Hypnosis for Pain Management

Within the realm of medicine, the method of hypnoanalgesia can be adapted for various situations. In most cases, the intervention consists of four main stages (Chaves, 1994). The first stage involves preparation of the patient. As can be expected, most patients come into hypnosis with various expectations. In order to obtain the maximum gain, the therapist works to direct the patient toward the most realistic goals. The second stage involves the hypnotic induction.

As studies have not shown that differences exist between indirect and direct suggestions, most therapists make use of a mixture of the two. In this stage, the therapist needs to help the patient enter into a focused and relaxed state. The third stage involves therapeutic suggestions. This is the most important stage in which the therapist focuses the attention of the patient. In the context of pain reduction, the therapist helps the patient develop
imaginary situations (regardless of feasibility) which will achieve the goal of less pain.

BackPain_zpsbb50a1b7An example is dissociation, in which the patient imagines the hand separate from the body or made of a different material. The fourth stage involves posthypnotic suggestions and termination. The posthypnotic suggestions allow the patient to retain achievements (i.e. pain reduction abilities) outside of the hypnotic state (e.g. with a tap on the shoulder).

The most researched form of acute (short-term) pain in the context of hypnosis is that associated with burn patients. The use of hypnosis is important at the outset as well as throughout the healing process.

For burn patients, the use of hypnotic induction as close as possible to the time of injury is essential as it helps to limit the amount of inflammatory reaction to the injury. Furthermore, the minds of the patients are focused upon entry into the emergency room which makes hypnosis easy to induce.

According to earlier studies, signs of inflammation are affected by the attitude of the patient toward the injury (Chapman et al., 1959). Therefore, the perception of heat at the burn site leads to increased inflammation and the perception of coolness leads to decreased inflammation.

Applied before the initiation of the natural response, hypnotic suggestions of cooling and anesthesia limit and prevent inflammation. Burn patients who accept the suggestions that the wounded area is ³cool² and ³comfortable² are easier to treat, more optimistic, and heal faster (Ewin, 1978).

As burn patients go through the healing process, the pain of caring for the wound is reported to be more severe than the pain of sustaining the wound. In order to prevent infection, patients must undergo daily debridement, which involves scraping necrotic tissue off the wound and applying antiseptic. The procedure causes excruciating pain. Since the frequency of wound care prohibits regular use of general anesthesia, the use of hypnoanalgesia is highly applicable (Patterson et al., 1996).

In a study done by Patterson et al. (1992), 30 burn patients undergoing debridement were randomly assigned to three groups: hypnosis, attention/pseudohypnosis (placebo), and no intervention (control).

The hypnosis condition included suggestions for relaxation, analgesia, amnesia, and comfort when touched on the shoulder. The placebo condition involved pseudohypnosis (closing your eyes, counting to 20, imagining yourself in a relaxing place), the touch on the shoulder, and instructions to distinguish between sensations of healing and signals of harm. The control condition provided no other procedures to alleviate pain.

The results showed that only the group which underwent true hypnosis reported a significant reduction in pain. The true hypnosis group reported a 46% decrease in pain from the baseline, the placebo group reported a 16% decrease, and the control group reported a 14% decrease.

Even though the placebo group believed that they underwent hypnosis, those assigned to that group did not report much less pain than those assigned to the control group. Therefore, the results discount the
effects of expectancy and reveal that pain reduction due to hypnoanalgesia goes beyond relaxation.

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