Hypnosis is a state of altered awareness in which we can become absorbed in more relaxing thoughts, ideas, images and feelings, and more easily distracted from negative or painful ones. Many people who benefit from hypnosis respond well to suggestions about feeling less pain, more comfort, increased energy, better sleep, and having rapid healing outcomes. Only about 10-20% of the general population does not receive good results from hypnosis; this group may benefit more from biofeedback and other methods.

There are many published, well-controlled research studies that focus on the use of hypnosis with surgery. In a recent review of 18 of these studies1, the overall result was that most patients treated with hypnosis have moderate to significantly better surgical outcomes including reports of less pain, use of fewer pain medications, and faster recovery. For example, medical hypnosis for orthopedic hand surgery, which is typically very painful, showed benefits that included significantly less post-surgery pain and anxiety, and fewer complications2. In a different study, 339 patients undergoing thyroid and parathyroid neck surgery, were divided into two groups. One group had hypnosis and an intravenous medication that kept them conscious while the other group was given general anesthesia. The hypnosis group had less pain, used fewer pain medications, and had shorter hospital stays3. In a similar study of 241 patients who underwent invasive medical procedures4, those who received pre-surgical instruction in self-hypnosis had less pain and anxiety than those who did not receive self-hypnosis instruction. In summary, a year 2000 review of published articles in the field of hypnosis concluded that "the research to date generally substantiates the claim that hypnotic procedures can ameliorate many psychological and medical conditions." 5

There has also been evidence that hypnosis may affect the way that pain is processed in the brain. In a recent study, volunteers who plunged their hands into hot water were measured by a PET scan. Later, they were hypnotized and told that the water would not seem as painfully hot. During hypnosis, the PET scan was readministered, showing significantly less activation in the anterior cingulate cortex, the part of the brain that is involved in expanding feelings of emotional distress and can also influence the inhibition of pain. On the other hand, the PET scan data obtained during hypnosis showed no decrease in activation in the somatosensory cortex region which is involved in processing the sensation of pain.6 These results suggest that even though the brain may continue to register the sensation of pain, hypnosis seems to help patients shift their experience of pain away from distress and suffering.

Hypnotic intervention has also been used successfully with many types of specific pain. In the treatment of burn patients, hypnosis has been used to reduce the pain associated with debridement (the scrubbing away of burned tissue to give new tissue a chance to grow) and wound cleaning, to modulate anxiety related to burn procedures, and to enhance coping styles such as repression and intellectualizing.7 With cancer patients, hypnotic suggestion helps to reduce the suffering related to many painful procedures such as the administration of chemotherapy and treatment-related throat pain and nausea. Hypnosis can also help to reduce the frequency and intensity of migraine headaches, and to relieve tension headaches8. In the area of dentistry, hypnosis is used to reduce orofacial pain held in the muscles and jaw, and pain, distress, and anxiety related to specific dental procedures such as root canals and extractions. Other significantly effective applications of hypnosis include reduction of anxiety and physical pain related to invasive medical procedures including endoscopies, intubation, catheter discomfort, and blood transfusions.

References

1 Montgomery, G.H., DuHamel, K.N., and Redd, W.N. (2000). A meta-analysis of hypnotic analgesia: How effective is hypnosis? International Journal of Clinical and Experimental Hypnosis, 48, 138-153.

2 Mauer, M.G., Burnett, K.F., Ouellette, E.A., Ironson, G.H., & Dandes, H.M. Medical hypnosis and orthopedic hand surgery: Pain perception, postoperative recovery, and therapeutic comfort. International Journal of Clinical and Experimental Hypnosis, 47, 144-161.

3 Defechereux, T., Meurisse, M., Hamoir, E., Gollogly, L., Joris, J., & Faymonville, M.E. (1999). Hypnoanesthesia for endocrine cervical surgery: A statement of practice. Journal of Alternative and Complementary Medicine, 5, 509-520.

4 Lang, E.V., Benotsch, E.G., Fick, L.J., Lutgendorf, S., Berbaum, M.L., Berbaum, K.S., Logan, H., & Spiegel, D. (2000). Adjunctive non-pharmacological analgesia for invasive medical procedures: A randomized trial. Lancet, 355, 1486-1490.

5 Montgomery, G.H., David, D., Winkel, G., Silverstein, J.H., and Bovbjerg, D.H. The effectiveness of adjunctive hypnosis with surgical patients: A meta-analysis. Anesthesia and Analgesia, 94, 1639-1645.

6 Rainville, P., Duncan, G.H., Price, D.D., Carrier, B., & Bushnell, M.C. Pain affect encoded in human anterior cingulated but not somatosensory cortex. Science, 277, 968-971.

7 Patterson, David. (1996). Burn pain. In Joseph Barber (Ed.), Hypnosis and Suggestion in the Treatment of Pain, pp. 267-302. New York: Norton.

8 Barber, J. (Ed.). (1996). Headache. In J. Barber (Ed.). Hypnosis and Suggestion in the Treatment of Pain, 158-184. New York: Norton.