Source of Featured Image: http://blog.oup.com/2013/03/hypnosis-for-chronic-pain-management/
A pocket watch going through a hypnotizing motion
Dear Pain Matters blog readers,
Hypnosis including hypnotherapy and self-hypnotherapy has been used for pain management for thousands of years. In fact, until the 19th century, hypnosis was the the sole treatment available to undergo surgery with reduced pain and suffering (Braid, 1847).
In essence, self-hypnosis may be a common experience involving an altered state of conscious awareness that may occur many times throughout each day. Some people describe self-hypnotherapy as being similar to ‘tuning out’, daydreaming, being in a trance-like, or meditative, state or having an ‘out of body experience’. A hypnotic experience may involve:
- Disassociation, where the patient’s perception of his/her environment including pain is temporarily reduced;
- Intense concentration or focused attention; and
- Suggestibility, whereby the patient may involuntarily respond to verbal and non verbal communication.
Hypnotherapy treatment for pain management may be offered by medical hypnotherapists, and has proven to be particularly effective for treating children (e.g. during treatment of needle phobia, renal dialysis). Clinicians may use hypnotherapy to help manage a range of conditions including phobias, addictions, anxiety, acute pain (e.g. childbirth pain, surgical pain, burns dressings) and chronic pain. Anaesthetists in Belgium often use hypnosis as an adjunct to general anaesthesia during removal of the thyroid gland, mastectomy and plastic surgery.
Until recently, scientific evidence for (self-) hypnotherapy’s potential role in chronic pain management was virtually non existent. Current studies report that intervention involving hypnosis may result in significant decreases in chronic pain, and that hypnotherapy was often more effective than non hypnotic interventions including physical therapy, education and attention (Elkins et al, 2007).
Imaging studies show that hypnosis can modulate activity in the anterior cingulate cortex (ACC). The ACC links the sensory cortex (that processes the sensory part of pain) with the limbic brain regions (that process the affect, unpleasant or suffering aspect of pain as well as related negative emotions).
In addition to hypnotherapy, a relaxation technique called Autogenic Training that involves self-hypnotherapy may also be useful for inducing the relaxation response. For more details, please refer to my earlier Blog Post:
https://painmatters.wordpress.com/2014/11/05/does-autogenic-training-lead-to-less-pain/ (Does Autogenic Training Lead to Less Pain?)
Hypnosis including self-hypnosis (e.g. Autogenic Training) can result in real and tangible physiological effects and may be able to reduce chronic pain. As such, (self-) hypnotherapy may be a useful addition to an overall pain management strategy.
Hypnosis has no known adverse effects if properly done by qualified medical hypnotherapists who have the chronic pain patient’s best interests in mind.
“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”
Galen, 130-200 C.E.
(1a) Explainer: How Does Hypnosis Relieve Pain?
The Conversation (21 June 2012)
(1b) Hypnosis for Chronic Pain Management
Oxford University Press Blog (16 March 2013)
(1c) Hypnosis Takes Your Mind Off Chronic Pain
ABC News (16 September 2011)
(2a) Elkins G, Jensen MP, Patterson DR.
Hypnotherapy for the Management of Chronic Pain.
The International journal of clinical and experimental hypnosis. 2007;55(3):275-287.
(2b) Elkins G, Johnson A, Fisher W.
Cognitive Hypnotherapy for Pain Management.
Am J Clin Hypn. 2012 Apr;54(4):294-310.
History of Hypnosis and Surgical Pain
(3) Braid, James
On Esdaile & Hypnotic Anaesthetic (from The Complete Writings of James Braid) – Letter to The Medical Times (1847)
For German readers
(4) Meichsner, Irene. Wenn der Schmerz Schmilzt. Bild der Wissenschaft (01.07.1999).