Hypnotherapy for pain management
This is an article I got published in Pain Matters magazine. Hypnotherapy is one of the best-known complementary therapies, but, it is also one of the least understood. Hypnotherapist Stephen McMurray explains how it works and how it can be used in pain management.
Hypnosis has its origins in the ideas of the late eighteenth-century with the Austrian physician Franz Mesmer, he believed that inducement of a sleep-like state, would assist people in healing their ailments. The Scottish physician James Braid further developed the medical applications of those theories in the middle of the nineteenth century and it is from his work that modern hypnosis derives.
The word ‘hypnosis’ derives from the Greek god of sleep – Hypnos. Hypnosis is a state of deep relaxation, increased suggestibility and narrowed focus. Hypnotherapy is when hypnosis is used for therapeutic purposes. The hypnotherapist assists the client to enter a state of hypnosis and then makes suggestions that help the subconscious mind achieve the desired therapeutic goals.
University of Hull researchers have utilised brain scans to see the impact hypnosis has on the brain. The brain scans showed that hypnotised participants had decreased activities in the parts of the brain linked with daydreaming or letting the mind wander and thus leaving the brain more likely to concentrate on tasks[i].
A major reason why physicians first took an interest in hypnosis was its success in relieving pain during major surgery. Hypnosis is used in three ways to manage pain – direct suggestion of pain reduction; changing the experience of pain; and directing attention away from pain and its source.
One method hypnotists use is direct suggestion – that the painful area is getting numb or the painful area has nerves which are controlled by switches in the brain and the client can turn these switches off. Another procedure is known as the ‘glove anaesthesia’ – where the hypnotist suggests a non-painful hand has lost sensitivity and therefore assures the client they have control over their pain sensitivity. The client can then rub the painful area with the anaesthetic hand and transfer the insensitivity and numbness.
Sometimes pain is difficult to locate to a particular area, which can make it difficult to manage. Hypnotists may suggest concentrating the pain into a small area and then moving it, for example, a pain in the hand may be moved to a tingling in a finger which makes it more tolerable.
There are a number of ways in which directing attention away from the pain can be achieved. One method is to forget the existence of the painful area. For example, the client may be helped to imagine that they have no right arm temporarily and therefore can not feel the pain. Other methods include different types of visualisations, which can transport the client away from the present where they are experiencing pain[ii].
The hypnotist would also assist the client in learning how to undertake self-hypnosis. The client would be able in their own time to reach a state of deep relaxation and narrowed focus. In this state, the client can direct their concentration on the desired result.
The research evidence for the effectiveness of hypnotherapy for pain management is growing. In a controlled study, forty patients with fibromyalgia were randomly assigned to groups which received either hypnotherapy (eight one-hour sessions of hypnotherapy with a self-hypnosis home practice tape over a three-month period) or physiotherapy (including 12 to 24 hours of massage and muscle relaxation training over a three month period). The researchers found that the group which received hypnotherapy showed significantly better outcomes than the group receiving physiotherapy, in terms of; muscle pain, fatigue, sleep disturbance, distress, and patient overall assessment of outcome[iii].
The BBC One Show presenter Michael Mosley investigated hypnosis for pain relief with Stewart Derbyshire of Birmingham University. Utilising a heat pad and a needle, hypnosis appeared to alter the sensation of pain and brain scans also illustrated the effect hypnosis had on the brain[iv].
In a study exploring the effectiveness of hypnosis to reduce osteoarthritis pain, it was shown that participants had a significant and substantial decrease in pain intensity after four weeks of treatment, which was maintained through 3 months and 6 months of follow-up[v].
Furthermore, research carried out by Withington Hospital in Manchester has illustrated that hypnotherapy successfully treated a significant majority of people with Irritable Bowel Syndrome (IBS) who took part in the study[vi]. The National Institute for Clinical Excellence (NICE) recommends hypnotherapy for the treatment of IBS[vii].
Obviously, if someone is in pain they must be seen by a qualified medical practitioner. There is growing evidence that hypnotherapy along with self-hypnosis can be effective in reducing pain and could be utilised alongside other treatments in a pain management programme.
[i] BBC (2009) Hypnosis has ‘real’ brain effect. [online] Available at: <http://news.bbc.co.uk/1/hi/health/8359170.stm> [Accessed 7 July 2013].
[ii]Hilgard, E.R. and Hilgard, J.R. (1994) Hypnosis in the Relief of Pain, Levittown, Brunner/Mazel.
[iii] Haanen, H.C. (1991) Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia,
Journal of Rheumatology, January, 18(1), pp.72-75.
[iv] BBC (2009) One Show. [online] Available at: <http://www.youtube.com/watch?v=ZqYpc8FAb64>
[Accessed 8 July 2013].
[v] Gay, M.C. et al. (2002) Differential effectiveness of psychological interventions for reducing osteoarthritis pain: a comparison of Erickson hypnosis and Jacobson relaxation, European Journal of Pain, 6(1): pp.1-16.
[vi] Mail Online (2013) Can hypnotherapy beat IBS? [online] Available at: <http://www.dailymail.co.uk/health/article-200446/Can-hypnotherapy-beat-IBS.html> [Accessed 8 July 2013].
[vii] National Institute for Health and Clinical Excellence (2008) Irritable Bowel Syndrome in adults – Diagnosis and management of irritable bowel syndrome in primary care, NICE clinical guideline 61, February.
