How Does Hypnotherapy Work?
Hypnotherapy, properly applied, is a tremendously potent tool for personal change and growth.  In clinical trials hypnosis has
been found effective in the treatment of a variety of concerns including overweight, pain, anxiety, PTSD, phobias, depression,
and insomnia. Evidence
that hypnotherapy works is abundant.

On the other hand,
how hypnotherapy works is the subject of substantial debate.  Hypnosis has been variously defined as
"Guided Imagination," an "Altered State of Consciousness," a "Relaxed, Hypersuggestible State," and a "Dissociated State."  
In my experience all of these descriptions may (or may not) be accurate in a particular session.  

Guided Imagination:  In this mode, the clinician uses guided imagery and carefully crafted suggestions to persuade the client
to change her or his beliefs, emotions and/or behaviors.  This is the method one finds in the plethora of self-hypnosis tapes
and CD's.  In my view too many hypnotherapists limit their repertoire to guided imagination. While useful as a component of
hypnotherapy, guided imagination in my view fails to respect, much less utilize, the individual's unique life experiences,
personality and goals in the healing process.  Thus it is often not successful at producing lasting change.

Altered State of Consciousness:   I have come to believe that most of us spend an awful lot of time in one altered state or
another.  Traumatic memories, financial and relationship stresses, television, regrets, fears, anxieties and desires all induct us
into their own peculiar trance states or "mental fogs."  These are mostly unintended and counterproductive altered states.  
Hypnosis is indeed another altered state of consciousness, but one that is induced intentionally and with the expressed
consent of the person entering this state, for the purpose of making positive and intentional life changes.

Relaxed, Hypersuggestible State:  While relaxation is not absolutely necessary to enter the hypnotic state, it helps if the client
feels safe and relaxed.  In this state the client is more open to
mutually agreed-upon suggestions that this or that particular
belief, feeling or behavior be changed in ways desired by the client.  It is virtually impossible to impose the therapist's
suggestion upon the client without the client's wholehearted agreement with that suggestion.  Thus the idea that a hypnotist
has the power to control another person's behavior without their full permission is false.  

Dissociated State: By disconnecting the conscious mind (the tip of the metaphorical iceberg) from the subconscious mind (the
powerful but primitive submerged portion of the iceberg), we are able to interact directly with the subconscious.  This deep
mind is the seat of our unfathomed drives and motivations.  The natural purposes of the subconscious mind are to protect us
and give us pleasure.  However, because this part of our mind lives beneath the ground of our daily lives, it sometimes fulfills
its purposes in unintelligent and counterproductive ways - through phobias, compulsions, insomnia, and unwanted behaviors
such as overeating, inappropriate anger, addiction, shyness and self-deprecation, to name a few.

Hypnotherapy thus enables the client to negotiate and reach agreements with her/his subconscious mind in order to heal the
deep roots of these destructive emotions, beliefs and behavioral patterns, thereby transforming them into positive and
constructive patterns of feeling, thought and action.  

Approaches that do not respect the role of the subconscious mind in the change process tend to fail.  For example, weight
loss programs that rely on dieting (conscious willpower) tend to lead to short term
weight loss followed by a gain in excess of
the starting level.  Psychologically, the reason for this may be summed up in Fritz Perls’ dictum, “the underdog always wins.”  
Perls, the father of Gestalt Therapy, explained that when the conscious mind battles urges from the more powerful
subconscious, the subconscious urge will ultimately prevail.  Thus we can consciously abstain from foods we enjoy for awhile,
but the subconscious craving will eventually overpower the conscious will, and so wreak mayhem with our diet.

My approach to hypnotherapy is to synthesize of the four primary approaches described above in such a way that each
particular client's unique needs and life experiences are respected and involved in the healing process.  

My initial aim is that the client understand and agree to the process s/he is about to undergo, and that I understand to the
client's satisfaction the changes s/he wishes to make in her or his life.  I then ask for a mutual agreement that will enable us to
work together.  My part of the agreement is that I will make sure the client is not harmed in any way by or during the
hypnotherapy session, and the client's part is that s/he will follow my instructions as diligently as possible.

I use a verbal induction to help the client enter the
relaxed, hypersuggestible state of consciousness.  Once s/he is in this
state, I want to
dissociate the conscious from the subconscious mind in order to begin a dialog between the two.  Usually there
are one or more subconscious sources of the problem.  I use the methods of
guided imagination to age regress the
subconscious mind to the time and place where the problem began.  We explore the events (if any) that led the person to the
decision to begin the maladaptive pattern, then negotiate a new decision more aligned with the conscious wishes and real
world needs of the person.  

Next, we use
guided imagination to explore barriers to the achievement and/or sustenance of the desired change.  A method I
like is to bring the person down into their “safe room,” have her or him view a large mirror containing their image at their
optimal self, then visualize or imagine what stands between them and their optimal mirror image.  Once a barrier is identified,
we negotiate with it using the client’s imagination to reify the barrier and give it a voice.  

I find that these “barriers” always have benevolent, if misguided, motives that are amenable to change when presented with
accurate information and a respectful request.  Often it is necessary to “make a deal,” such as “The conscious mind will use
its adult voice and body to make sure we’re never humiliated or violated again, and the subconscious will help to shed a given
amount of fat so the person can be healthier and more physically effective.”

Toward the end of the session, I ask the subconscious mind to help identify and then accept
post-hypnotic suggestions that
will enable this individual to resolve this particular issue.
 Finally, I bring the person out of the hypnotic trance with positive and
life-affirming suggestions.

Hypnotherapy is a wonderful tool with which to help people achieve their goals - including health, happiness and freedom -
without unnecessary stress and pain.  Hypnosis works directly with the subconscious mind to align its purposes with those of
the conscious mind. This creates a powerful alliance that enables us to make amazing changes in areas of our lives that
seemed intractable before, and to do so easily and pleasantly.
Nathan O’Hara is Director of the
Hypnosis Center of Ventura County.
He was rained in hypnotherapy at the
University of Houston (1975-76) and
also at the
Hypnosis Center of
Southern California. Dr. O’Hara’s
background also includes a Ph.D.
from the University of California, 10
years with Santa Barbara County
Health Department, 10 years with
Planned Parenthood, and several
more years as a public school teacher
and administrator.  His passions
include his wife Lucy, natural healing
arts, music, and the outdoors.
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