Hot flushes are among the better-supported uses of hypnosis. In clinical trials led by the psychologist Gary Elkins, women who had a five-week course of hypnosis with cooling imagery reported large reductions in hot flushes, far greater than those in a comparison group. The North American Menopause Society has recommended clinical hypnosis as a non-hormonal option.
The core of the method is simple: deep relaxation, and vivid mental imagery of coolness, practised every day. Here is a script you can record and use.
Before you start
- Hormone replacement therapy is the most effective treatment for menopausal symptoms and is suitable for most women. Talk to your GP about your options. Hypnosis is for women who cannot take HRT, prefer not to, or want something in addition.
- See your doctor if flushes come with weight loss, fever, palpitations or other unexplained symptoms, if you have bleeding after the menopause, or if you are under 45.
- Read the script first, fully awake, and adjust the imagery. Coolness means different things to different people.
- Record it slowly, pausing at the dots.
- Listen daily for at least five weeks. In the trials, daily home practice was part of the treatment.
- Never listen while driving.
It takes about twelve minutes.
Choosing your cool image
Pick what feels pleasantly cool to you. Not cold enough to be unpleasant.
- A walk in the mountains with snow on the ground
- A cool breeze from the sea
- A shaded forest beside a stream
- Standing by a waterfall, with fine spray on your skin
- A cool lake or pool
- A crisp autumn morning
Replace the mountain scene below with your own if you prefer.
The script
Settling
Make yourself comfortable… and let your eyes close.
Take a slow breath in… and a long, cool breath out. Again… breathing in… and slowly out.
With each breath out, let your body relax a little more.
Let your forehead smooth… your face soften… your jaw loosen…
Your shoulders drop… your arms grow heavy and loose…
Your chest and stomach soften… your breathing easy…
Your legs grow heavy… down to your feet.
Sounds around you can come and go. Nothing to do… nowhere to be.
Deepening
In a moment I will count from ten down to one. With each number, drift into a deeper, more comfortable state of relaxation.
Ten… nine… drifting down… eight… seven… calmer… six… five… four… deeper and more comfortable… three… two… and one.
The cool place
Now imagine yourself walking along a path in the mountains.
It is a clear, bright day. There is snow on the ground, white and clean, and snow on the branches of the trees.
Feel the cool, fresh air on your face… on your forehead… on your cheeks…
Feel it on your neck… and on your chest… cool and refreshing.
With each breath in, cool mountain air fills your chest… and that coolness spreads through your whole body…
Down your arms to your fingertips… through your body… down your legs.
Hear the snow soft under your feet… See your breath in the air…
A gentle, cool breeze moves across your skin. It feels wonderful… pleasantly cool… comfortable… and calm.
Perhaps there is a stream nearby, clear and cold. You might dip your fingers in… or rest a cool, damp cloth on the back of your neck.
Let the coolness soak in… deeper… all the way through.
The thermostat
Imagine that somewhere inside you there is a control, like a thermostat, that sets your body’s temperature.
See it clearly. Notice where it is set.
Now reach out and turn it gently down… to a setting that is just right… cool and comfortable.
Your body knows how to keep itself at this comfortable temperature… steadily… evenly… through the day and through the night.
Suggestions
More and more, your body stays cool and comfortable.
Hot flushes become fewer… milder… and shorter.
If you notice the first sign of warmth, you take a slow breath out… a wave of coolness flows through you… and the warmth fades.
You stay calm. It passes quickly, and you carry on with what you were doing.
At night you sleep deeply and comfortably… cool and at ease… and wake feeling rested.
You feel more and more in control, and more like yourself.
A cue
Whenever you want this coolness, breathe out slowly and think the word “cool”… and feel that mountain air on your face. The more you practise, the more quickly it comes.
Returning
In a moment I will count from one to five, and you will come back feeling cool, calm and refreshed.
One… beginning to return.
Two… feeling coming back into your arms and legs.
Three… aware of the room.
Four… a deeper breath.
Five… eyes open, awake and alert, cool and comfortable.
(At bedtime, leave out the counting up and end with: “And you can drift into a deep, cool, comfortable sleep.”)
Using the cue during a flush
- At the first sign, breathe out slowly.
- Think “cool.”
- Feel the mountain air on your face and chest.
- Let your shoulders drop. Tension and alarm make a flush worse.
- Let it pass.
Practise the cue when you are not flushing, so it is ready when you are.
What to expect
- Benefit builds over weeks. In the trials, the improvement grew across five weeks and was greater still at twelve.
- Daily practice matters.
- Not everyone responds equally. Women differ in how readily they take to hypnosis.
- Self-guided practice has not been tested as thoroughly as sessions with a trained therapist, so results may be smaller.
- Keep a simple diary: number of flushes each day, and how severe. Compare week one with week six.
Helpful extras
- Layers of clothing, a fan, a cool bedroom
- Noting and reducing triggers: alcohol, caffeine, spicy food, hot drinks, smoking
- Regular physical activity
- Cognitive behavioural therapy for menopausal symptoms, which also has good evidence and is recommended in UK guidance
After breast cancer
Hot flushes are common with breast cancer treatments, and HRT is usually not advised. The first major trial of this approach was in breast cancer survivors. If that is your situation, hypnosis is a reasonable thing to try. Tell your cancer team, who can also advise on non-hormonal medicines.
The bottom line
Relax, go somewhere cool in your mind, turn the thermostat down, and practise daily for five weeks. It is one of the more convincing uses of hypnosis, it costs nothing, and it works alongside anything else you are doing.
Next in the series: A Self-Hypnosis Script to Use Before Surgery
This article is for general information and is not medical advice.