The Role of Hypnosis For Pain Management
by Scott M. Fishman, MD

Question: How is hypnosis used to treat chronic pain and is it really scientifically proven?

Answer: Hypnosis is a widely practiced and time-tested method for managing pain.  Hypnosis has been around for centuries, and was first utilized by physicians over 100 years ago as a way to help patients in pain.  The word “hypnosis” – is derived from the Greek word “hypnos” which means asleep.  Early pioneers in the area of hypnosis used it to block the pain of amputations, before chemical anesthetics were available.  Although hypnotism has been utilized by many as a form of alternative medical therapy for many centuries, it remains today under close scientific scrutiny within the medical community.

My colleague, Dr. Daniel Rockers, a clinical psychologist who uses hypnosis for pain control, says that although hypnosis was called “sleep” by the Ancient Greeks, hypnosis is not exactly like sleep; although it may truly look like sleep to an observer.  When a patient is hypnotized, the mind is in a state of focused awareness.  This focused state has been used to alleviate many different kinds of pain:  pain from childbirth, dental work, burns, migraine headaches, cancer pain, arthritis and nerve pain.

He notes that the exact way hypnosis works is not fully understood.  There are, however, several possible ways that hypnosis could work to block, reduce, or eliminate pain.  One is that hypnosis decreases the amount of pain signal that gets sent to the brain.  Another way that hypnosis may work is that it redirects one’s attention to something other than the pain.  Still another way, is that hypnosis may help our mind to know that the pain is there, but not to feel it.  Dr. Rockers also believes that patients can learn to relax so deeply that their pain is reduced, or they can learn to put their hand to sleep and then transfer that numbness to a painful body part, thereby decreasing pain.  There are many other hypnotic suggestions that help reduce pain as well.

Many of Dr. Rockers’ patients ask him if hypnosis really works.  This is because they have often seen it used for entertainment, in which people do silly things in front of others.  He reminds his patients that medical hypnosis truly does work; studies have shown that nearly all patients with pain can benefit from hypnosis in some way.  Dr. Rockers often cites a well-known study of 86 women with metastatic cancer; the women using self-hypnosis reported half as much pain as those who did not use hypnosis.

In The War on Pain*, I describe a patient named Barbara who was able to utilize hypnosis as an effective tool to manage her pain:

“Barbara’s serious medical problems, including blindness and neuropathic pain from diabetes, frequently landed her in the hospital.  She was well-known to all of the nurses on the inpatient floor, and her many problems resulted in her taking multiple medications, all of which helped, but at the price of debilitating side effects.  Her fragile health required constant medical attention and frequent adjustments in her medications.  This time, she was hospitalized for a flare of abdominal pain.  While in the hospital, she deteriorated.  Diabetes not only caused her pain but also injured the nerves in her gut, slowing down the normal digestive action, a disorder called diabetic gastroparesis.  This condition, plus narcotic pain medication, had caused so much constipation that her bowels became distended . She was in grave danger. Changing her pain medication and a constant infusion of laxatives had no effect.  Her bowels were shut down.  Barbara believed she was dying, and all of her doctors were walking a tightrope; cutting back  on pain medication helped the bowel obstruction but left Barbara in agony.   They tried every conceivable pain reliever, but either her bowels or her fragile kidneys would rebel.  She hadn’t slept in days and was a picture of misery.

Dr. Holmgren knew Barbara well and they shared a degree of trust that allowed another option.  She asked Barbara if she was willing to try hypnosis.  As she explained,   “It’s like taking a familiar drive, during which you get lost in thoughts far removed from driving, but still arrive safe and sound at your destination.”   Barbara’s extreme distress surely made it tough to focus away from her pain, so Dr. Holmgren was not optimistic that she could be hypnotized.   She started by asking Barbara to close her eyes, even though she was blind, and picture her favorite place.  Dr. Holmgren figured that, at best, this soothing exercise would help the exhausted woman relax.  She told her to imagine this favorite place, which for Barbara  was a beach, and to sense everything about it – the wind on her face, the sand between her toes, the briny smell of salt water.

Dr. Holmgren watched as her breathing slowed and became deeper, and her facial muscles, which had been twisted into a grimace, smoothed.  Throughout, Dr. Holmgren asked the patient how she was feeling and although she made no suggestions about a trance or dropping into a deep sleep, Barbara’s head gradually drooped and she fell asleep.  Dr. Holmgren stayed for a while, relieved that for the first time in many days, Barbara was able to sleep.

The next morning, Dr. Holmgren checked in with Barbara’s nurse.   The nurse reported that Barbara slept through the night, and like a triumphant sign from the heavens, awoke in the morning and had a bowel movement.  Her pain was decreased, her bowel functioned, and she was out of danger.

Hypnosis continues to play an important role in pain management in the 21^st Century.  It offers a rare window into the mind-body connection, revealing clues about the power and control the mind has to both increase pain, and reduce it.  Hypnotism is an important piece of the mind-body puzzle, that allows one’s mind and state of consciousness the ability to take charge over the type of pain you are experiencing.  Although hypnotism may not be able to cure the underlying cause of pain, in most cases, it can help patients manage it.

*Fishman, SM and Burger, L:  The War on Pain.  New York, 1^st Ed., Harper Collins, 2000, p224-225.

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