Hypnotherapy in Pain Management

Hypnosis and states of relaxation to control pain is as old as prehistory.  In the 1800s, some doctors used trance states and hypnosis to do surgery on patients with success in even major surgical procedures.  The use of hypnosis for pain fell out of favor in the early to mid-1900s but began its resurgence and popularity in the 1960s. 

There are two basic misconceptions that have gotten in the way of using hypnosis for pain management.  The first was the assumption that pain was just a symptom of another disease and that taking care of the underlying disease would automatically eliminate the pain.  This is basically untrue. It was also believed that using hypnosis could be dangerous if it masked the pain of an existing situation.  For example, if you used hypnosis to reduce the pain of appendicitis, you ran the risk of causing the appendix to rupture. 

Another misconception was that pain could be psychological or physiological but not both.  Now we know that pain has both physiological and psychological factors involved in the same pain.  Because of this, pain can be effectively managed through hypnosis and, in at least one study, it did not impact the amount of time it took for the diagnosis of the cause of the pain to be determined. 

Hypnosis, for it to be effective, depends on a close relationship and trust in the hypnotist.  The hypnotist must be skilled in managing patients with chronic pain and adequate post-hypnotic suggestions should be utilized so that the pain-relieving effect can take place after the hypnosis-event is over. 

PET scans have shown actual changes in the brain of the hypnotized patient that are directly associated with the areas of the limbic system associated with feeling unpleasant feelings.  This means that hypnosis acts primarily on the brain, rather than on some peripheral body changes.  Increased delta activity of the brain waves, usually associated with relaxation, is also a factor in what makes hypnosis work.  Research has shown that this pain relief through hypnosis can work in real-live situations and not just in a laboratory setting. 

Things that must be considered before knowing that hypnosis will work in any given situation include the ability of the subject to be hypnotized, the type and quality of pain, whether the pain is acute and chronic, and the intensity and origin of the pain.  Unfortunately, not all patients can be hypnotized because they have a high hypnotizability threshold. 

One condition that is particularly good to treat with hypnosis is acute burn pain.  Patients who are undergoing burn dressing changes and debridement, for example, do very well when taught to increase their pain threshold through hypnosis.  It also appears to work in children. 

Surgeries using hypnosis along with conscious sedation can be performed in a variety of settings.  Patients report an increase in satisfaction with their surgical procedure when hypnosis was used along with the other modalities of IV conscious sedation and local anesthesia.  It reduces anxiety as well as does the giving of benzodiazepines. 

Hypnosis has been used for patients during and after liposuction surgery and after surgery on the heart.  Not only was pain and anxiety reduced but the patients were more medically stable if they had hypnosis when compared to those who did not have hypnosis. Pain treated with hypnosis is also helpful in patients who must go through otherwise painful physical therapy after an injury. 

Hypnosis has been a good thing for those with cancer pain.  It also seems to help in patients who have irritable bowel syndrome, with success rates as high as 80 percent.  In kids with fractures, hypnotic techniques include guided imagery and distraction techniques.  Hypnosis may even improve the degree of healing from these fractures. 

One technique used to treat pain is called the “glove technique”.  Patients are asked to imagine that their hand is immersed in an anesthetic gel or solution and that the pain relief in the hand can be transferred to any other site in the body where pain occurs.  They can even “transfer” the pain to a trusted hypnotherapist using this technique. 

Sometimes patients are given positive suggestions regarding their pain so they can reframe the pain in a better way.  It can increase, for example, the time in which a patient can keep their hand inside a bucket of ice.  Patients become in control of their pain and not the other way around. 

In chronic pain, hypnosis can address the issues of hopelessness and depression that often become a part of the chronic pain syndrome.  This means that chronic pain as well as acute pain can be candidates for hypnotic management.  Patients with complex chronic pain syndromes, such as low back pain and the pain of temporomandibular joint disorder can effectively decrease their need for pain medications through hypnosis.  It has also been used in sickle cell pain and in pain associated with cystic fibrosis.  MS patients and those with fibromyalgia can be helped as well.

Psychosomatic pain responds particularly well to hypnotic suggestions.  It seems to help with those who have erectile dysfunction as a result of psychosomatic pain.

There is a lot to learn about how and in what situations hypnosis can help in the medical profession, particularly in areas where acute and/or chronic pain is a factor.

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