The Body That Stays on Duty
Part Two of When Capable Women Cannot Switch Off
A client may say, “Nothing is wrong. I just can’t relax.”
She has finished her work. The family is safe. The emails have been answered. There is no immediate crisis. Yet her shoulders remain lifted, her breathing is shallow, and her mind continues searching for the next thing that requires attention.
She knows she needs rest while simultaneously feeling unable to let her guard down.
This is more than a problem of time management. It is the experience of a body that has learned to remain on duty.
Stress is not experienced only in the mind
Anxiety and chronic stress involve ongoing interactions among thoughts, emotions, bodily sensations, memories, and the autonomic nervous system.
When the nervous system detects challenge, it helps mobilize the energy needed to respond. Heart rate may increase, muscles prepare for action, attention narrows, and sleep becomes less accessible. These responses are adaptive when a threat requires action.
Difficulties arise when mobilization continues long after the immediate demand has passed.
For a high-performing client, the trigger may not be a visible danger. It may be the possibility of making a mistake, disappointing someone, being judged, losing control, or failing to anticipate a need. The threat may be social, relational, or symbolic, but the body’s response is real.
A person may therefore understand that nothing terrible is happening while still experiencing tension, agitation, gastrointestinal discomfort, racing thoughts, disrupted sleep, or a persistent sense of urgency.
What the research suggests
A review by Leo et al. (2024) examined the relationship among anxiety, hypnosis, and cardiovascular functioning. The authors concluded that hypnosis and hypnotherapy appear effective in reducing anxiety and may influence autonomic functioning by reducing sympathetic activation and increasing parasympathetic activity.
The authors were appropriately cautious. They emphasized that more research is needed to clarify the neurophysiological components of hypnosis and the mechanisms linking hypnotic interventions with cardiovascular functioning (Leo et al., 2024).
This distinction matters. Hypnotherapists should not promise that a particular bodily process will change or suggest that hypnosis replaces appropriate medical assessment or treatment. The evidence does, however, support what many practitioners observe clinically: Hypnosis can influence both the subjective experience of anxiety and its bodily expression.
The larger evidence base is promising but similarly requires nuance. An umbrella review of 49 meta-analyses found that hypnosis had the largest and most consistent effects for pain and medical procedures. Positive effects were also reported for other mental and physical health concerns, although only nine of the included meta-analyses were judged to be of high methodological quality (Rosendahl et al., 2024).
Responsible practice involves holding both realities: Hypnosis has meaningful therapeutic potential, and the evidence is stronger for some applications than for others.
Safety is an experience, not simply a fact
A person can be objectively safe without feeling safe.
Polyvagal Theory offers one influential framework for considering this difference. Porges (2022) proposes that feelings of safety emerge partly from internal physiological states regulated by the autonomic nervous system. From this perspective, removing an objective threat does not necessarily produce an immediate felt sense of safety.
Polyvagal Theory should be used as a theoretical lens rather than as a complete explanation or diagnostic system. Its most useful clinical principle may be that regulation is influenced not only by what practitioners tell clients but also by how safety, choice, connection, and predictability are experienced within the therapeutic relationship.
A client may not settle simply because the practitioner says, “You are safe.” She may begin to settle because she experiences that nothing is being demanded of her, her responses are respected, and she remains in control of the process.
The hypnotic relationship as co-regulation
Hypnosis is sometimes described primarily as a collection of techniques: induction, deepening, imagery, suggestion, and reorientation. These elements matter, but they occur within a relationship.
The practitioner’s pacing, vocal tone, responsiveness, and attunement all contribute to the experience. Porges (2022) emphasizes the potential role of vocal intonation, facial expression, and trusting social engagement in communicating cues of safety and supporting co-regulation.
In hypnotherapy, permissive language may reduce the pressure to perform hypnosis correctly. Invitations to notice, rather than commands to relax, allow the client to retain agency. Normalizing movement, swallowing, changing position, or opening the eyes communicates that the person does not need to become perfectly still to benefit.
For a client accustomed to meeting expectations, this can itself be therapeutic.
She may enter the session waiting to learn the correct way to go into trance, breathe, visualize, or respond. When the practitioner makes room for her own way of experiencing hypnosis, the session begins to challenge an older pattern: the belief that safety depends upon getting everything right.
Regulation before exploration
With anxious or trauma-affected clients, it can be tempting to move quickly toward causes, memories, or emotionally intense material. Yet a nervous system that is already overwhelmed may not benefit from additional activation.
Before deeper exploration, hypnosis can help the client develop experiences of orientation, grounding, containment, and return.
She might notice the support of the chair, the steadiness of the floor, or the rhythm of her breath without being required to change it. She might imagine a boundary that allows her to remain connected without absorbing everyone else’s needs. She might practise moving between mild activation and calm rather than attempting to remain completely relaxed.
This builds flexibility rather than dependence upon a single ideal state.
The client also learns that she can notice discomfort without being consumed by it. She can move toward a difficult feeling and then return to a stabilizing resource. She can remain present without either suppressing the experience or becoming overwhelmed by it.
Helping the body come off duty
The purpose of hypnotherapy is not to convince a client that she should never feel anxious. Anxiety has protective functions, and mobilization is sometimes necessary.
The aim is to help her recognize that vigilance does not need to remain active at all times.
The body can learn that a task has ended. Responsibility can be set down temporarily. Rest does not have to mean carelessness, vulnerability, or loss of control.
For the woman who has spent years holding everything together, one of the most meaningful hypnotic experiences may be surprisingly simple: discovering that, for a few moments, nothing needs to be managed.
And then discovering that the world continues to hold together while she rests.
References
Leo, D. G., Keller, S. S., & Proietti, R. (2024). “Close your eyes and relax”: The role of hypnosis in reducing anxiety, and its implications for the prevention of cardiovascular diseases. Frontiers in Psychology, 15, Article 1411835. https://doi.org/10.3389/fpsyg.2024.1411835
Porges, S. W. (2022). Polyvagal theory: A science of safety. Frontiers in Integrative Neuroscience, 16, Article 871227. https://doi.org/10.3389/fnint.2022.871227
Rosendahl, J., Alldredge, C. T., & Haddenhorst, A. (2024). Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: A 20-year perspective. Frontiers in Psychology, 14, Article 1330238. https://doi.org/10.3389/fpsyg.2023.1330238