The power of hypnosis to send people into trancelike states has not attracted enough serious research, according to Michael Heap of Sheffield University's centre for psychotherapeutic studies.

Dr Heap believes there are significant gaps in the academic understanding of hypnosis and in its effectiveness in treating clinical problems. There are only two university-based courses in hypnosis in the United Kingdom and Dr Heap argues that research "tends to be poor and much reporting is simply wrong".

Despite an upsurge in interest among academic and applied psychologists, medical practitioners and dentists over the past 40 years, he claims that the fledgling discipline is badly in need of some scientific respectability.

A new masters course is now up and running at Sheffield with an emphasis on research. Participants are medical or dental professionals interested in using hypnosis in their work. Projects include investigations into the effectiveness of hypnosis to treat dental phobia, infertility, smoking, irritable bowel syndrome and warts. There is also research on immunological changes associated with hypnosis and the impact of different kinds of the hypnotic imagery, where a patient is presented with a range of images under hypnosis, on heart rates and blood pressure.

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Dr Heap says: "Many more clinical trials are needed since much of the time we are relying on anecdotal evidence only."

As interest in the use of hypnosis has expanded to include not only treatment of medical conditions but also in enhancing athletic and creative ability, so the literature has flourished. There are now a number of learned journals devoted to the subject. However, Dr Heap says the quality of much of the literature is disappointing.

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The reason, he believes, is that hypnosis is not informed by a sound body of academic knowledge. "While psychoanalysis is informed by theories of the human mind, hypnosis is very weak," says Dr Heap. "There are all sort of ideas in existence but they are not informed by scientific understanding. Many are formed by the lay faction whose understanding of the unconscious mind is usually simplistic."

Dr Heap says it is vital to gain the interest of a much larger number of psychiatrists in order to shift the emphasis of hypnosis away from lay practitioners towards the more sceptical and disciplined approach of professionals.

"Most academic work in our field revolves around disproving and attacking theories," he says. "Much controversy still exists around states of consciousness."

Whether the hypnotic state exists as an altered state of consciousness or whether some other explanation lies behind its undoubted effectiveness is a source of heated debate. The growth of stage hypnotism over the past decade has intensified the discussion.

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Dr Heap takes a distinctly down to earth approach: "Most things which happen in hypnosis don't involve any altered state of consciousness," he says. "Some individuals are highly susceptible but usually it is down to imagination and responding to the demands of a situation."

Much of what accounts for the apparent success of post-hypnotic suggestion can be put down to compliance. When stage hypnotists tell their subjects to scratch their right ear when they hear a particular word they are relying largely on social pressure to persuade people to go along with their act.

However, in clinical hypnosis a similar technique is often used successfully, for example, in helping people to give up smoking. "This is not just a placebo effect but it is to do with the whole process of healing," he says. "There may be no scientific explanation."

Dr Heap began the postgraduate course at Sheffield six years ago as a diploma in response to a frequently expressed need for a comprehensive training programme in hypnosis at university level.

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In the UK as in many other countries, there are no legal restraints on the therapeutic practice of hypnosis and much available training tends to be rudimentary. "Hypnosis is becoming more widely applied within the health service by GPs, psychiatrists, dentists and educational psychologists," he said. "Nevertheless, the availability of hypnosis falls considerably short of potential demand and one reason for this is the lack of training available to the professional."

The course offered by Sheffield is not designed to train people to be hypnotherapists, rather it is open to health professionals who want to explore the use of hypnosis in their work.

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