Integrative Health Psychology

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Hypnosis in the Management of Chronic Pain

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There are many treatments for chronic pain, including those that fall under the heading of “complementary and alternative” (CAM). This post discusses hypnosis as aCAMpain management tool that can be used within the context of psychotherapy.

 The Impact of Chronic Pain

Pain is a complex perceptual experience that involves not only physical sensations, but also one’s thoughts about and emotional responses to it. Pain is described as chronic when is has persisted for 3-6 months or more. It is a significant source of distress for the pain sufferer and also affects those who care for him or her. Pain can have a significant impact on mood, and approximately half of those with pain also develop symptoms of anxiety and/or depression. Pain that is severe or not well managed can result in marked reductions in functioning across multiple aspects of one’s life. Specifically, pain can interfere with one’s close emotional relationships as well as with sexual intimacy. It can also make it difficult to function at work, or result in being unable to work at all. Pain often prevents sufferers from engaging in social and other activities that were once important to them, and this can further worsen mood symptoms and vice versa. Because pain is so complex and affects multiple areas, the best pain management strategies address the mind and emotions in addition to the physical body.

 Hypnosis for Symptom Management

Although medications and physical therapy can be invaluable pain management tools, and can also decrease distress, these therapies do not provide adequate pain relief for everyone. There is a good deal of research showing that hypnosis can help patients to decrease pain perception as well as help alleviate mood and other symptoms. Although it is not yet entirely clear how it works, hypnosis fosters an increased focus on one’s inner world. This can help patients become more receptive to (healthy) suggestions. A recent article in the New York Times emphasized that hypnosis is ultimately about returning a sense of control to patients. This statement is in contrast to the popular but inaccurate perception that hypnosis requires surrendering one’s control to another. I often explain to my patients that we all move in and out of hypnotic states many times per day. As an example, most people are familiar with the experience of having driven a car while being fully engrossed in a memory or making a mental to-do list, etc. We are not just “imagining” the to-do list; for a moment, we are engrossed by images of the items or tasks that comprise the list, the thoughts and feelings we have about them, and the like – even though another part of us continues to drive the car. Formal hypnosis typically involves working with a professional to induce a state of inner focus for some (presumably positive) purpose that is agreed upon beforehand.

 Although the potential uses for hypnosis are too many to list here, hypnotherapy has been used successfully to reduce postoperative and cancer-related pain, as well as other types of discomfort. It has also been shown to help quit smoking, as well as decrease feelings of anxiety and depression. These issues and more can be especially relevant for pain sufferers.

How do We Know the Benefits are Not Just “Wishful Thinking?”

One of the articles that I have found particularly interesting is a 2004 paper by Derbyshire and colleagues demonstrating that pain could also be induced by hypnosis. Specifically, using hypnosis designed for this purpose, the researchers were able to create the perception of pain in the right palms of 8 pain-free university students.  Not surprisingly, the students also experienced pain following an actual painful stimulus (which was delivered by a heated probe). In contrast to these results, simply imagining they felt pain did not produce a similar result. The team was able to use neuroimaging (fMRI) to further understand the brain areas activated by the different stimuli. Although the study was very small, and the results must therefore be interpreted cautiously, it helps to illustrate the very powerful impact that our minds can have on our bodies and brains – for better or worse. Because hypnotherapy is a powerful tool, and because mood symptoms are so common in chronic pain, it is best used by health professionals who are specifically trained in this modality.

Resources

 To find a mental health provider trained in hypnosis, please consult the American Society of Clinical Hypnosis: www.asch.net

 For more information about chronic pain, visit the website of the American Pain Society: www.ampainsoc.org

 For a link to the New York Times article mentioned above:

http://www.nytimes.com/2011/04/16/health/16patient.html?ref=health

 The reference for the scientific paper mentioned in this article is:

Derbyshire SW, Whalley MG, Stenger VA, & Oakley DA (2004). Cerebral activation during hypnotically induced and imagined pain. NeuroImage, 23, 392-401.

 Finally, for a good resource on learning self-hypnosis for pain management, consult Dr. Bruce Eimer’s book, “Hypnotize Yourself Out of Pain Now!” (Crown House Publishing, 2008).

*This post also appears on www.goodtherapy.org*

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This entry was posted on April 29, 2011 by in Chronic Pain, Complementary and Alternative Medicine, Health-Related Posts, Hypnosis.

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