Evidence supports the efficacy of hypnotic treatments, but there remain many unresolved questions regarding how hypnosis produces its beneficial effects. Most theoretical models focus more or less on biological, psychological, and social factors. This scoping review summarizes the empirical findings regarding the associations between specific factors in each of these domains and response to hypnosis. The findings indicate that (a) no single factor appears primary, (b) different factors may contribute more or less to outcomes in different subsets of individuals or for different conditions, and (c) comprehensive models of hypnosis that incorporate factors from all 3 domains may ultimately prove to be more useful than more restrictive models that focus on just 1 or a very few factors.
Hypnosis has had a gradual conceptual emergence from an alleged mystical experience, to sleep, to a psychological shift in concentration that activates a preexisting neuro-physiological circuitry. Data is presented to support the thesis that hypnotizability exists on a spectrum that has biological as well as psycho-social components. When there is synchrony between the bio-psycho-social components of hypnotizability as measured by the Hypnotic Induction Profile (an intact flow), psychotherapy is the primary treatment strategy, with medication secondary or not at all. When measurement reveals a lack of synchrony between biological factors as measured by the eye-roll sign and psycho-social responsivity (a nonintact flow), medication will be primary, with different degrees of psycho-social support.