Hypnotherapy in San Francisco
Hypnotherapy is the clinician-guided use of hypnosis – a state of focused attention, reduced peripheral awareness, and heightened responsiveness to suggestion – to work toward specific therapeutic goals. In a psychiatric setting it is typically used as an adjunct to psychotherapy rather than a standalone treatment, most often to help ease anxiety and stress or to address difficulty sleeping. A session generally moves through induction, deepening, therapeutic suggestion, and re-alerting, and may include training in self-hypnosis for practice between sessions. Responsiveness to hypnosis varies considerably from person to person.
At a Glance
- A 2019 meta-analysis of 17 trials found the average person receiving hypnosis for anxiety reduced anxiety more than about 79% of untreated control participants at the end of treatment[3]
- The same analysis reported that hypnosis tended to be more effective for anxiety when combined with other psychological therapies than when used on its own[3]
- A meta-analysis of randomized trials found hypnotherapy shortened the time to fall asleep compared with a waitlist, but not compared with a sham treatment, and rated most included studies as low methodological quality[4]
- Responsiveness to hypnotic suggestion, sometimes called hypnotizability, varies considerably between individuals, which may influence how much a given person benefits
- Because hypnosis can foster inaccurate recollections through unintended suggestion, it is generally not considered a reliable method for recovering forgotten memories[5]
Overview
Hypnosis is not sleep or a loss of control. It is a state of focused attention and absorption in which you may be more open to helpful suggestions. During hypnotherapy, the clinician guides you into that state and uses suggestions and imagery tailored to the changes you are working toward. You generally remain aware and can decline suggestions that do not fit your goals.
In psychiatric treatment, hypnotherapy is usually an adjunct to psychotherapy and, when appropriate, medication management. It is commonly explored for anxiety, stress-related tension, and difficulty falling or staying asleep. Hypnosis has also been studied for pain, irritable bowel syndrome, and anxiety around medical or dental procedures, although the strength of the evidence varies by condition.
People differ considerably in how readily they respond to hypnotic suggestion, so the approach is collaborative and individualized. Many clinicians also teach self-hypnosis for use between sessions, which may extend the benefit of the work done together.
What to Expect
- Initial assessment of your goals and history, and of suitability for hypnotherapy, including screening for conditions where hypnosis may not be appropriate.
- Explanation of what hypnosis is and is not, addressing common misconceptions, and obtaining informed consent for the approach.
- Induction, in which the clinician guides you into a relaxed, focused state using verbal cues, breathing, or imagery.
- Deepening, which gently increases the sense of focus and absorption.
- Therapeutic suggestion, in which tailored suggestions and imagery are offered in support of your specific goals, such as easing anxiety or preparing for sleep.
- Optional training in self-hypnosis so that you can practice the techniques independently between sessions.
- Re-alerting, in which the clinician guides you back to ordinary, fully alert awareness.
- Brief discussion of the experience and any suggestions for practice before the next session.
How does Hypnotherapy work?
- Hypnosis is thought to shift attention inward and narrow awareness of the surrounding environment. This produces focused absorption in which a person may be more receptive to constructive suggestions. It is not sleep or unconsciousness. You generally remain aware and retain the ability to end the session.
- Within that state, the clinician uses therapeutic suggestions and guided imagery directed toward your goals. These might involve cultivating calm, reframing anxious thoughts, or settling the mind toward sleep. The suggestions are collaborative and do not override your values or judgment.
- Many clinicians teach self-hypnosis, which gives you a way to enter a similar state on your own between sessions. Regular practice may reinforce the techniques over time.
- The precise mechanisms behind hypnosis are not fully understood and remain an area of active research. Attention, expectation, and individual differences in responsiveness to hypnosis are all believed to play a role.
When It's Recommended
- Anxiety symptoms and stress-related tension, often as an adjunct to psychotherapy
- Difficulty falling or staying asleep (insomnia), typically alongside sleep-focused behavioral approaches
- Support for coping with chronic pain as part of a broader treatment plan
- Symptom management in irritable bowel syndrome through gut-directed hypnotherapy
- Anxiety associated with medical or dental procedures
Have questions about this treatment?
Reach out to learn more from Mario A. Benitez-Lopez.
Recovery & Aftercare
- Hypnotherapy involves no physical procedure, and most people are able to return to their usual activities right after a session
- Any short-lived drowsiness or lightheadedness typically resolves quickly once ordinary awareness returns
- Benefits generally develop gradually over a series of sessions rather than after a single session
- Practicing self-hypnosis between sessions, when taught, may help reinforce and maintain the techniques over time
Alternative Treatments
- Psychotherapy, including cognitive behavioral therapy, and cognitive behavioral therapy for insomnia (CBT-I) for sleep difficulties
- Relaxation training, mindfulness, and other stress-reduction approaches
- Medication management when clinically indicated, typically discussed with a prescribing clinician
Frequently Asked Questions
- Hypnotherapy is the clinician-guided use of hypnosis – a state of focused attention and heightened responsiveness to suggestion – to work toward specific therapeutic goals. In psychiatric treatment, it is generally used alongside psychotherapy rather than as a standalone treatment, often to ease anxiety or improve sleep.
- No. Hypnotherapy involves no needles, medication, or physical procedure, so it is not painful. Most people describe it as deeply relaxing. Some people feel briefly drowsy or lightheaded afterward, and difficult emotions can occasionally surface during the work.
- For most people, hypnotherapy is generally considered safe when provided by a qualified, appropriately trained clinician. It may not be suitable for people with certain psychotic or dissociative disorders. The risks and cautions section explains these concerns in more detail.
- There is no fixed number. Benefits usually build gradually over a series of sessions rather than appearing after one session. Sessions are often scheduled weekly, and the plan is tailored to your goals. Self-hypnosis may also be taught for practice between sessions.
- A session usually begins with a discussion of your goals. The clinician then uses an induction to guide you into a relaxed, focused state, followed by suggestions and imagery aimed at those goals. The session ends with re-alerting to ordinary awareness. You generally remain aware throughout and can end the session at any time.
- Hypnotherapy may not be appropriate for people with active psychotic disorders involving hallucinations or delusions, or for people with dissociative disorders, because heightened suggestion and imagery could worsen symptoms. It is not a substitute for indicated psychiatric treatment. A thorough evaluation helps determine whether it is a suitable option.
- I use it as an adjunct to a primary treatment, not as my starting point. For chronic insomnia, I begin with CBT-I, the first-line behavioral treatment with the strongest evidence behind it. For anxiety, the starting point is usually CBT or exposure work, depending on the pattern. Hypnosis can support those treatments, particularly when physical arousal keeps someone tense at bedtime, but it remains an addition to the treatment plan.
- Then we use something else. This is a real possibility because responsiveness to hypnosis varies considerably and cannot be predicted beforehand. Hypnosis is one of several approaches I use, so finding that it does not suit you costs a few sessions rather than requiring a referral and a new intake elsewhere.
What are the risks of Hypnotherapy?
Who should avoid this
- Active psychotic disorders, such as conditions involving hallucinations or delusions, where the use of imagery and heightened suggestion may worsen symptoms; hypnosis is generally avoided or reserved for specialist settings
- Situations that would involve processing significant trauma outside a structured, appropriately supervised framework
- As a replacement for indicated psychiatric treatment of serious conditions, where established therapies are generally the primary approach
- Active intoxication with drugs or alcohol, which can interfere with focused attention and informed participation
Who needs extra care
- Dissociative disorders, where the focused, dissociation-like quality of hypnosis may exacerbate an already unstable sense of self and warrants caution or specialist care
Possible risks
- Transient dizziness, drowsiness, or headache may occur during or shortly after a session
- Emotional distress can arise when difficult thoughts, feelings, or memories surface during the work
- Hypnosis can foster false or distorted recollections, particularly when leading questions or unintended suggestions are involved, and it is not an appropriate technique for attempting to recover forgotten memories
- For people with certain conditions, such as psychotic or dissociative disorders, hypnosis may worsen symptoms and is generally approached with caution or avoided
- This is not an exhaustive list of potential risks; discuss any concerns with a qualified clinician before beginning treatment
Your practitioner
Mario A. Benitez-Lopez, MD
I am a board-certified adult psychiatrist and the founder of San Francisco Concierge Psychiatry. I completed my psychiatry residency at the University of Washington and hold a master's in clinical research from Stanford. I offer bilingual (English and Spanish) care in a concierge model built around small panels and longer sessions, spanning medication management, deprescribing, and evidence-based individual and couples therapy.
Sources & references
This article draws on 6 sources, including government health agencies, peer-reviewed research, leading medical institutions.
Government & research
- NCCIH – Hypnosis
- The Efficacy of Hypnosis as a Treatment for Anxiety: A Meta-Analysis (International Journal of Clinical and Experimental Hypnosis, 2019)
- Hypnotherapy for Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (Complementary Therapies in Medicine, 2015)
- Frontiers in Psychology – The Role of Hypnosis in Memory Recall and False Memory Formation (2025)
Medical institutions
Medically reviewed by Mario A. Benitez-Lopez, MD · Last reviewed: 2026-08-31