How Does Hypnotherapy Help FND? Understanding Prediction and Agency

Hypnotherapy may help people with Functional Neurological Disorder (FND) by working with prediction, expectation, attention and the sense of agency. Through hypnosis, clients can explore different ways of experiencing movement, physical sensations and bodily responses, helping them develop new expectations and rebuild confidence in what their bodies can do.

Understanding how hypnotherapy can help people with FND involves understanding prediction and agency – two closely connected concepts which help explain the experiences of people with FND and how hypnosis may help.

But these concepts aren't just relevant to FND. Understanding how expectation and agency influence our experiences, and how we can use hypnosis to work with them, can also help us develop a deeper understanding of hypnotherapy more generally. They're relevant to many of the difficulties our clients experience, and to how we can help people make changes that go beyond simply thinking differently.

Understanding Functional Neurological Disorder (FND)

FND is a complicated condition. For some people, it seems to develop after an illness or medical procedure. For others, it seems to appear out of the blue. Some people never understand why they’ve developed FND, whilst for others there appears to be a link with past trauma or ongoing stress.

What many people with FND share in common is that, once they’ve developed a symptom associated with FND – such as functional seizures, weakness in a part of the body, tremors or sensory disturbances – it can become ingrained as the new normal very quickly.

And there are two key concepts that can help us understand why.

Prediction and Expectation in FND

The first is prediction. Prediction is part of how we make sense of the world around us.

Let’s imagine you’ve made a cup of coffee and it’s sitting on the desk in front of you. In order to make it quick and simple to pick it up, your brain makes certain predictions. It predicts how far away it is. It predicts how heavy it is. It predicts how hot it is.

This means that you can very quickly reach out your hand and pick up the cup of coffee, based on your previous experiences. We need to be able to make predictions in this way to live our lives efficiently.

When someone has FND, and particularly if we think about FND symptoms involving weak or disrupted movement, it’s thought that part of the problem may involve the brain making inaccurate predictions about what is going to happen, based on previous experiences.

Let’s go back to the coffee cup example. If someone has developed weakness in their arm and has spilled coffee before, their brain might begin to predict that this is going to happen every time, even though it might only have happened once or twice.

And because the brain is predicting that this is going to happen, that prediction can actually influence how the arm moves, potentially making it more likely that they will spill the coffee again.

All of this is happening unconsciously, and it’s happening at lightning speed.

One important aspect of our work as hypnotherapists is helping clients understand the role of prediction and how, once the brain has become used to expecting something to happen, that expectation can influence what actually happens.

We can help clients, through their own personal experience of hypnosis, to experience what it's like to have a different outcome. To predict that something different will happen. And to rehearse that in a state of hypnosis so that the new experience becomes more familiar and feels more natural and achievable when they put it into practice in a real situation.

This is one of the ways hypnotherapy may help people with FND begin to develop different expectations about their physical responses.

Understanding Agency in Functional Neurological Disorder

Another key area where hypnotherapy can help people with FND is around agency.

Agency refers to our sense of being in control of our actions.

Without having to think about it, most of the time we feel that our bodies are going to do what we want them to do.

Imagine planning to get out of bed and walk to the door. You don’t need to give it too much thought – you simply get up and walk to the door. Without consciously considering whether or not you’re in control, things happen as you expected, which reinforces the feeling that you’re in control of your body. It does what you want and expect it to do.

When your body has acted in a way that was unexpected, and which, for some people with FND, has happened rapidly, repeatedly and in a way that can be extremely distressing, you can lose that sense of agency. You stop feeling in control and lose that trust in your body.

And once that happens, you may feel unsure about how your body is going to respond in a given situation and develop a sense of fear around certain activities.

This can create a fear cycle, where stress and anxiety can sometimes make movement more difficult. It can also make us more likely to focus closely on the action we’re trying to perform. And the more attention we give it, the less natural it can feel and the harder it can become.

A lack of agency regarding our bodies can also extend into a lack of agency around our lives more generally. We can lose confidence in our ability to get out, to do things we used to do, and to feel as if we're in control of our lives.

How Does Hypnotherapy Help FND? Understanding Prediction and Agency

Hypnotherapy can help people with FND rebuild their sense of agency and develop different expectations about how their bodies might respond.

We can encourage clients to experience, in a very realistic way, what it feels like to have greater control over their bodily responses.

There are various techniques we can bring in, including NLP techniques and encouraging a deeper connection between the mind and body, whilst imagining themselves carrying out chosen actions naturally, without deliberately thinking about every movement.

Because it’s that deliberate trying and monitoring which can sometimes make FND symptoms so much worse.

And this is where hypnotherapy offers something particularly valuable.

Rather than simply talking about what it might feel like to move differently, respond differently or regain confidence in their body, we can help clients actually experience those changes through hypnosis.

We can create opportunities for them to experience something that feels real, even before they're able to achieve it consistently in everyday life. That's something which can be much harder to achieve through talking therapy alone.

Combining Hypnotherapy with Other FND Treatments

Of course, hypnotherapy doesn't need to work in isolation. In fact, it can be particularly valuable when clients are also accessing other forms of support, such as specialist physiotherapy, psychological therapy or neurological care.

These approaches can complement one another, helping clients build on their experiences in hypnosis and gradually bring those changes into everyday situations.

For hypnotherapists learning to work with Functional Neurological Disorder, understanding how hypnosis can complement other approaches is an important part of developing a thoughtful, informed and client-centred practice.

Frequently Asked Questions About Hypnotherapy for FND

Can hypnosis help with Functional Neurological Disorder?

Hypnosis may help some people with FND by working with attention, expectation, physical responses and the sense of agency. It can provide opportunities to experience and rehearse different responses in a controlled therapeutic setting. Research into hypnosis for FND is promising in some areas, although more high-quality studies are needed to establish its effectiveness across different symptoms.

Why are prediction and expectation important in FND?

Our brains constantly use previous experiences to predict what might happen next. In FND, some researchers suggest that inaccurate predictions and expectations may contribute to disrupted movement, sensation and other functional symptoms. Understanding these processes can help therapists explore ways of supporting clients to develop different expectations and experiences.

How can hypnotherapy help someone regain a sense of control over their body?

Hypnotherapy can help clients explore experiences of movement, sensation and bodily responses in ways that may feel more natural and automatic. Through imagery, suggestion and mental rehearsal, clients can practise different responses and begin to rebuild confidence in their bodies.

Can hypnotherapy be used alongside physiotherapy for FND?

Yes. Hypnotherapy can be used alongside specialist FND physiotherapy and other appropriate treatments. Both approaches may address aspects of attention, movement, expectations and confidence, although they use different methods. Coordinated care can help clients build on what they learn and experience across different therapies.

Why Prediction and Agency Matter in Hypnotherapy Training

Learning about prediction, expectation and agency is about much more than understanding the theory behind FND.

It's about recognising how these processes influence people's experiences and how we can use hypnosis to help clients develop new responses.

Ultimately, we're helping clients develop new expectations about what their bodies can do, rebuild their sense of agency and begin to trust their own responses again.

And rather than simply telling them that change is possible, hypnosis gives us a way of helping them experience that possibility for themselves.

That's one of the most valuable things we can offer as hypnotherapists – not just helping people understand change, but giving them an opportunity to experience it.

And it's one of the reasons why developing a deeper understanding of prediction, expectation and agency is such an important part of specialist FND hypnotherapy training.

For qualified hypnotherapists interested in developing their skills in this area, our FND Hypnotherapy Training at Academy of the Inner Mind explores the research, therapeutic approaches and practical techniques involved in working with clients with Functional Neurological Disorder.

If you're a practitioner from a different background, such as a physiotherapist or psychiatrist, you might find it helpful to incorporate hypnotherapy techniques into your practice. If so, in adition to this specialist course you'll receive a complementary foundational hypnotherapy course which provides the context for incorporating hypnotherapy techniques into your practice.

References

Connors, M. H., Quinto, L., Deeley, Q., Halligan, P. W., Oakley, D. A., & Kanaan, R. A. (2024). Hypnosis and suggestion as interventions for functional neurological disorder: A systematic review. General Hospital Psychiatry, 86, 92–102. https://doi.org/10.1016/j.genhosppsych.2023.12.006

Edwards, M. J., Adams, R. A., Brown, H., Pareés, I., & Friston, K. J. (2012). A Bayesian account of 'hysteria'. Brain, 135(11), 3495–3512. https://doi.org/10.1093/brain/aws129

Tibben, M. I., van Opdorp, A., Bialek, W., Schaap, J., Tijssen, M. A. J., & Merkx, M. J. M. (2024). Efficacy of hypnosis and catalepsy induction in functional neurological disorders. Movement Disorders Clinical Practice, 11(2), 129–135. https://doi.org/10.1002/mdc3.13934

Voon, V., Gallea, C., Hattori, N., Bruno, M., Ekanayake, V., & Hallett, M. (2010). The involuntary nature of conversion disorder. Neurology, 74(3), 223–228. https://doi.org/10.1212/WNL.0b013e3181ca00e9