In the 1840s, a Scottish surgeon named James Esdaile was working in a hospital in Calcutta. Before ether or chloroform reached him, he performed hundreds of operations, some of them major, on patients in a trance. His colleagues in Britain were sceptical, and when chemical anaesthesia arrived, his methods were largely forgotten.
A century and a half later, an anaesthetist at Liège University Hospital in Belgium picked up the idea again, this time with modern monitoring. From the early 1990s, Dr Marie-Elisabeth Faymonville and her team began offering patients something they called hypnosedation: hypnosis combined with local anaesthetic and a light dose of sedation. Thousands of patients have since had thyroid surgery, breast surgery and plastic surgery this way. They were awake, talking, and many needed far less medication than usual. Some went home sooner too.
So does this mean you could skip the anaesthetic? No. Every one of those Liège patients still had their surgical area numbed, and the team was ready to give more medication at any moment. Hypnosis didn’t replace anaesthesia. It changed what the experience felt like, and that turns out to matter more than most people expect.
Pain is more than a signal
When you stub your toe, nerves send a message to your brain. But your brain doesn’t just receive that message. It interprets it. How frightened you are, where your attention is, and what you expect to happen all change how much it hurts.
That isn’t a way of saying pain is “all in your head.” It’s a description of how the nervous system works, and you’ve probably felt it yourself. A cut you don’t notice until you see it. A dental injection that feels worse because you’ve been dreading it all week.
In 1997, researchers in Montreal used brain scans to watch this happen. They gave hypnotised volunteers suggestions that a painful heat felt more or less unpleasant. The sensation itself didn’t change, but activity shifted in the anterior cingulate cortex, a brain region tied to how much pain bothers us. The heat was the same. The suffering wasn’t.
That’s the space where hypnosis works. It can:
- move your attention away from what’s happening to you
- calm the fear that turns up the volume on pain
- help muscles that would otherwise brace and tense to relax
- reframe sensations, so “pain” becomes “pressure,” “warmth,” or “something temporary.”
What the studies actually found
Two studies are worth knowing about.
In the operating room. In 2007, a team at Mount Sinai in New York gave women having breast surgery a 15-minute hypnosis session just before their operation. Compared with women who simply talked with a psychologist, the hypnosis group needed less anaesthetic during surgery. Afterwards they reported less pain, nausea and fatigue. Their surgery also cost the hospital roughly US$770 less per patient, mostly because it took less time in theatre.
In radiology. A 2000 study in The Lancet followed 241 patients having procedures through their blood vessels and kidneys. Those taught self-hypnotic relaxation used about half the sedative and pain medication of patients given standard care, and reported less pain. They also had fewer episodes of unstable blood pressure. Their procedures finished faster too, by around a quarter of an hour on average.
These aren’t miracle numbers, but they’re meaningful. Less sedation can mean less grogginess, less nausea, and a quicker return to feeling like yourself.
Will it work for you?
People differ in how readily they respond to hypnosis. Roughly one in ten people respond very strongly, a similar number barely respond at all, and most fall somewhere in between. You don’t need to be in the top group to benefit. Even modest responders often find their anxiety drops noticeably.
The type of procedure matters too. Hypnosis is a good fit for:
- dental work, where fear, gagging and needle anxiety are often the real problem (more on that in our guide to hypnosis dentistry)
- injections, blood tests, wound care and biopsies
- MRI scans and other imaging, where lying still and staying calm is half the battle
- surgery under local or regional anaesthetic, where you’re awake anyway and the main challenge is staying comfortable while time passes
- before and after surgery, to manage pre-op nerves and post-op discomfort.
For major surgery under general anaesthetic, hypnosis can help you prepare and recover. But it has no role in the operation itself.
What it feels like
If you’re picturing a swinging watch and a blank stare, forget it. Medical hypnosis is closer to being deeply absorbed in a good book: you’re aware of the room, but it fades into the background.
A clinician trained in clinical hypnosis therapy will usually meet you beforehand. They’ll ask what worries you, what has happened in past procedures, and what kinds of images feel calming to you, whether that’s a beach, a forest, or your grandmother’s kitchen.
During the procedure, they might guide you to:
- slow your breathing until it feels steady
- step into that calming place in your imagination
- turn down an imaginary “dial” on any discomfort
- notice the treated area feeling cool, distant, or numb
- come back to their voice whenever you feel unsettled.
You can still talk the whole time. If you need a pause or more anaesthetic, you can say so, and you’ll get it.
Try it yourself
Self-hypnosis is a skill, and like any skill it works better with practice. Start a week or two before your appointment, not in the waiting room.
Here’s a five-minute version:
- Sit somewhere comfortable and let your eyes rest on a single spot.
- Take three slow breaths, making each out-breath a little longer than the in-breath.
- Let your eyes close. With each exhale, imagine a wave of heaviness moving down from your scalp to your feet.
- Picture a place where you feel completely safe. Notice what you can see, hear, and feel on your skin there.
- Silently repeat a short phrase, such as steady and safe or one breath at a time.
- Now picture your appointment going smoothly. See yourself calm in the chair, the procedure finishing, and you walking out afterwards.
- Count slowly from one to five and open your eyes.
Do this once a day. By the day of your procedure, your body will know the route.
What hypnosis isn’t
It isn’t mind control. You can’t be made to do anything you don’t want to, and you can reject any suggestion.
It isn’t a test of willpower. If you need more medication, that isn’t failure. It’s what medication is for. A good practitioner will never make you feel you have to “earn” success by going without.
It isn’t always a calm experience. Sometimes old fears or memories come up. A skilled clinician will notice and adjust.
The bottom line
Esdaile’s patients had nothing else. Today, you don’t have to choose. The best results come when hypnosis works alongside modern anaesthesia: the drugs handle the nerves, and hypnosis handles the fear, the tension, and the long minutes on the table. Done well, that partnership can mean less medication, a smoother procedure, and a sense that you were part of your own care, not just something that happened to you.
Curious how strong the evidence is beyond medical procedures? Read our overview of Does Hypnosis Work.
Further reading
Rainville 1997 (brain-scan study)
Rainville P, Duncan GH, Price DD, Carrier B, Bushnell MC. “Pain affect encoded in human anterior cingulate but not somatosensory cortex.” Science. 1997;277(5328):968–971.
DOI: 10.1126/science.277.5328.968
Discusses how hypnotic suggestions changed how unpleasant the heat felt, and activity in the anterior cingulate, without changing the sensation itself.
Lang 2000 (radiology procedures)
Lang EV, Benotsch EG, Fick LJ, et al. “Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial.” The Lancet. 2000;355(9214):1486–1490.
DOI: 10.1016/S0140-6736(00)02162-0
Articles on the figures on 241 patients, roughly half the medication, less pain, fewer episodes of unstable blood pressure, and shorter procedures.
Montgomery 2007 (breast surgery)
Montgomery GH, Bovbjerg DH, Schnur JB, et al. “A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients.” Journal of the National Cancer Institute. 2007;99(17):1304–1312.
DOI: 10.1093/jnci/djm103
Discusses the 15-minute session, the reduced anaesthetic, less pain, nausea and fatigue, and the cost saving of about US$770 per patient.
Liège hypnosedation (patient numbers)
There isn’t one definitive source on this topic; the team published several papers with running totals.
- Faymonville ME, Meurisse M, Fissette J. “Hypnosedation: a valuable alternative to traditional anaesthetic techniques.” Acta Chirurgica Belgica. 1999;99(4):141–146. This is an overview with patient numbers up to that point.
- Faymonville ME, et al. “Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies: a prospective randomized study.” Pain. 1997;73(3):361–367. This supports “needed less medication.”
- Meurisse M, et al. “Hypnosis with conscious sedation instead of general anaesthesia? Applications in cervical endocrine surgery.” Acta Chirurgica Belgica. 1999;99(4):151–158. This covers the thyroid surgery and faster recovery.
Bonus: Esdaile
James Esdaile, Mesmerism in India, and its Practical Application in Surgery and Medicine (London, 1846). This is his own account of the Calcutta operations, and it’s available free on archive.org and Google Books.