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Hypnotherapy for Pain Management

Be sure to check out "Hypnotized - A Documentary About Chronic Pain" available for viewing here on our site.

 

The relationship between hypnosis and chronic pain management has a long and distinguished history.  In fact, where hypnotherapy is involved, there has likely never been any other condition researched as heavily in clinical studies than pain.   Almost 200 years ago Dr. Jules Cloquet employed the skills of a local hypnotist to place a female patient under what we refer to has hypno-anesthesia so that Dr. Cloquet could perform surgery for breast cancer.  The renowned Dr. Herbert Mayo recounted the event as follows:

“During the whole of the operation, the patient in her trance exhibited not he slightest sign of suffering.  Her expression of countenance did not change; nor was the voice, the breathing, or the pulse at all affected.”

Since then numerous clinical trials have presented study after study documenting the effectiveness of hypnosis in dealing with chronic pain, acute pain, pain from fibromyalgia, arthritis, rheumatoid arthritis, temporomandibular disorder (TMD/TMJ), cancer related pain, and phantom limb pains just to name a few.  Additionally, migraines and other headaches have had their own huge area of studies conducted on that one specific niche of pain; as has childbirth, burns, and the list goes on and on.  In fact there is so much research available on the efficacy of hypnosis and pain management that it can be difficult knowing where to start to address an overall general article on the subject.  To illustrate the massive amount of studies to choose from available today on the subject, we’ll consider for a moment only what can best be described as scholarly articles, or clinical studies.  As of the date of this article, a search of a popular scholarly article search engine for papers relating to pain and hypnosis returned well over 67,000 citations, with over 5000 in 2013 alone.  

With that said, pain management is a major focus of practice in this office for both adults and children.  Therefore as we launched this new site, getting an initial page posted on the subject was a matter of great importance.  As things progress we will be updating this page with a detailed article regarding pain management and hypnotherapy as well as several other articles and reference material on the subject.  Until then, we have included a synopsis of several research studies recommended by the American Hypnosis Association for further education on the subject. 

Additionally if you or someone you know is dealing with a chronic pain issue, and would like to speak with someone regarding hypnotherapy as an option, contact us online, or call the office at 469-225-9040.

Please note that the body uses pain as a warning signal or alarm, and only a licensed physician is qualified to make a determination as to if and when it is safe to turn the severity of a pain off, or even down.  We want what is best for our clients and that means making sure that their condition is being supervised by a medical doctor.  Therefore a medical referral is required for pain management sessions.

William Carpenter holds a certification in Emergency Hypnosis as well as a dual certification in Hypnosis and Pain Management from the American Hypnosis Association.

 

The following articles are recommended by the American Hypnosis Association for further education on pain management via hypnosis:

“Hypnotic Treatment of Chronic Pain”

Notes: “This paper reviewed various controlled trials involving the use of hypnosis to control pain. It concluded that hypnosis can provide a significantly greater reduction in pain than physical therapy, education, or the management of medications. It even found that the hypnotic treatment did not even have to be called 'hypnosis' for it to be effective.” (Jensen & Patterson, 2006)

“Hypnosis and Its Place in Modern Pain Management – Review Article”

Notes: This paper reviewed the various scientific studies that showed hypnosis was an effective treatment for pain management. It concluded that in spite of some of the "methodological flaws" involved in many of the studies, there was "sufficient clinical evidence of sufficient quality" to conclude that hypnosis is an effective treatment for chronic pain. (Amadasum, 2007)

“A Meta-Analysis of Hypnotically Induced Analgesia: How Effective is Hypnosis?”

This paper reviewed 18 studies conducted on the use of hypnosis to relieve pain over a two-decade period. It concluded that hypnosis provided an effective way to help people deal with pain because it had a "moderate to large hypnoanalgesic effect." It further concluded that hypnosis should be more widely used in the treatment of pain. (Montgomery, DuHamel, & Redd, 2000)

“Hypnosedation: a valuable alternative to traditional anaesthetic [sic] techniques”

Notes: This paper reports on the anecdotal use of hypnosis in over 1650 surgeries that were performed in the Department of Anesthesia and Intensive Care, at theUniversity ofLiège inBelgium. It confirmed that hypnosedation combined with local anesthesia can be used as an alternative to more traditional means of sedation. (Faymonville, Meurisse, & Fissette, 1990)

“Psychological Approaches During Conscious Sedation. Hypnosis Versus Stress Reducing Strategies: A Prospective Randomized Study”

Notes: Sixty patients who were going to have plastic surgery using local anesthetic and intravenous sedation (they could request midazolam and alfentanil if needed) were randomly placed into a control group where they were taught strategies for reducing stress, or into a group where they would receive hypnosis during the surgery. Their behaviour was monitored by a psychologist before, during, and after surgery where their levels of anxiety and pain, and feelings of being in control, were recorded.

Results: Not only did the group using hypnosis require significantly lower levels of midazolam and alfentanil than the control group; they reported experiencing significantly lower levels pain and anxiety; and a greater feeling of being in control during the entire process. Their vital signs were also found to be significantly more stable than those of the control group. This study suggests that hypnosis provides better perioperative pain and anxiety relief, allows for significant reductions in alfentanil and midazolam requirements, and improves patient satisfaction and surgical conditions as compared with conventional stress reducing strategies support in patients receiving conscious sedation for plastic surgery. (Faymonville, et al., 1997)

“Use of Hypnosis Before and During Angioplasty”

Notes: Thirty-two subjects were recruited for this study. Sixteen were randomly assigned to be in the control group and 16 were hypnotized before they underwent an angioplasty (a procedure where a balloon is inserted into a vein and then inflated to help open the vein while the patient remains conscious and aware).

Results: This study found that the surgeons involved were able to keep the balloon inflated 25% longer with the hypnotized group. Forty-four percent of the control group also asked for more pain medication, compared with only 13% of the hypnotized group. (Weinstein & Au, 1991)

"Naloxone Fails to Reverse Hypnotic Alleviation of Chronic Pain”

Notes: Some researchers had previously believed that the reason hypnosis helps to reduce chronic pain was that it caused the body to produce endorphins (our natural pain killers). To test this theory, 6 patients suffering from chronic pain (caused by peripheral nerve irritation) were taught self-hypnosis to reduce their feelings of pain. They were then randomly given either a saline solution (a placebo) or naloxone (a drug that is known to block the effects of endorphins) and were tested for pain at 5 minute intervals for an hour. If the analgesic effect of hypnosis was somehow caused by the internal production of endorphins, then naloxone would have caused the pain to return. However, the results of this study demonstrated that naloxone had no effect on the power of hypnosis to reduce pain. As a result, it was determined that endorphins are not involved in hypnotic pain control. (Spiegal & Albert, 1983)

"Functional Anatomy of Hypnotic Analgesia: A PET Study of Patients with Fibromyalgia”

Notes: In an attempt to understand what happens in the brain when a person is hypnotized and then given suggestions for pain relief, subjects were recruited who were suffering from the painful condition of fibromyalgia. PET (positron emission tomography) scans were then taken of their brains when they were resting and then when they were in a state of hypnotically-induced analgesia.

Results: The subjects all reported experiencing less pain when they were in the state of hypnosis, then they did when they were in a state of rest. The researchers also found that there were significant differences in the way the blood flowed through the brain in these two states. They found that during hypnotically-induced analgesia the blood flow "was bilaterally increased in the orbitofrontal and subcallosial cingulate cortices, the right thalamus, and the left inferior parietal cortex, and was decreased bilaterally in the cingulate cortex." This study proved that hypnosis leads to real physical changes in the brain. (Wik, Fisher, Bragée, Finer, & Ferdrikson, 1999)

“Hypnosis for the treatment of burn pain”

Notes: The clinical utility of hypnosis for controlling pain during burn wound debridement was investigated. Thirty hospitalized burn patients and their nurses submitted visual analog scales (VAS) for pain during 2 consecutive daily wound debridements (the process of removing nonliving tissue from burns). On the 1st day, patients and nurses submitted baseline VAS ratings. Before the next day's wound debridement, subjects received hypnosis, attention and information, or no treatment.

Results: Only hypnotized subjects reported significant pain reductions relative to pretreatment baseline. This result was corroborated by nurse VAS ratings. Findings indicate that hypnosis is a viable adjunct treatment for burn pain. (Patterson, Everett, Burns, & Marvin, 1992)

“Adjunctive self-hypnotic relaxation for outpatient medical procedures: A prospective randomized trial with women undergoing large core breast biopsy”

Notes: Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care, structured empathic attention, or self-hypnotic relaxation during their procedures.

Results: Women’s anxiety increased significantly in the standard group, did not change in the empathy group, and decreased significantly in the hypnosis group. Pain increased significantly in all three groups though less steeply with hypnosis and empathy than standard care. Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46min/$161 for standard care, 43min/$163 for empathy, and 39min/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management. (Lang, 1997)

Hypnosis for Treatment of HIV Neuropathic Pain: A Preliminary Report”

Notes: Painful HIV distal sensory polyneuropathy (HIV-DSP) is the most common nervous system disorder in HIV patients. The symptoms adversely affect patients' quality of life and often diminish their capacity for independent self-care. No interventions have been shown to be consistently effective in treating the disorder. The purpose of the present study was to determine whether hypnosis could be a useful intervention in the management of painful HIV-DSP. Participants were 36 volunteers with HIV-DSP who received three weekly training sessions in self-hypnosis. Participants were followed for pain and its sequelae for 7 weeks prior to the intervention, and for 7 weeks post intervention. Participants remained on the same standard-of-care pain regimen for the entire 17 weeks of the protocol. The primary outcome measure was the Short Form McGill Pain Questionnaire cale (SFMPQ) total pain score. Other outcome measures assessed changes in affective state and quality of life.

Results: Mean SFMPQ total pain scores were reduced from 17.8 to 13.2. The reductions were stable throughout the 7-week post intervention period. At exit, 26 out of 36 (72%) had improved pain scores. Of the 26 who improved, mean pain reduction was 44%. Improvement was found irrespective of whether or not participants were taking pain medications. There was also evidence for positive changes in measures of affect and quality of life. (Dorfman, George, Schnur, Simpson, Davidson, & Montgomery, 2013)

References

Amadasun, F. E. (2007). Hypnosis and its place in modern pain management-review article. The Nigerian postgraduate medical journal, 14(3), 238-241.

Dorfman, D., George, M. C., Schnur, J., Simpson, D. M., Davidson, G., & Montgomery, G. (2013). Hypnosis for treatment of HIV neuropathic pain: a preliminary report. Pain Medicine, 14(7), 1048-1056.

Faymonville, M. E., Mambourg, P. H., Joris, J., Vrijens, B., Fissette, J., Albert, A., & Lamy, M. (1997). Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies: a prospective randomized study. Pain, 73(3), 361-367.

Faymonville, M. E., Meurisse, M., & Fissette, J. (1999). Hypnosedation: a valuable alternative to traditional anaesthetic techniques. Acta Chirurgica Belgica, 99(4), 141-146.

Jensen, M., & Patterson, D. R. (2006). Hypnotic treatment of chronic pain. Journal of Behavioral Medicine, 29(1), 95-124.

Lang, E. V., Berbaum, K. S., Faintuch, S., Hatsiopoulou, O., Halsey, N., Li, X., ... & Baum, J. (2006). Adjunctive self-hypnotic relaxation for outpatient medical procedures: a prospective randomized trial with women undergoing large core breast biopsy. Pain, 126(1), 155-164.

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, 48(2), 138-153.

Patterson, D. R., Everett, J. J., Burns, G. L., & Marvin, J. A. (1992). Hypnosis for the treatment of burn pain. Journal of Consulting and Clinical Psychology, 60(5), 713.

Spiegel, D., & Albert, L. H. (1983). Naloxone fails to reverse hypnotic alleviation of chronic pain. Psychopharmacology, 81(2), 140-143.

Weinstein, E. J., & Au, P. K. (1991). Use of hypnosis before and during angioplasty. American Journal of Clinical Hypnosis, 34(1), 29-37.

Wik, G., Fischer, H., Bragée, B., Finer, B., & Fredrikson, M. (1999). Functional anatomy of hypnotic analgesia: a PET study of patients with fibromyalgia. European Journal of Pain, 3(1), 7-12.