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Hypnotherapy vs Placebos

by Robert Pell in General Topics · · 2 Replies · View last reply Respond
Robert Pell
Robert Pell


With a researchy / science-based backround and a history of ridiculing alternative medicine ("You know what they call alternative medicine that's been proved to work? Medicine!") I have been cautiously working my way through the evidence and rationale behind hypnosis and hypnotherapy.

A key point for me is the relationship between hypnotherapy and placebos.

I particularly struggled with the following: if a placebo is a treatment that delivers a positive effect solely through the well established psychological mechanisms of suggestion and expectation (rather than anything else), is this not exactly the same as hypnotherapy? If so, this raises all sorts of issues:


Is hypnotherapy 'just' a placebo?


Is it better than a placebo, and if so how would you even test that properly? How could you design a fair study?


How do YOU answer clients that ask if it's just a placebo? Tell them it's more than that? How do you back that up without wandering into claims of a hypnotic 'state' / trance... 


I'd be interested to hear other people's thoughts on whether they feel hypnotherapy is / is not a placebo, and their rationale behind it (extra points if you can back up points with references where relevant!)


I have now resolved this issue for myself, and would be happy to share my current thinking once I've heard some thoughts from my esteemed fellow graduates....!
 

Prem	 Bajaj
Prem Bajaj

Very valid thoughts!  I think you may like to consider few points and then compare again Hypnotherapy and Placebo effect.

Placebo effect is well explained due to the release of endorphins, therefore there is some alteration in the human mileu-interior.

Placebo effect naturally occurs with all kinds of treatments and that depends on various factors how well patients are handled by a therapist.

Hypnotherapy well done i.e. when combined with CBT is in my experience several multifold times more effective than a simple Placebo effect, "BUT", if it is done on a patient then it should be considered as a treatment alone only after a thorough medical examination along with basic haematology and biochemistry etc etc have been done and only if patient is put on any conventional medicines if so found essential by a medical doctor. If patient is labelled as solely suffering from a functional disorder and is ready to accept hypnotherapy as a treatment then in my experience if Hypnotherapy is "Well done" i.e. combined with CBT the results are fantastic. 

If hypnotherapy is done blindly or if the treating person feels that he/she has not taken basic considerations that the client or patient has not been to the physician ever then ofcourse hypnotherapy alone will work as placebo or may even be dangerous as it may mask certain important underlying medical conditions that could have been treated in a simple manner if timely diagnosed.

What are my friends views about these and what do you think about this Robert Pell?

Robert Pell
Robert Pell

Hey Prem, thanks for the reply.

Placebo effect is well explained due to the release of endorphins, therefore there is some alteration in the human mileu-interior

I thought placebos had been shown to do much more than just release endorphins - placebos can lower blood pressure (Gould et al 1981) and reduce swelling (Hashish et al 1988) for example. There have also been studies to show that placebo oxygen can affect levels of the hormone (?) PGE2  - research by a guy called Bennedetti but I admit I can't find a published paper, only coverage of his research on Horizon's Placebo program (which is veeeeery interesting - would recommend!). Forgive my lack of medical knowledge if I'm missing something here!

I completely agree that CBT and hypnotherapy is more effective than hypnotherapy alone, but I imagine that is true to a similar degree as to how CBT and a placebo is more effective than a placebo alone. I have nothing to back that up though!

It's also a very interesting point you raise that placebos can actually be dangerous if the positive effect masks a serious condition.

So...

as promised, my current answer to the question as to whether hypnotherapy is just a placebo is yes... and no.

There is a lot of evidence to suggest that the placebo effect can be significant, tapping into powerful psychological mechanisms like expectancy, with real neuropsychological effect. I believe that hypnotherapy uses exactly the same mechanisms (suggestion / expectatancy), but the difference is that hypnosis allows the client and practicioner to actively direct these mechanisms at the issues being faced.

Hypnosis basically gets you behind the controls of the placebo effect, rather than being anything unique like an altered state.

That's my current take on how this all works. 

Agree? Disagree anyone?