Hypnotherapy for Pain Relief

Cultures have utilised trance states to bypass pain for millennia. The Ancient Greeks used hypnotic trance, which they called 'incubation', to attain deep states of healing. The Romans also took on the Greek idea of sleep temples, where trance states were induced for days; one such 'temple of hypnosis' was unearthed in Gloucestershire, UK.

Many African and Asian cultures use or have used trance states, induced by rhythmic drumming and dancing, for many reasons, including enduring painful rituals, as with the Hindu Thaipusam festival in India or Thailand's Nine Emperor Gods festival, where devotees pierce their bodies with sharp hooks and push spears and swords through their cheeks. The Egyptians, Persians, Sumerians, Chinese, and New World Indians, from the Inuit in the north and all through the Americas, also knew about and utilised the state of trance, hypnosis.

In the 1840s James Esdaile, a Scottish surgeon employed by the East India Company at Hooghly Imambara Hospital, India and also as a medical officer at Hooghly Gaol Hospital, performed well over 300 'pain-free' major surgeries and 2000 minor ones, including amputations, removal of cataracts and the removal of massive tumours using, what he called 'mesmerism', though what is known today as hypnosis, or more specifically, hypno-analgesia and hypno-anaesthesia. It is also significant that the same official records reveal the unanticipated consequence that Esdaile’s hypno-analgesia surgeries not only prevented what would have been excruciating pain but also a huge reduction in the post-surgical mortality rate, from 50% to 5%, due to the significant lessening of post-operative shock.

"Pain is not a condition of the body; like hypnosis, it is a condition of the mind"

Clearly, being in a trance state can remove pain, but can a trance state be used to turn pain down, diminish it, keep it low or give a patient the means to lessen pain whenever it flares up? In my experience, the answer is most certainly yes. Pain is not a condition of the body; like hypnosis, it is a condition of the mind. Researchers have revealed our subconscious minds are 30,000 times more powerful than our conscious minds; hypnotherapy is simply a method to gain access to that power. We dip in and out of our subconscious constantly; it's our operating system, the storehouse of our life experiences, our deepest beliefs and rules that we, under normal circumstances, can't easily access or change. For example, a harmless little mouse may induce total panic if there's a belief within the subconscious linking mice with the feeling of complete terror and no amount of logical talking, 'thinking it through', or common-sense advice will change that, not until that corrupted pathway has been rerouted or rewritten, then change can be virtually instantaneous; such is the power of the subconscious mind and therefore, such is the power of hypnosis.

"Our findings strengthen the assertion that hypnosis is a very efficacious intervention for alleviating clinical pain"

Fortunately, over the past twenty years, hypnosis research regarding the alleviation of pain has boomed. In a recent 2021 meta-analysis of 'Hypnosis and the alleviation of pain', Leonard Milling concluded, "Our findings strengthen the assertion that hypnosis is a very efficacious intervention for alleviating clinical pain" and from Neuroscience & Biobehavioural Reviews, a 2019 paper by Trevor Thompson states, "Findings suggest that hypnotic intervention can deliver meaningful pain relief for most people and therefore may be an effective and safe alternative to pharmaceutical intervention". In a meta-analysis of 18 studies, it was shown that hypnosis can produce "A moderate to large hypno-analgesic effect", which supports the efficacy of hypnotic techniques for pain management. The results also indicated that hypnotic suggestion was equally effective in reducing both clinical and experimental pain (GH Montgomery, 2000). The website of the American Psychological Association, the largest scientific and professional organisation of psychologists in the United States, with over 122,000 members, currently states, "Hypnosis is likely to be effective for most people suffering from diverse forms of pain, with the possible exception of a minority of patients who keep themselves resistant to hypnotic interventions".

"Findings suggest that hypnotic intervention can deliver meaningful pain relief for most people and therefore may be an effective and safe alternative to pharmaceutical intervention"

Hypnosis is more effective than other non-pharmacologic interventions, such as physical therapy and pain education. It can provide analgesia, reduce stress, relieve anxiety, improve sleep and mood, and potentially reduce the need for opioids. Hypnosis can also enhance the efficacy of other orthodox treatments for pain.

"Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. The findings from these clinical trials also show that hypnotic treatments have a number of positive effects beyond pain control"

The hypnotherapeutic process used for pain reduction is, on one level, the same as any hypnotherapy treatment; a trance state is attained along with a deep state of relaxation, then, as patients are all different, different hypnotherapeutic imaginative tools are used according to each individual's condition, personality type and compliance levels.

Age has also been shown not to be an issue, as Susan Lutgendorf concludes in a 2007 study, "Older patients are hypnotizable and increasing age does not appear to mitigate the usefulness of hypnotic analgesia during invasive medical procedures". 

Everyone is hypnotisable!

Hypnotisability, or how easily a subject goes into deep trance, is something that crops up in a few studies where they suggest the more hypnotisable a patient is, the greater the pain reduction. My personal opinion ties in with Leonard Milling's 2008 paper in 'Current Pain and Headache Reports' where he concludes, "High hypnotic suggestibility is not necessary for successful hypnotic pain intervention", and I believe most hypnotherapists would agree, as this issue is really more about the skills of the therapist. A subject in a deep trance, not given adept guidance, may not necessarily do as well as a subject in a light trance led by a skilful hypnotherapist, but either way, hypnotherapy most definitely changes pain.

Nick Malyon MSc. BHSc. Dip.(hypno). Hypnotherapy for pain relief in Adelaide www.nickmalyonhypnotherapy.com 

www.nickmalyon.org 

Research

The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials.

Thompson, Terhune, Oram, Sharangparni, Rouf, Solmi, Veronese, Stubbs. Neurosci Biobehav Rev. 2019 Apr;99:298-310.

Findings suggest that hypnotic intervention can deliver meaningful pain relief for most people and, therefore, may be an effective and safe alternative to pharmaceutical intervention. High-quality clinical data is, however, needed to establish generalisability in chronic pain populations.

Hypnosis and the Alleviation of Clinical Pain: A Comprehensive Meta-Analysis

Leonard S. Milling, Keara E. Valentine, Lindsey M. LoStimolo, Alyssa M. Nett, & Hannah S. McCarley. Int J Clin Exp Hypn. p297-322 May 2021

Our findings strengthen the assertion that hypnosis is a very efficacious intervention for alleviating clinical pain.

Is high hypnotic suggestibility necessary for successful hypnotic pain intervention?

Leonard S Milling. Curr Pain Headache Rep. 2008 Apr;12(2):98-102.

High hypnotic suggestibility is not necessary for successful hypnotic pain intervention.

Hypnotic Approaches for Chronic Pain Management: Clinical Implications of Recent Research Findings

Mark P. Jensen and David R. Patterson Department of Rehabilitation Medicine, University of Washington. Am Psychol. 2014; 69(2): 167–177 Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. The findings from these clinical trials also show that hypnotic treatments have a number of positive effects beyond pain control.

Effects of Age on Responsiveness to Adjunct Hypnotic Analgesia During Invasive Medical Procedures.

Lutgendorf, Susan K.; Lang, Elvira V.; Berbaum, Kevin S.; Russell, Daniel; Berbaum, Michael L.; Logan, Henrietta; Benotsch, Eric G.; 

Schulz-Stubner, Sebastian; Turesky, Derek; Spiegel, David. (Feb-Mar 2007). Psychosomatic Medicine, Vol 69(2), 191-199. 

Conclusions: Older patients are hypnotizable, and increasing age does not appear to mitigate the usefulness of hypnotic analgesia during invasive medical procedures. 

Hypnosis to Manage Anxiety and Pain Associated with Colonoscopy for Colorectal Cancer Screening: Case Studies and Possible Elkins, Gary; White, Joseph; Patel, Parita; Marcus, Joel; Perfect, Michelle M.; Montgomery, Guy H. (Oct 2006). Benefits.International Journal of Clinical and Experimental Hypnosis, Vol 54(4), 416-431. 

Results suggest that hypnosis appears to be a feasible method to manage anxiety and pain associated with colonoscopy, reduces the need for sedation, and may have other benefits such as reduced vasovagal events and recovery time.