Spiders. Heights. Needles. Flying. The dentist’s chair. A phobia is more than dislike: it is an intense, automatic fear that is out of proportion to the real danger and that leads you to avoid things, sometimes at real cost to your life or health.
Hypnosis is a popular way of tackling phobias. Here is how it fits in.
The gold standard: exposure
The best-evidenced treatment for specific phobias is exposure therapy: facing the feared thing gradually and repeatedly until the fear response dies down. It works well, often in a handful of sessions.
The problem is that many people cannot bring themselves to do it. This is where hypnosis comes in. Most hypnotic treatment for phobias is, in effect, exposure carried out in the imagination while you are deeply relaxed.
What the evidence shows
Research on hypnosis for phobias is thinner than for pain or IBS. The most studied area is dental fear. A 2022 systematic review of 19 trials found that hypnosis often reduced dental anxiety, but results were inconsistent, with some studies showing little or no effect, and CBT had the stronger evidence. For other phobias, there are positive small trials and many case reports, but few large, rigorous studies.
A fair summary: hypnosis is a reasonable way of delivering and enhancing exposure, especially for people who find direct exposure too daunting, rather than a proven alternative to it.
How it is done
Systematic desensitisation. You and the therapist build a ladder of feared situations, from mildly uncomfortable to worst case. In hypnosis, you imagine each rung while staying relaxed, moving up only when the current one feels manageable.
The cinema technique. You imagine watching a film of yourself in the feared situation from a seat at the back of a cinema. The distance makes it tolerable. Gradually you move closer.
Mental rehearsal. You run through the situation going well, from start to finish, feeling calm and capable.
Anchoring. You link a physical cue, such as pressing two fingers together, to a state of calm, so you can call on it in real life.
Reframing sensations. A pounding heart is relabelled as excitement, or as the body preparing you to cope.
From imagination to reality
Imagined exposure is a stepping stone. For lasting change, you need to test it in the real world: look at the photo, visit the airport, sit in the dentist’s chair. A good therapist will set these as tasks between sessions.
How many sessions?
Simple phobias often respond in three to six sessions. Fears with deeper roots, or those that are part of a wider anxiety problem, take longer and may need a different approach.
When to see a specialist
If your fear began with a traumatic event, if you have panic attacks in many situations, or if you avoid so much that daily life is restricted, see your doctor or a mental health professional first.
The bottom line
Hypnosis can make facing a fear feel possible. The real cure is still the facing.
Next in the series: A Short History of Hypnosis: From Mesmer’s Magnets to MRI Scanners
This article is for general information and is not medical advice.