Hypnosis can be an interesting and potentially useful therapeutic tool, but when working with someone diagnosed with schizophrenia, considerable care is needed.
Schizophrenia is a complex mental health condition that can affect perception, thinking, emotional responses, motivation, and the ability to distinguish certain experiences from external reality. Some people experience hallucinations, delusions, or disorganized thinking, while others may have difficulties with concentration, memory, and everyday functioning.
This raises an important question: could hypnosis help someone with schizophrenia, or might it make certain symptoms worse?
The answer requires a cautious approach.
Hypnosis should not routinely be used with people diagnosed with schizophrenia, particularly when they are experiencing active psychosis or unstable symptoms. Hypnotic procedures can involve focused attention, absorption, imagery, and suggestions that alter subjective experiences. These features warrant particular consideration when someone is already experiencing hallucinations, delusions, or difficulties interpreting reality.
This does not mean that every person diagnosed with schizophrenia will necessarily respond adversely to hypnosis. Nor does it mean that a diagnosis automatically rules out every possible use of hypnotic techniques.
However, the potential risks, limited clinical evidence, and importance of established psychiatric treatment mean that hypnosis should never be approached casually in this population.
Let's explore the issues, including the potential risks, what the research tells us, and what practitioners should consider before contemplating hypnosis.
What is schizophrenia?
Schizophrenia is a serious psychiatric disorder involving disturbances in several aspects of mental functioning.
It is generally characterized by symptoms that can include:
Hallucinations: Experiencing things, such as hearing voices, that are not present in the external environment.
Delusions: Strongly held beliefs that are not supported by available evidence and are difficult to change.
Disorganized thinking: Difficulties organizing thoughts and communicating them coherently.
Negative symptoms: Reduced emotional expression, motivation, social engagement, or ability to experience pleasure.
Cognitive difficulties: Problems involving attention, working memory, processing speed, and executive functioning.
Not everyone experiences the same symptoms, and their severity can vary over time.
Some people experience periods of acute psychosis, while others achieve considerable stability with appropriate treatment and ongoing support.
It is important to recognize that schizophrenia is not simply a condition involving hallucinations or unusual beliefs. It is a multifaceted disorder that requires an individualized approach to care.
Why might hypnosis be a concern for someone with schizophrenia?
Hypnosis commonly involves directing attention toward particular thoughts, sensations, images, or experiences.
A practitioner might encourage someone to imagine a different environment, visualize an event, experience a sensation, or respond to a particular suggestion.
For many people, these activities are relatively straightforward.
However, schizophrenia can involve difficulties with reality monitoring, perception, and the interpretation of internally generated experiences.
This creates a potential concern.
For example, suggestions involving imagined voices, unusual sensations, altered perceptions, or the feeling of being controlled could be inappropriate for someone experiencing certain psychotic symptoms.
It would be particularly unwise to use hypnotic suggestions that encourage someone to interpret imagined experiences as real or to explore potentially distressing material without appropriate clinical oversight.
The concern is not that hypnosis inevitably causes psychosis. Rather, there is insufficient evidence to establish its safety and effectiveness as a routine intervention for people with schizophrenia, and particular techniques could be poorly suited to their symptoms.
What does the scientific research say about hypnosis and schizophrenia?
There has actually been some research investigating this question.
A Cochrane systematic review by de Santiago and Khan examined the available controlled trials of hypnosis for people with schizophrenia. The review identified three studies involving a total of 149 participants.⁽¹⁾
The studies compared hypnosis with standard treatment, relaxation, or listening to music.
The findings were interesting but inconclusive:
Hypnosis did not produce a clearly measurable improvement in participants' mental state.
The researchers found no discernible benefits in the measured areas of movement disorders or neurocognitive functioning.
Hypnosis appeared to be reasonably acceptable to participants.
The studies did not establish that hypnosis was more effective than the comparison interventions.
Perhaps most importantly, all three studies were relatively small, short, and conducted before 1983.
The researchers concluded that better-designed studies were needed before meaningful conclusions could be drawn about the usefulness of hypnosis for schizophrenia.⁽¹⁾
This is an important distinction: the review did not establish that hypnosis is an effective treatment, but neither did it establish that hypnosis is invariably harmful.
The available research is simply too limited to support confident conclusions about either its benefits or its risks.
Is hypnosis contraindicated for people with schizophrenia?
There is no reason to assume that every individual diagnosed with schizophrenia will have exactly the same response to hypnosis.
Nevertheless, there are good reasons for caution.
The Royal College of Psychiatrists specifically advises that hypnotherapy might not be suitable for people experiencing psychosis because it could make their symptoms worse.⁽²⁾
This is an important practical warning, particularly for practitioners who are not trained to assess or manage psychotic symptoms.
It is helpful to distinguish between three situations.
1. Someone experiencing active psychosis
This is the situation in which hypnosis should generally be avoided.
A person experiencing active hallucinations, delusions, severe disorganization, or significant difficulty distinguishing internal experiences from external events may be particularly vulnerable to inappropriate suggestions or experiences that increase distress or confusion.
A hypnotherapist should not attempt to treat active psychosis independently.
The priority should be appropriate psychiatric assessment, treatment, and support.
2. Someone whose schizophrenia is stable
This situation requires a more individualized assessment.
A person may have a schizophrenia diagnosis but be experiencing a sustained period of stability, with symptoms well managed through appropriate treatment.
That does not automatically establish that hypnosis is safe or beneficial.
Any consideration of hypnosis should involve the person's treating psychiatrist or appropriately qualified mental health professional, who can assess the individual's circumstances and advise whether it is appropriate.
Even then, hypnosis should not be assumed to offer an additional therapeutic benefit.
3. Someone with a history of schizophrenia who is currently in remission
A history of schizophrenia remains relevant even when someone is doing well.
The absence of obvious symptoms does not necessarily mean that every form of psychological intervention is appropriate.
A decision about hypnosis should take account of the person's clinical history, current functioning, treatment, previous experiences, and individual preferences.
It should be made in consultation with the professionals responsible for their mental health care.
Could hypnosis trigger hallucinations or delusions?
This is one of the most important safety questions.
There is not sufficient clinical evidence to establish that hypnosis routinely triggers hallucinations or delusions in people with schizophrenia.
However, the possibility of an adverse psychological response is a legitimate reason for caution, particularly when someone is experiencing psychosis.
Consider some examples of suggestions that could be inappropriate:
Encouraging someone to imagine hearing voices.
Asking someone to visualize imaginary people communicating with them.
Suggesting that another person is controlling their thoughts or actions.
Encouraging elaborate interpretations of unusual internal experiences.
Suggesting that imagined events are genuine memories.
Encouraging someone to explore beliefs that are already associated with distress or paranoia.
These examples illustrate why hypnotic suggestions need to be selected carefully.
A responsible practitioner should never reinforce delusional beliefs, encourage unusual experiences to be interpreted as external reality, or attempt to validate hallucinations as objectively real.
It is also important not to confuse a person's subjective experience with evidence that an imagined event actually happened.
Could relaxation hypnosis be safer than deeper hypnosis?
Relaxation and hypnosis are related but not identical.
Relaxation exercises generally aim to reduce physical and mental tension. Hypnosis typically involves a more focused form of attention and the use of suggestions.
It might seem reasonable to assume that a simple relaxation-based approach would be harmless for someone with schizophrenia.
However, that cannot be guaranteed.
Even a seemingly gentle exercise involving guided imagery, inward attention, or suggestions could be uncomfortable or unsuitable for someone experiencing certain symptoms.
The Cochrane review included comparisons between hypnosis and relaxation, but its findings were insufficient to establish that either intervention was beneficial for schizophrenia.⁽¹⁾
If relaxation techniques are being considered, the person's mental health professional should help determine which approaches are appropriate.
Simple, familiar relaxation activities may be preferable to elaborate hypnotic procedures, particularly when the person is experiencing psychological instability.
Could hypnosis help with anxiety in someone diagnosed with schizophrenia?
Anxiety can occur alongside schizophrenia and may have a considerable effect on quality of life.
Someone might experience anxiety about social situations, leaving home, interacting with other people, or coping with everyday responsibilities.
Hypnosis is sometimes used to address anxiety in other populations, but this does not establish that it is appropriate for people with schizophrenia.
There is an important distinction between treating anxiety in someone who has schizophrenia and attempting to treat schizophrenia itself.
For example, a person might have a stable psychiatric condition but also experience a separate anxiety problem.
In that situation, the anxiety deserves appropriate assessment and treatment.
Evidence-based psychological interventions, including cognitive behavioral therapy (CBT), may be appropriate depending on the person's circumstances.
The National Institute for Health and Care Excellence (NICE) recommends CBT for people with psychosis or schizophrenia, alongside appropriate psychiatric care. It also recommends family intervention for families who live with or have close contact with the person.⁽³⁾
Hypnosis should not be substituted for these established interventions.
If someone is interested in hypnosis as an additional approach to anxiety management, the possibility should first be discussed with their treating mental health professional.
Could hypnosis help improve confidence and self-esteem?
Confidence and self-esteem can be affected by the challenges associated with living with schizophrenia.
Some individuals may feel uncertain about their abilities, worry about how other people perceive them, or struggle with the social consequences of their condition.
Although hypnosis is sometimes used to address confidence and self-esteem in other settings, there is insufficient evidence to establish its effectiveness for these difficulties in people with schizophrenia.
Supportive psychological approaches may be more appropriate.
For example, CBT can help people examine unhelpful thinking patterns, develop coping strategies, and reduce distress.
Social support, rehabilitation, and activities that encourage independence and meaningful participation can also contribute to recovery.
The emphasis should be on supporting the individual rather than assuming that hypnosis can resolve the psychological and social challenges associated with schizophrenia.
Could self-hypnosis be used by someone with schizophrenia?
Self-hypnosis requires particular caution.
Unlike a session conducted by a qualified professional, self-hypnosis does not necessarily provide an opportunity for another person to monitor changes in symptoms, recognize emerging difficulties, or intervene if the experience becomes distressing.
Guided recordings can also contain suggestions or imagery that are inappropriate for someone experiencing psychosis.
For these reasons, people diagnosed with schizophrenia should not independently experiment with hypnosis or self-hypnosis without first discussing it with their treating mental health professional.
This is especially important if they have experienced hallucinations, paranoia, dissociation, or other symptoms that could make certain forms of inwardly focused imagery uncomfortable.
A person should never feel pressured to try hypnosis as a condition of receiving support.
What should a hypnotherapist consider before working with someone diagnosed with schizophrenia?
This is an especially important question for professional hypnotherapists.
A diagnosis of schizophrenia should prompt careful consideration, not an attempt to improvise a treatment.
Before contemplating any hypnotic intervention, a practitioner would need to consider several issues.
Establish the person's current mental health status
A diagnosis alone does not provide enough information.
The practitioner would need to know whether the individual is currently experiencing psychosis, whether symptoms are stable, and whether there have been recent changes in their mental health.
However, a hypnotherapist without appropriate clinical qualifications should not attempt to conduct a psychiatric assessment.
Obtain appropriate clinical guidance
The person's treating psychiatrist or mental health team should be involved in deciding whether hypnosis is appropriate.
A practitioner should not assume that a client's willingness to participate constitutes sufficient evidence of clinical suitability.
Understand the existing treatment plan
It is important to establish what psychiatric treatment and psychological support the individual is receiving.
Hypnosis must not interfere with prescribed medication, established treatment, or ongoing clinical monitoring.
Avoid inappropriate suggestions
Suggestions involving hallucinations, altered identity, imaginary voices, paranoia, memory recovery, or loss of control should be avoided.
The practitioner should also avoid techniques that encourage the person to reinterpret unusual experiences as evidence of external events.
Recognize professional limitations
A hypnotherapist who is not qualified to assess or treat psychosis should not attempt to manage it.
If the person is experiencing active symptoms, the appropriate response is referral to their mental health team.
Monitor for changes
If hypnosis has been specifically approved as part of a wider clinical plan, the qualified professional responsible for delivering it should monitor the person's response.
Any deterioration in mental state, increased distress, or unusual experiences should prompt reassessment and discontinuation of the intervention where appropriate.
What treatments are recommended for schizophrenia?
Although hypnosis has attracted some research interest, it is not an established treatment for schizophrenia.
There are several better-supported approaches.
Antipsychotic medication
Antipsychotic medication is an important component of treatment for many people with schizophrenia.
These medications can help reduce symptoms such as hallucinations and delusions.
The choice of medication should be individualized, taking account of effectiveness, side effects, previous treatment experiences, and the person's preferences.
Medication should only be changed or discontinued in consultation with the prescribing professional.
Cognitive behavioral therapy
CBT is an established psychological intervention recommended for people with psychosis and schizophrenia.
It can help individuals understand their experiences, manage distressing symptoms, develop coping strategies, and work toward personal recovery goals.
Family intervention
Family intervention can help people with schizophrenia and those close to them understand the condition and develop more effective ways of communicating and managing difficulties.
It can also support problem-solving and planning for periods when symptoms become more difficult.
Psychoeducation
Psychoeducation involves providing understandable information about schizophrenia, its symptoms, treatment options, and ways of managing the condition.
It can help individuals and their families make informed decisions and participate more confidently in treatment.
Rehabilitation and social support
Recovery involves more than symptom management.
Support with education, employment, social relationships, independent living, and everyday activities can make a meaningful difference to a person's quality of life.
These interventions can be adapted to individual needs and goals.
What if someone with schizophrenia specifically requests hypnosis?
The person's wishes should be treated respectfully.
A schizophrenia diagnosis does not mean that someone should automatically be excluded from discussions about complementary therapies or their own treatment preferences.
However, agreeing to hypnosis simply because the individual requests it would not necessarily be responsible.
A sensible response would be to:
Acknowledge their interest without making promises about the benefits.
Explain that the evidence for hypnosis in schizophrenia is very limited.
Discuss the possible concerns associated with psychosis.
Encourage them to speak with their treating psychiatrist or mental health team.
Respect the clinical advice they receive.
Continue to support them through appropriate, evidence-based care.
If the treating team advises against hypnosis, that recommendation should be respected.
If they believe a particular approach is appropriate, it should only be considered within a suitable professional framework.
Can hypnosis replace psychiatric medication?
Absolutely not.
Hypnosis should never be presented as an alternative to prescribed antipsychotic medication or other necessary psychiatric treatment.
There is no reliable evidence that hypnosis can replace medication in the treatment of schizophrenia.
Stopping or changing antipsychotic medication without medical supervision can increase the risk of relapse and other serious difficulties.
Anyone considering changes to their treatment should discuss them with their prescribing clinician.
A hypnotherapist should never advise someone to stop medication, reduce a prescribed dose, or abandon psychiatric care.
Is hypnosis likely to be beneficial for everyone with schizophrenia?
No.
Schizophrenia is a heterogeneous condition, meaning that people can experience very different symptoms, challenges, and treatment responses.
An approach that is suitable for one person may be inappropriate for another.
Even outside schizophrenia, people vary in their responses to hypnosis.
More importantly, the limited research into hypnosis for schizophrenia does not establish a reliable group of individuals who are likely to benefit.
It would therefore be misleading to suggest that hypnosis is generally beneficial, or that everyone with a stable diagnosis could safely participate.
The most responsible approach is individualized clinical decision-making, with established treatment remaining the priority.
So, should hypnosis be used with subjects diagnosed with schizophrenia?
The safest general recommendation is not to use hypnosis routinely with people diagnosed with schizophrenia, and to avoid it in anyone experiencing active psychosis.
There is some historical research into hypnosis for schizophrenia, but the available controlled studies are too limited and outdated to establish meaningful benefits or provide strong reassurance about safety.
The Royal College of Psychiatrists also cautions that hypnotherapy may be unsuitable for people experiencing psychosis because it could worsen their symptoms.⁽²⁾
This does not mean that every person with a schizophrenia diagnosis will necessarily have an adverse response to hypnosis.
However, any consideration of its use should involve the person's treating psychiatrist or appropriately qualified mental health professional. It should never replace established psychiatric treatment, and it should not be undertaken independently by an unqualified practitioner.
For hypnotherapists, the key message is straightforward: recognize the limits of your professional competence, prioritize the client's well-being, and refer to appropriate mental health services whenever necessary.
There are many effective ways to support people living with schizophrenia. Sometimes the most helpful thing a practitioner can do is recognize when a different form of care is more appropriate.
Reader-Friendly Summary
Hypnosis is not an established treatment for schizophrenia, and there is insufficient scientific evidence to demonstrate that it provides meaningful therapeutic benefits for this condition.
A small number of older clinical trials investigated hypnosis in people with schizophrenia, but their findings were inconclusive.
The Royal College of Psychiatrists cautions that hypnotherapy may be unsuitable for people experiencing psychosis because it could worsen their symptoms.
In particular:
Hypnosis should generally be avoided during active psychosis.
A stable schizophrenia diagnosis does not automatically establish that hypnosis is safe or beneficial.
Anyone considering hypnosis should first consult their treating psychiatrist or mental health team.
Hypnosis must never replace prescribed medication, CBT, or other appropriate psychiatric care.
Hypnotherapists should recognize their professional limitations and avoid working beyond their competence.
The priority should always be the person's safety, dignity, individual needs, and access to appropriate evidence-based treatment.
Notes
1. A. Izquierdo de Santiago and M. Khan, “Hypnosis for Schizophrenia,” Cochrane Database of Systematic Reviews, no. 4 (2007): CD004160.
2. Royal College of Psychiatrists, “Hypnosis and Hypnotherapy,” December 2021.
3. National Institute for Health and Care Excellence, Psychosis and Schizophrenia in Adults: Prevention and Management, Clinical Guideline CG178 (London: NICE, 2014; last reviewed July 29, 2025).