When an illness can no longer be cured, the purpose of care changes. The question is no longer how to beat the disease but how to live as well as possible with it. Palliative care is the branch of medicine devoted to that: relieving symptoms, easing distress, and supporting the person and their family.
Hypnosis has a small, useful place in it.
Why it fits
- It is gentle. There are no drug interactions and few side effects, which matters for people already taking many medicines.
- It can be done in bed, at home or in a hospice, in a few minutes.
- It gives back some control at a time when much has been taken away.
- It addresses body and mind together, which is how suffering is experienced.
- It can be taught, so a person or their carer can use it at three in the morning.
What it is used for
Clinical reports and reviews describe hypnosis being used in palliative care for:
- Pain, alongside medication
- Anxiety and fear
- Breathlessness, and the panic that comes with it
- Nausea and vomiting, including the anticipatory kind before treatment
- Sleep problems
- Fatigue
- Itching, muscle tension and other physical discomforts
- Distress during procedures
What the evidence shows
Research in this setting is difficult. People are very unwell, studies are small, and many participants cannot complete them.
A 2022 systematic review and meta-analysis examined hypnosis and music interventions for pain, anxiety, sleep and wellbeing in palliative care. Earlier reviews of mind-body therapies concluded that hypnosis may be useful for pain and insomnia, with stronger evidence for anxiety and for treatment-related nausea, particularly in children.
The honest summary is that the evidence is encouraging and limited. Much of what is known comes from studies of people with cancer earlier in their illness, where trials show benefits for pain, fatigue, nausea and distress. It is reasonable, though not proven, to expect similar help later on.
How it is adapted
Hypnosis for someone who is very ill looks different from a standard session.
- Short. Five to fifteen minutes, since concentration and energy are limited.
- Simple. A few slow breaths and a single image.
- Flexible. Done lying down, eyes open or closed, with interruptions expected.
- Personal. Built on a place or memory that matters to the person.
- Permissive. Nothing is demanded.
- Recorded, often in a familiar voice, for use at any time.
Suggestions are for comfort, ease and peace, not for cure.
Techniques
- A favourite place: somewhere real and loved, revisited in detail
- Comfort imagery: warmth, floating, being held
- For breathlessness: imagining cool air moving easily, a fan, a breeze at an open window, with slow breathing out
- For pain: the dial, or moving attention to a comfortable part of the body
- For nausea: a calm, settled stomach, cool fresh air
- For sleep: drifting, with permission to rest
- Life review: revisiting good memories, which many people find meaningful
For carers and families
Caring for someone who is dying is exhausting and frightening. The same simple techniques can help carers sleep and cope. A carer can also learn to guide a short relaxation for the person they are looking after, which gives them something helpful to do.
A simple version to read aloud, slowly:
“Let your breathing settle. There is nothing you need to do. With each breath out, let your shoulders soften. Think of a place where you have felt peaceful. See it. Hear it. Feel the air there. You can rest here for as long as you like.”
What it is not
- Not a substitute for pain relief or any medical care. If pain is not controlled, tell the team.
- Not a cure. Nobody should suggest that the right mental attitude will change the course of the illness.
- Not for everyone. Some people do not want it, and that should be respected.
- Not suitable during confusion or delirium, which are common in advanced illness.
- Not a way of avoiding difficult conversations.
It should be offered by someone working with the palliative care team, such as a nurse, doctor, psychologist or complementary therapist trained in hypnosis, never by someone promising more than comfort.
How to access it
- Ask the palliative care or hospice team whether relaxation, guided imagery or hypnotherapy is available. Many hospices offer complementary therapies free of charge.
- Ask about support for carers too.
- Cancer support charities and centres often provide these services.
The bottom line
At the end of life, small comforts matter a great deal. Hypnosis offers a few minutes of ease, a little more sleep, and a sense of having some say in how one feels. The evidence is limited, the risk is low, and for some people it is a real kindness.
Next in the series: Hypnosis Glossary: Key Terms Explained in Plain English
This article is for general information and is not medical advice. Speak to the palliative care team about managing symptoms.