Complementary Medicine: Hypnotherapy to Deal with Pain
We are all familiar with medication to deal with pain, however hypnosis is the most frequently cited form of non-pharmacologic cognitive pain control (1).
Hypnosis is an altered state of consciousness.
It is where one's attention is focused; this creates an environment in which the brain can process information to bring about beneficial changes in a person. Hypnotherapy, is a technique which can facilitate significant changes in mental processing and lasting changes in a person.
A meta-analysis of randomized controlled studies of clinical hypnosis identified 57 studies that demonstrated hypnosis as an effective treatment for a number of health disorders and conditions including pain.
Clinical hypnosis is one of the fastest-growing and most commonly employed categories of complementary and alternative medicines (CAM), as defined by the NCCAM (National Center for Complementary and Alternative Medicine) of the National Institutes of Health. A national health interview survey of medical usage in 2007 found that 4 out of 10 US respondents reported having used complementary and alternative medical treatments in the previous year.
Cancer patients suffer emotional distress [anxiety, depression] and may or may not experience pain, be it acute or chronic. The discomfort can become even more debilitating as emotional distress amplifies the pain levels. Furthermore, emotional distress and pain can hinder and complicate the recovery process for the patient.
According to Montgomery et al (2, 3) the observation is made that hypnosis should be regarded as an established, empirical treatment for pain relief. This is supported by further studies reporting favourable outcomes for cancer patients who underwent clinical hypnosis treatments (4,5,6).
In breast cancer, a study found that those assigned to treatment (standard care or expressive-supportive therapy) that included clinical hypnosis demonstrated significantly less pain. In addition, patients who underwent hypnosis reported significantly less of an increase in pain over time (7).
Research carried out by Syrjala and colleagues studied 45 cancer patients to evaluate the efficacy of hypnosis for pain relief following chemotherapy (8). Participants were randomized into the following conditions: hypnosis, cognitive behavioral therapy (CBT), attention control, and standard care. The hypnosis group showed a significant reduction in oral pain.
In another study, Montgomery and colleagues studied 200 patients undergoing excisional breast biopsy or lumpectomy (9). Participants in this study were randomly assigned to a hypnosis session or to a control condition involving nondirective empathic listening. The hypnosis group had significant reductions in pain intensity, self-reported pain unpleasantness, nausea, fatigue, and discomfort compared with the control.
A published review examined the evidence from clinically controlled trials, evaluating hypnosis for procedural-related pain in pediatric oncology (10). Eight randomized controlled trials were analyzed, demonstrating positive outcomes in clinical hypnosis for pain management in pediatric oncology.
Montgomery GH, DuHamel KN, Redd WH 2000, A meta-analysis of hypnotically induced analgesia: how effective is hypnosis? International Journal of Clinical Hypnotherapy, 48, 138-153
Montgomery GH, David D, Winkel G, Silverstein J, Bovbjerg D 2002, The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis, Anesthesia and Analgesia, 94, 1639-1645
Elkins G, Fisher W, Sliwinski J August 27, 2012, Clinical hypnosis for the palliative care of cancer patients, Oncology Nursing, Integrative Oncology, Palliative and Supportive Care, Survivorship
Syrjala KL, Cummings C, Donaldson GW 1992, Hypnosis or cognitive behavioural training for the reduction of pain and nausea during cancer treatment: a controlled clinical trial,Vol 48, Issue 2, Feb 1992:137–146 International Association for the Study of Pain
Lee JS, Pyun YD 2012, Use of hypnosis in the treatment of pain. The Korean Journal of Pain, 25(2), 75–80.
Spiegel D, Bloom JR: Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosom Med 45(4):333–339, 2009
Syrjala K, Cummings C, Donaldson G: Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: A controlled clinical trial. Pain 48(2):137–146, 2009
Montgomery GH, Bovbjerg DH, Schnur JB, et al: A randomized clinical trial of a brief hypnosis intervention to control the side effects in breast surgery patients. J Natl Cancer Inst 99(17):1304–1312, 2007
Richardson J, Smith JE, McCall G, et al: Hypnosis for procedure-related pain and distress in pediatric cancer patients: A systematic review of effectiveness and methodology related to hypnosis interventions. J Pain Symptom Manage 31(1):70–84, 2006