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Hypnotherapy for Fibromyalgia (FMS)

As with any subject on this site that discusses the merits of hypnotherapy in an area such as fibromyalgia, the objective will be to present facts from verifiable, clinical research studies, and not simply offer claims and opinions.  To that end I will not delve too deeply into the statistics and numbers regarding the widespread prevalence or symptoms of fibromyalgia, but it is important to understand how far reaching the issue has become.  According to the Centers for Disease Control in 2005 fibromyalgia affected an estimated 5 million adults, and sufferers of the syndrome on average missed almost 3 times as many days per year from work as their non-sufferer counterparts. 

Fibromyalgia can be an extremely frustrating condition, as its symptoms are so widespread, not to mention the various partners that seem to travel along with it, such as irritable bowel syndrome, rheumatoid arthritis, migraines and other headaches, fatigue, “fibro fog,” and a the list goes on and on.  Added to this is the difficulty in even getting a definitive diagnosis.  Fibromyalgia is a diagnosis of exclusion meaning that everything else must be ruled out even after all the signs and symptoms are found to match the disorder.  In fact, the CDC verifies that there isn’t even a diagnostic ICD9 code for fibromyalgia.  This can make the journey a long hard one that often lasts for years just to get a diagnosis.  In fact in one recent class for hypnotherapists seeking their specialist designation, it was cited that it takes an average of three years, and twenty-seven physician visits before the average person is diagnosed with FMS.  Unfortunately, the diagnosis isn’t the goal line for the victim of fibromyalgia, as knowing what it is doesn’t hold the gateway to a prescription that cures the problem.

Fortunately as with irritable bowel syndrome (IBS), and rheumatoid arthritis, clinical research studies have demonstrated there is hope for sufferers of fibromyalgia through hypnotherapy.  One of these controlled studies is discussed heavily in the Fibromyalgia Specialist classes for hypnotherapists referenced earlier.  The study which sought to compare the modality of hypnotherapy against that of physical therapy followed the progress of a group of patients with refractory fibromyalgia for 12 weeks, with a follow-up at 24 weeks.  The results of the study were very favorable for those seeking hope from a hypnotherapeutic approach.  Specifically it was noted that the patients in the hypnotherapy group showed a significantly better outcome with respect to their pain experience, fatigue on awakening, sleep patterns and disturbances, and their overall global assessment at both the 12 and 24 week points.  Additionally, clinically measured feelings of both mind and body (somatic and psychic) discomfort showed what the study cited as a “significant decrease” in some, but not all of the patients in the hypnotherapy group.  

Another important point for those who would prefer an alternative to prescription pain killers cited by the study was the reduction in the need for such drugs.  The article cites, “The reduction in pain medication used by the hypnosis group was quite remarkable,” and went on to state that “at the end of the study, 10 of 12 patients in [the] hypnotherapy group and 3 of 12 in the physical therapy group had reduced their paracetamol use” (Haanen et al. 1991).   As to the exact mechanism of why the hypnotherapy group did so much better, the study was unable to state for sure.  However the researchers did state, “Correction of the sleeping disturbances by hypnotherapy was the most consistent finding and possibly played an important role in the subjective improvement of fibromyalgia” (Haanen et al., 1991).

Since that study in 1991, much research has been done in the field of fibromyalgia, and though by some standards answers have remained elusive, one thing that continues to be proven again and again is that just as with its counterpart, IBS, hypnotherapy continues to show promise for those who continue to battle FMS.  In fact hypnosis continued to show such impressive results, that almost two decades later, studies sought to find out if it was truly the hypnotherapeutic interventions, or if some form of cognitive behavioral therapy might produce the same results.  Such was the question on the researchers’ minds when they initiated a pilot study that would later be published in The American Journal of Clinical Hypnosis.  In short the study compared the efficacy of cognitive behavioral treatments both with and without hypnosis, and compared them against treatment via a purely pharmacological approach.  As many had come to expect, the results suggested that the psychological treatment produced greater symptom benefits than the conventional medical treatment alone, and cited, “especially when hypnosis is added” (Martinez-Valero et al., 2008).

Continuing with research in this area, a very interesting study took place during the same time period.  In this study which would later be published in the European Journal of Pain, the researchers had accepted that suggestion following a hypnotic induction can readily modulate the subjective experience of pain.  However they wanted to determine if giving the same suggestions to the patient without using hypnosis would be equally effective.  To explore this as well as other related questions, the researchers employed the use of functional magnetic resonance imaging, (MRI) to document changes in the brain while the patient was given suggestions to both increase, and decrease their fibromyalgia pain sensation.  The process was given both in and out of the hypnotic state, and graphics of the MRI images were place in the article showing the Hypnotized Brains, the Un-Hypnotized Brains, and category highlighting the differences.  Although the article is both lengthy and fascinating, the following results sum up the findings quite well.  “Patients claimed significantly more control over their pain and reported greater pain reduction when hypnotized.”  They went on to state that changes were seen without the benefit of hypnosis, but not to the same magnitude.  Additionally the study cited, “Our results thus provide evidence for the greater efficacy of suggestion following a hypnotic induction. Pain relief was significantly greater when suggestion followed a hypnotic induction” (Derbyshire, Whalley, & Oakley, 2009).

Fibromyalgia and related syndromes are a large focus in my practice, and I would welcome the opportunitiy to work with you.  In general, the basic fibromyalgia protocol consists of 12 sessions, the first of which are held one week apart, and it is important that schedule be maintained.  After that the sessions are often spread out and the protocol is customized a bit depending on what is needed.

If you or someone you know suffers from FMS and would like to discuss hypnotherapy as an option, please contact us online, or call the office at 469-225-9040. 

As with any medical condition, or unresolved pain only your doctor can evaluate or diagnose your condition, and it is important that you be under a physician’s care.  Therefore a medical referral will be required to confirm that your medical doctor is aware of the hypnotherapy sessions and sees no conflict between the sessions and his treatment plans.

William Carpenter holds a certification for Hypnosis for Immune Disorders, as well as a dual certification in Hypnosis and Pain Management from the American Hypnosis Association. 

 

 

Other hypnotherapy certifications include Fibromyalgia Specialist, and Irritable Bowel Syndrome Specialist.

 

References

Derbyshire, S. W., Whalley, M. G., & Oakley, D. A. (2009). Fibromyalgia pain and its modulation by hypnotic and non‐hypnotic suggestion: An fMRI analysis. European Journal of Pain, 13(5), 542-550.

Haanen, H. C., Hoenderdos, H. T., Van Romunde, L. K., Hop, W. C. J., Mallee, C., Terwiel, J. P., & Hekster, G. B. (1991). Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia. The journal of Rheumatology, 18(1), 72-75.

Martínez-Valero, C., Castel, A., Capafons, A., Sala, J., Espejo, B., & Cardeña, E. (2008). Hypnotic treatment synergizes the psychological treatment of fibromyalgia: a pilot study. American Journal of Clinical Hypnosis, 50(4), 311-321.