Hypnosis, Repetition and Emotional Change

Many of the difficulties people bring to therapy-whether anxiety, relational distress, compulsive behaviors, or chronic pain-are not the result of conscious decision-making, but of repetition. Emotional and relational patterns form early in development, often as adaptive responses to caregiving relationships that were survival-critical. Over time, these patterns become procedurally encoded: automatic, preverbal, and resistant to insight alone (Schore, 2012). They shape how we experience our bodies, our desires, our capacity for intimacy, and our sense of self.

Chronic pain offers a particularly clear illustration of this process. Research demonstrates that early developmental trauma and relational disruption can fundamentally alter pain processing in the nervous system (Van der Kolk, 2014). When early needs for comfort, attunement, or protection go unmet, the body's stress response systems remain chronically activated. Pain becomes not just a physical signal, but an encoded memory-a somatic repetition of what could not be metabolized psychologically. Many individuals suffering from chronic pain carry histories of childhood adversity, and their bodies continue to "speak" what was never safely heard or held in relationship (Schore, 2012; Porges, 2011).

Psychoanalytic theory has long understood that intellectual awareness of a pattern does not necessarily transform it. As Freud (1920) observed in Beyond the Pleasure Principle, the compulsion to repeat operates beyond conscious control, rooted in what could not be remembered or symbolized. Yet hypnosis offers a way of working with these repetitions-including somatically encoded ones like chronic pain-at the level where they first took form: before language, in the realm of affect, sensation, and implicit relational knowing.

In the focused attention and inner absorption characteristic of hypnotic states, the mind becomes more receptive to metaphor, imagery, and somatic experience. As Stanford psychiatrist Dr. David Spiegel notes, hypnosis allows individuals to "mentally rehearse being the person you want to be" (Spiegel & Spiegel, 2004)-not through willpower or cognitive reframing, but through embodied experiential learning that bypasses the defensive structures of ordinary consciousness. For those with chronic pain, hypnosis has been shown to significantly reduce pain intensity and improve functioning by altering how pain signals are processed and experienced (Jensen & Patterson, 2014).

This is not about erasing the past or imposing new behaviors. Rather, hypnosis creates relational and neurobiological conditions under which procedurally encoded patterns-whether emotional, relational, or somatic—can be accessed, experienced differently, and gradually reorganized. The therapeutic relationship itself becomes a laboratory for new relational experience, while hypnotic work deepens contact with preverbal affective states that shaped early development.

Contemporary neuroscience supports what clinicians have long observed: hypnosis facilitates neuroplasticity, allowing for the revision of implicit emotional learning (Oakley & Halligan, 2013). When early patterns are re-experienced in a new relational context-one characterized by attunement, safety, and the therapist's capacity to tolerate what could not previously be held-transformation becomes possible. For individuals with chronic pain, this means the possibility of experiencing their bodies differently: not as sites of threat or betrayal, but as capable of sensation beyond suffering.

Over time, this process can soften rigidly defended patterns and restore access to emotional flexibility, autonomous desire, and embodied presence. Change occurs not through insight or instruction, but through repeated relational experience that reorganizes what was laid down before words.

—Dr. Stéphanie Gamache, PhD

References

Freud, S. (1920). Beyond the pleasure principle. SE, 18:1-64.

Jensen, M. P., & Patterson, D. R. (2014). Hypnotic approaches for chronic pain management: Clinical implications of recent research findings. American Psychologist, 69(2), 167–177. https://doi.org/10.1037/a0035644

Oakley, D. A., & Halligan, P. W. (2013). Hypnotic suggestion: Opportunities for cognitive neuroscience. Nature Reviews Neuroscience, 14(8), 565–576. https://doi.org/10.1038/nrn3538

Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.

Schore, A. N. (2012). The science of the art of psychotherapy. W. W. Norton & Company.

Spiegel, D., & Spiegel, H. (2004). Trance and treatment: Clinical uses of hypnosis (2nd ed.). American Psychiatric Publishing.

Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.