Chronic Pain & Hypnosis

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  • I simply diminish your pain.
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Hypnotherapy: What is it and How Can it Treat Chronic Pain?

Let’s take a look at what hypnotherapy is, what it involves and how it can make a significant difference for chronic pain patients.

You will no doubt have heard of hypnosis. You might have even seen dramatic hypnosis on stage or on TV. Don’t worry, real hypnosis is not about making you act in a way that is out of your control. Real clinical hypnotherapy is a safe, relaxing way to address psychological problems. It enables you to implement more positive thoughts and coping strategies

What is hypnosis?

What is hypnosis?

Hypnotic or ‘trance-like’ states have been used to treat physical and mental health since ancient times . The Egyptians used ‘dream temples’ while the Greeks used ‘sleep temples’ (otherwise known as ‘hypnos’) to treat ill health. Evidence of hypnosis techniques can be found in the bible dating back to 1500 BC! From there, hypnosis continued to be used and developed. In 1841 the term hypnosis was first used by a Scottish ophthalmologist named James Braid. He started to realise that hypnosis was psychological rather than anything mystical. Since then hypnosis has been researched and developed scientifically. In the present day it is being used to treat a wide variety of health problems.

Hypnosis makes use of the mind body connection , understanding how our thoughts and feelings can influence our physical health, just as our physical health can influence our mental health. Hypnotherapy uses relaxation and visualisation techniques to guide you into a state of deep peacefulness. Similar to mindfulness meditations , the brain lets go of distractions and becomes more focused. When you’re in a hypnotic state, your pulse and respiration rate slows down, and your brain starts to produce more alpha brainwaves. Alpha brainwaves indicate relaxation, positive mood, reduced anxiety and increased creativity.

When you’re in this hypnotic state, you are less inhibited. You’re more likely to be able to access memories and face problems that you might have been avoiding, or address feelings that you may have been bottling up. You’re also more open to suggestion. This 2019 study defines hypnosis as, “ a waking state of awareness, (or consciousness), in which a person’s attention is detached from his or her immediate environment and is absorbed by inner experiences such as feelings, cognition and imagery ”.

During hypnotherapy the therapist can help you to address and solve problems. They can guide you through replacing negative thoughts with positive ones. They can aid you in seeing how you can change your behaviours to live well

and better cope with your situation. The therapist may use imagery and ask you to visualize specific situations or scenes in order to guide you towards your goals. They may also speak to you during hypnosis and ask you to interact, in order to get to the root of problems.

The use of imagery is important. During a state of deep relaxation (like during hypnosis), the right side of our brain is being activated more dominantly than the left side. The right side of our brain is like our unconscious mind, the part which is more emotional and creative. While the left side is our conscious mind, the part which is more logical. The right side of our brain responds to imagery and symbols as this study explains. Therefore using imagery helps us to really engage with that side of the brain in this hypnotic state.

Research shows that when someone is imagining something during a hypnotic state, the same areas of the brain are being activated as if the person was actually in that situation. Mirror neurons in our brains activate when we are imagining actions or watching other people perform actions. The use of imagery is powerful with many potential uses. This is the basis for Graded Motor Imagery , a therapy which uses visualisation to train the brain away from pain. Hypnosis can be used to address mental illness such as anxiety, to deal with previous trauma, and to provide relief from many physical health issues.

How can hypnosis treat chronic pain?

How can hypnosis treat chronic pain?

People vary in how they will respond to hypnosis and how open they are to hypnotic suggestion. Patients who are fairly suggestable under hypnosis can show improvements in pain relief . This applies to the majority of us. However those who are highly suggestible will have greater relief from pain which is longer lasting. How responsive we are to hypnosis depends on many factors, including our motivation to manage our pain and individual personality traits.

Rather than trying to reduce the pain itself, hypnosis for chronic pain is often more focused on acceptance of your chronic condition, with the aim of reducing fear and anxiety around it. Our perceptions of pain can greatly influence our pain levels and how we manage our pain . If we are fearful, this can often lead to us avoiding situations we perceive might worsen our pain (known as fear avoidance). This avoidance can in fact worsen our symptoms over time.

Hypervigilance is common in pain patients, meaning patients become extremely aware of painful sensations, and this focus on pain makes pain worse.. This can often lead to pain catastrophizing , meaning patients are worrying about their pain excessively. These negative perceptions and emotions about chronic pain can reinforce to our brain that it needs to continue producing pain messages, therefore perpetuating the pain cycle and even worsening it. They can also be very distressing feelings to live with. By addressing these negative emotions and reducing fear, a patient’s quality of life can be vastly improved and their pain levels considerably reduced.

Some patients may benefit from hypnotherapy sessions which replace self doubt and feelings of helplessness with feelings of confidence and empowerment. In this case, the therapist may guide you through visualising situations which you usually find difficult and pain inducing, for example. They may help you to replace the expectation of pain and the feeling that you are not able to do anything about it, with a feeling of being pain free and taking control of the situation. This type of session can help you to understand that you can do something about your chronic pain and that things can improve.

Some hypnosis sessions focus on inducing an angelisic affect. This means that they use suggestions of being pain free, having reduced pain, or having increased functioning to help patients reduce pain levels. This pain relief technique (known as hypnoanalgesia) has been utilized for many pain scenarios with success. This in depth study on hypnoanalgesia explains that it has been highly effective in treating many types of acute and chronic pain including: “chronic oncological pain, HIV neuropathic pain, pain during extraction of molars, pain associated to physical trauma, pain in surgical procedures, pain associated to temporomandibular joint disorder, phantom limb, fibromyalgia, pain in amyotrophic lateral sclerosis, acute pain in children, lumbago and pain in childbirth” Some sessions may focus on forgetting past negative memories of pain, effectively trying to retrain the brain to forget that certain situations should cause pain, as this study discusses. Some therapists choose to use imagery to replace the sensation of pain with a more pleasant sensation, such as warmth. For example during hypnosis the therapist could ask you to imagine warmth in the place of pain from now on, anytime that you feel pain. They may incorporate this concept regularly into sessions, until it becomes a ‘habit’ which happens in your day-to-day life without you thinking about it. This could help your brain to break the association between certain painful movements or situations and in turn, help you to break free of the chronic pain cycle.

Since hypnotherapy can put you in a highly relaxed state, it can help to reduce stress levels and break the stress and pain cycle. Muscle tension can be eased and stiffness reduced. If hypnotherapy is engaged in regularly, this reduction in stress can markedly improve chronic pain symptoms. This type of hypnoanalgesia session can have fantastic results for pain patients. This study states that, “ hypnosis results in greater pain reductions across a variety of chronic pain conditions and pain-related outcomes, including intensity, duration, frequency, and use of analgesic medications when compared to standard care ” Hypnotherapy sessions which focus on changing pain beliefs and reducing pain sensations through hypnoanalgesia have been shown to have the most positive outcomes. When therapists work on reducing the physical sensation of pain and building a more positive, helpful perception of pain, chronic pain patients have shown significant improvements.

Studies have shown that 70% of chronic pain patients find their pain and other symptoms are reduced in the short term after hypnotherapy, while up to 30% find that these reductions last permanently.

Hypnosis for the Relief and Control of Pain

Hypnosis for the Relief and Control of Pain

Hypnosis is a set of techniques designed to enhance concentration, minimize one’s usual distractions, and heighten responsiveness to suggestions to alter one’s thoughts, feelings, behavior, or physiological state. Hypnosis is not a type of psychotherapy. It also is not a treatment in and of itself; rather, it is a procedure than can be used to facilitate other types of therapies and treatments. People differ in the degree to which they respond to hypnosis. The key to becoming hypnotized is the extent to which a person is hypnotizable, which is a very reliable and stable individual difference trait that indexes one’s openness to hypnotic suggestions.

Research shows that hypnosis works as part of a treatment program for a number of psychological and medical conditions, with pain relief being one of the most researched areas, as shown in a 2000 study by psychologists Steven Lynn, PhD, Irving Kirsch, PhD, Arreed Barabasz, PhD, Etzel Cardeña, PhD, and David Patterson, PhD. Among the benefits associated with hypnosis is the ability to alter the psychological components of the experience of pain that may then have an effect on even severe pain.

In recent years, the anecdotal and sometimes exaggerated evidence for the effectiveness of hypnosis to decrease sensitivity to pain – known as hypno-analgesia – has been supplemented by well-controlled experiments. In their 2003 review of controlled clinical studies, Dr. Patterson and fellow psychologist Mark Jensen, PhD, found that hypno-analgesia is associated with significant reductions in: ratings of pain, need for analgesics or sedation, nausea and vomiting, and length of stay in hospitals. Hypnosis has also been associated with better overall outcome after medical treatment and greater physiological stability. Surgeons and other health providers have reported significantly higher degrees of satisfaction with their patients treated with hypnosis than with their other patients.

Depending on the phrasing of the hypnotic suggestion, the sensory and/or affective components of pain and associated brain areas may be affected (as shown by the brain imaging research of neuropsychologist Pierre Rainville, PhD, and collaborators in 1999). Patients who are most receptive to hypnotic suggestions in general, or highly hypnotizable, have found the greatest and most lasting relief from hypnosis techniques, but people with moderate suggestibility (the majority of people) also show improvement. Factors such as motivation and compliance with treatment may also affect responsiveness to hypnotic suggestions.

Drs. Patterson and Jensen’s review concluded that hypnotic techniques for the relief of acute pain (an outcome of tissue damage) are superior to standard care, and often better than other recognized treatments for pain. Furthermore, a 2002 cost analysis by radiologists Elvira Lang, MD and Max Rosen, MD, that compared intravenous conscious sedation with hypnotic sedation during radiology treatment found that the cost of the hypnotic intervention was twice as inexpensive as was the cost for the standard sedation procedure. Chronic pain, which continues beyond the usual time to recover from an injury, usually involves inter-related psychosocial factors and requires more complex treatment than that for acute pain. In the case of chronic pain, Patterson and Jensen’s review found hypnosis to be consistently better than receiving no treatment, and equivalent to the other techniques that also use suggestion for competing sensations, such as relaxation and autogenic training (which is similar to self-hypnotism).

Cited Research

Lang, E. V., & Rosen, M. P. (2002). Cost analysis of adjunct hypnosis with sedation during outpatient interventional radiologic procedures. Radiology, 222, pp. 375-82.

Lynn, S. J., Kirsch, I., Barabasz, A., Cardeña, E., & Patterson, D. (2000). Hypnosis as an empirically supported clinical intervention: The state of the evidence and a look to the future. International Journal of Clinical and Experimental Hypnosis, Vol. 48, pp. 235-255.

Montgomery, G. H., DuHamel, K. N., & Redd, W. H. (2000). A meta-analysis of hypnotically induced analgesia: how effective is hypnosis? International Journal of Clinical and Experimental Hypnosis, Vol. 48, pp. 138-153.

Patterson, D. R., & Jensen, M. P. (2003). Hypnosis and clinical pain. Psychological Bulletin, Vol. 129, pp. 495-521.

Rainville, P., Carrier, B., Hofbauer, R. K., Bushnell, M. C., & Duncan, G. H. (1999). Dissociation of sensory and affective dimensions of pain using hypnotic modulation. Pain, Vol. 82, pp. 159-71.

American Psychological Association, July 2, 2004

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