The concept of hypnosis responsiveness, or hypnotizability, refers to how easily a person can enter a hypnotic state and respond to suggestions given during hypnosis. Research in this area has established that hypnotizability varies across individuals, and people tend to fall into three broad categories:
1. High Responders (about 10-15%)
These individuals are highly susceptible to hypnosis.
They can enter deep hypnotic states quickly and easily.
They respond very well to hypnotic suggestions, including changes in perception, memory, and behavior.
High responders often experience phenomena such as age regression, analgesia (pain reduction), and hallucinations under hypnosis.
This group is of particular interest in clinical hypnosis and research because they demonstrate the strongest effects.
2. Medium Responders (about 65-70%)
Most people fall into this middle category.
They respond moderately to hypnosis but may require more time or stronger suggestions.
Their experiences under hypnosis are usually less intense compared to high responders.
They can benefit from hypnosis in therapeutic settings but may not experience dramatic changes.
3. Low Responders (about 15-20%)
These individuals show little or no response to hypnotic induction.
They find it difficult or impossible to enter a hypnotic state.
Hypnotic suggestions have minimal effect on their perception or behavior.
This group may be skeptical or less open to the experience of hypnosis but could also have neurological or psychological factors limiting responsiveness.
Summary
Hypnotizability (also called hypnotic susceptibility or responsiveness) describes an individual’s typical capacity to enter a hypnotic state and to experience and act on hypnotic suggestions.
It is normally distributed in the population and reliably divides into higher, medium, and lower responsiveness groups. These groups differ in how readily they show perceptual, cognitive, behavioral and physiological changes under suggestion.
Hypnotizability is relatively stable across adulthood, can be measured with validated scales, and is associated with psychological, neurophysiological, and genetic factors. It has direct implications for clinical and research use of hypnosis.
Distribution of hypnotizability: high, medium and low responders
Population distribution: Large normative samples using standardized scales (e.g., Stanford Hypnotic Susceptibility Scale, SHSS; Harvard Group Scale of Hypnotic Susceptibility, HGSHS) show most people fall in the medium range, with smaller proportions of high and low responders. Typical estimates are: high responders ~10–15%, medium responders ~65–70%, low responders ~15–20% (these percentages vary slightly across studies and instruments). (Hilgard & Hilgard, 1975; Woody & Sadler, 2008).
High responders: rapidly enter deep hypnotic states; show robust responsiveness to suggestions that alter perception (e.g., hallucinations, anesthesia), memory (amnesia, age regression), and voluntary behavior; frequently show measurable physiological changes concordant with suggested states. High responders are especially valuable in experimental research because effects are stronger and more consistent (Bowers, 1992; Lynn & Rhue, 1991).
Medium responders: make up the majority. They reliably respond to many suggestions but typically show less dramatic or less consistent changes than high responders; may require more induction time, more vivid imagery, or tailored suggestions.
Low responders: show little or no observable response to standard hypnotic inductions and suggestions; they may resist entering a hypnotic state, show minimal experiential change, and exhibit weak behavioral responses to suggestions. Low responsiveness may reflect psychological factors (e.g., low rapport, skepticism, low absorption/openness), or neurocognitive differences.
Measurement of hypnotizability
Stanford Hypnotic Susceptibility Scale (SHSS), forms A, B, and C: a widely used individual (one-to-one) standardized measure with a series of 12–24 suggestions that assess motor, perceptual, cognitive, and amnesic responses (Weitzenhoffer & Hilgard, 1962). Scores classify individuals into low, medium, and high susceptibility.
Harvard Group Scale of Hypnotic Susceptibility (HGSHS-A): allows group administration; shorter and practical for screening large samples (Shor & Orne, 1962).
Waterloo-Stanford Group C (WSGC) and other scales: used in some settings.
Validity and reliability: these instruments show acceptable test–retest reliability over months to years (correlations typically .60–.80 in adults) and predictive validity for responsiveness to hypnotic suggestions in experimental and clinical settings (Hilgard, 1974; Milling et al., 2019). References: Weitzenhoffer & Hilgard, 1962; Shor & Orne, 1962; Hilgard, 1974.
Stability over time and developmental aspects
Adults: hypnotizability is moderately to highly stable across the adult lifespan. Longitudinal studies report substantial stability in hypnotizability scores over months and years, though modest changes can occur (e.g., due to practice, therapy, or life events) (Piccione, Hilgard, & Zimbardo, 1989).
Children and adolescents: hypnotizability can be higher in childhood and shows developmental trends; children often respond well to suggestion, but measures and classification differ from adult norms (Gehred & Lynn, 2014; Coughlan et al., 1990). Reference: Piccione et al., 1989.
Psychological, cognitive and personality correlates
Absorption: trait “absorption” (capacity for deep imaginative involvement) is one of the most robust correlates of hypnotizability (Tellegen & Atkinson, 1974). High absorption predicts greater responsiveness, though it is neither necessary nor sufficient.
Openness to experience: modest positive correlations with hypnotizability are reported (McConkey & Sheehan, 1981).
Expectation and motivation: positive expectancies and motivation to be hypnotized increase immediate responsiveness; these are important moderators but do not fully account for trait differences (Kirsch, 1999).
Cognitive control and imagery: some high responders show superior imagery vividness and certain attentional/monitoring profiles; others show differences in executive control that can facilitate dissociative responding to suggestion (Crawford et al., 1993; Woody & Sadler, 2008). References: Tellegen & Atkinson, 1974; Kirsch, 1999; Woody & Sadler, 2008.
Biological and neurological findings
Brain imaging: fMRI and PET studies show that hypnotic suggestions and hypnotizability interact with activity and connectivity in regions involved in attention, salience, default-mode processing, and sensorimotor integration — including prefrontal cortex, anterior cingulate cortex (ACC), insula, and parietal areas. High hypnotizability is often associated with differences in functional connectivity (e.g., altered fronto-parietal and salience-networks) during rest and during suggestion (Oakley & Halligan, 2013; McGeown et al., 2015; Egner et al., 2005).
EEG: some studies report trait-related differences in resting EEG patterns (e.g., alpha and theta), but findings are mixed and not yet definitive (Jensen et al., 2016).
Neurochemical/genetic: preliminary evidence suggests heritable components; twin studies indicate a genetic contribution to hypnotizability, but specific genes and mechanisms remain under investigation (Coe et al., 2017; Szekely et al., 2020). Neurochemical hypotheses (e.g., dopamine, opioid systems) have been proposed but are not conclusively established. References: Oakley & Halligan, 2013; Egner et al., 2005; McGeown et al., 2015; Coe et al., 2017.
Mechanisms: how suggestions produce changes
Multiple interacting mechanisms: cognitive control and top-down modulation, focused attention and reduced critical evaluation, expectation and social/relational context, and dissociative processes are all contributors. Different suggestions (e.g., sensory vs. motor vs. amnesia) may rely on different mixtures of mechanisms (Spanos, 1996; Lynn & Kirsch, 2006).
Not a single “trance” mechanism: current evidence argues against a unitary special state required for hypnosis. Instead, hypnotic responses typically reflect normal cognitive and neural processes recruited in particular ways (e.g., altered attentional dynamics, changes in metacognition) — especially in high responders (Woody & Sadler, 2008; Oakley & Halligan, 2013).
Clinical and practical implications
Screening: measuring hypnotizability can help clinicians estimate likely responsiveness and select techniques. For example, high responders are most likely to achieve dramatic analgesia or perceptual change; medium responders commonly benefit from hypnotherapy for pain, anxiety, and habit-control; low responders may still gain benefit from relaxation, cognitive-behavioral strategies, or tailored suggestions (Montgomery et al., 2000; Milling et al., 2019).
Tailoring approach: clinicians can adapt induction style (e.g., longer inductions, more imagery, or behavioral anchors), use post-hypnotic suggestions, or combine hypnosis with CBT to enhance benefit in medium responders.
Ethical and practical limits: hypnosis is not a guaranteed treatment; effectiveness varies with the target condition, practitioner skill, and patient characteristics.
Limitations and current research directions
Heterogeneity of measures and definitions: different instruments and suggestion sets yield somewhat different distributions and cutoffs, complicating cross-study comparisons.
Mechanistic specificity: more work is needed to link specific neural circuits to types of suggestions and to explain why some individuals show dramatic perceptual changes (e.g., hypnotic hallucination) while others do not.
Genetics and development: more large-scale genetic and developmental studies are needed to map heritability and critical periods.
Clinical trials: better-powered RCTs that stratify by hypnotizability would clarify for which conditions and which patients hypnosis is most effective.
Selected references (for further reading)
Weitzenhoffer, A. M., & Hilgard, E. R. (1962). Stanford Hypnotic Susceptibility Scale, Form C. Consulting Psychologists Press.
Shor, R. E., & Orne, E. C. (1962). Harvard Group Scale of Hypnotic Susceptibility, Form A. (Harvard University Press).
Hilgard, E. R. (1974). Hypnosis in the Relief of Pain. University of Chicago Press.
Piccione, C., Hilgard, E. R., & Zimbardo, P. G. (1989). On the degree of stability of measured hypnotizability over a 25-year period. Journal of Personality and Social Psychology, 56(2), 289–295.
Lynn, S. J., & Kirsch, I. (2006). Essentials of Clinical Hypnosis: An Evidence-Based Approach. American Psychological Association.
Oakley, D. A., & Halligan, P. W. (2013). Hypnotic suggestion and cognitive neuroscience. Trends in Cognitive Sciences, 17(9), 478–487.
Montgomery, G. H., David, D., Winkel, G., Silverstein, J. H., & Bovbjerg, D. H. (2002). The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesthesia & Analgesia, 94(6), 1639–1645.
Milling, L. S., Kirsch, I., & Gold, R. (2019). Effect sizes and clinical utility of hypnotic analgesia: A meta-analysis. International Journal of Clinical and Experimental Hypnosis, 67(3), 235–263.
Tellegen, A., & Atkinson, G. (1974). Openness to absorbing and self-altering experiences ('absorption'), a trait related to hypnotic susceptibility. Journal of Abnormal Psychology, 83(3), 268–277.
Woody, E. Z., & Sadler, P. (2008). Hypnosis and dissociation. In The Oxford Handbook of Hypnosis: Theory, Research, and Practice (pp. 69–91). Oxford University Press.
Egner, T., Jamieson, G., & Gruzelier, J. H. (2005). Hypnosis decouples cognitive control from conflict monitoring processes of the frontal lobes. NeuroImage, 28(4), 969–977.
McGeown, W. J., Mazzoni, G., Venneri, A., Merla, A., & Kirsch, I. (2015). Hypnotic induction decreases anterior default mode activity. Consciousness and Cognition, 33, 191–203.