Hypnosis has been dimonstrated being a powerful and succesfull tool in the treatment of pain (acute and chronic). However the success of hypnosis in the relief of pain is not empiric but supported by hundreds of papers in literature (Lee at al, 2012). Hypnotic analgesia has been shown as a quick and safe technique that can be used in any environment (Patterson DR et al, 2003), in any situation with anyone and it is extremely flexible and completely tailored on patients’ symptoms and necessities.
The fields of application include:
Musculoskeletal pain (acute and chronic): low back pain, neck pain, shoulder pain, temporomandibular pain . (Simon EP et al, 2000) (Elkins et al, 2007)Headaches and migraines (Hammond DC, 2007)Reflex sympathetic dystrophy (Complex Regional Pain Syndrome)(Siddiqui et al. 2000) (Lebon J et al, 2017)Fybromialgia (Haanen HC et al, 1991) (Bernardy et al, 2011) (Picard P et al, 2013)Burning pain and hypersensitivity of the skinPost-Herpetic neuralgiaIrritable Bowel Syndrome (IBS) and general abdominal pain (Tan G et al, 2005) (Chiarioni et al, 2008) (Palsson OS et al, 2015)Pelvic PainCancer related pain (Montgomery GH et al, 2010)Uncomfortable or painful medical and minor surgical procedures(Montgomery GH et al, 2002) (Elkins G et al, 2006) (Schnur JB et al, 2008) (Accardi MC et al, 2009)
However hypnosis doesn’t work exclusively directly on pain but it can be used to change all the factors we know are involved with pain. Negative beliefs and expectations, negative limitations, catastrophization, pain anticipation, central sensitization, kinesiophobia, fear avoidance etc.. Hypnosis offers great and several techniques to work these aspects out having a indirect impact on pain experience
“Hypnosis not only affects pain intensity, but it also affects the emotional responses to pain. In the brain, ACC is responsible for processing emotion. During hypnosis, when an unpleasantness due to pain is suggested to increase or decrease, the unpleasantness changed in accordance to the suggestions, and the ACC activity also changed accordingly.” Lee et al, 2012
There are hundreds of techniques that can be used to help the patient to manage pain. However the session has to be tailored completely on patient’s necessities and symptoms. Some patient would react better to direct suggestions and others to indirect ones and metaphors, some patients would work better with “time distortion suggestions” and others with dissociative techniques. The beauty of hypnosis is that is extremely flexible and follows no protocols.
The most famous techniques used in pain management are:
DistractionTime distortionSuggestions of numbness and insensitivity (usually in the hand and then spread on the painful spot)Paradoxical injuction (to be used with caution)MetaphorsDissociation (out of body experience)Displacement (the therapist ask the patient to imagine the painful spot moving towards another area in which pain can be managed better)ReinterpretationRelaxation
Hartland’s, Medical and Dental Hypnosis, fourth edition
Some authors suggest it is necessary a deep state of trance to have a successful outcome, however excellent results can be achieved even with a light state of trance. At the end of the session the patient will be taught to do self-hypnosis in order to improve and maintain the results.
Hypnosis goes together with medical interventions like drugs and physiotherapy and it can only be done after the patient is examined by a medical doctor to exclude any red flag.
In conclusion we can say that hypnosis is an effective and successful tool that can be used in pain management as literature says. It can be done anywhere, in any moment, without side effects and it takes few minutes only (from 5 minutes to 30 minutes depending on the patient). Regrettably, there are not so many health professionals who integrates hypnosis in their daily practice, therefore would be marvellous to see an increase in the use of this beautiful technique.
Thanks for reading
“I could be bounded in a nutshell and count myself a King of infinite space” Shakspeare, Hamlet
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