Medical hypnosis uses focused attention and therapeutic suggestions to influence patients’ experiences of anxiety, pain, and medical procedures. In ENT, it may be used as a complementary approach rather than a substitute for standard care, including during pediatric fibroscopy and otologic procedures, and for nasofibroscopy in adults who are anxious. Libourne Hospital in Libourne, France, has incorporated the approach into clinical practice, which was discussed at Rhinoforum 2026, held on June 18-20, 2026, at the Palais des Congrès in Bordeaux, France.

“It is an excellent tool for reassuring and comforting the patient, helping make care as minimally traumatic as possible,” said Olivier Duffas, MD, ENT surgeon and head of the Department of Otorhinolaryngology and Cervico-Maxillofacial Surgery, Centre Hospitalier Robert Boulin (Libourne Hospital).

Why is hypnosis incorporated into clinical care, particularly during fibroscopic procedures? “It is an excellent tool for reassuring and relieving the patient, helping make the procedure as minimally traumatic as possible,” said Duffas. Hypnosis is induced through verbal guidance and involves focused attention, reduced awareness of external stimuli, and increased responsiveness to suggestions. These features are consistent with the definition developed by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association, which describes hypnosis as a state that involves focused attention, reduced peripheral awareness, and increased responsiveness to suggestions.

“Hypnosis gives the patient an active role,” said Charlotte Cellier, nursing assistant at Libourne Hospital who practices medical hypnosis in the ENT department. The hypnotic state may help patients draw on internal resources to manage their anxiety and pain.

Hypnosis has been recognized by numerous medical societies for decades, including the British Medical Association and the American Medical Association, dating back to the 1950s. In April 2011, the French National Authority for Health endorsed validated nonpharmacologic therapies, including hypnosis. In 2013, the French National Academy of Medicine addressed complementary therapies, such as hypnosis, and their role among available healthcare resources.

In 2015, hypnosis was evaluated by the French National Institute of Health and Medical Research (Inserm), including its use in anesthesia and irritable bowel syndrome. The assessment found evidence supporting its use in some settings, while noting that the strength of the evidence varied by indication.

In France, medical hypnosis is used to treat acute and chronic pain, perioperative anxiety, and support during interventional procedures. It is also used in oncology, obstetrics, and irritable bowel syndrome.

Hypnotic State and Brain

Hypnosis involves focused attention combined with partial disengagement from the surrounding environment, altered perceptions, and increased responsiveness to suggestions. It may provide access to internal sensory and emotional processes. “A dissociation occurs,” said Cellier. “There is also cognitive absorption. Free will is preserved during medical hypnosis.”

From a neurophysiologic perspective, “reversible and measurable changes in the brain are observed on functional MRI,” said Duffas. “No total loss of control is observed, but rather increased cognitive flexibility, which is precisely the intended effect.”

According to the researchers, hypnosis places the left hemisphere, associated with the conscious mind, analysis, and logic, on standby in favor of networks associated with unconscious processes and emotional and imaginative functions, including those involving the right hemisphere.

Activity in the default mode network was reduced, leading to less rumination and self-focused thoughts. Activity in attentional networks is enhanced, resulting in greater focus and receptivity to suggestions. Activity in the posterior cingulate cortex also tends to decrease, reducing critical monitoring and self-observation.

Hypnosis may also affect the brain regions involved in pain processing. Research has found that hypnotic analgesia can reduce the intensity and unpleasantness of experimentally induced pain and alter the activity of brain regions involved in the processing of pain.

Clinical Implications

Hypnosis can be offered at any age and adapted to the maturity, needs, and sensitivity of children and adolescents. Responsiveness varies among individuals: 10%-15% of people are highly receptive, 70% are moderately receptive, and 10%-15% are less receptive. Uncontrolled psychotic disorders, severe dissociative states, paranoia, major cognitive disorders, and patient refusal are considered contraindications to hypnosis.

In practical terms, how does a medical hypnosis session work?

“The first step is to establish the relationship by observing, acknowledging, and defining the goal,” said Cellier.

The second stage involves induction, with a focus on “shutting down the external network” through breathing, the five senses, and relaxation.

The third stage corresponds to a trance state during which the patient is guided through their imagination while creativity is stimulated. A dissociation from reality, described as “here and elsewhere,” develops, accompanied by changes in pain perception and therapeutic work.

The fourth stage involves returning to an ordinary state of consciousness.

The technique of “indirect suggestion” involves diverting conscious attention by directing it toward a monotonous stimulus, such as a steady voice or a fixed point, said Cellier. This technique reduces conscious resistance and facilitates access to unconscious processes.

Hypnosis also acts on certain areas of the brain that are involved in the regulation of pain and fear, resulting in increased local blood flow.

Negative suggestions should be rephrased as positive suggestions. Terms with negative connotations, including pain, stinging, discomfort, fear, cold, and trials, should be avoided. Words that evoke pleasure, relief, or enjoyable activities may activate the brain’s reward circuit and reduce activity in the brain networks involved in pain processing.

Feedback from Libourne Hospital has been positive. Hypnosis is now routinely used during endoscopy, the placement and removal of transtympanic ventilation tubes in children, vocal cord medialization under local anesthesia, and skin surgery under local anesthesia. It has also been extended to short procedures that may cause stress regardless of age.

Duffas and Cellier reported practicing medical hypnosis at Libourne Hospital.

This story was translated from Medscape’s French edition.