How does Cognitive therapy contrast with Hypnotherapy?

I thought some might be interested in my understanding of how Cognitive therapy contrasts with Hypnotherapy, as a supporter of both therapies.

If a clients says to the therapist..." I can't cook" the CBT approach would be to challenge that idea by seeking to find a more true statement. The new statement might be " I find cooking hard, but I can cook something (beans on toast)." The new belief would be based on reality but have a more positive spin and would banish the door slamming "I can't".

The hypnotherapist would seek to suggest to the client that they can cook by, for instance, relaxing the client first and then taking them on a 'journey' where cooking success is imagined.

Both therapies seek to challenge the original belief of the client and both seek to set up a 'I can cook' feeling or belief in the client. The homework would also be similar. Seeking out ingredients and putting them together in a small and simple fashion that builds the belief without resorting to attempting a full banquet in the first week!

Some hypnotherapists view their work as dealing with the 'subconscious' whereas cognitive therapy is seen as dealing with the 'conscious'. I think in practise both kinds of therapy are doing things consciously. Seeking new beliefs through conversation or imagining positive outcomes are both really conscious activities.

Some hypnotherapists are calling themselves "Cognitive Hypnotherapists" which reflects the growing acceptance that Hypnotherapy is in essence very similar to Cognitive therapy but with the added element of visualisation and relaxation.

What are your thoughts on this subject?

28 Replies

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  • Hi Jonathan. Have you managed to get help through Anxiety UK?

  • Jonathan I took your first post literally when you said you were saving up. I misunderstood.

    I am not implying anything. I was unaware of your connection with Anxiety UK.

    As a therapist who has donated his time to Anxiety UK for the last 10 years I am a supporter of Anxiety UK.

  • Hiya Andrew

    Hope you are well.

    In relation to Hypnotherapy and CBT both have use ... yet their value is poles apart .

    For example, as a 'relaxation' technique hypnotherapy is worthwhile. It does relax people and it would leave a person who is angst feeling they have found a means of relaxation.

    Even so, Hypnotherapy is associated with soothsayers even charlatans. And it often steals an air of respectability by masquerading as a science. If more were done to explain that hypnotherapy is a mere relaxation technique then, in my opinion, the technique itself might lose its dubious reputation.

    Since all people who become hypnotised are already willing to 'let themselves go', this eagerness to embrace the experience of being hypnotised can seduce a persons' imagination into beleiving they have found something mystical, on the one hand, or a Svengali-like mentor in a hypnotist on the other. People who have fallen under the spell of a hypnotists' words fail to see how they themselves are utilising their own 'will' by 'letting go' in the first place. Rather they lose sight of their active participation and come to think of hypnotism and the hypnotist as 'magic'.

    Unless you spell-out hypnotherapy is relaxation ...which I am almost certain some good fellows' like yourself do Andrew ... you create unhealthy curiosity in the subject which, in turn, continues to give hypnotism a burgeoning deference.

    Should a hypnotist spell out that hypnotherapy is a mere relaxation method ...stripping it of its sophistication and esotericsm ... then this, in my opinion, would garner both the hypnotist, and the method itself, much more respect. After all, to be able to relax is a blessing ...and people who cannot relax but who eventually acheive relaxation almost certainly have a better chance of reaching their goals. Hypnotism would be thanked more for engendering relaxation in a subject were it not true that it is still bathed in the public eye in a false mysticism.

    Once you have dressed a relaxation technique in the garb of sophistication you create a false impression. This, in my view, is unethical and deceitful. That's not to say all hypnotists are just that ! I'm sure you are a good man Andrew. But there are many who, after a six month course at the polytechnic, come to sell hypnotherapy as the preserve of the intellectually and sophisticated few.

    In CBT, on the other hand, both parties bring their intellects and knowledge to bear upon a 'problem'. Unlike hypnotherapy, the subject in CBT plays a more or less equally active part alongside their therapist.

    The two share their respective knowledge of a problem and, in doing so, a special union of satisfaction between the subject/therapist emerges. In CBT not only the subject derives 'satisfaction' since the therapist's identity as 'therapist' is also bound up in the client since without a client there would have never been a therapeutic role to play in the first place ! On the one hand, so-called job-satisfaction is experienecd by the therapist and, gratitude in the client on the other. It is this parity that sets CBT apart from hypnotherapy .

    Vince : )

  • Hi Vince

    Modern hypnotherapy is not simply about " Relaxation" or even “hypnotising people and telling them they will feel better”, although this can certainly form part of treatment.

    Almost all modern hypnotherapy inevitably draws upon concepts and techniques from the wider culture of psychotherapy. However, some forms of hypnotherapy do this to a minimal degree, while others do so to a greater extent and in a more sophisticated manner. As one contemporary authority on the subject writes,

    A century ago, hypnotherapy often consisted of a hypnotic induction, followed by suggestions of symptom removal. Consequently, hypnotherapy has been viewed by some writers as a mode of therapy that might be compared with psychodynamic, cognitive-behavioural, or other therapeutic approaches. However, suggestions for symptom relief play a relatively minor role in contemporary hypnotherapy. Instead, hypnotherapy generally consists of the addition of hypnosis to some recognised form of psychotherapy. (Kirsch et al., 1995: 214)

    Many training programmes place hypnotherapy squarely within the context of modern psychotherapy. The ideal training in hypnotherapy selects techniques for integration within a hypnotic psychotherapy framework. It does so based upon a philosophy of evidence-based (technical) eclecticism, which endorses therapeutic techniques mainly on the basis of their support from the best independent research evidence available.

    Hypnotherapy has always been pragmatic and while dedicated to a particular methodology (hypnosis) it has both drawn from and inspired the theories and practices of most other schools of psychotherapy. Indeed it is arguably the multi-component nature of modern clinical hypnosis that makes it such a powerful and flexible tool.

    The development and publication of a broad research base has allowed evidence-based technical eclecticism, mixing and matching techniques that have a proven effectiveness, within the field of clinical hypnosis.

    Moreover, there is reason to believe that much of what can be done by therapeutic methods outside of hypnosis can be done more effectively with hypnosis. Hypnosis seems to raise motivation, focus attention, enhance relaxation, increase responsiveness to suggestions, and improve visualisation. It therefore seems capable of enhancing other forms of psychotherapy.

    There is evidence from a range of studies showing that using hypnosis increases the impact of other therapeutic techniques. Moreover, the use of hypnosis in psychotherapy allows the therapist to engage in ways that would seem unusual in normal dialogue, for example, repeating a positive suggestion or image many times. Hypnotherapy also provides a range of strategies and techniques which add significantly to the armamentarium of other therapies.

    The ideal model for hypnotherapy would select techniques for integration within a hypnotic psychotherapy framework based upon a philosophy of evidence-based (technical) eclecticism, which endorses therapeutic techniques mainly on the basis of their support from the best independent research evidence available.

    Michael

  • Hi Vince

    Thanks for your reply.

    I think most of your concerns are well founded but I would hope that most modern hypnotherapists are quick to educate the client about how hypnosis contains no magical or mystical aspect. Certainly those that call themselves Cognitive Hypnotherapists would instruct their clients in how the sessions involve a collaborative partnership. But you are right to warn that some hypnotherapists evoke concepts that are unproven and misleading. For example, past life regression or 'universal energy'. Not my bag!

    Funnily enough it is often the client that comes with an over-sophisticated view of hypnosis whereupon I spend some time debunking the myths. I am sure that therapists of all kinds are faced with clients who bring expectations and theories of therapy that are out of kilter with that of the therapist.

    I think your last paragraph sketches a dynamic that also arises in hypnotherapy.

    As you can probably tell I am more interested in the overlap between CBT and hypnotherapy than the differences. And it is my guess that an experienced hypnotherapist incorporates many CBT ideas in the same way as positive suggestion plays a large role in a 'pure' CBT session.

    Andrew Cunningham

  • Good post Andrew and Michael . Thank you for sharing your knowledge . Vince: )

  • Your welcome Vince

  • To Andrew and Mikey

    When suffering with severe depression, when would be the ideal time to have CBT in your opinion? In the past whilst depressed I have been offered CBT and gone to a first assessment but have not had the treatment coarse as the thera pist did mot think it would be suitable at that time which I agreed with, is it more suitable when the depression has lifted as a means of altering my thought patterns and the way I look at a situation to help in the future and try not to get depressed in the first place, after this last bout of depression I was offered CBT again and went to a couple of meetings but could not continue because of clashes in times I could get appointments and work commitments unfortunately! After 8 months off work in the last 2 years money is tight so work has to come first at this time as you can imagine, I was just wondering if you think I should persue this and would it be helpful now that I am well again?

  • Hi Thunderacer

    I think trying to use therapy when in distress is a tough one. A bit like trying to mend the rudder in the middle of a storm.

    When you are feeling well it is easier to work with a therapist (or therapeutic ideas) so I would say yes why not give it a go. The irony for many is that when they feel well they dont feel the need to 'work' on themselves and therefore increase the likelihood of getting ill sooner.

    Think of those pioneers out in the Wild West who sweat through the summer piling up a fantastic wood pile in preparation for the winter.

  • Thanks Andrew, think you are right when I am effected by "IT" I feel in no psychological state to take in new information let alone alter the way my thought prosess works. In the past when I have got better I have tried to forget it has happened but it has taken a long time to realise that I need to understand it more and look at ways to try and prevent it coming back rather than ignore it and have that niggling feeling in the back of my mind that it is coming back. Steve

  • Hi Steve

    Yes, preparation is good. We do that in other areas of our lives, why not with our mental health?

    Andrew

  • Have also in the past 3-4 years been able to talk more openly about my disorder, not embarassed about it anymore! And am more likley to tell someone they are ignorant or predgadist if they react badly to what I have told them, doesn't impress them much but hey ho past caring about what other peole think of me anymore, they can take me or leave me as I am! You soon find your true friends when suffering a mental illness

  • Hi all, hav bin told im not well enough 2 do CBT at the moment + is a waitin list of 3mnths, thats a life time away. Cant get out of bed these days but do also hav a nasty flu bug in which is hinderin my recovery. a couple of mnths ago looked in2 hypnotherapy but was shocked at the price, way out of my budget in havin none. do people like my self hav 2 suffer in silence or is they a way 2 get hlp on the nhs..the problem bein i live up north in a very poor twn + i suspect resources will b stretched 2 the maxium. wiv kindest regards leeanne.**

  • Exactly, and that is what I am saying below. One sentence reply to a desperate person.

    "Shocked at the price". "Way out of my budget". "Suffer in silence". "Resources stretched to the maximum". This is the real world, guys, and is not an isolated one but very common. j.

  • Hi Leeanne

    Have you applied to Anxiety UK to see if there is help in your area?

    Andrew

  • No never thought about it until now, thanku. i asked crisis team about bein put on the 3mnth waitin list as the phycotherspist sugested but they told me i cant b put on whilst under the crisis team + am not well enough 2 attend. but i thougt by 3mnths come i might b. if theyde of put me on wen 1st got wiv the crisis team over 2mnths ago i would b 2 thirds through the waitin list. Im ill enough 2 go in hospital but still cant get on the waitin list, makes no sence. They say theyve had this question raised a lot. kindest regards leeanne.**

  • Who was it who said "For heavens sake protect me from intellectuals". Carl Jung said, "I am glad I am Jung and not a Jungian". What words of wisdom. I doubt whether many of the people on this site understood a word of what has been said. OK, so I am out of work; have a mortgage to pay; have very little money; suffer from anxiety (and not surprisingly so). Have two children to feed. Sold the car. Can't get treatment on the NHS for weeks, if not months. Doctor has prescribed drugs, the only free choice I have. Have paid in taxes all my working life. Can't even afford the graduated payments available by Anxiety uk. Should we not be addressing the CAUSE of this problem and not how to cure it. Although that is important too. You can't afford to pay so you wait for treatment when it is desperately needed. Get on to your MP; your local NHS Trust, your Local Health Committee. Write to the Secretary for Health. Do something for these poor souls who need help. They want FREE treatment not platitudes.These blogs would be better on an Alternative Therapy journal not on this site. I am, fortunately, retired so I do not have any of the above problems, but of empathy I find none on this blog. J.

  • I am already mesmerised by the price of hypnotherapy and CBT !!!!! On these prices it seems only the so-called better-off can get better !!! If it is such a worthwhile occupation, then why the high-prices ? Things that are worthwhile usually are done without high charges ?

    It seems to be that if you are poor, like me , then your chance of becoming ill with so-called mental problems increases. And so why are therapists tailoring their fee to exclude poor people ?

    Not that being poor bothers me much, but it (poverty) is a bar to private therapy .

    It really is bleak up North you know. : ) ) I blame the rich !!! (Joking Here ) !!!!!!!! : ) : )

    Vince (Lancashire) : ) : ) : ) : )

  • Hi.Vince. I sympathise with you. £40 for the first session and £30 thereafter, and that is the MINIMUM of charges. £40 is HALF a state pension for a single person!! A lot of money is being made out of suffering. I am not saying that the labourer is not worthy of his hire. But I am saying that these therapies should be readily available on the NHS without extended waiting times. The therapist could then be paid from NHS funds. And one visit is never enough. You may need many £30 pounds to complete treatment. Then of course the therapist's would bleat that we were doing them out of a livelihood. God knows we pay enough for the NHS service. It is far from free considering the taxes required to run it. No problem with that if we had the service for anxiety sufferers but we don't, far from it.

    A lot of therapists would love the American system where the rich get 1st. class treatment and the poor 2nd. class. So called 'celebrities' pay thousands for psychiatric treatment and we pay with our license fees. Expecting any sort of justice in this world is expecting too much. You are so right. What price do you put on empathy, understanding, love, caring. These cost nothing and are freely available by the good folk on this site. Bless them all. J.

  • Well said 2 every1 who has commented on this touchy topic. i checked out a hypnotherapist in burnley(a very underprivelidged twn) were i live, and he is suposed 2 b really good, i thought if i knew it would hlp me i would beg, steal + borrow(parden the pun) until i was told the price, was expectin about £30-£40 but how wrong was i, he wanted £60 an hour + thats comin frm a very poor underprivelidged twn up north. kindest regards leeanne.**

  • Let's hope that this blog encourages therapists to provide at least some of their services for free.

    As you rightly say there is a lot of need for therapy but also there are a lot of therapists out there as well. Some therapists may have to pay room hire costs which makes it harder to provide free therapy.

    Maybe phone therapy( using skype perhaps) is an option in some cases. Costs would be kept to a minimum and therefore encourage therapists to give some of their time for free.

  • Andrew. I am not getting at you or anyone in your profession. My wife and I ran an Alternative Therapy Clinic for some years and all the practitioners charged. Of course they did because, as you say, they had rents and other overheads to pay. But we got together and decided to devote one day (some did two) to those who were unable to pay. Along the lines of vets who devote a day or two to the PDSA free of charge. We thought that if it can be done for animals then it could be done for humans! I think the problem is the excessive fees charged. Around here (Kent) a practitioner for Hypnotherapy charges £30 to £40 for a session but I have seen £60 plus being charged. (one was £75! per session.).This puts it out of the range of the average worker because, as you know, more than one session is required. There is also the possibility of abuse. We made sure that those seeking free help were actually really hard up. Your costs in London must be enormous. I know it is up to the individual practitioner but the professional bodies could look into this. As you say, this blog may help. Regards. jonathan.

  • I agree that for a clinic or therapist to set aside time for giving free therapy is a great idea. Lets hope that people's need for therapy inspires others to meet that need.

    In my particular case my costs are fixed, my outgoings are the same if I have 10 or 100 clients. This makes it easier to, for example offer services to Anxiety UK.

    For therapists who have hourly rate costs to pay then it's a lot harder, hence the idea of a therapist doing some sessions over the phone from home...for free!

  • I am sorry but I don't understand most of what has been said and I don't consider myself stupid. The language that is being used is far above my head and I find it very hard to understand. The thing I do understand is that I have been messed about with therapists and psychologists and yes the worst of all psychiatrists for 34 years with the NHS. Every new person wants the full story of my life, dates, times, occasions all of which are written down already in my file. By the time that is done my time has run out and lo and behold ...the next time I would go it was someone new. I have often said till I am blue in the face " If I had money I would love to check in somewhere private and pay to get well". I know I am not the only one that feels like this as well. It is like looking through a window into heaven. So, I resolve to talk to people on here who actually have experience of this condition. That is half the battle , realising you are not alone. Books and tapes are read and watched, exercises learned and relaxation practiced. This has to be done slowly to "sink" into my tired and exhausted mind. I am a victim of the system, yet refuse to regard myself as a victim. Believe it or not I still have quite a lot of pride left after all the trash I am prescribed , weaned off and prescribed again and again. I take 23 tablets a day! and have to try and act like a "normal" person, expected to run a home ( and I do ) pay bills and everything else that is expected of me except I cannot work as I also have a scoliosis and am in a lot of pain as well day and night. I am a carer for my 80 year old Mother. Me!! a carer!! it's a bloody joke that went wrong isn't it?.The point of all this crap that I have written is it all boils down to MONEY and TIME which in 34 years I have not got. I can't travel well either being agoraphobic . I do consider I have come on in leaps and bounds just being able to offload on this site to people who actually care because they have either " been there" or "are there". I would NOT put any faith in ANY therapist again ever, ever, ever. I will never stop hoping though!

    Love and Best Wishes x Ella x

  • Hi.ella. I have just read this and I would suggest that your story is reflected by many, many people. With money you can get any treatment you want; without it you are at the mercy of the poor old NHS. Angry, bitter, yes, who wouldn't be. Are we supposed not to be angry? When Christ kicked the money lenders out of the Temple was He angry? (It's alright, therapists, I DO NOT think I am Christ). There is such a thing as righteous anger. Never felt it, therapists? Then I feel sorry for you. Perhaps at £60+ an hour you do not have to worry overmuch whether you can pay your fuel bills. A lot; an awful lot, do. Come into the real world. Visit the impoverished Northern towns. See what poor people on the poverty level really have to put up with. j.

  • Hello ellabella, I understand how you feel. I have been on tablets for 41 years and you get sick of the sight of them. The tablets are supposed to make you feel better but they dont. I hate the phone as well. It is pot luck if I answer it or not. The number of tests I have had over the years is unreal and I have had that many diagnosis I have lost count. I also have agoraphobia and I have an appointment with a CBT this afternoon. I havent slept a wink all night and Thinking the worst as usual. Thinking I am about to die. I feel sick this morning. I am not scared about going for CBT but I know that for as long as I live I will never accept that the episodes I have are down to anxiety and depression. Hope you have a good day ellabella best wishes Carol x

  • Oh and I nearly forgot....scared of the phone as well LOL XXXX

  • Besides money and time it also seems that the area you live in can and does have implications to how you are treated on the NHS! I have had no real problem with the service I have recieved ( besides the time factor ) and have always been able to see councilor's for CBT and such like, as was said above, it is government and councils that need to get involved and stop the waste of major waste of money by consultant pen pushers and make cuts from the top end of the NHS rather than the skilled and trained lower paid staff! Then maybe services would be the same all over this country

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