Hypnotherapy has a long history, so it is perhaps not surprising that a vast number of hypnotherapy models, types and approaches have evolved. This blog explores some of the key types of hypnotherapy and how you might apply them in a therapy session.
Perhaps you are just now discovering hypnosis and considering in which direction to focus your training. Or maybe you have already started to learn and would like a bigger or more varied range of tools to work with. You will soon discover that effective ‘hypnotherapy’ is more than simply following a ‘script’ or one standardised approach. In fact, you may come across terms like ‘eclectic’ (taking from a diverse range of sources), ‘integrative’ (combining a number of different therapy approaches), and ‘pluralistic’ (using more than one approach at the same time).
Hypnotherapy, Clinical Hypnosis and Clinical Hypnotherapy
Before we get immersed in different approaches, it can be good to explore some ‘labels’ relating to hypnosis, hypnotherapy and also the use of the term ‘clinical’. If you conduct even a brief search of the internet you are likely to find that both hypnotherapy practitioners and trainers seem to use a variety of terms when talking about hypnotherapy. Often practitioners will use the terms presented on their certification. This can be complicated by some (not all) trainers giving their training very grand titles in the hope that it makes the course look more comprehensive. A brief note on this, when choosing your hypnotherapy training, always look at the content, not the title. One simply titled ‘Hypnotherapy Certificate’ course could have 500+ hours of superb content. Whereas another course that offers you a grandly-titled ‘Master Clinical Hypnotherapy Diploma’ could be a cheap ‘distance learning’ course, with weak content. Content is key here!
OK, so back to terminology. ‘Hypnotherapy’ involves the application of therapeutic approaches, together with hypnosis. Whilst most hypnotherapy approaches would also work in the absence of hypnosis, the hypnosis element tends to make the therapy more effective, smoother or quicker (or all of these). We then come on to the terms ‘clinical hypnosis’ and ‘clinical hypnotherapy’. The most accurate definition of these terms is simply; hypnotherapy approaches that are used for a clinical purpose and/or in a clinical setting. Thus, when a hypnotherapist is working with a client on pain management, they are working in a clinical context. If a hypnotherapist were to work in a hospital or healthcare setting on clinical conditions, such as pre-surgical anxiety then they would be working in a clinical setting.
However, if you see a hypnotherapist calling their work ‘clinical hypnotherapy’ and yet they are working on someone’s confidence preparing for a cake-decorating competition, it may not necessarily be an accurate use of the term ‘clinical hypnotherapy’. Interestingly, some ‘clinical hypnotherapy’ courses, are in fact just ‘regular hypnotherapy courses’ with very little clinical-specific content. So, do be aware of the fact that (in the UK at least), content is more important than label.
By understanding the most popular terms and approaches within hypnotherapy you can focus your studies and development as a practitioner towards a style of working that most suits your goals. This neatly leads us on to the very first pair of approaches, which may seem to be polar opposites, yet each offers a contribution towards the therapeutic outcome of your hypnotherapy session.
Problem-focused-hypnotherapy & Solution-focused hypnotherapy
The ‘problem-focused’ hypnotherapist tends to focus their attention solely on addressing the problem, whether eliminating it or changing it to something more palatable. Many clients will come to a therapy session with a focus on their problem. As a hypnotherapist, if you do not recognise/discuss the problem at all (and instead just talk about a solution) the client may feel unheard, which can negatively affect the session. With ‘solution-focused’ hypnotherapy, the hypnotherapist listens to the problem, and then finds out what the client actually wants, in terms of a ‘therapy goal‘. So, though a client may come to a session wanting ‘less of the problem’, a good hypnotherapist will often help them to achieve this whilst giving them ‘more of a solution’. For example, let’s say ‘Jessica’ saw her hypnotherapist because she felt stressed and she wanted to be less stressed. If the focus of the session was all about ‘being less stressed’, Jessica would still end up keeping her focus on the problem (being stressed). However, upon further ‘solution-focused’ enquiry, it turns out that she actually wanted to feel more ‘in control’. Therefore, the session worked on stress management and reducing the problem, yet also took a solution-focused approach, helping Jessica move towards her desired outcome.
Further on in this blog we will spend more time exploring some of the many traditional approaches to hypnotherapy. Before that, it is worth mentioning one of the key figures in modern hypnotherapy, Milton Hyland Erickson (5th December 1901 – 25th March 1980), an American psychiatrist and psychologist who specialised in hypnosis. He later became the founding president of the American Society for Clinical Hypnosis. Erickson often took a highly unconventional approach to psychotherapy and developed a unique approach to hypnosis which evolved into a therapeutic model using metaphors, story-telling and a range of indirect suggestion approaches, including a fondness towards confusion approaches (“in almost all my techniques there is a confusion”), which can work particularly well with individuals who are resistant. Dr. Erickson’s influence reached beyond the world of hypnosis, and he was one of the individuals modelled by Richard Bandler and John Grinder in their early development of Neuro-Linguistic Programming (NLP).
‘Ericksonian hypnotherapists’ will often only draw their techniques from true Ericksonian approaches, which can seem, at times unconventional. For example, giving a client a difficult homework task from which they will gain insight and learning, or telling a client a story which seems, at first hearing, to have little bearing on the presenting issue (you can Google ‘Erickson’s Joe the Florist’ story as a prime example of this). It can take time to develop Ericksonian approaches to a level where the hypnotherapy practitioner is both eloquent and elegant. Ericksonian hypnotherapy approaches are often taught within broader hypnotherapy training, as hypnotherapists, particularly those who work from a more integrative perspective, will be able to make use of Ericksonian hypnotherapy approaches as a part of their overall hypnotherapy strategy.
The first hypnotherapy approach that a client is likely to encounter, whether problem or solution-focused, is that of ‘behavioural hypnotherapy’. As you might imagine, the key focus here is on helping a client to identify unhelpful behaviours, actions, responses and habits and working out what they want to do instead, then working towards achieving that change. For example, let’s say a client named John wanted to stop biting his nails. It was an old habit from childhood. His hypnotherapist helped him find out when he usually bit his nails (when he was stressed, it was a comfort-seeking habit) and what he could do instead (take some deep breaths and use some other stress-management techniques as appropriate). This habitual change was then supported with suggestions in hypnosis and the new behaviour was practiced using an approach called ‘future pacing’ (kind of like mental rehearsal in hypnosis). This behavioural hypnotherapy approach helped John see that he could employ this new behaviour in stressful situations which gave him the confidence to carry on with the new behaviour after the session. A behavioural hypnotherapy approach is primarily directed towards creating change in the present. This makes it one of the least ‘intrusive’ forms of hypnotherapy and, as a result, a popular first method for professional hypnotherapists.
Some clients will seek hypnotherapy because they are aware that they have limiting thoughts and beliefs, other clients may become aware of unhelpful beliefs as they work to change habits and behaviours. The mind likes routine and just as we can get into habitual ways of doing things (e.g. you probably brush your teeth the same way each day), we can also get into habitual ways of thinking. For example, you might have tried Marmite once as a child and thought it was the worst taste ever. You may not have tasted it since, yet your palate changes as you mature and, if you tried it now, you might actually love it (no promises though!).
In the same way, if you had an argument with someone with tattoos, you might then go through the rest of your life believing that everyone with tattoos is argumentative. We know that the mind works using certain ‘Rules of the mind’ and ‘Laws of Suggestion’, yet our minds can also develop ‘cognitive distortions’ or faulty ways of thinking. Examples include ‘generalisations’ e.g. all dogs bite (after one dog bit), ‘black and white thinking’ (e.g. something is either 100% good or 100% bad, with no ‘middle ground’) and ‘absolute demands’ (e.g. ‘I should always be happy’). Unfortunately, these demands can be unhealthy and unrealistic, leading to disturbance. A hypnotherapist can use cognitive hypnotherapy approaches (often combined with behavioural and other approaches) such as Rational Emotive Behaviour Therapy (REBT), Acceptance and Commitment Therapy (ACT), and even mindfulness approaches. The hypnotherapist will help the client develop healthier and more rational ways of thinking about situations and then work towards helping the client consistently be able to respond in these positive ways.
There are some hypnotherapists who just work from one particular perspective, such as ‘hypno-analysis’, whereas others will use analytical hypnotherapy techniques where indicated by the intake information and after a discussion with the client. Analytical hypnotherapy approaches are particularly helpful when a client wants to know ‘why’ they have a problem behaviour or response. Analytical techniques can employed to seek out the ‘root cause’ and help a client then gain insight and move forward into a more positive behaviour or response in the future. Analytical hypnotherapy approaches can also be used to help create long-lasting change on a subconscious level, without the client necessarily needing to ‘know the answers’ in order to create a positive change. This is often achieved using techniques such as ‘parts therapy’, where the subconscious mind creates a dialogue between the ‘problem part’ and a potential ‘solution part’.
Some clients will arrive at their first hypnotherapy session either expecting to be taken back to their childhood, or worried that they might be, yet regression can be a highly effective (and safe) tool when used appropriately. ‘Regression to cause’ takes the client back in their mind to past events (whether positive or negative) which may have some relevance to their present experience. The idea being that insight can be gained and a new more helpful response can be generated. However, there is a risk that, when not managed correctly, the client may become more traumatised by having to connect with unpleasant past experiences. Conversely, it may be that the client’s issue doesn’t actually relate to childhood at all and was formed far more recently. Given this, a hypnotherapist will generally take a more behavioural, cognitive and even analytical approach before considering regression, so going from ‘least intrusive’ towards ‘more intrusive’ throughout the therapy process.
As an exception to the ‘last resort’ concept mentioned above, regression is a popular first approach for phobias. The reason being, most phobias start early in childhood. For example, Anna had a phobia of buttons. She had no conscious idea of when it first started and her parents didn’t remember either. When her hypnotherapist used a regression technique (the ‘Affect Bridge’), it transpired that it related back to a time as a young child. She was playing with her grandmother’s tin of buttons when she knocked over a vase. Her grandmother told her off for not paying attention and she became very upset. However, she loved her grandmother so, in her mind, it became the button’s fault she got told off. Therefore, buttons became bad and she started to avoid them. Over time this response strengthened until she would do all she could to avoid touching buttons, becoming phobic of them. When Anna found out about the incident during a regression session, she gained a new perspective and was able to move forward with a new, more positive response.
The other exception is the use of regression for resource building. We all have positive experiences in our past and these can be revisited to strengthen our current experience and help us achieve our desired outcomes and goals. A good example of this is a hypnotherapy technique known as ‘anchoring’, where a connection is made to past experiences of feeling confident, and linked to a physical action (such as squeezing two fingers together). This action can then be used at times of the client’s choosing to trigger an experience of confidence (e.g. in a job interview). This positive use of regression is often employed early on in the hypnotherapy process or throughout.
For some people, their belief is that they have already lived in one or more ‘past lives’ and that exploring those lives can give them insight (e.g. perhaps they presently don’t like swimming in the sea and during a past life regression they may come to realise that they drowned in a past life). Past life regression can also provide closure, by ‘cutting the link’ to an unpleasant or unhelpful past life. The key point here relates to the beliefs of the client. Although there is no requirement for a hypnotherapist to work outside of their own belief systems, you can work effectively on a past life issue even if, as a hypnotherapist, you have doubts or an absence of belief in past lives. Indeed, there are many different perspectives on the topic of past lives. Some believe in reincarnation, others think of it as a ‘social construct’, where people act ‘as if’ they were someone else. There are others who consider that a past life is actually a ‘metaphor’ for an aspect of or issue in the individual’s own (present) life. Either way, past life regression can be a valid therapeutic approach for some clients, though, like regression, it is not a first approach.
Hypnotherapy and talking therapies
So far, we have explored the most common overarching categories of approaches used within hypnotherapy. However, if you were to check on Wikipedia or other information sources, you will find lengthy lists of psychotherapies, with around 200 different types from abreaction therapy (cathartic release of emotions) to vegetotherapy (physical manifestations of emotions). Two of the most commonly blended approaches of hypnosis and talking therapy are with counselling and psychotherapy:
Hypnotherapists and counsellors rarely study both topics as full courses at the start of their training. More commonly, trained counsellors may later study hypnotherapy to give an added dimension to their talking therapy work. Alternatively, hypnotherapists who may have lacked the ‘talking therapy’ element in their initial training may later undertake further studies to be able to add counselling and talking therapy approaches to their (out-of-hypnosis) therapy work. There are some ‘hypno-counselling’ courses out there where students can learn a combined approach, however learning both therapies separately in order to integrate them later will often give a greater practical understanding of how each can be used most effectively.
Taking a more integrative approach to talking therapies, psychotherapy training does offer a range of approaches, such as humanistic, gestalt and psychodynamic, thus giving the practitioner a broader range of models to apply most effectively for their client. Hypnotherapy works well alongside much of psychotherapy and you might be surprised at quite how many elements of psychotherapy are taught on a good hypnotherapy course as an integral part of the hypnotherapy training. However, many psychotherapy courses may be very heavily focused on psychotherapy with very little hypnotherapy training included, which often means a psychotherapist must undertake further study to develop their hypnotherapy skills in order to be able to work more effectively in hypnosis with their clients.
Hypnotherapy and complementary therapies
There are many other complimentary or alternative therapies that can be used alongside hypnotherapy. For example, ‘hypno-massage’ is starting to become more popular, with the use of hypnotic suggestion and therapeutic techniques during a physical massage. This can be particularly helpful where a client is storing tension and emotion in their body. A ‘hypno-reiki’ approach, blending hypnosis and reiki, can work well with clients who lack the words to sufficiently express what they are experiencing. Another blend of complementary therapies is ‘hypno-reflexology’, using either foot or hand reflexology whilst giving hypnotic suggestions, whether general or specific to the reflex points receiving attention. Similarly, ‘hypno-acupuncture’ blends the physical use of acupuncture together with the psychological application of hypnotherapy approaches.
Many neuro-linguistic programming (NLP) techniques can be employed by hypnotherapists. Indeed, often a therapist may regard themselves as using a hypnotherapy approach when in was originally considered to be an NLP one e.g. ‘fast phobia cure’, ‘6-step reframe’, and the ‘sub-modality shift’ technique. In fact, many NLP courses will also include a brief introduction to hypnotherapy (though it often is very brief, leaving NLP practitioners wanting further training in hypnotherapy). As well as that, the opposite is also true, and most good hypnotherapy training courses will include a range of appropriate NLP techniques to use within the hypnotherapy session.
A final mention goes to the emergence of ‘standalone’ hypnotherapy techniques, such as ‘The Swan’, ‘The Arrow’, ‘Kinetic Shift’, ‘Old Pain 2 Go’ and so on. Many standalone hypnotherapy techniques can be successfully applied with various different issues/goals. However, a thorough understanding of the core components of behavioural, cognitive, analytical and regressive hypnotherapy will enable you to understand the commonalities in structure between standalone models and approaches that you are likely to already know. Having a pre-defined structure/model to work to can help therapists to remember a technique. However, care is best taken when using models, in order to ensure that the client is receiving the best therapeutic approach for them. Just because ‘the fast phobia cure’ works well for anxiety as well as phobias, that doesn’t necessarily mean it is the first-choice approach for an anxiety client. A good hypnotherapist will have the breadth of training to understand which approaches to choose for each individual client.
Choices, choices, choices
So, how do you choose where and how to learn? Well, start by working out what you want to learn. Then figure out the ‘where’, ‘how’ and ‘with whom’. Do your research and find out what you need to know. A broad yet ‘sufficiently deep’ training will cover a range of approaches over a sensible period of time (likely not a couple of hours or a day or two). It can be tempting to engage in a rapid/intensive training course, yet research strongly indicates rapid learning without ongoing reinforcement is soon lost. So, learning over a longer period, with time for reflection and practice generally works best. If you are looking towards becoming a hypnotherapist, seek the views of others who have been through the training that you’re thinking about taking, check out the trainers and their qualifications and experience, then look at what the training would give you and how much of it you would be able to use. If you want further information on choosing a course, perhaps take a look at this blog on hypnosis training costs & options.
Becoming a good hypnotherapist won’t happen overnight, yet there is no time like the present to make a start towards developing the underpinning knowledge to support you in gaining the skills and experience you will need to work effectively using hypnosis and hypnotherapy. We hope you’ve enjoyed this blog on the different types of hypnotherapy. If you have any more questions about this topic or anything else for that matter, do please get in touch, because we’re always happy to help!
– written by Dr Kate Beaven-Marks