What Cognitive Hypnotherapy Actually Is And Why It Worked When Nothing Else Did

Sheren Gaulbert spent nearly a decade in debilitating vulvodynia pain. She tried diets, supplements, physiotherapy, exercise. She tried self-hypnosis early on but it didn't help. Then, almost ten years in, she tried it again. Within a week, she left the house on her own for the first time in years.

She didn't want to believe it was the self-hypnosis, so she spent years finding out why it had worked.

The Thing That Sounds Strange Until You Understand It

Cognitive hypnotherapy is one of those terms that tends to stop people before they start. The word hypnotherapy carries a lot of cultural baggage – stage shows, swinging watches, being made to do things against your will. Carla puts it plainly: when she first heard the word hypnotherapy, she was scared of it. A previous attempt hadn't worked. She didn't know what to make of it.

Sheren's explanation is disarmingly straightforward.

"We live our lives mostly in some sort of trance. These are automatic processes." ~ Sheren Gaulbert

When you drive a familiar route and arrive without remembering the journey. When you lose track of time reading. When words come out of your mouth without you having to consciously construct each sentence. These are trance states, ordinary, everyday, utterly normal. Cognitive hypnotherapy works with those automatic processes, not against them.

What It Actually Does for Chronic Pain

The nervous system and chronic pain exist in a loop of prediction, response and reinforcement. The brain builds a picture of what a situation will feel like based on past experience. That picture triggers a physiological response (adrenaline, pelvic floor tension, withdrawal behaviours) before anything has even happened. And the response reinforces the prediction for next time.

Cognitive hypnotherapy works to interrupt that loop at multiple points. It looks at the context in which pain is better or worse. It explores the structure of how a person actually experiences their pain: the qualities, the associations, the sensory details. And it addresses the predictive processing, such as the unconscious worst-case thinking that shapes what a person expects their future to look like.

"We want to dehypnotise them out of that trance. If their trance is worst case scenario going off into the future, we want to undo that." ~ Sheren Gaulbert

For people with endometriosis or chronic pelvic pain and mental health challenges, that worst-case trance is often entirely understandable. It has been built and reinforced by years of painful experience, clinical dismissals and genuine unpredictability. Understanding that it can be interrupted – and how – is one of the most useful things this episode offers.

Why Gentleness Matters

Sheren is clear that working with chronic pelvic pain specifically requires a particular kind of care. The pelvic area holds tension that is connected not just to pain but to emotion, memory and nervous system activation that has been building for a long time. Moving too quickly without first building a genuine foundation of safety can surface things that need proper support.

The approach she describes is slow, individual and led entirely by the person in front of her. No two people need the same thing. No two people experience pain the same way. What works as a movement strategy for one person would mean nothing to another. The personalisation is not a luxury, it's the whole point.

Carla's reflection on what finally helped her is quietly powerful.

"The best thing that happened to me was genuinely just stop and slow down. I feel like I was in a rush to just be better, do better, feel better." ~ Carla Cressey

For endometriosis specifically, a condition where PTSD-level responses are common and often unrecognised, the case for individualised, psychology-informed care as part of every treatment pathway is not a fringe argument. It is, as this episode makes clear, a clinical necessity.

 Listen to the full conversation with Sheren Gaulbert and Carla Cressey now.

Resources and research discussed here