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Hypnosis for Pain

Can the power of suggestion really help you reduce pain, anxiety, and blood pressure? It just might.

WebMD Feature

Reviewed By Gary Vogin

For me, cramming in college wasn't about mastering material before an exam. It was about squeezing in my studies before a migraine knocked me flat. When the fuzziness started creeping into my head, I knew it was just a matter of time. Leaning over my chemistry book, I'd race to memorize before the thumping began. Learning chemical reactions was not an option in my darkened bedroom, hammers whacking the inside of my head for days at a time.

What freed me from those hammers was hypnosis, a practice that people have used for medical purposes for more than a century. In the last several decades, researchers have subjected hypnosis to the scrutiny of clinical trials -- and it has passed with flying colors. It's been successfully used to soothe acute and chronic pain stemming from surgery, cancer, kidney stones, back conditions, and invasive medical and dental procedures. Still, many people who might benefit from the technique don't explore it. For some, hypnosis carries a stigma, perhaps because of the "performer" hypnotists, who make people cluck or moo in front of large audiences.

Fortunately for me, these were not my only associations with the technique. A friend had told me about her success using hypnosis to control pain from Crohn's disease, and I went to see her hypnotherapist. We taped a 10-minute session, and I listened to it every morning and evening. Within a couple of months, my migraines were gone.

"If this were a drug, everyone would be using it," says David Spiegel, MD, a psychiatrist at Stanford University. "Changing your mental set can change what's going on in your body."

"Most patients benefit from the use of hypnotic suggestion for pain relief," says Guy Montgomery, PhD, a behavioral scientist at the Mount Sinai School of Medicine in New York. (Montgomery published a meta-analysis on the subject in the April 2, 2000 issue of the International Journal of Clinical and Experimental Hypnosis.)

Tapping the Power of Suggestion

During hypnosis, subjects enter a state of inner absorption, concentration, and focused attention, in which they pick up suggestions particularly well. In this condition, they can tap into normally unused mental powers to create new possibilities of experience. "Hypnosis is simply a refined form of applied imagination," says Donald F. Lynch Jr., MD, a urological oncologist at the Eastern Virginia School of Medicine, who has used the technique to help patients alleviate the pain, anxiety, and depression associated with cancer.

Results from several papers have recently furnished compelling new evidence for the powers of hypnosis. The April 29, 2000, issue of the journal The Lancet reported that hypnosis reduced pain, anxiety, and blood pressure complications in patients undergoing invasive medical procedures. (Hypnosis was compared with standard care and supportive attention, such as encouragement and active listening.) In addition, the procedures took significantly less time in the hypnosis treatment group, probably because the healthcare workers didn't have to interrupt their activities to deal with the patients' pain or to stabilize blood pressure, says Spiegel. Patients in the hypnosis group also required less than half as much painkilling medication as those in the standard group.

Patients most commonly employ the technique in addition to other treatments, but it can also be used by itself. Alexander A. Levitan, MD, MPH, a medical oncologist in Minneapolis, has participated in numerous surgeries, including hysterectomies and tracheostomies, in which hypnosis was used as the sole agent for pain control.

How Does It Work?

No one knows exactly how hypnosis works, but scientists have several ideas. "Hypnosis changes your expectations about how intense the pain will be," says Montgomery. "That alters your experience of the subsequent pain."

Spiegel offers an alternative explanation. "You focus your attention on a competing image that blocks your perception of the pain," he says.

Researchers are currently testing these theories by way of various experimental approaches. Some studies, for example, are documenting the physiological changes that occur under hypnosis. The process activates certain parts of the brain, including the portion that focuses attention. "By concentrating elsewhere, a person inhibits the pain from coming to conscious awareness," says Helen Crawford, an experimental psychologist at Virginia Polytechnic Institute and State University.