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Hypnosis for pain

Baby cryingHypnosis is an extremely effective treatment for both acute and chronic pain. Pain is one of the few areas where hypnosis can be applied clinically in the absence of a broader treatment framework - although hypnosis allied to cognitive behavioural techniques may well be an extremely effective intervention.

A number of studies have examined the effectiveness of hypnosis in treating pain, either when used alone or alongside cognitive behavioural therapy. Pain is one of the best-researched areas - there have been a number of meta-analyses (literally a study of studies - one of the most a reliable ways to find out if there is an effect) of hypnosis for pain control.

Methods of pain control

Hypnotic approaches to pain relief typically take three forms:

  • Direct suggestion for symptom change
  • Dissociative approaches - encourages clients to mentally 'go elsewhere' and leave the pain behind
  • Resource utilisation - a more Ericksonian approach

Evidence for the effectiveness of hypnosis as a treatment for pain

There is considerable evidence for the effectiveness of hypnosis as a treatment for acute and chronic pain. A selection of important results are reviewed here.

"Findings from controlled trials indicate that hypnosis is effective for reducing chronic pain intensity on average, but that there is also substantial individual variation in outcome. Importantly, hypnosis for chronic pain has few negative side effects. In fact, with hypnotic treatment most patients report positive side effects, such as an improved sense of well-being, a greater sense of control, improved sleep, and increase satisfaction with life, independent of whether they report reductions in pain." (Jensen & Patterson, 2014).

Randomized controlled trials

Tan, et al (2014)

This study randomised 100 veterans with chronic low back pain into 4 treatment groups: 1) 8 session of hypnosis, 2) 8 sessions of hypnosis + recordings, 3) 2 sessions of hypnosis + recordings, 4) 8 sessions of biofeedback. Participants in all conditions reported significant reductions in pain, but improvements were greater in the hypnosis groups, and treatment gains were maintained over 3 months. There were no differences between the hypnosis groups, indicating that even very short hypnosis interventions can be effective in relieving pain.

Meta-Analyses

Meta-analyses are essentially studies of studies. Where individual studies can sometimes show contradictory results, meta-analyses can be used to assess the performance of a treatment over a number of studies - this takes advantage of a larger sample size and hopefully leads to a more reliable result.

Montgomery, David, Winkel, Siverstein & Bovbjerg (2002)

This meta-analysis examined the results of 20 published controlled studies examining the use of hypnosis as an adjunct with surgical patients. In these studies hypnosis was typically administered to patients in the form of a relaxing induction phase followed by suggestions for the control of side effect profiles (e.g. pain, nausea, distress). Only studies in which patients were randomised to either a hypnosis or control group (no-treatment, routine care, or attention control group) were included. The results revealed that patients in the hypnosis treatment groups had better outcomes than 89% of the patients in the control groups. It was found that adjunctive hypnosis helped the majority of patients reduce adverse consequences of surgical interventions.

Montgomery, DuHamel & Redd (2000)

This meta-analysis examined the effectiveness of hypnosis in pain management. It compares studies that evaluated hypnotic pain reduction in healthy volunteers vs. those using patient samples, looks at the relationship between hypnoanalgesic effects and participants' hypnotic suggestibility, and determines the effectiveness of hypnotic suggestion for pain relief relative to other nonhypnotic psychological interventions. Examination of 18 studies revealed a moderate to large hypnoanalgesic effect, supporting 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.

AuthorDateStudy typeResult

Tan et al

2014

RCT

This study randomised 100 veterans with chronic low back pain into 4 treatment groups: 1) 8 session of hypnosis, 2) 8 sessions of hypnosis + recordings, 3) 2 sessions of hypnosis + recordings, 4) 8 sessions of biofeedback. Participants in all conditions reported significant reductions in pain, but improvements were greater in the hypnosis groups, and treatment gains were maintained over 3 months. There were no differences between the hypnosis groups, indicating that even very short hypnosis interventions can be effective in relieving pain.

Montgomery et al

2000

Meta analysis

This meta-analysis examined the effectiveness of hypnosis in pain management. It compares studies that evaluated hypnotic pain reduction in healthy volunteers vs. those using patient samples, looks at the relationship between hypnoanalgesic effects and participants' hypnotic suggestibility, and determines the effectiveness of hypnotic suggestion for pain relief relative to other nonhypnotic psychological interventions. Examination of 18 studies revealed a moderate to large hypnoanalgesic effect, supporting 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.

Montgomery et al

2002

Meta analysis

This meta-analysis examined the results of 20 published controlled studies examining the use of hypnosis as an adjunct with surgical patients. In these studies hypnosis was typically administered to patients in the form of a relaxing induction phase followed by suggestions for the control of side effect profiles (e.g. pain, nausea, distress). Only studies in which patients were randomised to either a hypnosis or control group (no-treatment, routine care, or attention control group) were included. The results revealed that patients in the hypnosis treatment groups had better outcomes than 89% of the patients in the control groups. It was found that adjunctive hypnosis helped the majority of patients reduce adverse consequences of surgical interventions.

Adachi et al

2014

Meta analysis

This meta-analysis assessed the efficacy of hypnosis for managing chronic pain. When compared with standard care, hypnosis provided moderate treatment benefit. Hypnosis also showed a moderate superior effect as compared to other psychological interventions for a nonheadache group. The results suggest that hypnosis is efficacious for managing chronic pain.

 

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