Feature Archive

Hypnosis Goes Mainstream

By learning self-hypnosis, you can help reduce pain and anxiety.

By Jeanie Lerche Davis
WebMD Feature

Reviewed By Brunilda Nazario

Hypnosis is no longer just a stage-show act.

During the past 10 years, it has slipped quietly into mainstream medicine -- helping people quit smoking, even cut back or stop using pain and anxiety medications.

There's good research backing it up. But many people don't really understand what hypnosis is all about.

Marc Oster, PsyD, a Chicago psychologist, relies on self-hypnosis when he gets dental work done. "I get novacaine, just like other patients, but I don't need as much of it because I'm under hypnosis. Afterward, I can go back to work for a full day. When the novacaine wears off, I don't have the pain, the jaw ache, or the headache that other people have," he tells WebMD.

Hypnosis is merely a tool -- a technique to tap into the subconscious, says Oster, who heads the American Society of Clinical Hypnosis.

No pocket watches are involved and no one clucks like a chicken afterward.

In fact hypnosis is a state of concentration and focused attention. With it the mind can be more powerful. You simply have slipped into your subconscious.

In a hypnotherapist's office, you can learn self-hypnosis. Don't worry, you won't lose control. You won't do anything against your will. "No one takes away our choice under any conditions -- no one can make you do anything you wouldn't normally do," says Jane Ann Covington, a hypnotist in Atlanta and founder of the Hypnosis Institute International Center for Developing Mastery.

In hypnosis, you don't even lose consciousness, Covington tells WebMD.

"If I said something inappropriate to you, you would either disregard it or get up and leave," she says. "You would react as you normally would."

Mind Over Body

The process of hypnosis involves focusing deeply on a thought or image -- letting imagery become totally absorbing. The hypnotist will talk to you, gently guiding you into a very relaxed state.

While you are in this deeply relaxed, focused state, the therapist presents a suggestion, to help you solve your problem. When the mind is intensely focused, these suggestions have a powerful impact, which is the magic of hypnosis.

Afterward, you will be very much aware of what happened.

Covington uses hypnosis to help people enhance their lives by creating needed changes, building confidence, controlling habits and addictions, and even developing creativity and intuition. She's been doing this for more than 25 years, she tells WebMD. All hypnosis is self-hypnosis, she says.

Oster has also incorporated hypnosis into his psychotherapy practice for upwards of 25 years. Teaching his patients self-hypnosis is his goal, too. "When you learn to hypnotize yourself -- so the suggestion is there whenever you need it -- that's power."

The American Psychology Association has endorsed hypnosis for a number of years. In 1995, the National Institutes of Health announced its support for hypnosis for cancer pain and other pain conditions. Research from Harvard Medical School and other institutions is showing evidence that hypnosis is indeed a process of mind over body.

Hypnosis seems to block nerve receptors in the brain -- those that control sensations of pain, anxiety, and discomfort, Oster tells WebMD.

Self-hypnosis is so easy to learn, even young children can pick it up, he says. He's taught very young children -- as young as five years old -- to quiet their own anxiety and hyperactivity, Oster tells WebMD.

Hypnosis is also sometimes covered by insurance. Growing numbers of insurance companies, as well as Medicare, have begun covering hypnosis of treatment of pain or posttraumatic stress disorder (PTSD), says Oster.

Also, since many doctors do consider hypnosis to be a tool of their trade there's no need for them to bill separately for hypnosis. "I may do hypnosis, but I'm also doing psychotherapy for general anxiety disorder, which insurance does cover," Oster tells WebMD.

But before trying hypnosis, it's important to check out professional web sites for listings of credentialed practitioners, he explains.

Inroads Into Anxiety

For nearly 13 years, Elvira Lang, MD, has been using hypnosis to calm patients at Beth Israel Deaconess Hospital in Boston. Lang runs the catheterization lab where her patients get drainage tubes inserted or changed.

It's not the most pleasant procedure, and most patients need medication to ease the anxiety -- especially if it's going to take awhile. Some have the same procedure time after time; "their stress level goes up each time they come in, and they typically need more drugs with each procedure," says Lang.

But teach them self-hypnosis, and "it's like breaking the spell," she says. "If we can give them one good experience, show them their own resourcefulness, it carries over. We are finding that when patients are under hypnosis, they have less pain, less anxiety, and they're done faster."

Hypnosis makes the procedure cheaper, too, says Lang. Her study published a few years ago showed that the hospital saves more than $100 per procedure. That's a potential annual savings of $1 million because hypnosis shortens the procedure time and cuts the need for sedation.

What's Going On?

"We describe it as a form of concentration," Lang says. "We tell our patients: 'Imagine yourself in a safe and comfortable place, a restful place.'

"It's a very simple technique to learn," Lang explains. "The result is very powerful. It keeps the whole atmosphere quite relaxed. Everyone is focused; the patient is focused and the providers are focused."

Some people are more hypnotizable than others. Some can go more deeply into the hypnotic state, and may not need drugs to relax them. Others need more help relaxing -- perhaps getting both medications and hypnosis.

Because the body is under less stress during hypnosis, there are no "wild fluctuations in heart rate and blood pressure during the procedure," says Lang.

Even if a crisis occurs during a procedure, patients are able to stay focused. "It's much less stressful for everyone, when we use hypnosis," she says.

In fact, the relaxation lasts well beyond the procedure, Lang tells WebMD. She's tracking effects on women having breast biopsies. It's a relatively short procedure, lasting 30 to 40 minutes. "We actually see quite a carryover; for a week afterwards, the women report less anxiety. When the diagnosis comes, they can cope better."

Cutting Pain Medication

Helen Crawford, PhD, an experimental psychologist at Virginia Polytechnic Institute and State University in Blacksburg, studies hypnosis in treatment of chronic low back pain and painful jaw alignment problems.

In some chronic pain cases, the pain itself can create a strong "nerve signature" in the brain, a pattern that can be reactivated very easily, Crawford explains.

The pain then becomes a vicious cycle, as the brain has literally 'programmed' itself to react to even the slightest pain -- creating a bigger pain sensation that feels very real. To break this cycle, it's a matter of breaking the spell.

Interestingly, those people who are most prone to developing this nerve signature also seem to be the most hypnotizable. "It's all about using your wonderful focus abilities to your benefit, and hypnosis helps you do that," Crawford tells WebMD. "It's all about learning how to control, how to inhibit, this pattern."

Miracles in the Burn Unit

Hypnosis is also helping people with severe burns to dampen their own often excruciating pain.

"Burn care involves pulling off bandages and scrubbing them really hard, Dave Patterson, MD, a rehab specialist at the University of Washington Harborview Burn Center, tells WebMD. "That pain is worse than when they get burned initially, and they have to go through it repeatedly. We can prepare them for it."

He's developed a virtual-reality program to give burn patients a hypnotic suggestion -- to "fly around" in a snow-filled canyon -- during this excruciating daily procedure.

His studies have shown roughly a 25% to 30% drop in pain, Patterson reports. "For most patients, it takes the edge off, makes them feel better. With some, it's dramatic. It works so well they don't need pain medicine at all."

Easing Intestinal Troubles

Bruce Naliboff, PhD, a psychologist and co-director of the Center for Neurovisceral Sciences and Women's Health at UCLA School of Medicine, has used hypnosis for many years to help patients with irritable bowel syndrome (IBS).

It's a disorder that's not well understood, and sometimes difficult to treat. "So anything that might work, people jump on," Naliboff tells WebMD.

And it works, amazingly -- although it's not clear how. There's no evidence that the intestinal tract itself has changed. Even the tract's sensitivity doesn't seem to change, says Naliboff. "But people do report they feel better, and symptoms decrease.

"We don't really know why hypnosis works with IBS ... it's a very difficult area to research," says Naliboff. "But the same could be said of many medications -- that we don't exactly understand how and why they influence symptoms."

To find an expert certified in hypnosis -- and who work under a code of ethics -- check the web sites for the American Society of Clinical Hypnosis and the American Society of Experimental and Clinical Hypnosis. The American Council of Hypnotist Examiners also provides certification after extensive training.

Published May 17, 2004.


SOURCES: American Society of Clinical Hypnosis. American Society of Experimental and Clinical Hypnosis. Marc Oster, PsyD, clinical psychologist, Chicago; president, American Society of Clinical Hypnosis. Jane Ann Covington, hypnotist, Atlanta; founder, Hypnosis Institute International Center for Developing Mastery. Elvira Lang, MD, director of catheterization, Beth Israel Deaconess Hospital, Boston. Helen Crawford, PhD, experimental psychologist, Virginia Polytechnic Institute and State University, Blacksburg, Va. Dave Patterson, MD, rehabilitation specialist, University of Washington Harborview Burn Center. Bruce Naliboff, PhD, psychologist; co-director, Center for Neurovisceral Sciences and Women's Health at UCLA School of Medicine.

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