16d • Hypnotherapy
Formal Power in the Helping Relationship and the Collaborative Position of Hypnotherapy
All helping relationships are shaped by formal power long before the practitioner and client meet. This power does not arise from personality or interpersonal dynamics, but from structure: professional roles, credentials, ethical codes, and social institutions. It forms the underlying architecture of the relationship and establishes expectations around authority, responsibility, and protection.
Although contemporary therapeutic approaches often strive for collaboration and equality, an inherent power imbalance remains. This imbalance is not accidental. It exists to safeguard clients, maintain professional standards, and create a reliable container in which change can occur. Ethical practice does not depend on the elimination of power, but on its conscious and responsible use.
Formal power within helping professions is commonly understood to rest on two foundations: legitimate power and expert power. Legitimate power derives from the practitioner’s professional role, training, and ethical accountability. It grants authority to set the parameters of the work, including session structure, boundaries, and professional conduct. Expert power, by contrast, emerges from the perception that the practitioner possesses specialised knowledge or skills that can help the client navigate their difficulties. Clients seek help because they believe the practitioner understands something about change that they do not yet understand themselves.
One of the most visible expressions of formal power in many therapeutic models is the ability to diagnose. When a practitioner assigns a clinical label, they are using institutional authority to categorise a client’s experience. This can be experienced as validating and clarifying, or as limiting and stigmatising. Regardless of its impact, the power to diagnose resides with the professional rather than the client. This reality highlights the importance of ethical restraint, transparency, and humility when such authority is exercised.
Clients, however, are not without formal power. The most significant power held by the client is informed consent. Clients have the legal and ethical right to understand what is being proposed, to ask questions, to decline particular approaches, and to withdraw from the work entirely. No ethical practitioner can proceed without the client’s ongoing consent. This right acts as a counterbalance to professional authority and is central to client autonomy.
Hypnotherapy operates within this same ethical framework, yet it engages with formal power in a distinctive way. Unlike many therapeutic modalities, hypnotherapy is typically non-diagnostic. Rather than locating authority in the naming of disorders or conditions, hypnotherapy focuses on patterns of thought, belief, emotion, and behaviour. This shift moves the emphasis away from pathology and toward process.
By working with patterns rather than diagnoses, hypnotherapy reframes the client’s experience as learned, contextual, and changeable. Beliefs and emotional responses are explored not as symptoms of disorder, but as adaptations that once served a purpose and can now be revised. In this model, the practitioner does not claim authority over the client’s identity. Instead, expertise is applied to facilitating awareness and change, while meaning remains grounded in the client’s lived experience.
Collaboration is therefore central to hypnotherapeutic practice. The hypnotherapist brings an understanding of subconscious learning, attention, imagery, and emotional processing, along with the skills required to guide the process safely. The client brings personal history, emotional truth, and subjective meaning. Change emerges through the interaction of these contributions, rather than being imposed by professional authority.
This collaborative stance does not eliminate formal power. Hypnotherapists still hold responsibility for boundaries, ethical conduct, and the structure of the work. Informed consent remains essential, particularly when working with altered states of awareness. What differs is the way power is expressed. Rather than defining or directing the client, the practitioner holds the frame within which the client explores and updates their internal patterns.
Ethical difficulties arise when power is mishandled at either extreme. When practitioners deny or minimise their authority, boundaries can blur and responsibility becomes unclear. When practitioners rely too heavily on authority, client autonomy is diminished and the work risks becoming coercive. Hypnotherapy seeks a balanced position, in which professional responsibility is clearly held while client agency is actively supported.
In this sense, hypnotherapy demonstrates that authority and collaboration are not opposing forces. When formal power is acknowledged and ethically contained, it provides stability rather than domination. The practitioner becomes a guide rather than an arbiter of truth, supporting the client in understanding how their internal system operates and how it can change.
Ultimately, the effectiveness and integrity of any helping relationship depend not on the absence of power, but on how consciously it is held. Hypnotherapy offers a model in which power is transparent, bounded, and used in service of the client’s autonomy and growth, rather than over it.
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Formal Power in the Helping Relationship and the Collaborative Position of Hypnotherapy
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