Hypnotherapy is one of the most widely misunderstood therapeutic approaches in existence. Ask ten people what it is and you will get ten different answers — most of them shaped by stage shows, films, or the vague sense that it involves someone swinging a pocket watch and commanding you to sleep.

As someone who practises clinical hypnotherapy in London every week, I want to offer a more grounded answer. Not a textbook definition, but an explanation of what hypnotherapy actually is, what happens in a real session, why it works, and what it can and cannot do. If you are considering hypnotherapy and want to understand it properly before deciding, this is written for you.

Hypnosis and Hypnotherapy: The Distinction That Matters

Hypnosis and hypnotherapy are related but not the same thing, and the difference is important.

Hypnosis is a natural state of focused, inward attention — a condition of deep mental relaxation in which the critical, analytical part of the mind quietens and the subconscious becomes more accessible and receptive. It is not sleep, and it is not unconsciousness. People in hypnosis are aware of their surroundings, can hear everything, and remain in complete control. What changes is the quality of inner focus: thoughts slow, the body relaxes, and the mind becomes unusually receptive to imagery, suggestion, and new perspectives.

Hypnotherapy is the clinical application of that state. It is the use of hypnosis as a therapeutic tool — to explore the subconscious roots of a problem, change unhelpful patterns of thought or behaviour, and create new emotional responses. Think of hypnosis as the vehicle and hypnotherapy as the journey. The trance state on its own does nothing particularly useful. It is what a skilled therapist does within that state that produces change.

What Actually Happens in a Hypnotherapy Session

I think the most useful thing I can do here is describe what a session actually looks like, because the reality is very different from the popular image.

A first session always begins with a thorough consultation. Before any hypnosis takes place, I spend considerable time understanding the person — their history with the issue they have come about, when it started, what triggers it, how it has affected their life, and what they are hoping will be different. This is not just administrative. It directly shapes everything that follows. Hypnotherapy is not a generic process; it is tailored to the individual.

The hypnosis itself begins with an induction — a guided process of progressive relaxation, usually involving slow, deliberate breathing and attention to physical sensations, that leads the person into a deeply relaxed, receptive state. This typically takes five to fifteen minutes. There is nothing dramatic about it. Most clients describe it as similar to the feeling of being almost asleep but still aware — comfortable, unhurried, and calm.

Once in that state, the therapeutic work begins. Depending on the issue and the approach being used, this might involve guided visualisation, direct or indirect suggestion, regression to earlier memories, parts work, or a combination of these. The client is not passive — they are an active participant, responding to guidance, exploring their inner landscape, and engaging with the process. I am not doing something to them; I am working with them.

At the end of the session, the person is gently brought back to full alert awareness. Most clients feel noticeably calmer than when they arrived. Some feel a shift quite immediately. Others find that changes emerge gradually over the days following a session, as the subconscious continues to integrate what was worked on.

Why the Subconscious Mind Is Central to This Work

To understand why hypnotherapy works, it helps to understand the relationship between the conscious and subconscious mind.

The conscious mind is the part we identify with most readily — the part that reasons, analyses, plans, and makes deliberate decisions. But the conscious mind is actually responsible for a surprisingly small proportion of our behaviour. The vast majority of what we do, feel, and react to is driven by the subconscious — the accumulated store of experiences, beliefs, emotional associations, and automatic patterns laid down over a lifetime.

This is why so many people find that knowing something consciously does not change how they feel or behave. A person with a fear of flying knows rationally that flying is safe. A person with social anxiety knows intellectually that the people around them are not a threat. A person trying to change a long-standing habit knows perfectly well why they should. The conscious knowledge is real, but it is not where the problem lives. The problem lives in the subconscious — in automatic responses, emotional associations, and beliefs that operate below conscious awareness.

Hypnotherapy works because the trance state creates a direct channel to the subconscious. In that state, we can identify where a pattern originated, update the emotional meaning attached to past experiences, introduce new beliefs and responses, and rehearse new ways of thinking and behaving at the level where they will actually take effect. This is what distinguishes hypnotherapy from purely conscious-level interventions like advice, reasoning, or willpower.

The Ericksonian Approach I Use

There are several schools of hypnotherapy, and it is worth knowing that they differ significantly in approach. My training and practice is rooted in Ericksonian hypnotherapy, developed by the American psychiatrist Milton H. Erickson.

Erickson’s approach departed from the more directive, authoritarian style of classical hypnosis. Rather than issuing commands to the subconscious, Ericksonian hypnotherapy uses indirect suggestion, metaphor, and conversational techniques that work with the individual’s own inner resources and language. The approach is collaborative rather than prescriptive.

In practice, this means I am not telling a client’s subconscious what to do. I am creating conditions in which the subconscious can find its own resolution — drawing on the client’s own experiences, strengths, and capacity for change. This tends to produce more lasting results because the change comes from within the person rather than being imposed from outside.

What Does the Research Say?

Hypnotherapy has a substantial and growing evidence base, though it is not always well publicised.

The British Psychological Society published a formal review of the evidence concluding that hypnosis is a genuinely effective therapeutic technique across a range of conditions. The American Psychological Association similarly recognises hypnotherapy as an evidence-based approach for pain, anxiety, and related conditions.

Neuroimaging research has now given us a clearer picture of what is happening in the brain during hypnosis. Stanford researchers (Jiang et al., 2017) identified distinct changes in activity in regions associated with focused attention, body awareness, and the connection between action and awareness during hypnotic states. This confirms that hypnosis is a distinct and measurable neurological state — not relaxation, not sleep, not placebo.

A meta-analysis by Kirsch et al. (1995) demonstrated that adding hypnotherapy to cognitive-behavioural therapy enhanced treatment outcomes significantly — across anxiety, phobias, and other conditions — compared to CBT alone. The research on gut-directed hypnotherapy for IBS is particularly strong, with response rates consistently above 70% in multiple controlled trials.

What Hypnotherapy Can and Cannot Do

I want to be direct about this, because I think unrealistic expectations do a disservice to people considering hypnotherapy.

What hypnotherapy is well-suited for

The conditions I see the clearest and most consistent results with are: anxiety and stress, social anxiety, public speaking fear, phobias, insomnia, IBS and gut-related conditions, chronic pain, confidence, low self-esteem, trauma responses, habits and compulsive behaviours, and performance anxiety. These are all conditions where the subconscious plays a central role in maintaining the problem — which is precisely where hypnotherapy operates.

What hypnotherapy is not

Hypnotherapy is not a quick fix that bypasses the need for engagement and commitment. The client’s willingness to engage with the process matters enormously. It is also not a replacement for medical treatment where medical treatment is needed — I always work alongside, not instead of, any medical care a client is receiving. And it cannot make you do something you fundamentally do not want to do. The idea that a hypnotherapist can override a person’s will is a myth with no basis in the clinical or scientific literature.

Common Questions

Can everyone be hypnotised?

Most people can enter a useful hypnotic state, though depth varies. Research suggests that around 10-15% of people are highly hypnotically responsive, around 10-15% find it difficult to enter a trance state, and the majority fall somewhere in the middle. In my experience, the people who struggle most are often those who are highly anxious about losing control — and working gently with that concern is itself part of the therapeutic process. Hypnotherapy does not require deep trance to be effective; even lighter states are sufficient for most therapeutic work.

Will I remember what happens in a session?

Yes, in almost all cases. Hypnotherapy is not amnesia. Most clients remember the session clearly, in the same way they would remember a vivid daydream. Occasionally, in very deep states, some details may be hazy — but this is the exception, not the rule, and does not affect the therapeutic outcome.

How many sessions will I need?

This depends entirely on the issue and the individual. A specific phobia or one-off event like a wedding speech might be addressed in 3-4 sessions. Longer-standing anxiety, social anxiety, or trauma-related patterns typically need 6-10 sessions. I always give an honest assessment at the first consultation rather than a vague open-ended commitment, because I think clients deserve to know what they are signing up for.

Is it the same as mindfulness or meditation?

There are overlaps — both involve relaxed, inward attention — but they are different practices with different purposes. Mindfulness is primarily about present-moment awareness and non-reactive observation of thoughts. Hypnotherapy uses the relaxed state as a starting point for active therapeutic work: changing beliefs, updating emotional responses, and rehearsing new patterns. They can complement each other well, but they are not interchangeable.

If You’re Considering Hypnotherapy

The best way to understand whether hypnotherapy is right for you is to have a conversation about your specific situation. I offer a free initial phone consultation — no commitment, no pressure — where we can discuss what you’re dealing with, what the work would involve, and what realistic outcomes look like.

In-person sessions are at 364 City Road, London EC1V 2PY, a short walk from Angel Station. Online sessions are available for clients across the UK. Call 020 7101 3284 or book below.

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About the Author

Antonios Koletsas is a clinical hypnotherapist and certified Ericksonian hypnotherapist based in London, registered with the General Hypnotherapy Standards Council (GHSC) and the General Hypnotherapy Register (GHR). He works with clients on anxiety, stress, phobias, confidence, chronic pain, IBS, and sleep at his City Road practice and online across the UK.

References

Jiang, H. et al. (2017). Brain activity and functional connectivity associated with hypnosis. Cerebral Cortex, 27(8), 4083–4093.

Kirsch, I., Montgomery, G. & Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 63(2), 214–220.

British Psychological Society (2001). The Nature of Hypnosis. BPS Working Party Report.

Whorwell, P.J. et al. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet, 324(8414), 1232–1234.

Hammond, D.C. (2010). Hypnosis in the treatment of anxiety and stress-related disorders. Expert Review of Neurotherapeutics, 10(2), 263–273.