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In my 20-plus years as a hypnotherapist, I think I’ve heard all the jokes, misconceptions and weird ideas people have about what I do, but today I’m going to look at something that is often used to dismiss hypnosis as irrelevant, “It’s just a placebo”. Usually, when this is said, the implication is that hypnosis (and by extension placebo) just don’t work. But in fact, that’s very unfair to both approaches.
What is a Placebo?
This is a blog for hypnotherapists, so I’m going to assume that you know what hypnosis is. But knowing more about placebos will be useful.
Placebos are substances or treatments that shouldn’t have
any physical effect because they have no active ingredients. But they do, because
our minds make them effective via the power of suggestion. An example would be
giving someone a sugar or starch pill with no active ingredients and telling
them it was for headaches. If the placebo is effective, their headache will
subside. The word “placebo” means “I will please” in Latin and refers to this
positive psychological effect.
Placebos are often dismissed as being for placating
hypochondriacs or patients for whom there is no effective treatment. However, multiple
studies have demonstrated that placebos have an observable effect. When new medications
are tested, they are measured against both a control group (who receive no
treatment), and a placebo group (who, obviously enough, receive placebo
treatments). This indicates how effective the medication is, compared to both.
Placebos tend to work best on self-observed symptoms and
mental health conditions, rather than physical conditions. For example, while a
placebo is unlikely to make a cancer tumour disappear, it is very likely to
reduce the associated pain, alleviate the fear of the illness worsening, and
lessen the side effects of chemotherapy. The benefits of these effects can’t be
underestimated. Reductions in pain, anxiety or depression can lower blood
pressure and stress hormone levels, which in turn improve the immune response.
This can also help the patient adopt a healthier mindset, making it easier for
them to care for themselves and follow doctors’ instructions, thus leading to a
domino effect towards easier recovery. [1]
In most cases, the person being given the placebo is not
told 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 when
the patients involved know they are receiving a placebo. [2]. How this works is not yet clear
but, probably, renewed hope and the feeling that they are taking steps towards dealing
with 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 may
spontaneously develop them as a response to the suggestion.
Comparing Hypnosis and Placebo
Both hypnosis and placebos are subject to widespread misconceptions
about 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 mind
rather than having direct physical effects on the body. By changing someone’s
expectations, they change the outcome. Responding to hypnosis or a placebo
doesn’t mean you are weak-willed or gullible; both can work on anyone.
However, there are differences. As I’ve mentioned, placebo is
typically presented deceptively; the person receiving it usually believes it is
an effective remedy. Hypnosis, on the other hand, arguably works best when
presented honestly and when the hypnotherapist and client are working together
towards the goals.
Ethical Considerations in Hypnosis and Placebo Use
Whether you are using either hypnosis or placebos, ethics
are important.
As hypnotherapists, we’re encouraged to work cooperatively and
transparently with our clients and to obtain informed consent. Clients should
be fully aware of the process and have realistic expectations.
Traditionally, a placebo has been delivered with a built-in
level of deception. The client or patient can’t give informed consent because
they don’t have all the facts. This is defended by arguing that the placebo
works better that way – broadly, the end justifies the means - but it’s often difficult
to find the ethical line between getting the best results for your patient or client
and being honest with them.
Long-term Effects of Hypnosis and Placebo
It’s also worth looking at the issue of whether hypnosis and
placebo have a comparable effect over the longer term.
Although both rely on the power of suggestion, studies have
shown that placebo effectiveness is only moderately connected to hypnotic
susceptibility. [3] Hypnotic
suggestion tends to produce more stable and consistent results than a placebo.
So, while placebos are good for short-term relief, this
might not be true over longer periods because they address only symptoms and
not any underlying issues. Hypnotherapy tends to have better long-term
outcomes.
When used by suitably qualified individuals, both placebo
and hypnotherapy can have clear, measurable, positive effects. They can be used
together, or separately to help your clients.
How much do you think placebo plays a part in hypnotherapy? Do
you use it consciously in your practice? Let me know in the comments below.
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
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