Can Hypnosis Enhance Psychedelic-Assisted Psychotherapy?
When used correctly, hypnosis can likely potentiate psychedelic-assisted therapy.
Posted July 10, 2025 | Reviewed by Michelle Quirk
Psychedelic assisted psychotherapy (PAP) has great potential to alleviate suffering from mental illness and other causes, and hypnosis can potentially facilitate the impact of PAP. However, just as it is critical to guide people in such therapies using scientifically informed approaches employed by well-trained therapists, it is important to combine hypnosis with PAP in a careful and clinically informed manner.
I became familiar with PAP while working with patients with terminal illnesses or wasting neurological disease as I sought approaches to allay the severe anxiety that comes with such illnesses. I later learned personally how useful PAP can be to address the grief associated with losing a child. When I began to investigate the science supporting PAP, particularly psilocybin and MDMA, I was astounded by the quality of the data and publications. Top international scientists publishing multiple double-blind placebo -controlled studies in journals such as the New England Journal of Medicine , JAMA, and Nature demonstrate a remarkable impact of these agents on depression , severe anxiety (including that associated with death) and posttraumatic stress disorder ( PTSD ). Effect sizes in these studies exceed those typically seen with standard psychotherapy or pharmacotherapy. Neuroimaging studies show temporary but marked reorganization of neuronal connections and changes in the default mode network of the brain, increased brain connectivity through increased dendrite formation, and beneficial modulation of emotional circuitry and amygdala reactivity. A search for research by Robin Carhart-Harris will lead the reader to many of these studies.
Psychedelic agents should not be used cavalierly. Reports of “bad trips” requiring ER visits, and concerns that inappropriate use of these agents in poorly screened patients can lead to or exacerbate mania or psychosis , argue for careful and skillful use by well-trained therapists. Personal recreational experience with such agents in no way qualifies one to provide this therapy.
Much of my career as a National Institutes of Health-funded research scientist has focused on combining hypnosis with conventional psychotherapy. I have published on combining hypnosis with virtual reality distraction, meditation , and cognitive therapies, mainly in the realm of pain management . Along with Mark Jensen, I have confirmed the classic finding of Irving Kirch and colleagues in 1995 that hypnosis greatly increases the effects of psychotherapy. However, I have learned that it is best not to confuse or combine hypnosis with approaches such as meditation and immersive virtual reality distraction. Meditation, free from the potentially contaminating and distracting influence of hypnotic suggestion and cognitive interference, for instance, is best as a stand-alone practice. Analogously, we should not assume that just because hypnosis can augment traditional psychotherapy that it necessarily will be of benefit combined with PAP.
Frequent advice from qualified PAP therapists is for the patient to, “trust your inner healing intelligence and let the medicine do its work.” In other words, during medicine journeys, patients are encouraged to welcome whatever comes up and trust that the plant or medicine is leading them on the correct therapeutic path. This can be quite difficult because psychedelic journeys can be challenging and fraught with physical and/or emotional discomfort. Patients may attempt to distract themselves from such anxiety and unpleasantness rather than staying with/working through it and recognizing that the medicine is doing its work and “you get the journey you need.” This is one reason patients are encouraged to avoid idle conversation and to wear blindfolds that facilitate “going inside” and being with the experience. Thus, during the height of a psychedelic journey experience, I believe hypnosis is likely useless and potentially even counterproductive, as it can distract individuals from what is unfolding within them.
However, I contend that there are two phases of PAP during which hypnosis can be very useful: preparation and integration. Effective PAP requires educational preparation in one or more pre-journey sessions during which the patients’ goals are clarified, and they are given information about what to expect. For instance, fears of losing one’s mind or that one is dying may arise during the journey and are always transient. Patients are encouraged to “lean into” their experience during a journey rather than talking about or analyzing it. Surrendering to the experience in this way is easier said than done, however. Hypnosis can teach patients to how to open-up to internal experience, and this skill facilitates doing so during the journey itself
The Integration Phase
Hypnosis can also enhance the integration phase of PAP after the journey. Profound therapeutic shifts in outlook and brain function often follow a PAP journey, and a key role of the therapist in post-journey sessions is to help the patient integrate these changes and this experience into their lives. PAP is not about just having an interesting experience—it is about using that experience to change one’s behavior and how one approaches one’s life thereafter. Hypnosis, like meditation or journaling, assists with the integration process by opening the patient to their internal experience and helping them recognize, be present with, and process this material. Hypnosis doesn’t replace meditation, but beautifully complements it during the integration phase and can augment the impact of the psychedelic journey.
I should note that psychologists, starting with the work of Lynn and Evans, and continuing with Alldredge and Elkins, are working on the concept of using hypnosis to induce mystical or psychedelic states. There is evidence that hypnosis can create such effects, but not that they can translate into the profound therapeutic changes that come with PAP. This is a worthwhile pursuit indeed, but a different matter from the premise of this post.
I contend that hypnosis can greatly facilitate preparation for and the integration of powerful psychedelic assisted therapy experiences, though research in this area is yet to be done. However, use of hypnosis during psychedelic journeys is potentially counterproductive, distracting and detracting from the innate PAP healing process. I hope that the suppositions put forth in this post are supported by scientific studies focused on combining these modalities.
In writing this post, I relied on the input of psychiatrist Randy Buzan who has been a mentor to me for using PAP. Randy was kind enough to preview my piece and weigh-in on the science of PAP. I also want to mention that Ciara Christensen, a leader in the field of hypnosis, has been presenting on combining PAP and hypnosis.
Goodwin et al., Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine 2022,387: 1637–1648
Madero, S & Alvarez O, Premise, promise and challenges of MDMA assisted therapy for PTSD. Euro Neuropsychopharmacology 2023. May, 70, 20–21
Patterson, D.R. and Mendoza, M.E. Clinical Hypnosis for Pain Control: A Comprehensive Approach (2nd edition) Washington DC: American Psychological Association (2024)
Patterson, D.R., Hoffman, H.G., Palacios, A.G., & Jensen, M.J. (2006). “Analgesic effects of posthypnotic suggestions and virtual reality distraction on thermal pain.” Journal of Abnormal Psychology, 115(4), 834–841.
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David R. Patterson, Ph.D., ABPP , is an emeritus professor from the University of Washington School of Medicine who has specialized in rehabilitation/health psychology, pain control, hypnosis, and Zen Buddhism/mindfulness.
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