Braid can be taken to imply, in later writings, that hypnosis is largely a state of heightened suggestibility induced by expectation and focused attention. In particular, Hippolyte Bernheim became known as the leading proponent of the "suggestion theory" of hypnosis, at one point going so far as to declare that there is no hypnotic state, only heightened suggestibility. There is a general consensus that heightened suggestibility is an essential characteristic of hypnosis. In 1933, Clark L. Hull wrote:
Modern hypnotherapy is widely accepted for the treatment of certain habit disorders, to control irrational fears, as well as in the treatment of conditions such as insomnia and addiction. Hypnosis has also been used to enhance recovery from non-psychological conditions such as after surgical procedures, in breast cancer care and even with gastro-intestinal problems, including IBS.
Hence, the social constructionism and role-taking theory of hypnosis suggests that individuals are enacting (as opposed to merely playing) a role and that really there is no such thing as a hypnotic trance. A socially constructed relationship is built depending on how much rapport has been established between the "hypnotist" and the subject (see Hawthorne effect, Pygmalion effect, and placebo effect).
Stage hypnosis is a form of entertainment, traditionally employed in a club or theatre before an audience. Due to stage hypnotists' showmanship, many people believe that hypnosis is a form of mind control. Stage hypnotists typically attempt to hypnotise the entire audience and then select individuals who are "under" to come up on stage and perform embarrassing acts, while the audience watches. However, the effects of stage hypnosis are probably due to a combination of psychological factors, participant selection, suggestibility, physical manipulation, stagecraft, and trickery. The desire to be the centre of attention, having an excuse to violate their own fear suppressors, and the pressure to please are thought to convince subjects to "play along". Books by stage hypnotists sometimes explicitly describe the use of deception in their acts; for example, Ormond McGill's New Encyclopedia of Stage Hypnosis describes an entire "fake hypnosis" act that depends upon the use of private whispers throughout.
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During hypnosis, a person is said to have heightened focus and concentration. The person can concentrate intensely on a specific thought or memory, while blocking out sources of distraction. Hypnotised subjects are said to show an increased response to suggestions. Hypnosis is usually induced by a procedure known as a hypnotic induction involving a series of preliminary instructions and suggestion. The use of hypnotism for therapeutic purposes is referred to as "hypnotherapy", while its use as a form of entertainment for an audience is known as "stage hypnosis". Stage hypnosis is often performed by mentalists practicing the art form of mentalism.
In 2002, the Department for Education and Skills developed National Occupational Standards for hypnotherapy linked to National Vocational Qualifications based on the then National Qualifications Framework under the Qualifications and Curriculum Authority. NCFE, a national awarding body, issues level four national vocational qualification diploma in hypnotherapy. Currently AIM Awards offers a Level 3 Certificate in Hypnotherapy and Counselling Skills at level 3 of the Regulated Qualifications Framework.
“Learning hypnotherapy does not commit you to drastically changing your therapy practice,” says hypnotherapist Catherine Reiss. “The training will allow you to more quickly and effectively get to the cause of your clients’ unwanted behaviors and the feelings they present with it, but it also facilitates the use of trance in more traditional formats.”
In 2011, a Russian "evil hypnotist" was suspected of tricking customers in banks around Stavropol into giving away thousands of pounds worth of money. According to the local police, he would approach them and make them withdraw all of the money from their bank accounts, which they would then freely give to the man. A similar incident was reported in London in 2014, where a video seemingly showed a robber hypnotizing a shopkeeper before robbing him. The victim did nothing to stop the robber from looting his pockets and taking his cash, only calling out the thief when he was already getting away.
To investigate the effectiveness of cognitive hypnotherapy (CH), hypnosis combined with cognitive-behavioral therapy (CBT), on depression, 84 depressives were randomly assigned to 16 weeks of treatment of either CH or CBT alone. At the end of treatment, patients from both groups significantly improved compared to baseline scores. However, the CH group produced significantly larger changes in Beck Depression Inventory, Beck Anxiety Inventory, and Beck Hopelessness Scale. Effect size calculations showed that the CH group produced 6%, 5%, and 8% greater reduction in depression, anxiety, and hopelessness, respectively, over and above the CBT group. The effect size was maintained at 6-month and 12-month follow-ups. This study represents the first controlled comparison of hypnotherapy with a well-established psychotherapy for depression, meeting the APA criteria for a "probably efficacious" treatment for depression.
Braid soon assimilated Carpenter's observations into his own theory, realising that the effect of focusing attention was to enhance the ideo-motor reflex response. Braid extended Carpenter's theory to encompass the influence of the mind upon the body more generally, beyond the muscular system, and therefore referred to the "ideo-dynamic" response and coined the term "psycho-physiology" to refer to the study of general mind/body interaction.
Hypnosis is not a unitary state and therefore should show different patterns of EEG activity depending upon the task being experienced. In our evaluation of the literature, enhanced theta is observed during hypnosis when there is task performance or concentrative hypnosis, but not when the highly hypnotizable individuals are passively relaxed, somewhat sleepy and/or more diffuse in their attention.
Hypnotherapy expert, Dr Peter Marshall, former Principal of the London School of Hypnotherapy and Psychotherapy Ltd. and author of A Handbook of Hypnotherapy, devised the Trance Theory of Mental Illness, which provides that people suffering from depression, or certain other kinds of neurosis, are already living in a trance and so the hypnotherapist does not need to induce them, but rather to make them understand this and help lead them out of it.