Hypnosis in the Management of Chronic Pain

There are many treatments for chronic pain, including those that fall under the heading of “complementary and alternative” (CAM). This article discusses hypnosis as a CAM pain 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.

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 and References:

  • 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).

© Copyright 2011 by Traci Stein. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • lewis

    April 28th, 2011 at 7:17 PM

    hypnosis is actually making your mind believe something right? so if a person with chronic pain is subjected to hypnosis, isnt it that he is being made to believe to forget the pain? this doesn’t really address the real issue of eliminating the pain from the body,does it?

  • Camille

    April 29th, 2011 at 4:34 AM

    For many years people thought of hypnosis as a crock, something that only kooky people did. But I do think that in the past several years this has gained some respect especially in the treatment of ailments for which nothing “physical” has seemed to be able to treat. For smoking, weight loss, anger managemnet, and a myriad of other issues that one may face, hypnosis has proven to be amazingly effective and I know that I am not the only one who applauds these kinds of advances in science and health.

  • Traci Stein

    April 29th, 2011 at 7:29 AM

    Hi Lewis and Camille,

    Thanks for your thoughtful comments/questions.

    Lewis, you ask a very important question that I address more specifically in my personal blog: wordpress.com/2011/02/07/managing-the-bad-neighbor-that-is-chronic-pain-or-the-solution-is-in-your-head/

    But to answer you briefly, your brain is the reason you can even experience bodily pain at all. It’s necessary for “interpreting” what that “ouch!” signal means. Pain and what it means are communicated from the brain to the body and vice versa as follows: There are neural pathways that run from the body to the brain (“ascending pathways”) and also from the brain to the body (“descending pathways”). What we know from current research is that how the brain interprets pain is affected not only by what’s going on in the body (nerves, tissue, etc.) but also by our thoughts and feelings. Incredible but true.

    Why this is so is not yet well understood, but 1.) pain is processed by or registered in some of the same brain areas that register emotion, memory, etc.
    2.) the descending pathways mentioned above can send a different message to the body (such as one of profound calm or relaxation). This message can actually reduce the severity of perceived pain – even when the pain is caused by injury to nerves or other tissue. Because, again, pain requires the brain’s involvement for you to interpret it as pain.

    I often describe this process as like having a very narrow road leading from the brain to the body and vice versa. There’s really only enough room on that road for one “car” (pain, massage, hypnosis-induced relaxation, etc.) to drive up or down the middle at a time. If another car (like hypnosis-induced relaxation) is sent down from the brain, or up from the body (such as rubbing the painful area, which creates a new sensation),the first car (pain) will get pushed to the side in a way. Pushing the pain to the side can decrease our distress about the pain and also make it less noticeable or severe.

    Does that help?

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