Self-hypnosis · Atlas

1. Introduction

Version followed: clinician-taught self-hypnosis as described in American Society of Clinical Hypnosis (ASCH) teaching material (Linda Thomson's self-hypnosis teaching decks) and the UW–Madison Osher Center clinician tool (Rakel, adapted from Gurgevich 2007), with Capafons' Rapid Self-Hypnosis (Valencia, 1998) as the named eyes-open variant, David Spiegel's floating and split-screen exercises (Stanford) as described by Spiegel himself, and the 8-session HYlaDO self-hypnosis programme structure (Montréal) for group or course delivery. Self-hypnosis is a skill and delivery format used across clinical hypnosis, not a single manualised therapy; there is no one founder or treatment manual. [source: Thomson, ASCH; UW Osher; Capafons 1998; Ogez et al. 2024]

What it is. Self-hypnosis is a hypnotic state the client enters on their own, without the therapist present, to relax, gain self-control over a symptom or response, or build self-efficacy. It relies on focused attention, inner absorption and receptiveness to the client's own suggestions. ASCH teaching distinguishes it from hetero-hypnosis (therapist-guided) and spontaneous trance. [source: Thomson, ASCH]
Core idea of change. The client learns a repeatable sequence (entry, deepening, self-suggestion or imagery, re-alerting) first with the therapist, then with less and less help, until a brief personal cue reliably brings on the state and the client can apply suggestions in daily life. Capafons frames this in behavioural terms: shaping, chaining and fading, reinforced by the therapist's praise, by the bodily experience of responding, and by the client's growing self-efficacy. The Osher tool and many clinicians teach that "all hypnosis is self-hypnosis" (a view Thomson attributes to Erickson, 1948, and questions), meaning the client is always the one producing the state and stays in control. [source: Capafons 1998; UW Osher; Thomson, ASCH]
Scope in this guide. Clinical use only, by licensed professionals within their competence, as an adjunct to psychotherapy or, for physical symptoms, as an adjunct within medical care after medical assessment. It is not a treatment for physical disease, and never a way to retrieve or verify memories. Stage hypnosis and any non-consensual use are outside clinical practice. [synthesis; source for stage-hypnosis harm: Gruzelier]

2. Framework

No source gives one fixed schedule. The phases below combine Thomson's prerequisites and three teaching stages (ASCH), the Osher clinic-then-home sequence, Capafons' graded steps, and the course formats of HYlaDO and the Jensen/Williams VA trial. [source: as named per phase]

Phase 0 – Assessment, screening and consent (session 1, often combined with Phase 1)

Goals: confirm the problem has been assessed medically where relevant (Spiegel's example: chest pain may be cardiac, which hypnosis would not address); screen for vulnerability (see contraindications below); agree goals; obtain informed consent. [source: Spiegel, Huberman Lab; Gruzelier]
Optional: estimate hypnotic responsiveness. Options in the sources: Spiegel's Hypnotic Induction Profile (scored 0–10) and his quick eye-roll sign; Capafons' pre-assessment with falling-backward and interlaced-fingers exercises; the Modified Stanford Hypnotic Clinical Scale (used in the Jensen/Williams trial). Use licensed scales as published; items are not reproduced here. [source: Spiegel, Huberman Lab; Capafons 1998; NCT02653664 protocol]
Move on when: the client is screened as suitable, medically assessed where needed, and consents.

Phase 1 – Education and tailoring (part of session 1)

Goals: remove fear and misconceptions with everyday analogies (daydreaming, "driving trance", absorption in a film); stress that hypnosis needs the client's cooperation and does not remove control; set realistic expectations that this is a skill that improves with practice; gather material for tailoring (favourite place, colour, activities). [source: UW Osher; Thomson, ASCH]

Phase 2 – A positive guided (hetero-hypnotic) experience, separate from the problem (sessions 1–2)

Goals: give the client a pleasant, successful first experience; let them notice hypnotic phenomena (heaviness, lightness, time change); build basic entry and deepening skills. Thomson's rule: teach hypnosis separately from the presenting problem, and introduce self-hypnosis only after orientation, a positive trance experience, exposure to hypnotic phenomena and some induction and deepening skill. [source: Thomson, ASCH]
Move on when: the client has had at least one comfortable experience and can describe how they got there. In Capafons' method, do not move to the next step until the expected sensations appear and any fears, disbelief or disappointment are resolved. [source: Capafons 1998]

Phase 3 – Teaching self-hypnosis: three stages of fading (sessions 2–4, plus home practice)

Stage A: the therapist coaches every step. Stage B: the therapist gives only reminders while the client runs the sequence. Stage C: the client guides themselves with no therapist input. [source: Thomson, ASCH]
An audio recording may be given as temporary support ("training wheels"), to be dropped when the client is ready. [source: Thomson, ASCH; HYlaDO in Ogez et al. 2024]
Before leaving the session, the client mentally rehearses doing it at home (when, where, how) and reviews how they reached the state so they can repeat it. [source: Thomson, ASCH]

Phase 4 – Application to the target problem

Goals: add problem-specific self-suggestions or imagery (relaxation, alertness, comfort, temperature change, split-screen restructuring of stressors, pain imagery) to the established routine. [source: Capafons 1998; UW Osher; Spiegel, Huberman Lab; Ogez et al. 2024]

Phase 5 – Consolidation and generalisation

Goals: practise in varied places; shorten the routine to a brief cue usable with eyes open in daily situations; review use and adjust. [source: Capafons 1998]

Typical session counts and formats (by version)

Osher clinic tool: one in-clinic walk-through of the full sequence, then home use; for symptoms such as headache, no limit on how often it is used. [source: UW Osher]
Spiegel: clinical hypnosis often in one or two sessions; his app uses elements of about 15 minutes and refreshers of one to two minutes. [source: Spiegel, Huberman Lab]
Capafons Rapid Self-Hypnosis: session number not stated; practice the full sequence three times a day (morning, afternoon, night) in varied places. [source: Capafons 1998]
HYlaDO (chronic pain, version 1.0): eight sessions – an introduction, an introduction to hypnosis, five sessions each built on one guided exercise with self-practice advice, and a closing feedback session; delivered by a hypnotherapist as weekly videoconferences, with recordings and written self-practice guidance. [source: Ogez et al. 2024]
Jensen/Williams VA trial (chronic pain): manualised group self-hypnosis training, eight weekly sessions of about 90 minutes, with homework. The detailed session content was not available in the protocol excerpt opened. [source: NCT02653664 protocol] [uncertain]

Screening and contraindications given in the sources

Screen vulnerable individuals; serious unwanted effects (chronic psychopathology, seizures, stupor, spontaneous dissociative episodes, resurfacing of trauma memories often with age regression, two first-episode schizophrenia cases) occur almost only in clinical and stage use; risk factors named are high hypnotizability with strong personal involvement and vulnerability to schizophrenia. Common, short-lived effects include headache, linked to de-hypnotising and anxiety. [source: Gruzelier]
Exclusions used in self-hypnosis trials (research criteria, not formal clinical contraindications): psychotic or major thought disorder; recent psychiatric hospitalisation or unstable severe psychiatric conditions; active suicidal intent; active delusional thinking; severe cognitive impairment; recent misuse of dissociative anaesthetics, hallucinogens, opioids, cocaine or amphetamines; structural brain disease such as dementia or disabling stroke; hearing impairment for audio-only programmes. [source: NCT02653664 protocol; Stanford NCT03931772]
Added [synthesis]: severe dissociative disorders and unprocessed trauma (self-hypnosis imagery can trigger intrusions; teach only within a phase-based trauma plan after stabilisation); epilepsy (given Gruzelier's seizure reports, discuss with the treating physician); never practise while driving or operating machinery; no self-hypnosis for age regression or memory retrieval.

3. Guiding principles

The client is in control; hypnosis needs cooperation. Say so early and act on it: the client can stop, open their eyes or change any suggestion at any time. [source: UW Osher]
Educate before inducing. Fear and myths block response; spend the first minutes on analogies and questions. [source: UW Osher]
Tailor every element. Build the imagery from the client's own favourite place, colours and activities, not a stock script. [source: UW Osher]
Teach the skill separately from the problem. Get a good, neutral experience first; only then point it at symptoms. [source: Thomson, ASCH]
Skill-building frame and realistic expectations. Present self-hypnosis as a learnable skill that improves with practice and depends on effort, not as something done to the client. [source: Thomson, ASCH; Capafons 1998]
Be permissive and collaborative. Offer choices, co-write suggestions with the client, phrase them positively, invite corrections and ask for feedback each time. [source: Thomson, ASCH]
There is no failure. Treat any experience as information for adjusting the method (a view Thomson attributes to Brown and Fromm, 1986). [source: Thomson, ASCH]
Shape, chain and fade. Build the routine in small steps, link them, then remove the therapist's prompts and the scaffolding exercises so the client's own cue does the work. [source: Capafons 1998; Thomson, ASCH]
Do not advance past a step that is not working. Explore fears, disbelief or disappointment before going on; switch method if needed. [source: Capafons 1998]
The anchor is the client's own response. In Rapid Self-Hypnosis the cue is the client's recalled bodily sensation, not a therapist-installed post-hypnotic command; this keeps ownership with the client. [source: Capafons 1998]
Practise often and in varied places. Generalisation needs repetition outside the consulting room. [source: Capafons 1998]
Use it only when attention is free. Not while driving or when attention is needed elsewhere. [source: Thomson, ASCH; driving example is synthesis]
Keep the body comfortable whatever is on the screen. In Spiegel's approach, the client learns to keep physical calm while looking at a problem, which separates bodily reaction from the stressor. [source: Spiegel, Huberman Lab]
Medical assessment comes first. Self-hypnosis supports medical care for physical symptoms; it does not replace diagnosis or treatment. [source: Spiegel, Huberman Lab]
Screen for vulnerability. Assess psychosis risk, dissociation and trauma history before teaching. [source: Gruzelier]
Match method to client. Clients with an internal locus of control, self-reliance and comfort with fantasy tend to do well; clients who prefer dependence on the therapist or need high structure may need more support or another method. [source: Thomson, ASCH]
End with confidence and enjoyment. Close sessions with ego-strengthening feedback and keep practice pleasant. [source: Thomson, ASCH]

4. Intervention inventory

The sources give names and structures but few full scripts. All example wording below is illustrative, written for this guide, not taken from any founder's script. The usual order in a session is: preparation and consent, entry (induction), deepening, therapeutic self-suggestion or imagery, re-alerting, debrief, then home-practice planning.

4.1 Screening, consent and goal-setting

Purpose / when: First session, before any induction.
Steps: (1) Take the history and check that physical symptoms have been medically assessed. (2) Screen for psychosis or psychosis risk, severe or unstable psychiatric illness, active suicidal intent, severe dissociation, unprocessed trauma, severe cognitive impairment, recent dissociative or hallucinogenic drug misuse, and seizure history (criteria in Section 2). (3) Explain what self-hypnosis is and is not, common short-lived effects (for example headache or lingering drowsiness), and that it supports rather than replaces other care. (4) Agree one concrete goal and how you will both know it is helping. (5) Record consent. [source: Gruzelier; NCT02653664; NCT03931772; Spiegel, Huberman Lab; consent sequence is synthesis]
Example language (illustrative): "Before we try anything, I want to check a few health questions and explain what this will and won't do. You'll be in charge the whole time, and you can stop whenever you like."
Watch for: unusual beliefs about mind control, wishes to "find out what really happened" (redirect: self-hypnosis is not used to retrieve memories), hidden medical issues behind the symptom.

4.2 Education and demystification

Purpose / when: Remove fear and set the skill frame; session 1 and whenever doubts surface. [source: UW Osher; Thomson, ASCH]
Steps: (1) Ask what the client has heard about hypnosis. (2) Link the state to familiar experiences: daydreaming, arriving somewhere by car without remembering the drive, being absorbed in a film. (3) State that it needs the client's cooperation and does not take away control. (4) Present it as a skill that grows with practice. (5) Contrast with stage shows if the client raises them.
Example language (illustrative): "You already know this state – the way a good film pulls you in. We're going to learn to switch that kind of focus on deliberately and use it for something you choose."
Watch for: relief, questions, a willingness to try. Persistent fear means more discussion before induction.

4.3 Tailoring interview

Purpose / when: Collect material to personalise imagery; session 1. [source: UW Osher]
Steps: Ask for a favourite place (real or imagined), favourite colour, favourite activities, and sensory details (sounds, smells, textures). Ask what the client does not want included (for example water, heights, being alone). Write the answers down and use them in the scripted elements.
Example language (illustrative): "Where do you feel most at ease? What do you notice there – the sounds, the light, the smells?"
Watch for: places tied to loss or trauma; choose another or let the client invent one. [synthesis]

4.4 Estimating hypnotic responsiveness (optional)

Purpose / when: To inform expectations and method choice, not to exclude people. [source: Spiegel, Huberman Lab; Capafons 1998; NCT02653664]
Steps: Options: (a) Spiegel's eye-roll sign – the client tilts the head back slightly, looks up, then lowers the eyelids while still looking up; more white of the eye showing roughly suggests higher hypnotizability. Spiegel calls this a rough indicator only; the formal measure is his Hypnotic Induction Profile (0–10). (b) Capafons' pre-assessment with a falling-backward exercise and an interlaced-fingers exercise. (c) A standardised clinical scale such as the Modified Stanford Hypnotic Clinical Scale. Administer licensed scales from their published manuals.
Example language (illustrative): "This quick check gives us a rough idea of how naturally this comes to you. Whatever the result, we'll find a version that fits."
Watch for: Spiegel's figures: roughly two-thirds of adults are hypnotizable, about 15% highly; hypnotizability is fairly stable and training changes it only slightly, so focus on the problem rather than on raising scores. Low scorers may do better with Capafons' method, relaxation-based skills or non-hypnotic approaches. [source: Spiegel, Huberman Lab; Capafons 1998]

4.5 First guided experience (hetero-hypnosis), problem-neutral

Purpose / when: Give a positive first trance and expose the client to hypnotic phenomena before self-practice. [source: Thomson, ASCH]
Steps: (1) Choose one entry method (4.6–4.10) and one deepening method (4.11–4.13). (2) Guide the client through entry, deepening and a pleasant neutral experience (for example the favourite place). (3) Add one simple phenomenon, such as noticing heaviness or lightness in a hand, or time seeming to pass differently. (4) Close with ego-strengthening and re-alerting (4.22). (5) Debrief (4.23).
Example language (illustrative): "There's nothing to fix today. Just notice what it's like to settle in, and let any heaviness or lightness come in its own way."
Watch for: comfort, slower breathing, stillness, and afterwards a report that it was pleasant. Discomfort or intrusive images means stop, re-alert and review suitability.

4.6 Breath-based entry

Purpose / when: The simplest entry; first choice for children and anxious clients. [source: Thomson, ASCH; Spiegel, Huberman Lab]
Steps: (1) Sit comfortably, feet supported. (2) Take one deep breath, then breathe out slowly; Spiegel stresses the slow exhale as the signal that this is time to relax. (3) Continue with relaxed belly breathing, attention on the rise and fall. (4) With each out-breath, let a little more tension go. (5) Move to a deepening method.
Example language (illustrative): "Take one full breath in … and let it out slowly, longer than the in-breath. Let that slow breath out tell your body it's time to rest."
Watch for: over-breathing or dizziness; slow the pace and return to normal breathing.

4.7 Eye-roll entry

Purpose / when: A fast, structured entry that clients can repeat alone. [source: ASCH eye-roll deepening script; Spiegel, Huberman Lab for the eye-roll sign]
Steps (structure from the ASCH eye-roll script, paraphrased): (1) Roll the eyes upward. (2) Slowly close the eyelids while taking a deep breath and holding it. (3) Breathe out, let the eyes relax, and imagine drifting down into a warm, pleasant feeling. (4) Notice the chair and floor supporting the body and let the body rest into that support. (5) Follow the breath, releasing tension on each exhale. (6) Continue with a body scan or safe place.
Example language (illustrative): "Look up as if at the top of your head … now let your eyelids close while you keep looking up, and take a deep breath and hold it … breathe out, let your eyes relax, and let yourself sink into the chair."
Watch for: eye strain or headache (keep the eye-roll brief); contact lens discomfort. [uncertain] Spiegel's full self-hypnosis instructions in his book Trance and Treatment are not drawn on; only the eye-roll sign, floating and the split screen are taken from Spiegel.

4.8 Eye opening and closing with the breath

Purpose / when: An eye-based entry listed in ASCH self-hypnosis teaching for clients who like a rhythmic task. [source: Thomson, ASCH]
Steps: The deck names this method without steps. A workable sequence [synthesis]: on each in-breath open the eyes; on each out-breath close them; let the eyelids grow heavier with each cycle; after several cycles allow them to stay closed and continue to deepening.
Example language (illustrative): "Open your eyes as you breathe in, close them as you breathe out … and whenever they'd rather stay closed, let them."
Watch for: eyes staying closed on their own is the usual sign of entry. [synthesis]

4.9 Progressive muscle relaxation or body scan

Purpose / when: Entry or deepening for tense clients; a building block in ASCH self-hypnosis teaching and the eye-roll script. [source: Thomson, ASCH; ASCH eye-roll script]
Steps: Either tense and release muscle groups in turn (PMR), or, without tensing, relax each area on an out-breath, from the feet and legs up through the torso, arms, shoulders, neck, face and jaw.
Example language (illustrative): "Breathing out, let your feet and legs go soft … next breath, your belly and chest … then your shoulders, letting them drop."
Watch for: muscle tension in jaw and shoulders easing; with pain conditions, avoid strong tensing of painful areas. [synthesis]

4.10 Magnetic fingers

Purpose / when: An ideomotor elicitation listed in ASCH self-hypnosis teaching; it gives the client a visible sign of response. [source: Thomson, ASCH]
Steps: No steps are given in the source opened. A common form [synthesis, general practice, not attributed]: clasp the hands, extend the two index fingers so they point up with a gap between them, focus on the gap and imagine the fingers drawn together as if by magnets; when they touch, let the hands rest in the lap and continue.
Example language (illustrative): "Just watch the space between your fingers, and notice whether they seem to want to move closer."
Watch for: fingers drifting together is the sign; if nothing happens, treat it as information and switch method (no failure). [uncertain] the exact ASCH version is not drawn on here.

4.11 Finger-press trigger

Purpose / when: A brief cue the client can use anywhere to start the state; taught in the Osher clinic tool. [source: UW Osher]
Steps: (1) Press thumb and index finger together (an "OK" sign). (2) Take a deep breath and hold it for a count of five. (3) Breathe out and release the fingers at the same time. (4) Continue into the staircase or safe place, or use it alone as a quick reset.
Example language (illustrative): "Press your thumb and finger together, breathe in and hold … two, three, four, five … and as you breathe out, let your fingers and your shoulders go."
Watch for: over time the gesture should bring a quicker sense of calm; pair it consistently with the full routine first.

4.12 Staircase deepening

Purpose / when: The Osher tool's induction and deepening step. [source: UW Osher]
Steps: (1) Imagine a staircase of ten steps leading down to the favourite place. (2) Count down from ten to one, one step per breath. (3) On each step relax one area in turn: face and jaw, temples and eyes, neck and shoulders, arms, chest, belly, pelvis, legs, toes. (4) Arrive at the place at one.
Example language (illustrative): "Ten … stepping down, letting your jaw loosen. Nine … your eyes and temples softening …"
Watch for: fear of stairs or falling; offer a path, lift or slope instead. [synthesis]

4.13 Safe or favourite place

Purpose / when: Deepening and a stable base for later work; used in the Osher tool and the ASCH eye-roll script. [source: UW Osher; ASCH eye-roll script]
Steps: (1) Arrive at the place from the tailoring interview. (2) Explore it through each sense (sights, sounds, smells, temperature). (3) Notice what makes it feel safe and protected. (4) Settle there. The ASCH script adds a time-expansion step: a few minutes feel much longer, so the calm feels lasting. The Osher tool notes the exploration step can be skipped when time is short.
Example language (illustrative): "Look around your place … what colours are there? What can you hear? Find the spot where you feel most protected, and settle there."
Watch for: negative intrusions into the place; change the place or add protective features chosen by the client, and if distress continues, re-alert. [synthesis]

4.14 Floating

Purpose / when: Spiegel's core body state for self-hypnosis, used for stress, sleep and pain. [source: Spiegel, Huberman Lab]
Steps: After the breath entry, imagine the body floating somewhere safe and comfortable (a bath, a warm pool, space), and keep that floating comfort as the background for any further work.
Example language (illustrative): "Let your body feel as if it's floating – in warm water, or wherever floating feels best to you – supported and light."
Watch for: in Capafons' data many people did not feel floating with Spiegel's method; if floating does not come, use heaviness instead (4.18). [source: Capafons 1998]

4.15 Split screen

Purpose / when: Spiegel's restructuring exercise for stress, worry and sleep; keeps the body calm while the mind looks at a problem. [source: Spiegel, Huberman Lab]
Steps: (1) Enter the floating state (4.14). (2) Picture an imaginary screen and put the stressor on it. (3) The one rule: whatever appears on the screen, the body stays floating and comfortable. (4) Optionally, use a second half of the screen for what the client can do about the problem (Spiegel describes this pairing for traumatic material: the feared event on one side, the person's protective actions on the other). (5) Re-alert.
Example language (illustrative): "Keep your body floating. Now let the worry show up on a screen in front of you – you can look at it, while your body stays exactly as comfortable as it is now."
Watch for: the client reports seeing the problem with less bodily arousal and some sense of control over their reaction. Trauma caution: use the trauma version only inside a phase-based trauma treatment, after stabilisation, with readiness assessed, the client in control of screen distance and content, grounding rehearsed, and the material treated as the client's experience, not as historical fact to be uncovered. Stop and ground if the client becomes overwhelmed or dissociates (Section 5). [synthesis for the trauma safeguards]

4.16 Writing self-suggestions with the client

Purpose / when: Phase 4, when pointing the skill at the goal. [source: Thomson, ASCH]
Steps: (1) Draft suggestions together. (2) Phrase them positively (what the client wants, not what they want to avoid). (3) Keep them permissive and believable. (4) Let the client correct the wording until it sounds like their own voice. (5) Add ego-strengthening lines (for example about how quickly they are learning). (6) Ask for feedback after trying them, and revise.
Example language (illustrative): client's own line, for example "I can let my shoulders soften whenever I notice them rising" rather than "I won't be tense".
Watch for: suggestions that are absolute, punitive or about other people; rewrite them. [synthesis]

4.17 Symptom-focused imagery (adjunct within medical care)

Purpose / when: Once the routine is stable and the symptom has been medically assessed. Adjunct only, not a treatment for the underlying condition. [source: UW Osher; Spiegel, Huberman Lab; Ogez et al. 2024]
Steps – tension-type headache (Osher): after the safe place, relax the head and imagine a cool mountain breeze on the face and forehead while the hands stay warm (for example in pockets); repeat as needed. The tool notes there is no limit on how often this can be used.
Steps – pain (Spiegel): imagine a change in the painful area such as cooler or warmer, tingling or numb, or float in cool water, or go in imagination to a pleasant place elsewhere; first sort the pain: is it a signal of new damage, which needs attention, or part of healing, which can be turned down?
Steps – pain (HYlaDO themes): guided exercises on emotional release, acceptance, pain modification, pain reduction with a "magic glove" image and confidence building, each ending with suggestions that support self-practice. [uncertain] The exercise contents were not described in the paper opened; only themes and the five-part exercise structure are given.
Example language (illustrative): "Let the area feel a little cooler, as if a cool cloth were resting there … notice any change in the sensation, however small."
Watch for: reduced pain or tension ratings before and after practice (HYlaDO and the VA trial rated pain before and after sessions). New, changed or severe pain needs medical review, not more hypnosis.

4.18 Rapid Self-Hypnosis (Capafons, Valencia)

Purpose / when: An eyes-open, brief, low-imagery method for clients who do not respond to floating or levitation, or who need to use the skill discreetly in daily life. Developed as a coping skill to add to cognitive-behavioural treatment. [source: Capafons 1998]
Steps (structure paraphrased): (1) Preparation: explain the method can be used discreetly; reassure the client they will not fall. (2) Hand pressing: palms together without interlacing fingers; on each slow out-breath press the hands gently together, so that by the third out-breath the hands feel heavy when dropped onto the thighs. If out-breaths are rushed, use the image of breathing out so a candle flame moves but does not go out. (3) Falling back: lean forward slightly from the chair back, then let yourself fall back into it and notice the relaxation and a brief, mild sense of stillness; practise until it is comfortable and inconspicuous. (4) Chaining: press hands on the out-breaths, then drop the hands onto the thighs as you fall back; notice heaviness. (5) Immobility suggestions: eyes may close if the client wishes; the therapist gives slow, rhythmic suggestions that the hands grow heavier and stick to the legs, with optional images (soft rope, glue, a weight); the client tests by trying to lift them. (6) Reversal: suggestions that the hands become light and normal again. (7) Re-alerting: count to three, eyes open, alert, clear and calm.
Example language (illustrative): "Each time you breathe out, press your palms together a little … and as you lean back, let your hands drop and feel how heavy they've become."
Watch for: in Capafons' sample most participants reported strong heaviness. No sensations at all suggests interference (fear of hypnosis or of being hurt, disbelief, disappointment that it is not mysterious): pause and explore before continuing; if still no response, consider sensory-recall training or a non-suggestive method. Caution with clients for whom falling back into a chair is unsafe (for example back problems, frailty). [synthesis for the physical caution]

4.19 Self-cue from sensory recall and eyes-open use

Purpose / when: After Rapid Self-Hypnosis is learned, so the client can bring on the state in seconds, eyes open, and then give themselves suggestions. [source: Capafons 1998]
Steps: (1) Identify the arm that felt heaviest. (2) The client recalls that heaviness and stillness, using the remembered sensation as their own signal. (3) Once heaviness arrives, the client gives themselves a chosen suggestion: relaxation, alertness, numbness or comfort in an area, or warmth or coolness. (4) Practise during conversation and ordinary activities. (5) Fade the full sequence until the cue alone works.
Example language (illustrative): "Remember how your right arm felt when it was heavy and still … let that feeling come back now, and when it's there, say your phrase to yourself."
Watch for: the client controls the cue; Capafons stresses it is their own response, not a therapist's post-hypnotic command.

4.20 Post-hypnotic suggestions for practice and anchoring objects

Purpose / when: End of guided sessions, to support self-practice. [source: Ogez et al. 2024; Thomson, ASCH]
Steps: (1) Near the end of a guided exercise, suggest that the client will find it easy to return to this state in their own practice and that the benefits continue. (2) Optionally, link the state to an object (Thomson's "souvenirs") chosen during the guided session, which the client later holds or looks at to start self-hypnosis. (3) Thomson also suggests inviting the client to "go right back" into the state once before ending, to show they can.
Example language (illustrative): "Whenever you choose to practise, you can find your way back here more easily each time."
Watch for: suggestions must be agreed with the client in advance and limited to their stated goals. [synthesis]

4.21 Sleep application

Purpose / when: Night waking with worry. [source: Spiegel, Huberman Lab]
Steps: (1) On waking, do not check the clock (it cues arousal). (2) Enter floating. (3) Put the worry on the imaginary screen while the body keeps floating. (4) Let sleep come; no re-alerting needed if the aim is sleep. [re-alerting omission is synthesis]
Example language (illustrative): "Leave the clock alone. Let your body float, and put the thought on the screen – it can wait there till morning."
Watch for: less time awake; persistent insomnia warrants assessment (for example sleep apnoea, depression). [synthesis]

4.22 Re-alerting

Purpose / when: End of every practice that is not meant to lead to sleep. [source: UW Osher; Capafons 1998; ASCH eye-roll script]
Steps (versions): (a) Osher: reverse the staircase, counting up from one to ten as energy returns to the body, the voice rising, eyes opening when ready. (b) Capafons: count to three, eyes open, alert, clear and calm. (c) ASCH script: return at a comfortable pace by noticing the surroundings and the chair's support; opening the eyes marks full alertness. Self-hypnosis clients use the same count on their own.
Example language (illustrative): "One … two, more energy coming back … three, eyes open, fully alert and clear-headed."
Watch for: lingering heaviness or drowsiness (Capafons notes this especially in people with low blood pressure): have the client close the eyes and count to three again, or imagine a brisk physical task such as running for a bus. Check alertness before the client drives. [source: Capafons 1998; driving check is synthesis]

4.23 Debrief

Purpose / when: After every guided session. [source: Capafons 1998; Thomson, ASCH]
Steps: Ask what the client noticed, what helped, what got in the way, what they would change; adjust the next session; give ego-strengthening feedback on what went well.
Example language (illustrative): "What did you notice? Was there anything you'd like me to say differently, or leave out?"
Watch for: headache, anxiety, unexpected memories or images (Section 5).

4.24 Mental rehearsal and review of the route in

Purpose / when: Before the client leaves, to bridge from session to home. [source: Thomson, ASCH]
Steps: (1) While still in the state, the client imagines practising later today, tomorrow and next week: where, when and how they will be most comfortable. (2) The client mentally replays the steps they took to get into the state so they can repeat them. (3) Tell them home practice may feel different and they can choose new imagery.
Example language (illustrative): "Picture yourself tomorrow, in the place you'll practise … and go back over how you got here today, step by step."
Watch for: a concrete plan (time, place, trigger) at the end of the session.

4.25 Recordings as temporary support

Purpose / when: Early home practice. [source: Thomson, ASCH; Ogez et al. 2024; Spiegel, Huberman Lab]
Steps: Record the tailored session (with consent) or provide programme recordings; agree from the start that the recording is "training wheels" to drop as the client becomes able to guide themselves. Spiegel's app model uses longer elements (about 15 minutes) and short refreshers (one to two minutes).
Watch for: reliance on the recording months later; plan its fading (4.26).

4.26 Three-stage fading and home-practice schedule

Purpose / when: Across Phases 3–5. [source: Thomson, ASCH; Capafons 1998]
Steps: (1) Stage A: you coach every step. (2) Stage B: the client leads, you prompt only if needed. (3) Stage C: the client does it alone in session while you observe silently. (4) Home practice: Capafons asks for the full routine three times daily (morning, afternoon, night) in different places; Thomson advises practising only when attention is free and increasing practice over time. (5) Shorten the routine as it becomes reliable.
Example language (illustrative): "This time, you lead. I'll stay quiet unless you'd like a reminder."
Watch for: reliable entry without prompts; a brief cue that works; use in real situations.

4.27 Loss and legacy focus (Spiegel's group use)

Purpose / when: Grief, in supportive group work Spiegel describes. [source: Spiegel, Huberman Lab]
Steps: After breath and floating: (1) picture the person who died and let the sadness be there for a few minutes; (2) then shift to one thing that person left the client that they still carry; (3) optionally, imagine what that person would advise.
Example language (illustrative): "Let yourself be with them for a moment, sad as it is … now notice something they gave you that you still carry."
Watch for: complicated or traumatic grief may need trauma-informed pacing and grounding. [synthesis]

4.28 Children

Purpose / when: Paediatric adaptation. [source: Thomson, ASCH; Spiegel, Huberman Lab]
Steps: Start with breathing (Thomson); use playful imagery such as a magic carpet journey (listed by Thomson, no script given); give more structure than with adults, and let a parent guide the child; the child can choose a pleasant place to "visit" during medical procedures (Spiegel). Children often learn quickly (UW Osher).
Example language (illustrative): "Where would you like to fly on your magic carpet today?"
Watch for: parental consent and child assent; keep sessions short. [synthesis]

4.29 Group or course delivery

Purpose / when: For services teaching self-hypnosis to several clients, for example pain clinics. [source: Ogez et al. 2024; NCT02653664]
Steps: Follow the HYlaDO outline: an introductory session; a session introducing hypnosis; five sessions, each with one guided exercise built in five parts (induction, deepening, goal-specific work, post-hypnotic suggestions to sustain effects and support self-practice, guided return to alertness) plus self-practice advice; a closing session for conclusions and feedback. Give recordings and written practice guidance; offer ongoing practice groups. The VA trial used manualised 90-minute weekly groups over eight weeks with homework and before-and-after pain ratings.
Watch for: group-specific distress (the VA protocol notes distress from hearing others describe pain and discomfort from sitting still); screen out people unsuited to groups.

5. Handling problems

No response or "nothing happened". Treat it as information, not failure (Thomson, citing Brown and Fromm). Capafons: suspect interference – fear of hypnosis or of harm, disbelief, or disappointment that the method is not mysterious – and stop to explore it before going on; build responsiveness with sensory-recall exercises; if there is still no response, move to emotional self-regulation or a non-suggestive approach. Also try a different entry (breath, eye-roll, Rapid Self-Hypnosis), since responses vary by method; Capafons reports that many people did not feel floating or arm lightness with Spiegel's approach but did feel heaviness with his. [source: Thomson, ASCH; Capafons 1998]
Low hypnotizability. Spiegel: hypnotizability is fairly stable and practice raises it only a little, so focus on the problem rather than on getting "deeper"; he also notes people with marked obsessive-compulsive traits tend to be less hypnotizable. Offer relaxation-based or cognitive-behavioural skills alongside or instead. [source: Spiegel, Huberman Lab; alternatives are synthesis]
Fear of losing control. Repeat that hypnosis needs the client's cooperation; start with eyes-open methods (Rapid Self-Hypnosis) or short practices with the client counting themselves out; agree a stop signal. [source: UW Osher; Capafons 1998; stop signal is synthesis]
Lingering heaviness, drowsiness or feeling "spaced out" after practice. Re-alert again (close eyes, count to three, open), or imagine a brisk physical task; this is more common with low blood pressure. Have the client stand and move, and confirm alertness before driving. [source: Capafons 1998; driving check is synthesis]
Headache or anxiety afterwards. Gruzelier lists headache linked to de-hypnotising and anxiety as a common, short-lived effect. Re-alert more gradually, shorten sessions, keep eye-roll brief, review content for anxiety triggers. [source: Gruzelier; responses are synthesis]
Overwhelm, unexpected traumatic memories, abreaction or dissociation during practice. [synthesis, informed by Gruzelier's reports of spontaneous dissociative episodes and resurfacing trauma memories] (1) Stop the suggestions; speak in a calm, normal voice; invite eyes open. (2) Ground in the present: name the date and place, feel the feet on the floor and the chair, describe five things in the room, slow breathing. (3) Do not explore or interpret the material as a recovered memory; acknowledge the distress and treat it as the client's experience. (4) Once settled, review what happened and whether self-hypnosis practice should pause. (5) Ask the client to stop home practice until reviewed and give a plan for what to do if it recurs at home (open eyes, ground, contact details, crisis line if needed). (6) Reconsider suitability; trauma processing belongs in a phase-based trauma treatment, not in self-hypnosis homework.
Psychotic-like experiences or a marked change in reality testing. Stop hypnosis and assess urgently; Gruzelier describes first-episode schizophrenia after hypnotherapy and stage hypnosis and recommends screening vulnerable people. [source: Gruzelier; urgent assessment is synthesis]
Seizure history. Gruzelier reports seizures among rare serious effects; discuss with the treating physician before teaching and avoid hyperventilation in entry methods. [source: Gruzelier; responses are synthesis]
Non-adherence to home practice. Use Thomson's mental rehearsal (when, where, how) inside the session; keep practice short and pleasant; provide a recording; link practice to existing daily routines; review a practice log each session; reduce the target (for example one brief cue practice a day) rather than abandon practice. [source: Thomson, ASCH; Capafons 1998 for frequency; habit-linking and logs are synthesis]
Dependence on the therapist or recording. Plan fading from the outset (Thomson's three stages; recording as training wheels); move the client to leading the routine in session; agree a date to try practice without the recording. Clients who prefer dependence or high structure may need more scaffolding. [source: Thomson, ASCH]
Using self-hypnosis to avoid medical care or to override warning symptoms. Agree that new, changed or severe symptoms are checked medically first; teach Spiegel's distinction between pain that signals damage (act on it) and pain from healing (can be turned down). [source: Spiegel, Huberman Lab]
Practising in unsafe situations. Never while driving or when attention is needed; Thomson's rule is to practise only when attention is free. Teach eyes-open, brief cues (4.19) for use in public. [source: Thomson, ASCH; Capafons 1998]
Requests to use self-hypnosis to remember what happened. Decline; explain that hypnotic recall is not reliable and can create false confidence or distress; redirect to the agreed goal or to trauma-focused therapy if indicated. [synthesis, consistent with Gruzelier's warning about recovered memories with age regression]
Imagery becomes negative (safe place invaded, unwanted images). Let the client change the place, add protective features of their choosing, or switch to non-imagery methods (breath, heaviness); re-alert if distress persists. [synthesis]
Rupture: client feels pushed, "done to", or that failure means they are defective. Name it, apologise for anything that felt imposed, return control (client chooses method, wording and pace), and reaffirm the skill frame and "no failure" stance. [synthesis; permissive and collaborative stance from Thomson, ASCH]
Group delivery problems. Distress from hearing others' pain stories, or discomfort from sitting still: allow movement and posture changes, set group norms about sharing, and offer individual follow-up. [source: NCT02653664 protocol for the risks; responses are synthesis]
Children who struggle alone. Add structure and let a parent guide practice; keep it brief and playful. [source: Spiegel, Huberman Lab; Thomson, ASCH]

Sources

Sources:

Further reading (not drawn on) [uncertain where relied on]:

Brown DP, Fromm E (1986). Hypnotherapy and Hypnoanalysis. (cited by Thomson for the "no failure" stance)
Garver RB (1984). Eight steps to self-hypnosis. American Journal of Clinical Hypnosis 26(4):232–235.
Hammond DC (1992). Manual for Self-Hypnosis. ASCH.
Hammond DC (1990). Handbook of Hypnotic Suggestions and Metaphors. Norton.
Sorkis D (1986). Teaching Self-Hypnosis: An Introductory Guide for Clinicians. Norton.
Spiegel H, Spiegel D (2004). Trance and Treatment: Clinical Uses of Hypnosis, 2nd ed. American Psychiatric Publishing. (source of the Hypnotic Induction Profile)
Gurgevich S (2007). Self-hypnosis techniques. In Rakel D (ed.), Integrative Medicine, 2nd ed.
Zarren J, Eimer B (2002). Brief Cognitive Hypnosis. Springer.
Eimer BN (2002). Hypnotize Yourself Out of Pain Now! New Harbinger.

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