Most professionals working in hypnotherapy subscribe to some form of person-centred practice. This means we aim to treat each client as a unique individual, bringing their life experiences with them into the therapy room.
I will now explore this idea in more depth by examining one model of person-centred care: the biopsychosocial model.
This model does exactly what its name suggests—considering all aspects that a client brings when seeking professional help: physical, mental, and environmental. It studies and analyses how these various elements interact and impact the client.
The biopsychosocial model has been widely used in medical research, particularly in large-scale studies of diseases such as HIV and AIDS. It is also applied in mental health to assess how a client’s environment and beliefs interact with their physical state.
What is the Biopsychosocial Model?
Before the term was coined, numerous health professionals in different fields were already exploring how the mind could affect physical behaviour, while others examined the impact of environment on mental health. The task was to integrate and systematise these insights.
Various models have attempted to achieve this. However, it is generally agreed that the original biopsychosocial model was developed by George L. Engel and Jon Romano at the University of Rochester in 1977. Its roots go back further, though—some elements can be traced to psychological models developed after the First World War in an effort to understand and treat the vast amount of trauma, both physical and mental, experienced by soldiers. Experts recognised that it would be absurd not to consider this trauma in treatment.
Other thinkers contributed to this shift towards a more complex understanding of the person. For instance, earlier in the 20th century, Adolf Meyer emphasised the importance of considering each client’s personal history when diagnosing and planning treatment. Later, in the 1960s, Urie Bronfenbrenner developed ideas suggesting that interpersonal relationships do not exist in isolation but are shaped by social structures, including economic and political factors. This reinforced the concept that everything around us influences our physical and mental health.
More recently, the term “syndemic” has been used to explore the interplay of factors affecting health. Syndemic theory highlights that health outcomes are not purely biological but are deeply influenced by social and environmental factors. It calls for integrated public health approaches to address these interconnected issues, reduce disparities, and improve population health. This framework has become particularly relevant in understanding large-scale disease and illness. For example, research has shown that COVID-19 had a more severe impact on poorer communities, not just in terms of physical health but also considering the pressures of low wages, overcrowded housing, and limited access to healthcare. Understanding these interactions can help improve health outcomes.
Applying the Biopsychosocial Model to Hypnosis
As mentioned earlier, most successful hypnotherapists aim for a person-centred, whole-person approach. The biopsychosocial model enhances our understanding of this. It serves as a guide for considering the various elements affecting individual clients and determining the appropriate weight to give each factor. If we get this balance right, we achieve better outcomes.
Let’s examine the three core elements:
Biological
I will explore the biological processes in the brain during hypnosis in a later blog. For now, it is important to recognise that hypnosis can influence brain wave patterns. The goal of the hypnotherapist is to facilitate an optimal brain wave state for learning and creativity, allowing the client to examine their problem and develop solutions.
There is evidence that some individuals have a greater propensity to enter these states, often referred to as hypnotic responsiveness.
Social
With these biological processes as a foundation, the therapist’s role in interacting with the client becomes central. The relationship between therapist and client can positively influence brain activity, improving well-being and increasing the likelihood of a successful outcome.
A strong therapeutic relationship enhances the effectiveness of hypnosis. This is a social interaction and, therefore, an integral part of the biopsychosocial model. However, other social factors also come into play.
For instance, cultural factors can shape a client’s expectations. Someone who has seen a stage hypnosis performance may worry that they will be made to do something against their will, leading to resistance in therapy. Others may be highly sceptical of hypnosis because they cannot directly see its effects. Addressing these concerns is essential for achieving success.
Psychological
Here, we consider the client’s personal beliefs and behavioural patterns. Expectations and motivations are crucial, as are cognitive maps shaped by past experiences.
A client’s receptiveness to hypnosis depends largely on their desire for change. This desire can be influenced by psychological or social factors, such as whether they have successfully changed before, whether they have witnessed change in others, whether they are undergoing hypnosis for themselves or at the request of someone else, and how they prioritise this change in their life.
A skilled therapist will explore these factors carefully through expert questioning during sessions.
Of course, psychological and social factors often overlap.
Each of these three elements—biological, social, and psychological—interacts to determine the success of hypnotherapy.
To summarise: biological mechanisms (e.g., hypnotisability), social interactions (e.g., therapist-client rapport), and psychological factors (e.g., belief systems) all play key roles in hypnotherapy success.
The biopsychosocial model provides a valuable framework for understanding this complex process.
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Coming Next
In my next article, I will explore ethical considerations when applying psychological principles in therapy—focusing on fairness and transparency in building trust with clients.