Subjective Units of Distress (SUDs): A Hypnotist’s Guide to Measuring Change

Imagine walking into a hypnosis session and being asked, “On a scale from 0 to 10, how bad does this issue feel right now?” This simple question might seem insignificant, but it’s actually a powerful tool for measuring emotional or physical distress.

Subjective Units of Distress (SUDs) provide a clear, structured way to gauge a client’s experience before, during, and after hypnosis. Whether working with anxiety, pain, cravings, or trauma, hypnotists can use SUDs to track progress, validate their results, and fine-tune their approach.

But when exactly should SUDs be used, and how do they fit into different hypnosis techniques like Ego State Therapy or the ADAC protocol? This guide breaks it all down.

What Are Subjective Units of Distress (SUDs)?

SUDs are a numeric scale (typically from 0 to 10) that helps measure the intensity of a problem.

• 0 = No distress at all
• 10 = The worst possible distress

For example, a hypnotist might ask, “How strong is your craving for a cigarette right now?” If the client responds with a 7 out of 10, this provides a baseline measurement before any intervention begins.

The key benefit of using SUDs is tracking change over time. After a hypnosis technique is applied, the hypnotist can ask the same question again. If the number drops significantly, it's clear that progress has been made.

When Should Hypnotists Use SUDs?

SUDs are valuable because they provide measurable feedback at key points during a hypnosis session:

1. Before the session: Establish a clear starting point. This provides objective data that can be compared later.
2. During the session: Check if the intervention is working. If the SUD number isn’t dropping, the hypnotist can adjust their approach accordingly.
3. After the session: Confirm that the issue has been reduced or eliminated. The goal is to aim for zero—but even reducing an issue from an 8 to a 2 can be a major success.

Using SUDs in Different Hypnosis Techniques

SUDs aren’t just a general measurement tool—they integrate seamlessly into specific hypnosis techniques to make them even more effective.

1. SUDs in the ADAC Protocol

SUDs play a key role in the ADAC protocol, a powerful method for resolving emotional distress. This structured approach helps hypnotists:

• Identify the starting level of distress.
• Apply therapeutic techniques to reduce discomfort.
• Use the SUD scale to track progress in real-time.

By continuously measuring the level of distress, hypnotists can ensure they are making genuine, measurable improvements for their clients.

2. SUDs in Ego State Therapy

Every person operates through different ego states—distinct parts of the personality that take control at different times.

When using Ego State Therapy, SUDs help pinpoint which part of the client is experiencing distress.

For example, a smoker might have conflicting ego states related to their habit:

• The Smoker Ego State: “I need a cigarette right now.”
• The Health-Conscious Ego State: “I want to quit smoking for good.”

If a hypnotist asks, “How badly do you want a cigarette right now?”, the response will depend on which ego state is currently executive. 

If the person is in a healthy, non-smoking state, their craving might be low. But if the smoker ego state takes control later, the craving will become much higher.

This highlights why SUDs aren’t just measuring distress—they’re also revealing which ego state is experiencing it.

Key Considerations When Using SUDs in Hypnosis

To maximize the effectiveness of SUDs in hypnosis, a few key points should be considered.

1. Adapting SUDs for Children

Young children may struggle with numerical scales, so hypnotists can use size-based language instead:

• "How big is the hurt?"
• "Show me with your hands how much it bothers you."

By making SUDs more visual and intuitive, children can still express their distress levels effectively.

2. Working With Physical Pain

SUDs are commonly used for pain management with hypnosis, but pain can sometimes shift between ego states.

Even if a hypnotist reduces pain for the executive ego state, another ego state might still be holding onto it.

Pro tip: Using ideomotor signals (finger movements to indicate 'yes' or 'no') can help determine whether pain relief has been fully integrated across all ego states. Comprehensive training in ideomotor signals is available in our Advanced Hypnotherapy Techniques course.

3. Always Test Your Work

Many hypnotists fear testing their results, worrying that the issue may not have been fully resolved. However, testing is essential.

Discovering any remaining distress in the session is better than receiving an angry call later.

Ways to test:

• Future pacing: “Imagine yourself in the same situation tomorrow. How does it feel now?”
• Ideomotor signals: Using muscle movements to confirm if the change has fully integrated.

Always Aim for Zero – But Reframe Success If Needed

The goal in hypnosis is always to eliminate distress completely (a SUD score of 0). But sometimes, reducing an issue from a 10 to a 2 is still a powerful transformation.

A great reframing question for clients is:

"If we could only get this down to a 1 or 2, would that still be a good outcome?"

When clients agree, they’ll recognize and appreciate the improvement—even if complete elimination isn’t immediately possible.

Using Subjective Units of Distress (SUDs) is a simple yet powerful way for hypnotists to:

• Measure the severity of an issue
• Track progress throughout a session
• Ensure lasting change by confirming results

By integrating SUDs into hypnosis techniques like Ego State Therapy and the ADAC Protocol, hypnotists can make their work more effective, measurable, and evidence-based.

So, if you’re not already using SUDs in your hypnosis practice, it’s time to start! This one simple tool could radically improve your results and give your clients the confidence that real, measurable change is happening.