Hypnosis and Pain Management
March 14, 2009 Written by JP [Font too small?]I would venture a guess that most of us haven’t had the experience of being in a hypnotic state. We’ve seen people being hypnotized on TV or perhaps even in magic performances. But the difference between artistic representations of hypnosis and the reality of clinical/medical hypnotherapy is quite dramatic.
One of the primary functions of clinical hypnotherapy is to help achieve a calm state of focused attention in which you’re receptive to positive suggestions and less resistant to change. The ultimate goal is to help you develop more control over your physical sensations and your psychological state of mind. At no point during this treatment are you ever out of control or at the mercy of the treating hypnotist. That is a common misconception that needs to be dispelled.
Several studies have recently been published that attest to the mind/body benefits of this gentle, healing art. I’m a very ardent supporter of mind/body medicine. Anytime we can safely use the mind to facilitate healing the body, I’m all for it. It’s empowering, it’s non-toxic and, more often than not, it’s low in cost or free.
“You Are Getting Very, Very Healthy”
In April of 2009, a study will be published in the International Journal of Clinical and Experimental Hypnosis. In it, 22 volunteers with Multiple Sclerosis (MS) and chronic pain were enrolled in a trial to examine the effects of “self-hypnosis training” on the perception of pain.
In order to offer a basis for comparison, about half of the participants were asked to engage in daily “progressive muscle relaxation”. This is a very basic form of meditation. The remainder of the MS volunteers were provided with self-hypnosis training.
Those who employed the self-hypnosis reported significantly greater reductions in overall pain scores. An interesting observation is that these benefits were maintained during a 3 month follow-up assessment. Perhaps this was because most of the participants voluntarily decided to continue with the hypnosis on their own.
Hypnotherapy appears to modify other forms of pain as well. Recent research from Norway provides a compelling follow-up to the first study. 16 patients (12 women and 4 men) with Chronic Widespread Pain (CWP) were divided into two groups for this trial. CWP is a disorder that is defined by four or more days of pain (per week) lasting for at least 3 months. It is often associated with fibromyalgia.
In this experiment, one group received conventional treatment and hypnotherapy. The other volunteers began the trial receiving only conventional care. In this case, conventional treatment consisted of: antidepressants, pain medications, physical therapy and chiropractic. The design of study was as follows:
- Those receiving hypnosis attended a half-hour hypnotherapy session once a week for a total of 10 weeks. The hypnotic agenda was to promote “ego-strengthening”, the reduction of muscle tension and to promote relaxation.
- A symptom questionnaire measured pain scores before the experiment and afterward.
The results of the study were quite dramatic. Those receiving hypnotherapy experienced a 20% reduction in pain. The benefits remained present when a re-examination was conducted one year later.
Perhaps that most shocking finding was that the group that received only conventional care experienced a 21% increase in pain levels!
Hypnosis may also be a safer tool to use in acute situations such as during childbirth. A study by Middlesex University in London found that self-hypnosis helped a small group of pregnant mothers during labor. Pain is both a physical and emotional process. The pregnant women in this experiment reported that self-hypnosis brought about important soothing effects. Here’s what they noted:
- a decrease in the sensation of anxiety and fear, accompanied by “positive thoughts”
- a feeling of pressure, rather than sharp pain
- a lack of fatigue both during and after the birthing process
- a sensation of consolation, relief and self-confidence
- more awareness about the stages of labor
- a lack of suffering during labor pain
The authors of the study mentioned that the pregnant women perceived the hypnosis-guided birth “as being very satisfactory compared to their previous experiences.”
All of these reported effects are clearly positive. But we can look beyond that. For instance, what are the benefits of being able to avoid unnecessary medications? How much money could be saved? What kind of an impact would such a self-reliant therapy have on our feelings of self-worth? Would finding success with hypnosis open the door to using it in other areas relating to the health of the mind and body? The possibilities are vast and very hopeful indeed.
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Hypnosis, Multiple Sclerosis, Pain
Posted in Alternative Therapies, Mental Health
April 6th, 2015 at 1:47 pm
Update: Hypnosis improves cognition and sleep in seniors …
http://www.sciencedirect.com/science/article/pii/S0028393215000627
Neuropsychologia Volume 69, March 2015
Improving sleep and cognition by hypnotic suggestion in the elderly
Highlights
• Hypnotic suggestions increase the amount of deep sleep by 57% in the elderly.
• Deeper sleep by hypnosis improves prefrontal cognitive functioning.
• Well-controlled study using high density EEG recordings in the sleep laboratory.
• Hypnosis might have the potential to benefit sleep and cognition in healthy aging.
Abstract
Sleep quality markedly declines across the human lifespan. Particularly the amount of slow-wave sleep (SWS) decreases with age and this decrease is paralleled by a loss of cognitive functioning in the elderly. Here we show in healthy elderly females that the amount of SWS can be extended by a hypnotic suggestion “to sleep deeper” before sleep. In a placebo-controlled cross-over design, participants listened to hypnotic suggestions or a control tape before a midday nap while high density electroencephalography was recorded. After the hypnotic suggestion, we observed a 57% increase in SWS in females suggestible to hypnosis as compared to the control condition. Furthermore, left frontal slow-wave activity (SWA), characteristic for SWS, was significantly increased, followed by a significant improvement in prefrontal cognitive functioning after sleep. Our results suggest that hypnotic suggestions might be a successful alternative for widely-used sleep-enhancing medication to extend SWS and improve cognition in the elderly.
Be well!
JP
January 16th, 2016 at 3:04 pm
Updated 1/16/16:
http://www.ncbi.nlm.nih.gov/pubmed/26767506
BMC Geriatr. 2016 Jan 15;16(1):14.
Hypnosis can reduce pain in hospitalized older patients: a randomized controlled study.
BACKGROUND: Chronic pain is a common and serious health problem in older patients. Treatment often includes non pharmacological approaches despite a relatively modest evidence base in this population. Hypnosis has been used in younger adults with positive results. The main objective of this study was to measure the feasibility and efficacy of hypnosis (including self hypnosis) in the management of chronic pain in older hospitalized patients.
METHODS: A single center randomized controlled trial using a two arm parallel group design (hypnosis versus massage). Inclusion criteria were chronic pain for more than 3 months with impact on daily life activities, intensity of > 4; adapted analgesic treatment; no cognitive impairment. Brief pain inventory was completed.
RESULTS: Fifty-three patients were included (mean age: 80.6 ± 8.2- 14 men; 26 hypnosis; 27 massage. Pain intensity decreased significantly in both groups after each session. Average pain measured by the brief pain index sustained a greater decrease in the hypnosis group compared to the massage group during the hospitalisation. This was confirmed by the measure of intensity of the pain before each session that decreased only in the hypnosis group over time (P = 0.008). Depression scores improved significantly over the time only in the hypnosis group (P = 0.049). There was no effect in either group 3 months post hospitals discharge.
DISCUSSIONS AND CONCLUSION: Hypnosis represents a safe and valuable tool in chronic pain management of hospitalized older patients. In hospital interventions did not provide long term post discharge relief.
Be well!
JP
April 5th, 2016 at 10:40 am
Updated 04/04/16:
http://www.ncbi.nlm.nih.gov/pubmed/27043785
Thorac Cardiovasc Surg. 2016 Apr 4.
The Beneficial Effect of Hypnosis in Elective Cardiac Surgery: A Preliminary Study.
Background: Single-session hypnosis has never been evaluated as a premedication technique in patients undergoing coronary artery bypass grafting (CABG). The aim of the present study was to evaluate the beneficial effects of clinical hypnotherapy on perioperative anxiety, pain perception, sedation, and necessity for ventilator assistance in patients undergoing CABG.
Methods: Double-blind, randomized, clinical trial was performed. Forty-four patients undergoing CABG surgery were randomized into two groups. The patients in group A received preprocedural hypnosis by an anesthesiologist. Patients in group B (control) had only information on the surgical intervention by the same anesthesiologist. State-Trait-Anxiety Index-I (STAI-I) and Beck Depression Inventory (BDI) were performed preoperatively in both groups. Visual analog scale (VAS) and Ramsay sedation scale (RSS) were evaluated on 0th, 1st, 2nd, 4th, 6th, 8th, 10th, 12th, and 24th hours, postoperatively. Postoperative anxiety level, analgesic drug consumption, and duration of ventilator assistance and intensive care unit (ICU) stay were also documented.
Results: When anxiety and depression levels were compared, significantly lower STA-I and BDI values were detected in group A after hypnotherapy (p = 0.001, p = 0.001, respectively). Significantly less total doses of remifentanil (34.4 ± 11.4 vs. 50.0 ± 13.6 mg) and morphine (4.9 ± 3.3 vs. 13.6 ± 2.7 mg) were administered in group A in the postoperative period. Ventilator assistance duration (6.8 ± 2.0 vs. 8.9 ± 2.7 hours) was also shorter in group A when compared with that in group B (p = 0.007).
Conclusion: Hypnosis session prior to surgery was an effective complementary method in decreasing presurgical anxiety, and it resulted in better pain control as well as reduced ventilator assistance following CABG surgery.
Be well!
JP
July 14th, 2017 at 6:26 pm
Updated 07/14/17:
https://link.springer.com/article/10.1007%2Fs11606-017-4116-9
J Gen Intern Med. 2017 Jul 12.
Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting.
BACKGROUND: Medical management of acute pain among hospital inpatients may be enhanced by mind-body interventions.
OBJECTIVE: We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantly reduce acute pain intensity and unpleasantness compared to a psychoeducation pain coping control. We also hypothesized that mindfulness and suggestion would produce significant improvements in secondary outcomes including relaxation, pleasant body sensations, anxiety, and desire for opioids, compared to the control condition.
METHODS: This three-arm, parallel-group randomized controlled trial conducted at a university-based hospital examined the acute effects of 15-min psychosocial interventions (mindfulness, hypnotic suggestion, psychoeducation) on adult inpatients reporting “intolerable pain” or “inadequate pain control.” Participants (N = 244) were assigned to one of three intervention conditions: mindfulness (n = 86), suggestion (n = 73), or psychoeducation (n = 85).
KEY RESULTS: Participants in the mind-body interventions reported significantly lower baseline-adjusted pain intensity post-intervention than those assigned to psychoeducation (p < 0.001, percentage pain reduction: mindfulness = 23%, suggestion = 29%, education = 9%), and lower baseline-adjusted pain unpleasantness (p < 0.001). Intervention conditions differed significantly with regard to relaxation (p < 0.001), pleasurable body sensations (p = 0.001), and desire for opioids (p = 0.015), but all three interventions were associated with a significant reduction in anxiety (p < 0.001). CONCLUSIONS: Brief, single-session mind-body interventions delivered by hospital social workers led to clinically significant improvements in pain and related outcomes, suggesting that such interventions may be useful adjuncts to medical pain management. Be well! JP