A hypnotic state is a state between wakefulness and sleep, a state of heightened concentration and receptivity that results in suspension of peripheral cues. The effect of a hypnotic state results in alteration of perception and attention. Hypnosis has been tested for its effect on pain, anxiety, depression, chemotherapy-induced nausea and vomiting (CINV), hot flashes, and fatigue in patients with cancer. Hypnosis has been delivered in various formats, including individual in-person sessions, CD program, and self-hypnosis.
Rajasekaran, M., Edmonds, P.M., & Higginson, I.L. (2005). Systematic review of hypnotherapy for treating symptoms in terminally ill adult cancer patients. Palliative Medicine, 19, 418–426.
Databases searched were MEDLINE and Index Medicus, EMBASE, CINAHL, CancerLIT, Allied and Complementary Medicine Database (AHMED), PsycINFO, CISCOM, Cochrane Database, and Database of Abstracts and Reviews of Effects (DARE).
The search yielded 27 studies from 1974–2003, only one of which was a randomized controlled trial (RCT). Authors analyzed only the RCT.
Results of one RCT documented effectiveness of hypnotherapy in treating symptoms in terminally ill adult cancer patients.
The lack of well-designed studies to be analyzed calls for further research, involving effectively designed studies, to establish the effectiveness of hypnotherapy.
Bragard, I., Etienne, A.M., Faymonville, M.E., Coucke, P., Lifrange, E., Schroeder, H., . . . Jerusalem, G. (2017). A nonrandomized comparison study of self-hypnosis, yoga, and cognitive-behavioral therapy to reduce emotional distress in breast cancer patients. International Journal of Clinical and Experimental Hypnosis, 65, 189–209.
To compare the effects of self hypnosis, yoga, and cognitive-based therapy (CBT) on psychological and sleep patient outcomes
Women with non-metastatic breast cancer selected whether they wanted to participate in groups receiving CBT, self hypnosis, or yoga interventions. CBT included six weekly 90 minute group sessions led by trained psychologists. The yoga intervention included six weekly 90 minute group sessions of Hatha yoga and a DVD for use in home practice. Self-hypnosis sessions were 2 hours every two weeks for 12 weeks in small groups. The intervention included tasks and discussions inspired by CBT, with a 15 minute hypnosis exercise at the end of the session. They also received a CD with hypnosis exercises and homework assignments between sessions.
PHASE OF CARE: Multiple phases of care
Prospective, non-random, three-group trial
The majority of patient selected the hypnosis intervention. Anxiety and depression declined significantly in the yoga and hypnosis groups (p < 0.05). Fatigue and insomnia declined in the hypnosis group (p < 0.05). Most attended at least five sessions and practiced at least weekly at home. All three interventions showed medium effect sizes for change in anxiety (Cohen’s d range = 0.57-0.77).
Yoga and self-hypnosis group sessions were associated with decline in anxiety and depression. Self-hypnosis was also associated with improvement in sleep and fatigue scores.
Findings suggest that self hypnosis can be helpful to reduce anxiety, depression and insomnia in women with breast cancer. If relevant resources are available to clinicians this could be a low risk and beneficial activity for symptom management.
Gregoire, C., Bragard, I., Jerusalem, G., Etienne, A.M., Coucke, P., Dupuis, G., . . . Faymonville, M.E. (2017). Group interventions to reduce emotional distress and fatigue in breast cancer patients: A 9-month follow-up pragmatic trial. British Journal of Cancer, 117, 1442–1449.
To determine the long-term (nine months) effectiveness of three different group interventions compared to usual care for patients with breast cancer
Participants were allowed to select one of three groups to receive either cognitive behavioral therapy, yoga, and self-hypnosis. People who declined to participate were in a control group. Measurements were taken T0 through T3 to include before and after the short-term interventions, at month 3, and at month 9 follow-up.
PHASE OF CARE: Multiple phases of care
Three group intervention self-selection; testing at T0, T1, T2 (month 3), T3 (month 9)
Demographics; medical history; Hospital Anxiety Depression Scale (anxiety and depression emotional distress); Quality of Life 30-item questionnaire (fatigue); Insomnia Severity Index (sleep quality)
Only results from baseline (T0) and the month 9 follow-up (T3) were reported using MANOVA with repeated analysis and post-hoc analysis.
Post-hoc comparisons of time T0-T1: hypnosis group showed significant decreases in anxiety (p = 0.000), depression (p = 0.004), and fatigue (p = 0.045). Yoga group showed significant decrease in anxiety (p = 0.01).
Post-hoc comparisons of time at T3: hypnosis group showed decreases in anxiety (p = 0.000), depression (p = 0.000), and fatigue (p = 0.002); yoga group showed decrease in anxiety (p = 0.024).
Self-hypnosis led to improvements in anxiety, depression, and fatigue. Anxiety improved in the yoga group. There were no improvements in the CBT or control groups.
Two of the three interventions may be helpful in reducing anxiety, depression, or fatigue when measured at nine months. Self-hypnosis may help patients improve emotional distress such as depression and anxiety, and may also reduce fatigue; yoga may also help improve anxiety. Larger samples and longer follow-up studies are needed.