated the neurobiological mechanisms underlying its therapeutic effects. Understanding these mechanisms is crucial for optimizing treatment protocols, identifying appropriate patient populations, and integrating hypnotherapy into mainstream healthcare delivery.

This comprehensive review synthesizes the latest evidence on hypnosis and hypnotherapy, with particular emphasis on therapeutic impact across various clinical conditions, neurobiological substrates, evidence-based outcomes, and comparative effectiveness. The review aims to serve as an authoritative resource for clinicians, researchers, and patients seeking credible information about hypnotherapy’s potential as a healing modality. By examining both the scientific foundations and clinical applications of hypnosis, this article provides a balanced perspective that acknowledges the intervention’s strengths while identifying areas requiring further investigation.

The contemporary evidence base for hypnotherapy is substantial and growing. Recent meta-analytic reviews encompassing hundreds of primary studies have documented effect sizes comparable to established psychological interventions, with particularly robust findings for pain management, depression, and anxiety disorders (Rosendahl et al., 2024). Importantly, these benefits are achieved without the side effects associated with pharmacological treatments, positioning hypnotherapy as an attractive option for patients seeking holistic, integrative approaches to health and wellness.

2. Neurobiological Mechanisms of Hypnosis

2.1. Neural Networks and Brain Regions

The therapeutic efficacy of hypnosis is grounded in its capacity to modulate specific neural networks and brain regions involved in pain processing, emotional regulation, and cognitive control. Neuroimaging research has consistently identified the anterior cingulate cortex (ACC) as a critical hub in hypnotic analgesia and emotional modulation. The ACC, which plays a central role in integrating emotional and cognitive aspects of pain perception, shows altered activation patterns during hypnotic states, contributing to reduced pain intensity and improved emotional regulation (Bicego et al., 2022).

Recent functional near-infrared spectroscopy (fNIRS) studies have revealed that hypnotherapy differentially affects the default mode network (DMN) compared to cognitive behavioral therapy in depressed patients. The DMN, which encompasses the medial prefrontal cortex, posterior cingulate cortex, and precuneus, is implicated in self-referential thinking and rumination—core features of depression. Exploratory analyses suggest that hypnotherapy may modulate DMN connectivity, though these effects require replication with larger samples and correction for multiple comparisons (Haipt et al., 2024).

Particularly compelling evidence comes from studies examining functional connectivity changes following hypnotherapy. In patients with mild to moderate depression, hypnotherapy uniquely decreased functional connectivity between the Extrastriate Body Area (EBA) and Superior Temporal Sulcus (STS), regions crucial for emotional processing of body-related stimuli. This effect was moderated by rumination levels: patients with lower baseline rumination showed decreased right STS activation following hypnotherapy, while highly ruminating patients showed increased activation, potentially reflecting improved emotional processing capacity (Haipt et al., 2022). These findings suggest that hypnotherapy’s neural effects may be personalized based on individual cognitive-emotional profiles.

Neuroimaging evidence also indicates that hypnotic suggestions significantly influence self and environmental consciousness networks, as well as attentional and somatosensorial networks.

This modulation explains the phenomenological experiences reported during hypnosis, including feelings of disengagement from external surroundings and modifications in body sensations and spontaneous thoughts (Vanhaudenhuyse et al., 2020).

2.2. Electrophysiological Correlates

Electroencephalography (EEG) studies have provided temporal precision in understanding how hypnosis modulates cognitive and emotional processing. In patients with social anxiety disorder, hypnotherapy significantly reduced both early (N170) and late (Late Positive Potential, LPP) event-related potential components during face processing tasks. The N170 component, associated with early perceptual processing of faces, and the LPP, reflecting sustained attention to emotionally salient stimuli, both showed reduced amplitudes following six weekly hypnotherapy sessions. Critically, these electrophysiological changes correlated positively with symptom improvements, suggesting that hypnosis reduces attentional bias to threat-related social stimuli through modulation of both automatic and controlled processing stages (Zhang et al., 2024).

These electrophysiological findings complement neuroimaging data by demonstrating that hypnosis operates across multiple temporal scales—from rapid, automatic perceptual processes (within 200 milliseconds) to sustained evaluative processes (300-800 milliseconds post-stimulus). This multi-level modulation may explain hypnotherapy’s broad therapeutic effects across diverse symptom domains.

2.3. Pain Modulation Pathways

The neurophysiology of hypnotic analgesia represents one of the most extensively studied aspects of hypnosis research. Neuroimaging studies consistently demonstrate that hypnosis modulates the “pain matrix”—a distributed network of brain regions including the ACC, insula, somatosensory cortices, thalamus, and prefrontal cortex. During hypnotic analgesia, these regions show altered activation patterns that correspond to reduced pain perception and decreased emotional distress associated with pain (Bicego et al., 2022).

The ACC appears particularly central to hypnotic pain modulation, given its role in integrating sensory, affective, and cognitive dimensions of pain. Hypnotic suggestions for analgesia can selectively reduce the affective-motivational component of pain while leaving sensory-discriminative aspects relatively intact, suggesting that hypnosis operates primarily through top-down cognitive and emotional regulatory mechanisms rather than through peripheral sensory gating.

Recent evidence also suggests that hypnosis may influence descending pain modulation pathways, including endogenous opioid and non-opioid analgesic systems. While the precise neurochemical mechanisms remain under investigation, the clinical observation that hypnotic analgesia can be achieved without pharmacological intervention—and can enhance the effects of analgesic medications—points to engagement of intrinsic pain regulatory systems (Dorta et al., 2024).

3. Clinical Applications and Therapeutic Impact

3.1. Depression and Mood Disorders

Depression represents one of the most extensively studied applications of hypnotherapy, with mounting evidence supporting its efficacy as both a standalone treatment and an adjunct to other interventions. Meta-analytic evidence from 10 studies incorporating 13 trials demonstrates that hypnosis for depression symptoms yields a mean weighted effect size of 0.71 at the end of active treatment, indicating that the average hypnosis participant improved more than 76% of control participants. At longest follow-up, the effect size remained substantial at 0.52, demonstrating durability of treatment effects (Milling et al., 2018). These effect sizes are comparable to well-established psychological interventions for depression, establishing hypnotherapy as a credible first-line treatment option.

Randomized controlled trials comparing hypnotherapy directly to cognitive behavioral therapy (CBT)—the gold standard psychological treatment for depression—have yielded particularly compelling results. In a landmark non-inferiority trial of 152 patients with mild to moderate depression, hypnotherapy proved non-inferior to CBT after six months of outpatient treatment, with both treatments achieving comparably high long-term remission rates of 73% after a median of 30 weeks (Acharya et al., 2023). Remarkably, these benefits persisted at 3.5-year follow-up, with symptom improvements maintained across both self-rated and clinician-rated measures (Fuhr et al., 2023). This long-term efficacy is particularly noteworthy given the chronic, recurrent nature of major depressive disorder.

Recent evidence suggests that cognitive behavioral therapy combined with hypnosis (CBTH) may offer advantages over CBT alone. In a randomized controlled trial of 66 participants with major depressive disorder, both CBT and CBTH were probably efficacious, but the CBTH completer group significantly outperformed CBT at 12-month follow-up regarding remission and response rates. Additionally, CBTH showed significantly higher associations between treatment credibility, expectancy, and mood outcomes, suggesting that hypnotic elements may enhance patient engagement and treatment adherence (Ramondo et al., 2024).

The mechanisms underlying hypnotherapy’s antidepressant effects likely involve multiple pathways. Neuroimaging evidence suggests modulation of the default mode network, which is hyperactive in depression and associated with rumination and negative self-referential thinking (Haipt et al., 2024). Additionally, hypnotherapy may enhance emotional regulation capacity through changes in functional connectivity between brain regions involved in processing emotional body-related stimuli (Haipt et al., 2022). These neural changes translate into clinically meaningful improvements in depressive symptoms, quality of life, and functional capacity.

3.2. Chronic Pain and Fibromyalgia

Chronic pain conditions, particularly fibromyalgia, represent another domain where hypnotherapy has demonstrated exceptional therapeutic value. Fibromyalgia, characterized by widespread musculoskeletal pain often refractory to pharmacological treatment, poses significant challenges for patients and clinicians alike. Recent randomized controlled trials have established hypnosis as an effective intervention for this challenging condition.

In a rigorously designed, blindly-evaluated trial, 49 participants with fibromyalgia and moderate to severe chronic pain received either eight weekly one-hour hypnotherapy sessions or control sessions consisting of casual conversation. The hypnosis group showed significant reductions in pain scores at both post-intervention and three-month follow-up compared to baseline. Critically, the analgesic effect of hypnosis combined with pharmacological treatment was superior to first-and second-line pharmacological treatment alone. Beyond pain reduction, hypnosis significantly improved all secondary outcomes including sensory and affective dimensions of pain, pain unpleasantness, pain catastrophizing, anxiety, depression, sleep quality, fibromyalgia impact, and quality of life—all without inducing adverse events (Dorta et al., 2024).

These multimodal benefits are particularly significant given fibromyalgia’s complex symptom presentation. The finding that hypnosis improves not only pain but also mental health, sleep, and quality of life suggests that the intervention addresses underlying pathophysiological mechanisms rather than merely masking symptoms. The durability of effects at three-month follow-up indicates that hypnotherapy may induce lasting neuroplastic changes that support sustained symptom relief.

Additional evidence from a prospective randomized controlled study of 47 female fibromyalgia patients demonstrated that standardized adjuvant hypnosis (three sessions plus six months of self-hypnosis practice) significantly reduced pain intensity, fibromyalgia symptoms, depression, and anxiety while improving well-being compared to medical treatment alone. These positive effects persisted at six-month follow-up, highlighting the value of teaching patients self-hypnosis techniques for ongoing symptom management (Aksoy et al., 2023).

Comparative effectiveness research has examined how hypnotherapy performs relative to other psychological interventions for fibromyalgia. While both hypnotherapy and Acceptance and Commitment Therapy (ACT) significantly reduced pain intensity, ACT demonstrated significantly greater reductions in all pain dimensions (sensory, affective, evaluative, miscellaneous) at three-month follow-up, suggesting that ACT may offer more stable therapeutic outcomes for some patients (Rasti et al., 2024). These findings underscore the importance of personalized treatment selection based on patient preferences, symptom profiles, and treatment goals.

3.3. Anxiety Disorders and PTSD

Anxiety disorders represent another clinical domain where hypnotherapy has shown considerable promise. In social anxiety disorder, a condition characterized by intense fear of social evaluation and avoidance of social situations, hypnotherapy has demonstrated both symptomatic and neurophysiological benefits. A study of 69 participants with social anxiety disorder found that six weekly hypnotherapy sessions significantly reduced symptoms and modulated attentional bias to threat-related stimuli. Specifically, hypnotherapy reduced both early (N170) and late (LPP) event-related potential components during face processing, with these electrophysiological changes correlating positively with symptom improvements (Zhang et al., 2024). This evidence suggests that hypnotherapy reduces social anxiety by modifying automatic and controlled attentional processes that maintain the disorder.

For military personnel experiencing anxiety and depression, cognitive behavioral hypnotherapy (CBH) showed advantages over standard CBT. In a quasi-experimental study of 45 military personnel receiving eight 1.5-hour sessions over eight weeks, participants in the CBH group showed greater reductions in both anxiety and depression compared to the CBT group, with larger effect sizes for the combined intervention (Heydarian et al., 2024). These findings suggest that hypnotic elements may enhance the efficacy of cognitive-behavioral interventions for anxiety and mood symptoms.

Network meta-analysis of hypnotherapy approaches for sexual trauma recovery has revealed differential effects of various hypnotic modalities. Cognitive-behavioral hypnosis was most effective in reducing PTSD symptoms, while traditional hypnosis showed the greatest benefit in alleviating anxiety and enhancing intimate relationship quality (Hui-Ting, 2024). These findings highlight the importance of tailoring hypnotic approaches to specific symptom targets and treatment goals.

3.4. Surgical and Procedural Pain Management

The perioperative period represents a critical window where hypnotic interventions can significantly impact patient outcomes. A pre-registered randomized controlled trial of 92 adults undergoing major oncologic surgery demonstrated that perioperative clinical hypnosis significantly reduced in-hospital opioid consumption compared to treatment-as-usual, with a significant opioid-sparing effect.

Additionally, hypnosis protected against increases in pain catastrophizing at one-week post-surgery, a psychological factor that predicts worse pain outcomes and prolonged recovery (Rosenbloom et al., 2024). These findings are particularly significant given the current opioid crisis and the urgent need for effective non-pharmacological pain management strategies.

The opioid-sparing effects of hypnosis extend beyond immediate post-operative pain management. Systematic review and meta-analysis of 70 randomized controlled trials (n = 6,078) examining adjunctive hypnosis for clinical pain found small additional analgesic effects when hypnosis was paired with usual care for chronic pain, medical procedures/surgical pain, and burn wound care. When combined with education, hypnosis yielded medium effects for chronic pain, and when paired with analgesic medicines, it produced medium analgesic effects. These findings establish hypnosis as a valuable adjunct that can enhance the effectiveness of standard pain management approaches (Jones et al., 2024).

3.5. Irritable Bowel Syndrome

Irritable bowel syndrome (IBS), a functional gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits, has proven responsive to hypnotherapeutic intervention. A three-arm randomized clinical trial of 72 adults with refractory IBS compared hypnotherapy, cognitive behavioral therapy, and a control condition. Both hypnotherapy and CBT significantly improved chronic pain indices and cognitive emotion regulation at post-test, with treatment efficacy remaining stable at six-month follow-up (Pourkaveh et al., 2023). These findings establish hypnotherapy as an effective psychological intervention for IBS, a condition where mind-body interactions play a central pathophysiological role.

The efficacy of hypnotherapy for IBS likely reflects its capacity to modulate gut-brain axis communication, reduce visceral hypersensitivity, and enhance emotional regulation. Given that psychological stress and emotional dysregulation are known to exacerbate IBS symptoms, hypnotherapy’s effects on both pain perception and emotional processing may address core maintaining factors of the disorder.

4. Evidence-Based Outcomes and Efficacy

4.1. Meta-Analytic Evidence

The most comprehensive synthesis of hypnosis efficacy comes from a meta-analysis of 49 meta-analyses encompassing 261 distinct primary studies, providing a 20-year perspective on hypnosis for mental and somatic health issues. This ambitious review revealed that hypnosis can positively impact mental and somatic health, with reported effect sizes ranging from d = -0.04 to d = 2.72. Specifically, 25.4% of effects were medium (d ≥ 0.5) and 28.8% were large (d ≥ 0.8) when compared against control conditions. The most robust evidence was found for patients undergoing medical procedures, those experiencing pain, and populations of children and adolescents (Rosendahl et al., 2024).

These meta-analytic findings are particularly compelling because they synthesize evidence across diverse conditions, populations, and study designs, providing a bird’s-eye view of hypnotherapy’s therapeutic potential. The consistency of positive effects across multiple meta-analyses strengthens confidence in hypnosis as an evidence-based intervention rather than a placebo or non-specific effect.

For depression specifically, meta-analytic evidence demonstrates mean weighted effect sizes of 0.71 at end of treatment and 0.52 at longest follow-up, comparable to established psychological interventions (Milling et al., 2018). However, systematic reviews have noted that evidence quality varies, with some reviews concluding that evidence is of very low quality due to methodological limitations in primary studies, precluding strong clinical recommendations pending better evidence (Souza et al., 2024). This highlights the ongoing need for rigorously designed trials with adequate sample sizes, appropriate control conditions, and long-term follow-up.

4.2. Long-Term Outcomes

One of the most clinically significant aspects of hypnotherapy is the durability of its therapeutic effects. Unlike some interventions that show initial promise but fade over time, hypnotherapy demonstrates sustained benefits extending months to years post-treatment. In depression treatment, hypnotherapy achieved remission rates of 73% after a median of 30 weeks, with these benefits maintained at 12-month follow-up (Acharya et al., 2023). Even more remarkably, symptom improvements persisted at 3.5-year follow-up in a randomized controlled non-inferiority study comparing hypnotherapy to CBT (Fuhr et al., 2023).

For chronic pain conditions, the durability of hypnotic analgesia is equally impressive. In fibromyalgia patients, significant pain reductions and improvements in mental health, sleep, and quality of life were maintained at three-month follow-up (Dorta et al., 2024). When patients were taught self-hypnosis techniques, positive effects on pain, fibromyalgia symptoms, depression, and anxiety persisted at six-month follow-up (Aksoy et al., 2023). These findings suggest that hypnotherapy, particularly when combined with self-hypnosis training, equips patients with enduring self-regulation skills that support long-term symptom management.

The mechanisms underlying these long-term benefits likely involve neuroplastic changes in brain networks involved in pain processing, emotional regulation, and cognitive control. By repeatedly engaging these networks during hypnotic states and practicing self-hypnosis, patients may strengthen adaptive neural pathways while weakening maladaptive ones, resulting in sustained symptom relief even after formal treatment ends.

4.3. Effect Sizes and Clinical Significance

Effect sizes provide a standardized metric for evaluating the magnitude of treatment effects, facilitating comparisons across studies and interventions. The effect sizes observed for hypnotherapy across various conditions are clinically meaningful and often comparable to or exceeding those of established treatments. For depression, effect sizes of d = 0.71 at end of treatment represent a medium-to-large effect, indicating substantial clinical benefit (Milling et al., 2018). For pain management, meta-analytic evidence shows small to medium additional analgesic effects when hypnosis is used adjunctively, with effect sizes varying based on the primary intervention with which hypnosis is combined (Jones et al., 2024).

Beyond statistical significance and effect sizes, clinical significance is reflected in the proportion of patients achieving remission or clinically meaningful symptom reduction. In depression trials, remission rates of 73% represent excellent outcomes comparable to first-line treatments (Acharya et al., 2023). For fibromyalgia, the finding that hypnosis combined with pharmacological treatment was superior to pharmacological treatment alone demonstrates clear added clinical value (Dorta et al., 2024).

Importantly, these clinical benefits are achieved without the adverse effects associated with many pharmacological treatments. The absence of significant adverse events across multiple trials enhances the clinical appeal of hypnotherapy, particularly for patients who have experienced medication side effects or prefer non-pharmacological approaches.

5. Comparative Effectiveness and Integration

5.1. Hypnotherapy Versus Cognitive Behavioral Therapy

Direct comparisons between hypnotherapy and cognitive behavioral therapy—the most extensively validated psychological treatment—provide crucial evidence for hypnotherapy’s clinical credibility. Multiple randomized controlled trials have now demonstrated that hypnotherapy achieves outcomes comparable to CBT for depression. In a non-inferiority trial of 152 patients with mild to moderate depression, hypnotherapy was non-inferior to CBT after six months of treatment, with both achieving 73% remission rates and sustained benefits at 3.5-year follow-up (Acharya et al., 2023; Fuhr et al., 2023).

These findings are particularly significant because they establish hypnotherapy as a viable alternative to CBT, expanding treatment options for patients and clinicians. Some patients may prefer hypnotherapy’s focus on experiential, imagery-based techniques over CBT’s more structured, cognitive approach. Additionally, hypnotherapy may be more accessible for patients who struggle with the homework assignments and cognitive demands of CBT.

Neuroimaging studies comparing hypnotherapy and CBT have revealed both shared and distinct neural mechanisms. While both treatments reduce depressive symptoms, they appear to engage different neural pathways. Hypnotherapy uniquely decreased functional connectivity between the Extrastriate Body Area and Superior Temporal Sulcus, with effects moderated by rumination levels (Haipt et al., 2022). These differential neural effects suggest that hypnotherapy and CBT may be optimally suited for different patient subgroups based on cognitive-emotional profiles and neural characteristics.

5.2. Adjunctive Hypnosis

The use of hypnosis as an adjunct to other treatments represents a pragmatic approach that can enhance outcomes without requiring wholesale replacement of existing treatment protocols.

Systematic review and meta-analysis of adjunctive hypnosis for clinical pain demonstrates that adding hypnosis to usual care, education, psychological interventions, or medicines produces small to medium additional analgesic effects (Jones et al., 2024). While these effects may appear modest in magnitude, they are clinically meaningful for patients experiencing chronic pain, where even small improvements can significantly enhance quality of life and functional capacity.

For surgical patients, adjunctive perioperative hypnosis significantly reduced opioid consumption and protected against increases in pain catastrophizing (Rosenbloom et al., 2024). These opioid-sparing effects are particularly valuable in the current healthcare context, where reducing opioid use while maintaining adequate pain control is a critical priority. The finding that hypnosis can achieve these dual goals—reducing opioid consumption while improving pain-related psychological factors—establishes it as a valuable component of multimodal perioperative care.

5.3. Combined Approaches

Integrating hypnotherapy with cognitive behavioral therapy represents a promising approach that may harness the strengths of both modalities. Cognitive behavioral therapy with hypnosis (CBTH) combines CBT’s structured, skills-based approach with hypnosis’s capacity to access and modify subconscious processes and enhance experiential learning. Evidence suggests this combined approach may offer advantages over either treatment alone.

In a randomized controlled trial of major depressive disorder, CBTH completers significantly outperformed CBT alone at 12-month follow-up regarding remission and response rates.

Additionally, CBTH showed significantly higher associations between treatment credibility, expectancy, and mood outcomes, suggesting that hypnotic elements enhance patient engagement and treatment adherence (Ramondo et al., 2024). For military personnel with anxiety and depression, cognitive behavioral hypnotherapy produced greater symptom reductions than CBT alone (Heydarian et al., 2024).

The integration of hypnotherapy and CBT offers several potential advantages. Hypnotic induction may enhance patients’ receptivity to cognitive restructuring and behavioral interventions. The relaxed, focused state achieved during hypnosis may facilitate deeper processing of therapeutic content and more effective consolidation of new learning. Additionally, hypnotic suggestions can be tailored to reinforce CBT skills and enhance motivation for behavioral change.

6. Safety Profile and Adverse Events

One of the most compelling aspects of hypnotherapy is its excellent safety profile. Across the extensive body of research reviewed, no significant adverse events were reported in association with hypnotic interventions. This absence of adverse effects stands in stark contrast to pharmacological treatments, which often produce side effects ranging from mild to severe and may carry risks of dependence, tolerance, and withdrawal.

The safety of hypnotherapy has been documented across diverse populations and conditions. In fibromyalgia patients receiving eight weekly hypnotherapy sessions, no adverse events were induced despite significant therapeutic effects (Dorta et al., 2024). Similarly, in depression trials comparing hypnotherapy to CBT over extended follow-up periods, no safety concerns emerged (Acharya et al., 2023; Fuhr et al., 2023). For surgical patients receiving perioperative hypnosis, the intervention was well-tolerated and produced beneficial effects without complications (Rosenbloom et al., 2024).

Systematic reviews examining hypnosis for depression and pain management have consistently noted the absence of significant adverse effects (Jones et al., 2024; Souza et al., 2024). This safety profile makes hypnotherapy particularly attractive for vulnerable populations, including patients with multiple comorbidities, those taking multiple medications, pregnant women, and individuals who have experienced adverse effects from other treatments.

It is important to note that while hypnotherapy is generally safe, it should be administered by trained, qualified practitioners who can appropriately screen patients, tailor interventions to individual needs, and manage the therapeutic relationship. Contraindications may include active psychosis, severe dissociative disorders, or situations where the patient is unable or unwilling to provide informed consent. When practiced ethically and competently, hypnotherapy represents one of the safest therapeutic modalities available.

7. Future Directions and Clinical Implications

The robust evidence base for hypnotherapy’s efficacy, combined with its excellent safety profile, supports broader integration of hypnotic interventions into mainstream clinical practice.

However, several important directions for future research and clinical development warrant attention.

First, while meta-analytic evidence demonstrates overall efficacy, individual studies vary in methodological rigor. Future research should prioritize large-scale, adequately powered randomized controlled trials with appropriate control conditions, blinded outcome assessment, and long-term follow-up. Standardization of hypnotic protocols would facilitate comparison across studies and support development of evidence-based treatment manuals.

Second, research is needed to identify predictors of treatment response and to develop personalized approaches to hypnotherapy. Neuroimaging evidence suggests that individual differences in brain network organization and cognitive-emotional profiles may moderate treatment effects (Haipt et al., 2022). Identifying which patients are most likely to benefit from hypnotherapy versus other interventions could optimize treatment selection and improve outcomes.

Third, the mechanisms underlying hypnotherapy’s therapeutic effects require further elucidation. While neuroimaging studies have identified key brain regions and networks involved in hypnotic states, the precise neurochemical and molecular mechanisms remain incompletely understood.

Research examining how hypnosis influences neurotransmitter systems, inflammatory processes, and gene expression could provide deeper mechanistic insights and identify novel therapeutic targets.

Fourth, the optimal “dose” of hypnotherapy—including number of sessions, session duration, frequency, and the role of self-hypnosis practice—requires systematic investigation. Current studies employ varying protocols, making it difficult to determine optimal treatment parameters. Dose-response studies could inform more efficient and cost-effective treatment delivery.

Fifth, technology-assisted approaches to hypnotherapy delivery warrant exploration. Virtual reality combined with hypnotic techniques represents an emerging area with potential to enhance treatment engagement and accessibility (Louras et al., 2024). Smartphone applications for self-hypnosis practice could support treatment adherence and long-term maintenance of benefits. Telehealth delivery of hypnotherapy could expand access for patients in underserved areas.

From a clinical implementation perspective, several barriers to broader adoption of hypnotherapy must be addressed. These include limited training opportunities for healthcare providers, misconceptions about hypnosis among both clinicians and patients, and inadequate insurance coverage for hypnotherapy services. Professional organizations, academic institutions, and healthcare systems should collaborate to develop training programs, disseminate evidence-based information, and advocate for policy changes that support integration of hypnotherapy into standard care pathways.

Finally, research examining hypnotherapy’s cost-effectiveness is needed to inform healthcare policy and resource allocation decisions. Given hypnotherapy’s potential to reduce medication use, healthcare utilization, and disability, economic analyses may demonstrate favorable cost-benefit ratios that support broader implementation.

8. Conclusions

The evidence reviewed in this comprehensive article establishes hypnosis and hypnotherapy as credible, effective, and safe therapeutic modalities with broad applications across mental and somatic health conditions. From 2018 to 2026, rigorous scientific research has illuminated the neurobiological mechanisms underlying hypnotic phenomena, documented robust therapeutic effects across diverse clinical populations, and demonstrated outcomes comparable to or exceeding established treatments.

The neurobiological evidence reveals that hypnosis modulates key brain networks involved in pain processing, emotional regulation, and cognitive control, including the anterior cingulate cortex, default mode network, and pain matrix. These neural changes translate into clinically meaningful improvements in symptoms, functioning, and quality of life. Electrophysiological studies demonstrate that hypnosis operates across multiple temporal scales, modifying both automatic and controlled cognitive-emotional processes.

Clinical applications of hypnotherapy span a remarkable range of conditions, with particularly robust evidence for chronic pain, fibromyalgia, depression, anxiety disorders, PTSD, surgical pain, and irritable bowel syndrome. Effect sizes are medium to large, with many studies demonstrating remission rates of 70% or higher. Critically, these benefits are sustained over months to years post-treatment, indicating that hypnotherapy induces lasting changes rather than temporary symptom suppression.

Comparative effectiveness research establishes hypnotherapy as non-inferior to cognitive behavioral therapy for depression, while combined approaches integrating hypnotic and cognitive-behavioral elements may offer advantages over either treatment alone. As an adjunct to usual care, education, or pharmacological treatments, hypnosis produces additional therapeutic benefits, including opioid-sparing effects in surgical patients.

The safety profile of hypnotherapy is exemplary, with no significant adverse events reported across extensive research. This absence of side effects, combined with demonstrated efficacy, positions hypnotherapy as an attractive option for patients seeking non-pharmacological treatments or those who have experienced adverse effects from medications.

For patients suffering from chronic pain, depression, anxiety, or other conditions addressed by hypnotherapy, this evidence offers genuine hope for healing. Hypnotherapy provides a pathway to symptom relief that honors the mind-body connection, empowers patients with self-regulation skills, and supports long-term wellness without the burden of medication side effects. For clinicians, hypnotherapy represents a valuable tool that can be integrated into existing treatment frameworks to enhance patient outcomes.

As we look to the future, the continued growth of hypnosis research, combined with efforts to improve training, disseminate evidence-based information, and address implementation barriers, promises to bring the benefits of hypnotherapy to increasing numbers of patients. The evidence is clear: hypnosis and hypnotherapy deserve recognition as mainstream, evidence-based interventions that can transform lives and promote healing across a broad spectrum of human suffering.