Hypnosis in the Treatment of Depression (2026)
Merranda McLaughlin
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Barbara S. McCann
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
Correspondence: mccann@uw.edu
Keywords: hypnosis; depression; evidence-based therapy; imagery; positive expectancy; behavioral activation
Depression is a leading cause of disability worldwide, profoundly impairing emotional well-being, cognition, interpersonal functioning, and daily life, while posing a substantial public health burden (Liu et al., 2020). Depression is widely understood to emerge from a confluence of genetic, biological, psychological, and environmental influences and is maintained through interacting processes such as negative cognitive patterns, behavioral withdrawal and avoidance, emotional dysregulation, interpersonal difficulties, and reduced environmental reinforcement (Beck & Bredemeier, 2016). Various forms of psychotherapy (CBT, behavioral activation, and interpersonal therapy), as well as antidepressant medications, are well-established evidence-based treatments for depression and are effective for many individuals (Cuijpers, 2017). However, many clients experience treatment resistance, partial response, and/or difficulties with adherence or tolerability (McIntyre et al., 2023).
The integration of hypnotic strategies into psychotherapy represents an evidence-based, though comparatively underutilized, approach for addressing these maintaining factors in depression. Hypnosis has been defined as “a state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion” (Elkins et al., 2015). Contemporary clinicians integrate hypnotic strategies through multiple theoretical orientations, including cognitive behavioral therapy (CBT; Alladin, 2010; Yapko, 2001), Ericksonian approaches (Çınaroğlu et al., 2026), and others.
Research examining hypnotic strategies, though limited, is promising. Two meta-analyses found hypnotic interventions to be significantly more effective than control conditions for reducing depressive symptoms (Milling et al., 2019; Shih et al., 2009). Milling et al. (2019) and a transdiagnostic meta-analysis of Ericksonian hypnosis (Çınaroğlu et al., 2026) further noted that the magnitude of improvement associated with hypnosis was comparable to established evidence-based psychotherapies. More recent randomized controlled trials (RCTs) comparing CBT with hypnotic strategies to CBT alone for mild-to-moderate major depressive disorder demonstrated that CBT with hypnotic strategies had equivalent effectiveness to CBT alone at posttreatment and at follow-up (Fuhr et al., 2021, 2023).
Some studies suggest that CBT with hypnosis may outperform CBT alone on certain depressive outcomes (Alladin & Alibhai, 2007), although outcomes beyond 12 months may ultimately be comparable (Fuhr et al., 2023). Additionally, a meta-analysis examining CBT with hypnosis across multiple conditions (such as mood disturbance, pain, and obesity) found that CBT with hypnosis generally produced superior posttreatment outcomes compared to CBT alone (Ramondo et al., 2021). However, follow-up periods in this literature remain relatively short, and further high-quality research specific to depression is needed.
Several mechanisms have been proposed to explain why hypnotic strategies may augment psychotherapy for depression. Alladin (2010) suggested that hypnosis may deepen experiential and emotional engagement with newly developed adaptive beliefs, thereby strengthening cognitive restructuring processes. Moreover, hypnosis may enhance positive expectancy and reduce hopelessness, both of which are highly relevant to depressive symptomatology (Alladin & Alibhai, 2007). Hypnosis may bolster the effectiveness of specific components of CBT, such as behavioral activation (McCann & Collin, 2024). Posthypnotic suggestions may increase the application of therapeutic skills outside of sessions (Yapko, 2001), while self-hypnosis practice may contribute to the maintenance of therapeutic gains over time (Ramondo et al., 2021). Hypnotic procedures involving imagery, future-oriented rehearsal, attentional shifting, and emotional regulation may also help counteract entrenched patterns of rumination, withdrawal, and negative self-appraisal frequently observed in depression (Yapko, 2001).
Overall, current evidence suggests that hypnotic strategies in the treatment of depression are promising. Although more RCTs are needed, particularly regarding long-term outcomes and mechanisms of change, existing findings support the use of hypnosis in depression treatment. Hypnosis may be an additional avenue for treatment for individuals who do not fully respond to medication or traditional psychotherapeutic approaches alone.
References
Alladin, A. (2010). Evidence-based hypnotherapy for depression. International Journal of Clinical and Experimental Hypnosis, 58(2), 165–185. https://doi.org/10.1080/00207140903523194
Alladin, A., & Alibhai, A. (2007). Cognitive hypnotherapy for depression: An empirical investigation. International Journal of Clinical and Experimental Hypnosis, 55(2), 147–166. https://doi.org/10.1080/00207140601177897
Beck, A. T., & Bredemeier, K. (2016). A unified model of depression: Integrating clinical, cognitive, biological, and evolutionary perspectives. Clinical Psychological Science, 4(4), 596–619. https://doi.org/10.1177/2167702616628523
Çınaroğlu, M., Yılmazer, E., & Noyan Ahlatcıoğlu, E. (2026). Ericksonian hypnotherapy: A systematic review and meta-analysis of RCTs. Psychiatry International, 7(1), Article 16. https://doi.org/10.3390/psychiatryint7010016
Cuijpers, P. (2017). Four decades of outcome research on psychotherapies for adult depression: An overview of a series of meta-analyses. Canadian Psychology/Psychologie Canadienne, 58(1), 7-19. https://doi.org/10.1037/cap0000096
Elkins, G. R., Barabasz, A. F., Council, J. R., & Spiegel, D. (2015). Advancing research and practice: The revised APA Division 30 definition of hypnosis. American Journal of Clinical Hypnosis, 57(4), 378-385. https://doi.org/10.1080/00207144.2014.961870
Fuhr, K., Meisner, C., Broch, A., Cyrny, B., Hinkel, J., Jaberg, J., Petrasch, M., Schweizer, C., Stiegler, A., Zeep, C., & Batra, A. (2021). Efficacy of hypnotherapy compared to cognitive behavioral therapy for mild to moderate depression: Results of a randomized controlled rater-blind clinical trial. Journal of Affective Disorders, 286, 166–173. https://doi.org/10.1016/j.jad.2021.02.069
Fuhr, K., Meisner, C., & Batra, A. (2023). Long-term outcomes of depression treatment with hypnotherapy or cognitive behavioral therapy. Journal of Nervous and Mental Disease, 211(7), 519–524. https://doi.org/10.1097/NMD.0000000000001647
Liu, Q., He, H., Yang, J., Feng, X., Zhao, F., & Lyu, J. (2020). Changes in the global burden of depression from 1990 to 2017: Findings from the Global Burden of Disease study. Journal of Psychiatric Research, 126, 134-140. https://doi.org/10.1016/j.jpsychires.2019.08.002
McCann, B. S., & Collin, A. (2024). Hypnotically enhancing behavioral activation in the treatment of depression. American Journal of Clinical Hypnosis, 66(2), 97–107. https://doi.org/10.1080/00029157.2023.2270005
McIntyre, R. S., Alsuwaidan, M., Baune, B. T., Berk, M., Demyttenaere, K., Goldberg, J. F., Gorwood, P., Ho, R., Kasper, S., Kennedy, S. H., Ly-Uson, J., Mansur, R. B., McAllister-Williams, R. H., Murrough, J. W., Nemeroff, C. B., Nierenberg, A. A., Rosenblat, J. D., Sanacora, G., Schatzberg, A. F., … Maj, M. (2023). Treatment‐resistant depression: Definition, prevalence, detection, management, and investigational interventions. World Psychiatry, 22(3), 394-412. https://doi.org/10.1002/wps.21120
Milling, L. S., Valentine, K. E., McCarley, H. S., & LoStimolo, L. M. (2019). A meta-analysis of hypnotic interventions for depression symptoms: High hopes for hypnosis? American Journal of Clinical Hypnosis, 61(3), 227–243. https://doi.org/10.1080/00029157.2018.1489777
Ramondo, N., Gignac, G. E., Pestell, C. F., & Byrne, S. M. (2021). Clinical hypnosis as an adjunct to cognitive behavior therapy: An updated meta-analysis. International Journal of Clinical and Experimental Hypnosis, 69(2), 169–202. https://doi.org/10.1080/00207144.2021.1877549
Shih, M., Yang, Y.-H., & Koo, M. (2009). A meta-analysis of hypnosis in the treatment of depressive symptoms: A brief communication. International Journal of Clinical and Experimental Hypnosis, 57(4), 431–442. https://doi.org/10.1080/00207140903099039
Yapko, M. D. (2001). Treating depression with hypnosis: Integrating cognitive-behavioral and strategic approaches. Routledge. https://doi.org/10.4324/9780203717523