Hypnotherapy for Psychogenic Non-Epileptic Seizures (PNES) and Functional Neurological Disorder (FND)
- David George
- Jul 20
- 8 min read
Introduction
Living with Psychogenic Non-Epileptic Seizures (PNES) or Functional Neurological Disorder (FND) can be profoundly challenging, impacting physical, emotional, and social well-being. These conditions, though distinct from neurological diseases like epilepsy, cause real and distressing symptoms that can disrupt daily life. Hypnotherapy, particularly when informed by the concept of neurohypnosis, is gaining attention as a powerful intervention for managing PNES and FND. This article explores the nature of these conditions, the neurophysiological mechanisms underlying hypnotherapy and neurohypnosis, and how these approaches, especially when delivered by trained providers with expertise in brain function and injury, may offer relief. It also highlights innovative treatment approaches, such as those at Neuregen in Scottsdale, which integrate hypnotherapy with other therapies for comprehensive care.
Understanding PNES and FND
Functional Neurological Disorder (FND) is characterized by neurological symptoms—such as weakness, tremors, sensory disturbances, or seizures—that cannot be explained by structural neurological damage or disease (Stone et al., 2020). PNES, a common subtype of FND, manifests as seizure-like episodes without the epileptiform brain activity seen in epileptic seizures (Brown & Reuber, 2016). These episodes, often triggered by psychological stress, trauma, or emotional distress, are involuntary and not "faked," despite historical misconceptions (Reuber, 2019). PNES affects approximately 5 per 100,000 people annually and is diagnosed in up to 25% of patients evaluated in epilepsy monitoring units (Hallett et al., 2021). Both conditions are associated with high levels of disability, reduced quality of life, and increased healthcare utilization (Hallett et al., 2021).
FND and PNES are thought to arise from disruptions in how the brain processes and integrates sensory, motor, and emotional information. The brain, likened to a computer with intact hardware but faulty software, struggles to send and receive signals correctly (Knight, 2024). This dysfunction often stems from a complex interplay of psychological factors, such as trauma or stress, and neurobiological alterations in brain connectivity and regulation (Pick et al., 2019). For individuals with PNES, episodes may reflect a dissociative response to overwhelming emotional or psychological triggers, making brain-focused psychological therapies, including hypnotherapy and neurohypnosis, particularly relevant (Brown & Reuber, 2016).
The Nature and Mechanisms of Hypnotherapy and Neurohypnosis
Hypnotherapy involves inducing a state of focused attention and heightened suggestibility, often described as a trance-like state, to facilitate therapeutic change (Elkins et al., 2015). Defined by the American Psychological Association’s Division 30 as “a state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion” (Elkins et al., 2015, p. 6), hypnosis allows individuals to access subconscious processes, reframe experiences, and modulate emotional and physiological responses.
Neurohypnosis takes this a step further by explicitly leveraging knowledge of brain function and neurophysiology to enhance the therapeutic impact of hypnosis (Halsband & Wolf, 2019). This approach integrates insights from neuroscience to target specific brain networks and processes, making it particularly suited for conditions like FND and PNES, which involve disrupted neural connectivity. Neurohypnosis is grounded in the understanding that hypnosis can modulate brain activity in ways that promote neuroplasticity—the brain’s ability to reorganize and form new neural connections—offering a powerful tool for addressing the underlying neural dysfunction in these disorders (Halsband & Wolf, 2019).
Neurophysiological Basis of Hypnotherapy and Neurohypnosis
The neurophysiological mechanisms of hypnosis and neurohypnosis involve multiple brain regions and neurotransmitter systems. Research suggests that hypnosis modulates functional connectivity in the brain, particularly in networks involved in attention, emotion regulation, and self-awareness (Acunzo et al., 2021). Neurohypnosis builds on this by tailoring interventions to specific neural pathways implicated in FND and PNES. Key neurochemicals and brain regions include:
Dopamine: Elevated dopamine levels are associated with increased hypnotic suggestibility, potentially enhancing the brain’s ability to process and respond to therapeutic suggestions (Acunzo et al., 2021). In neurohypnosis, providers may use suggestions designed to engage dopamine-rich areas like the prefrontal cortex to improve cognitive flexibility and emotional regulation.
Glutamate: As the brain’s primary excitatory neurotransmitter, glutamate is indirectly linked to hypnotic responding, possibly by enhancing neural excitability in regions like the prefrontal cortex, which governs attention and executive function (Acunzo et al., 2021). Neurohypnosis may target glutamate-mediated pathways to enhance neural integration.
GABA: Increased GABA activity, which promotes relaxation and inhibits neural overactivity, may contribute to the calm, focused state induced by hypnosis, reducing stress-related triggers for PNES (Acunzo et al., 2021). Neurohypnosis leverages GABA to stabilize overactive neural circuits.
Serotonin and Oxytocin: While less conclusive, serotonin may enhance suggestibility, and oxytocin may influence social and emotional bonding during hypnotherapy, though evidence is mixed (Acunzo et al., 2021).
Hypnosis alters activity in the default mode network (DMN), which is involved in self-referential thinking, and the salience network, which directs attention to relevant stimuli (Deeley, 2016). Neurohypnosis enhances these effects by using targeted suggestions informed by neuroimaging and neurophysiological data to modulate specific brain regions, such as the anterior cingulate cortex, which is often hyperactive in FND (Halsband & Wolf, 2019). These changes can reduce hypervigilance to internal sensations and improve emotional regulation, addressing the dysregulated stress responses underlying PNES and FND (Pick et al., 2019).
Hypnotherapy and Neurohypnosis as Powerful Therapies for the Brain
Hypnotherapy, and particularly neurohypnosis, is a powerful therapy for the brain when administered by trained providers who understand brain function and injury. Providers with expertise in neuroscience and psychiatry can tailor hypnotic interventions to target specific neural dysfunctions, such as the disrupted connectivity between the prefrontal cortex and limbic system seen in FND and PNES (Pick et al., 2019). This targeted approach enhances the brain’s neuroplasticity, allowing it to rewire maladaptive pathways and restore functional integration (Halsband & Wolf, 2019). For example, suggestions designed to enhance prefrontal control can help patients regain agency over involuntary symptoms like seizures or tremors.
Moreover, providers trained in brain function can use neurohypnosis to address the psychological and somatic components of FND and PNES simultaneously. By combining hypnotic techniques with knowledge of trauma-related brain changes, these providers can help patients process traumatic memories safely, reducing the emotional triggers that precipitate symptoms (Knight, 2024). This is particularly important given that 25–75% of PNES patients report a history of trauma, such as abuse or loss (van den Berg & Pye, 2023). The precision of neurohypnosis, guided by an understanding of brain injury and dysfunction, makes it a uniquely effective tool for restoring balance to the brain’s regulatory systems.
Hypnotherapy and Neurohypnosis in FND and PNES
Hypnotherapy has a long history of use for FND, dating back to the 19th century when pioneers like Charcot and Janet used suggestion to treat “hysteria” (Deeley, 2016). Modern research supports its efficacy, with a systematic review of 35 studies involving 1,584 patients finding that 87% showed significant symptom improvement, including many with complete resolution in the short term (Hallett et al., 2021). Neurohypnosis enhances these outcomes by using neuroscience-informed techniques to target specific brain dysfunctions. For PNES, these approaches can help by:
Addressing Triggers: Techniques like the rewind method allow patients to process traumatic memories without reliving them, reducing seizure triggers (Knight, 2024). Neurohypnosis may enhance this by targeting limbic system hyperactivity, a common feature in PNES.
Enhancing Self-Regulation: Hypnosis and neurohypnosis promote relaxation and self-control, helping patients manage stress and autonomic arousal, which are common precipitants of PNES (Brown & Reuber, 2016). Neuroscience-informed suggestions can strengthen prefrontal-limbic connectivity, improving emotional regulation.
Reframing Symptoms: By altering perceptions of symptoms, these therapies can reduce the distress and disability associated with FND, empowering patients to regain control (Yeo et al., 2018). Neurohypnosis may specifically target the salience network to reduce symptom-focused attention.
For example, a case study of a patient with PNES and intellectual disability found that hypnotherapeutic relaxation significantly reduced seizure frequency (Turner et al., 2011). Neurohypnosis, when applied by providers with expertise in brain function, could further optimize outcomes by tailoring interventions to the patient’s unique neurophysiological profile. However, limitations in study designs, such as small sample sizes and lack of randomized controls, highlight the need for further research (Hallett et al., 2021).
Benefits for Individuals with PNES and FND
For those living with PNES and FND, hypnotherapy and neurohypnosis offer a non-invasive, patient-centered approach that can complement other therapies. By targeting the psychological and neurophysiological roots of these conditions, they may:
Reduce seizure frequency and intensity.
Improve emotional regulation and stress management.
Enhance quality of life by reducing disability and stigma.
Address trauma without triggering seizures (Knight, 2024).
The American Psychiatric Association and the International League Against Epilepsy emphasize the importance of psychological therapies for PNES and FND, with hypnosis and neurohypnosis recognized as promising interventions (Hallett et al., 2021; van den Berg & Pye, 2023). However, patients should work with trained providers, particularly those with expertise in brain function and injury, to ensure optimal outcomes.
Neuregen’s Integrative Approach in Scottsdale
Neuregen, a clinic in Scottsdale, Arizona, specializes in innovative treatments for FND and PNES, integrating hypnotherapy and neurohypnosis with other psychotherapeutic and brain-based therapies. At Neuregen, hypnotherapy is administered by providers board-certified in psychiatry and mental health, who are trained in the neurophysiological underpinnings of FND and PNES. These providers use neurohypnosis to target specific brain networks, leveraging their expertise in brain function to enhance the therapeutic impact of hypnosis. This approach is sometimes combined with therapies such as ketamine therapy, which can enhance neuroplasticity and emotional processing, and neuromodulation techniques, to target dysfunctional brain networks (Neuregen, 2025). This multimodal strategy aims to address both the psychological triggers and neurophysiological underpinnings of FND and PNES, offering personalized care to improve symptom management and quality of life.
Conclusion
Hypnotherapy, particularly when enhanced by the neuroscience-informed approach of neurohypnosis, holds significant promise for individuals with PNES and FND. By leveraging neurophysiological mechanisms like dopamine modulation, enhanced functional connectivity, and neuroplasticity, these therapies can address the root causes of these disorders. When delivered by trained providers with expertise in brain function and injury, such as those at Neuregen in Scottsdale, hypnotherapy and neurohypnosis become powerful tools for restoring brain regulation and improving quality of life. While research is promising, ongoing studies are needed to establish standardized protocols. Neuregen exemplifies the potential of integrating these approaches with advanced therapies to provide holistic, brain-focused care.
References
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