Hypnosis and Altered States

Hypnosis is a psychological state characterized by focused attention, reduced peripheral awareness, and an enhanced capacity to respond to suggestion. The concept has stimulated intense debate over whether hypnosis constitutes an altered state of consciousness or a context-driven set of social and cognitive processes .

Historically, the practice evolved from 18th-century mesmerism and 19th-century medical demonstrations into modern hypnotherapy and experimental paradigms. The trajectory spans ritual techniques, early neurology and psychiatry, and contemporary evidence-based practice .

Neuroscientific research investigates how hypnotic suggestion modulates attention, perception, pain, and memory via large-scale brain networks. Findings implicate the default mode network, salience detection, executive control, and predictive processing mechanisms .

Clinically, hypnosis is used as an adjunct for acute and chronic pain, anxiety and phobias, habits, and psychosomatic symptoms. Recreational and erotic practices exist within negotiated consent frameworks, raising questions about suggestibility, agency, and ethics .

Etymology

The term hypnosis derives from the Greek hýpnos (“sleep”). James Braid adopted the term in the 1840s to describe focused states of attention that resemble, but are distinct from, natural sleep .

History

Franz Anton Mesmer (1734–1815)

Mesmer’s theory of animal magnetism framed illness as an imbalance of invisible magnetic fluids. His public treatments in Paris involved dramatic group séances, where patients held metal rods attached to a central vat (baquet) supposedly filled with magnetized water. Patients often experienced convulsions, remission of symptoms, or ecstatic states.

In 1784, the French Royal Commission, including Benjamin Franklin and Antoine Lavoisier, investigated Mesmer’s claims. They concluded that no magnetic fluid existed and that cures were due to imagination and expectation. Despite discreditation, Mesmer’s practices spread across Europe, influencing both medicine and popular culture. Mesmerism became a precursor to hypnosis by demonstrating the psychological power of ritual, authority, and belief.

Marquis de Puységur and Somnambulism

Armand-Marie de Puységur, a student of Mesmer, transformed mesmerism by focusing on calm trance rather than dramatic crises. In 1784, he induced a shepherd into a sleep-like state where the subject could speak, respond to questions, and recall forgotten experiences. Puységur called this artificial somnambulism, likening it to sleepwalking.

He observed rapport between magnetizer and subject, where the subject obeyed verbal suggestions but later experienced amnesia. These observations prefigured modern notions of hypnotic rapport, dissociation, and posthypnotic suggestion. Puységur’s shift from spectacle to subtlety profoundly shaped later therapeutic approaches.

James Braid and Early Experimentalism

In the 1840s, Scottish surgeon James Braid coined the term hypnotism after witnessing a mesmeric demonstration. He rejected theories of magnetic fluids and proposed that hypnosis was a psychological phenomenon based on focused attention, eye fixation, and fatigue of the nervous system.

Braid introduced systematic inductions, emphasizing verbal suggestion and concentration. He initially believed hypnosis was a form of nervous sleep but later recognized its uniqueness. His work gave hypnosis scientific respectability and helped distinguish it from occultism. Braid’s insistence on naturalistic explanations paved the way for hypnosis as an experimental science.

The Nancy School and Suggestibility

In late 19th-century France, Ambroise-Auguste Liébeault and Hippolyte Bernheim founded the Nancy School. They emphasized that hypnosis was a normal psychological process, rooted in suggestibility, rather than a pathological condition. Bernheim argued that all humans are suggestible, with hypnosis being an extension of everyday influence.

Their therapeutic methods relied on verbal suggestion to relieve pain, insomnia, and psychosomatic symptoms. The Nancy School’s emphasis on suggestibility influenced Sigmund Freud, who trained briefly in Nancy. Their approach directly challenged Charcot’s pathological view, igniting the “Paris-Nancy debate” in France.

Jean-Martin Charcot (1825–1893)

Charcot, a leading neurologist at the Salpêtrière Hospital in Paris, viewed hypnosis as an abnormal neurological state linked to hysteria. He categorized stages of hypnotic trance: catalepsy, lethargy, and somnambulism, which he presented through theatrical public demonstrations.

Charcot’s model associated hypnosis with pathology, reinforcing the belief that only hysterics could be hypnotized. His work attracted attention in Europe, shaping medical perceptions, but was later criticized for methodological flaws and suggestion effects. Still, his prominence brought hypnosis into mainstream neurology and psychiatry.

Pierre Janet and Dissociation

Psychologist Pierre Janet studied hysteria and traumatic memory, developing the concept of psychological dissociation. He proposed that hypnosis produced “psychological automatism,” where behavior could occur outside conscious awareness. Janet’s theory helped explain hypnotic anesthesia, amnesia, and posthypnotic suggestion.

His work bridged clinical hypnosis with early trauma theory, showing how dissociation could protect against overwhelming experiences. Janet’s ideas influenced later models of PTSD and dissociative disorders.

Sigmund Freud and the Cathartic Method

Freud initially employed hypnosis, alongside Josef Breuer, to uncover repressed memories in patients with hysteria. Their “cathartic method” involved inducing hypnosis, eliciting forgotten memories, and releasing associated emotion (abreaction).

Although Freud later abandoned hypnosis in favor of free association, it shaped his theory of the unconscious and repression. He acknowledged hypnosis’s therapeutic potential but criticized its limitations, including patient resistance and variability in responsiveness. Freud’s transition from hypnosis to psychoanalysis marked a turning point in psychotherapy.

Hull, Hilgard, Barber, and Spanos

In the 20th century, experimental psychology reframed hypnosis with empirical methods.
- Clark Hull (1933) emphasized conditioning, arguing hypnosis was a learned response.
- Ernest Hilgard (1970s) proposed the neodissociation theory, suggesting hypnosis divided consciousness into executive and hidden observer components.
- Theodore Barber and later Nicholas Spanos championed sociocognitive theories, viewing hypnosis as role enactment, imagination, and expectancy effects rather than a special state.

This debate between “state” and “non-state” models remains central to hypnosis research.

Milton H. Erickson (1901–1980)

Milton Erickson, a psychiatrist and hypnotherapist, revolutionized clinical hypnosis with indirect, permissive methods. He emphasized metaphors, storytelling, and utilization of patient strengths, rather than authoritarian commands. Erickson’s approach was highly individualized, encouraging patients to access unconscious resources.

His techniques influenced strategic and family therapy, neuro-linguistic programming (NLP), and modern hypnotherapy. Erickson’s work restored hypnosis’s legitimacy in American medicine after decades of skepticism.

Contemporary Developments

From the mid-20th century to today, hypnosis has been integrated with neuroscience, cognitive psychology, and clinical practice. fMRI and EEG studies map neural correlates of suggestion, while standardized scales improve research reliability. Hypnosis is used in medical contexts including surgery, dentistry, and chronic pain, while also expanding into experimental psychology.

Contemporary debates concern whether hypnosis is an “altered state,” a sociocognitive performance, or an integration of both. The growing acceptance of hypnosis as an adjunct therapy continues to elevate its standing in scientific and clinical practice.

The historical trajectory of hypnosis sets the foundation for the development of structured induction methods and clinical techniques, linking early theoretical debates with modern practice.

The historical trajectory of hypnosis sets the foundation for the development of structured induction methods and clinical techniques, linking early theoretical debates with modern practice.

Induction Methods and Hypnosis Techniques

Induction methods are not simply mechanical procedures, but involve ritual, pacing, and social signaling. The hypnotist’s voice tone, rhythm, and gaze control are crucial in creating expectancy and framing the experience. Stage hypnotists often use rapid inductions with dramatic flair, while clinicians prefer gentler progressive relaxation and imagery protocols.

Measurement tools such as the Stanford Hypnotic Susceptibility Scales (SHSS) and Harvard Group Scale of Hypnotic Susceptibility (HGSHS) provide standardized batteries of tasks, from simple arm levitation to complex posthypnotic amnesia. These allow researchers to stratify participants and better understand individual differences in hypnotizability.

Ericksonian techniques emphasize conversational hypnosis, in which metaphors, double binds, and permissive suggestions bypass resistance. Confusion inductions momentarily overload cognitive processing to enhance receptivity. Neuro-linguistic programming (NLP), though controversial, adapts Ericksonian principles into structured interventions.

Physiologically, inductions often produce slowed breathing, altered heart rate variability, and changes in galvanic skin response. These correlate with reports of relaxation, narrowed attention, and reduced self-monitoring.

Neuroscience and Scientific Research

Functional neuroimaging reveals that hypnosis can alter activity in brain regions associated with perception, pain, and cognitive control. For example, hypnotic analgesia reduces activity in the somatosensory cortex and increases activation of descending pain modulatory regions such as the periaqueductal gray.

Default Mode Network (DMN): The DMN, which includes the medial prefrontal cortex, posterior cingulate cortex, and angular gyrus, is associated with self-referential thought, autobiographical memory, and “mind wandering.” Hypnosis often reduces DMN activity, reflecting a dampening of self-monitoring and internal dialogue . This attenuation correlates with subjective reports of absorption and diminished sense of agency. In some studies, hypnotic suggestion specifically disrupts th...

Executive Control Networks (ECN): The executive control network, anchored in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), is central to top-down regulation of attention and action. Hypnosis often enhances functional connectivity between the DLPFC and insula, as well as between the ACC and sensory cortices . These shifts appear to strengthen the brain’s ability to reframe perception (e.g., reducing pain intensity) and to prioritize hypnotic ...

Hypnotizability as a Trait: Research indicates hypnotic responsiveness is relatively stable across a person’s lifespan, with some evidence for heritability. Personality traits such as absorption, fantasy proneness, and openness to experience are associated with higher hypnotizability. Developmentally, children often display high responsiveness that can diminish with age .

Neurochemistry: Dopamine, oxytocin, and endorphins play roles in hypnotic responding, affecting reward, bonding, and pain modulation. Studies show dopamine agonists can increase hypnotizability, and oxytocin has been implicated in trust and suggestibility .

Comparative States: Hypnosis has been compared to sleep, meditation, psychedelic experiences, and dissociation. While all involve shifts in consciousness and self-monitoring, hypnosis is distinguished by the role of social suggestion and the intentional alteration of perception and memory.

Computational Models: Predictive coding theories argue hypnosis modifies the weighting of top-down predictions and sensory input, effectively reshaping conscious perception. This framework integrates both state and sociocognitive theories, positioning hypnosis as a dynamic interaction of expectation, attention, and prediction error processing.

Key Sources for Neuroscience and Research Expansion:
- McGeown, W. J., Mazzoni, G., Venneri, A., & Kirsch, I. (2009). Hypnotic induction decreases anterior default mode activity. Consciousness and Cognition.
- Jensen, M. P., Patterson, D. R., & Montgomery, G. H. (2016). Hypnosis in the treatment of clinical pain. American Psychologist.
- Faymonville, M. E., Laureys, S., et al. (2003). Neural mechanisms of analgesia induced by hypnosis and placebo suggestions. NeuroImage.
- Piccione, C., Hilgard, E. R., & Zimbardo, P. G. (1989). On the stability of hypnotizability over time. Journal of Personality and Social Psychology.
- Bryant, R. A., Hung, L., Guastella, A. J., & Mitchell, P. B. (2012). Oxytocin as a moderator of hypnotizability. Psychoneuroendocrinology.

Clinical and Experimental Applications

Clinical Domains:
- Trauma therapy: Hypnosis can facilitate safe exposure and resource imagery, though use for memory recovery is discouraged.
- Dermatology: Hypnosis has been used to reduce itching and speed wound healing.
- Pediatrics: Children respond strongly to hypnotic games and imagery; hypnosis can aid in painful procedures.
- Dentistry: Hypnosis reduces gag reflex, anxiety, and need for anesthesia.

Evidence base: Systematic reviews and meta-analyses report moderate effect sizes for pain, anxiety, and some psychosomatic conditions. Hypnoanalgesia is particularly robust, with applications from burn care to childbirth. Case studies highlight dramatic reductions in opioid use when hypnosis is employed perioperatively.

Experimental Paradigms: Laboratory hypnosis enables causal study of hallucinations, Stroop interference, motor paralysis, and time distortion. For instance, suggestions of paralysis reduce motor cortex activation, while suggested hallucinations activate sensory areas corresponding to the imagined modality.

Overall, hypnosis provides both a therapeutic adjunct and a scientific tool to probe the construction of conscious experience.

Recreational and Erotic Hypnosis

Erotic hypnosis has a cultural history stretching back to pulp fiction of the early 20th century, in which "mind control" was a recurring theme. In the late 20th century, underground kink communities began to integrate hypnosis into role-play. With the rise of the internet, online communities began distributing hypnotic scripts, audio recordings, and video demonstrations, which have been discussed in qualitative research on digital sexual cultures.

Techniques in erotic contexts include posthypnotic triggers (words, touches, symbols that cue automatic responses), fractionation (inducing and breaking trance repeatedly to deepen suggestibility), and conditioning of specific arousal responses. These methods overlap with stage techniques but are adapted for intimacy and negotiated scenarios.

Stage hypnosis emphasizes entertainment, compliance, and public display, while erotic hypnosis focuses on private exploration, arousal, and power exchange. Despite overlap, practitioners stress the importance of context and consent.

Safety guidelines stress pre-scene negotiation, clear safewords, and aftercare. Trauma-informed approaches are increasingly emphasized in both clinical and recreational contexts. Communities debate risks of dependency and difficulties distinguishing imagined experiences from lived reality (as reported in case studies). Depicted in adult media, erotic fiction, and online subcultures, hypnosis is framed within broader cultural narratives of dominance and submission. These accounts are documented primarily in qualitative studies and self-reports rather than large-scale clinical research.

Cultural and Historical Perspectives

Hypnosis and trance states appear across cultures in shamanism, religious rituals, and communal healing practices. Indigenous shamans use drumming, chanting, and rhythmic movement to induce trance-like states, often interpreted as spirit journeys. Pentecostal and charismatic Christian traditions feature glossolalia and ecstatic states with parallels to hypnotic absorption. In Sufi whirling and Buddhist meditation, repetitive movement and focus similarly alter consciousness.

Arts and Literature: Hypnosis has been a theme in gothic novels, stage melodramas, and later cinema, often portrayed as a tool of seduction or control. Films from Svengali (1931) to contemporary thrillers depict hypnotists as mysterious figures wielding extraordinary power. Music and theater have also incorporated trance motifs to explore altered states.

Comparative Anthropology: Anthropologists have documented trance in diverse societies, from possession rituals in West Africa to ayahuasca ceremonies in South America. While culturally framed differently, scholars note both similarities and distinctions between these trance states and modern hypnosis, particularly regarding social context and symbolic interpretation.

Military and Espionage: Beyond MKULTRA, Cold War narratives about “brainwashing” and hypnotic assassins influenced popular imagination. Military-funded hypnosis research, though rarely successful in coercion, underscored anxieties about psychological manipulation.

Technology and Future Directions

Virtual Reality Hypnosis (VRH): VR platforms have been investigated in pilot studies for guided hypnosis. Immersive environments enhance focus and absorption, with applications in pain relief, phobia treatment, and relaxation.

AI-Driven Hypnosis: Pilot projects and experimental research have begun to explore chatbots and AI-driven platforms that simulate hypnotic suggestion, but these remain theoretical and in early stages of research. These remain exploratory and theoretical, raising ethical and practical concerns around consent, personalization, and potential misuse.

Wearables and Neurofeedback: Experimental devices tracking EEG, heart rate variability, and galvanic skin response have been tested to provide feedback for deepening trance. Neurofeedback training may enhance hypnotizability or stabilize trance states.

Subliminal Messaging and Immersive Media: Advertising, gaming, and immersive AR/VR may employ suggestion-like techniques, raising debates about “everyday hypnosis” in consumer culture.

Future Risks and Benefits: While technology may democratize access to hypnotherapy, its potential risks - including exploitation, commercialization, and challenges to informed consent - are emphasized in academic and policy discussions. Scholars advocate proactive ethical frameworks governing AI- and VR-based hypnosis applications.