Research shows that hypnotherapy can help people overcome phobias, particularly when combined with other therapeutic modalities.
An integrated hypnotherapeutic approach could start showing results after one or two sessions, though a longer course of treatment may be needed.
Imaginal exposure can help lead to desensitisation, allowing clients to stay safe and calm while imagining their fear.
My interest in working with phobias, and in hypnotherapy generally, started when I myself had hypnotherapy for a severe driving phobia. After just one session, I went from being unable to leave the small town where I lived to driving extensively for a new job I’d just accepted. While I don’t love driving, and still get a bit confused, I was personally blown away by the improvement in what had become a crippling phobia. (In this article, I’m talking about specific phobias, formerly called simple phobias, which are connected with specific items or situations, as opposed to social phobia, also known as social anxiety)
Phobias are defined as extreme, overwhelming, debilitating and irrational reactions to specific triggers. While most of us are fearful of particular things, and fear is often a perfectly reasonable response to certain situations, phobias are extreme fear responses which are out of all proportion to the trigger. The trigger itself need not represent an inherent danger, and people can be phobic of anything from balloons to tomato soup.
People can develop phobias in their childhood, often as the result of an unpleasant experience, such as being stung by a bee or bitten by a dog. Sometimes children learn to develop a phobic response by witnessing the fearful behaviour of a parent or sibling. Phobias can be culturally predominant or can be an extreme response to situations or things which do have a level of inherent danger.
Research into the efficacy of hypnotherapy in the treatment of phobias and other anxiety disorders suggests that hypnosis is most effective when combined with other psychological interventions, such as cognitive behavioural therapy (CBT) (1) and in-vivo or virtual reality exposure (2).
When I’m working with patients with phobias, I combine hypnotherapy primarily with CBT and a controlled form of exposure therapy that uses the imagination, called imaginal exposure. Having established a client’s beliefs around what triggers their phobic response, I then work with them in a state of hypnosis to let them "experience" what would happen if they developed a new belief that was more helpful and realistic.
Imaginal exposure allows them to expose themselves to their fear in a controlled way and may be more accessible to some people than in-vivo exposure. As they repeatedly place themselves in the previously fearful situation, their physical response may begin to change. As the client becomes desensitised, their usual fight-or-flight response is typically replaced by a calmer reaction.
Though hypnotherapy can in some cases start to show positive effects rapidly, many clients benefit from ongoing work with their hypnotherapist over the course of several sessions. In my clinical experience, specific phobia treatment, using the multi-modality approach outlined above, can work effectively for many clients in one or two sessions.
Hypnotherapy for phobias
The state of hypnosis is characterised by brain changes which tend to allow for greater emotional control and less self-consciousness (3) This means that people are more likely to put themselves into imaginal situations and that, in those situations, they can retain more control over their emotional responses.
People tend to experience imaginal situations in a very realistic manner when they are in a state of hypnosis. So despite the fact that there is no snake, swimming pool, or aeroplane, they can still "experience" the situation similarly to how they would if the source of their fear was actually present. What's more, they experience their new, desired outcome almost exactly as if they had already experienced it. Combined with the fact that some people are more likely to be responsive to positive suggestion when in a state of hypnosis, hypnotherapy may provide an effective therapeutic intervention for phobias.
1. Valentine, KE, Milling, LS, Clark, LJ & Moriarty, CL (2019) The Efficacy of Hypnosis as a Treatment for Anxiety: A Meta-Analysis, International Journal of Clinical and Experimental Hypnosis,67:3, 336-363, DOI: 10.1080/00207144.2019.1613863
2. Hirsch JA. (2018) Integrating Hypnosis with Other Therapies for Treating Specific Phobias: A Case Series. Am J Clin Hypn. Apr;60(4):367-377. doi: 10.1080/00029157.2017.1326372. PMID: 29485374.