Is Hypnosis Therapy?

Therapy? Common versus Clinical Use

There are several words in our language and culture that play double-duty, that have an “official” (clinical, legal, proscribed) use or meaning, and also have currency in general, informal conversation. Sometimes the difference between the two isn’t important, and sometimes it is very serious. Sometimes it is vitally important for the distinction to be made clear.

“Therapy” is one of these words that gets used a lot, in different contexts, to mean different things. There is an eccentric gift shop in Seattle called (literally) “Retail Therapy” but I’m almost certain no one goes in there expecting any formal therapeutic work to be done. At the same time, therapy is a legally protected term that only licensed practitioners (psychologists, counselors, psychiatrists, and so on) can use to describe their work. We all know that touch can be therapeutic, social interaction can be therapeutic, naps can be therapeutic, healthy diet and exercise can be therapeutic… but they aren’t therapy. Oftentimes the difference is obvious (think of shopping at “Retail Therapy”). But with hypnosis, sometimes, the difference isn’t as clear, and that lack of clarity can border on duplicity.

In Washington State, hypnosis for therapeutic ends is regulated by the state. If all I wanted to do was stage hypnosis – get people to sing like Elvis or bark like a dog for entertainment – then I wouldn’t need to be registered. If, however, I intend to use hypnosis for the purpose of helping people achieve balance in their lives or effect the changes they want to make, essentially using it for therapeutic purposes, I must be registered and accountable to the state. In Washington State, I am registered legally as a “hypnotherapist” - the only state in the US that uses that language exclusively. But I most often describe myself simply as a “hypnotist” because I don’t want to imply or give the impression of being something that I am not: specifically, a licensed mental health worker.

The word “therapy” generally means establishing or maintaining balance in one’s life. And that’s a great description of what most of us are trying to do in all sorts of ways. It is also a legal term that denotes a particular kind of professional relationship between a licensed provider and a patient, and includes a host of responsibilities and protections that aren’t applicable in other relationships in our lives. That is why it is important for hypnotists of all stripes to be clear and up-front about our credentials and intentions. Part of that clarity is not taking advantage of the potential for misunderstanding of assumptions to give us more legal authority than we have.

So hypnosis, like many things, can be therapeutic – absolutely, especially if done with a skilled and ethical hypnotist in a professional setting. But unless hypnosis is done by a licensed provider in the context of therapy, it shouldn’t be called therapy – and “hypnotherapy” has the dangerous potential (likelihood?) to be confusing or misleading in that regard. To be honest, I wouldn’t expect most therapists who use hypnosis to call it “hypnotherapy” either, because it is only a tool used in the greater process of therapy. (No one uses “conversation-therapy” or “inviting-them-to-sit-down therapy.”)

In recent years hypnotists and the psychological community have come to more-or-less an understanding reserving “hypnotherapy” for licensed providers only, even if (as in Washington State, for example) “hypnotherapy” is the legal category distinguishing it from hypnosis-for-entertainment. To maintain the not-for-entertainment distinction, some hypnotists have used the term “clinical hypnosis.” But that hardly seems better to me.

I think the general public is savvy enough to distinguish the “hypnosis” I do in my office from the “hypnosis” you might find on the center stage of the state fair. I don’t feel the need to emphasize my legal status as a “hypnotherapist” because it only invites confusion, especially given the ability for people in different states (and therefore under different laws or expectations) to find and contact me.

There are other words like this in everyday use, like “anxiety” and “depression.” When clients describe themselves as having anxiety or depression, I’ll almost always ask for clarification: is that a diagnosed disorder, or are you using that word to simply describe how you’re feeling? The reality is that people use “anxiety” and “depression” all the time to refer to feelings or moods or behaviors that fall well below any diagnostic level. I use them myself in conversation with family and friends.

In a professional environment like hypnosis, however, we run into the same problem: am I implying the ability to diagnose a disorder by using terms that have potentially-diagnostic overtones? This is a delicate matter, indeed, because I don’t want to discourage my clients from describing to me what they are feeling in their own words, and I don’t want to give up the opportunity to speak to them in their own language, so to speak.

So there is a fine line that I actually find helpful to walk with my clients. Among licensed professionals (psychologists and counselors and the like), the clinical terms “anxiety” and “depression” have very specific meaning. They use those words in the same way that massage therapists would identify specific muscles, or doctors specific regions of the brain. In conversation I might toss out the name of a muscle group or a term like “pre-frontal cortex”, but it is probably clear that I’m not using them in the same way that a professional is. For those licensed mental health professionals, the words “anxiety” and “depression” fulfill certain diagnostic criteria and are followed by certain steps to take (or to avoid taking). When used by the general public, we simply don’t mean this when using those words. We use them much more broadly, un-specifically, generally, sometimes as a catch-all buzz-word that could describe (or hide?) all kinds of feelings.

We often use anxiety to describe worry, fear, frustration, panic, a general sense of mistrust or suspicion, and a number of other emotional and even physical phenomena. Most of the time, when we talk about being “depressed” we mean something sub-clinical, like the blues, discouragement, being in a funk, fatigue, frustration, worry, and so on. These words, used in a general way, can point to a dizzying number of different feelings, emotions, and even “states.” So those terms can just as often be distracting or distancing ourselves from talking about our feelings, as often as they are pointing us at what we are experiencing.

When working with clients, as much as possible, I like to dial in more specifically on what they are feeling. “When you say you feel anxious, what are you feeling? What does that feel like to you?” Or, even better: “If I were feeling what you are feeling when you’re ‘anxious,’ what would I be experiencing?” If I were “depressed” in the same way you are, how would I know? With this kind of conversation we are able to dig deeper than the catch-all terms “anxiety” or “depression.”

It isn’t that those words aren’t good words to use – however we describe our feelings is important and informative. But I find it helpful (and so do my clients!) to discern what precisely we’re talking about. And since we don’t typically use those terms in their specific, diagnostic sense, it is helpful to clarify what we are dealing with.

Can hypnosis help with depression or anxiety? Only if you're using those words in the common, sub-clinical vernacular. Diagnoses can only be given or "worked on" by a person licensed to give that diagnosis, or someone under their supervision. It is better to think of this not in terms of "anxiety" or "depression", but rather in helping with mood, anger, frustration, sadness, worry, fear, and so on. Hypnosis, when done ethically and competently, is a professional service that helps normal, everyday people with normal, everyday problems.

So, is hypnosis therapy? In some general sense, yes, it is. But that language can be misleading, and making sure that it isn’t misleading can require a few paragraphs to explain and make sure everyone is on the same page and understanding about the difference between licensure and sub-clinical helpful visualization and conversation. I find it easier to simply avoid the issue altogether by identifying what I do as hypnosis, leaving the therapy-question at the door. In the paperwork clients get (and are asked to read) it clarifies several times my legal and professional status, and distinguishes what I do (and what I will not do). That’s usually more than enough.

I would have serious concerns about any hypnotist who leaned on using the term “hypnotherapy” (even in Washington State), or “clinical hypnosis,” or used “depression” or “anxiety” (or any other “clinical” wording) to give an impression of licensure to an unsuspecting public.