Hypnosis can be a divisive topic with polarised views about its legitimacy, efficacy and place within mainstream medicine (whatever that is). The following story that appeared online recently triggered some thoughts and musings (and a bit of a long post)
“This remarkable footage shows a hypnotist having her wisdom tooth removed without any pain relief. Sharon Waxkirsh, who works in north London, said she felt no pain during or after the procedure. Two incisions were made using a scalpel and she had one stitch, as well as having the tooth removed. But the hypnotist said she felt nothing after putting herself into a trance while she was in the dentists chair.”
Hypnosis for pain management is nothing new, but perhaps it’s slowly gaining more interest within the scientific community and losing some of its undeserved woo status (there is still a LOT of rubbish out there of course).
Professor Mark Jensen who spoke about hypnosis at the recent Explain Pain3 in Melbourne has authored numerous papers on the use of hypnosis in pain, including this open access paper which provides a nice overview of hypnosis and the neurophysiology of pain. It also contains the following statement that should gladden the hearts of noijam readers
“The stimulation or damage that excites these receptors, and the information about this stimulation transmitted along the C, A-delta, and A-beta fibres, is not pain. Pain does not occur until structures in the brain become activated and involved”
Professor Jensen has been to our shores previously, sharing and promoting the research and benefits of hypnosis for pain:
‘Professor Jensen says there is physical evidence that hypnosis works to alleviate chronic pain.
“Imaging studies have shown that hypnotic therapy influences all of the cortical areas and neuro-physiological processes that underline pain,” he said.
“Helping patients manage pain can have a significant psychological impact. What people do to manage pain and what they think about pain, and their social environment, can all influence pain and its negative impact on functioning.”
Professor Jensen says clinical trials have shown hypnosis can reduce daily pain intensity for patients.
“Hypnosis still has a certain stigma to it,” he said. “However we are seeing this treatment option used to manage debilitating physical and psychological conditions including phobias and addiction.
“It may be that physicians are not recommending hypnosis to their patients due to a lack of understanding of the process, or it may be that patients are wary of hypnosis.”‘
Milton Erickson, quite rightly recognised as one of the key pioneers in the medical use of hypnosis (although his work is not without controversy and critics) famously dealt with both pain and a wary patient in one of his many documented case studies (more on this below)
Erickson’s approach to hypnosis was rather unique. His methods for inducing hypnotic states have had volumes written about them, but once a hypnotic state was achieved his ‘method’ would generally involve the use of story and metaphor.
In one of my favourite Erickson stories, he was asked by a relative to try and help “Joe”, a florist who had undergone radical surgery for a facial tumour after which he had been told the tumour was malignant and that he had approximately one month to live. Joe was experiencing excruciating pain in his final weeks and days of life. Erickson recounted his interaction with Joe in one of his many writings, a fuller account can be found here, but following are some excerpts.
“I was introduced to Joe, who acknowledged the introduction in a courteous and friendly fashion. I doubt if he knew why I was there. Upon inspecting him, I noted that much of the side of his face and neck was missing because of surgery, ulceration, maceration, and necrosis. Severe pain distressed him continuously, and he could not understand why the doctors could not handle their business as efficiently and competently as he did his floral business.
After the introduction, Joe wrote, “What do you want?” Despite my doubts about being able to help him, I felt that if I was genuinely interested in him and desired to help him, this would be some comfort both to him and to the family members within listening distance in the side room.
I began an approach to hypnosis which I call the interspersal technique. It is a way of talking as if in a casual conversation, but certain words and phrases are given special emphasis so they will be effective suggestions.
I said, “Joe, I would like to talk to you. I know you are a florist, that you grow flowers, and I grew up on a farm in Wisconsin and I liked growing flowers. I still do. So I would like to have you take a seat in that easy chair as I talk to you. I’m going to say a lot of things to you, but it won’t be about flowers because you know more than I do about flowers. That isn’t what you want. Now, as I talk, and I can do so comfortably, I wish that you would listen to me comfortably as I talk about a tomato plant.
That is an odd thing to talk about. It makes one curious. Why talk about a tomato plant? One puts a tomato seed in the ground. One can feel hope that it will grow into a tomato plant that will bring satisfaction by the fruit it has. The seed soaks up water, not very much difficulty in doing that because of the rains that bring peace and comfort and the joy of growing to flowers and tomatoes.
You cannot see it grow, you cannot hear it grow, but grow it does-the first little leaflike things on the stalk, the fine little hairs on the stem. Those hairs are on the leaves too, like the cilia on the roots; they must make the tomato plant feel very good, very comfortable if you can think of a plant as feeling, and then, you can’t see it growing, you can’t feel it growing, but another leaf appears on that little tomato stalk and then another. Maybe-and this is talking like a child-maybe the tomato plant does feel comfortable and peaceful as it grows.
Quite some time later, Joe’s wife came tiptoeing into the room carrying a sheet of paper on which was written the question, “When are you going to start the hypnosis?” I was continuing the description of the tomato plant uninterruptedly, and Joe’s wife, as she looked at Joe, saw that he was not seeing her, did not know that she was there, that he was in a somnambulistic trance. She withdrew at once.
I wonder if the tomato plant can, Joe, feel, really feel, a kind of comfort. You know, Joe, a plant is a wonderful thing, and it is so nice, so pleasing just to be able to think about a plant as if it were a man. Would such a plant have nice feelings, a sense of comfort as the tiny little tomatoes begin to form, so tiny, yet so full of promise to give you the desire to eat a luscious tomato, sun-ripened, it’s so nice to have food in one’s stomach, that wonderful feeling a child, a thirsty child has and can want a drink. Joe, is that the way the tomato plant feels when the rain falls and washes everything so that all feels well?” (Pause.)
You know, Joe, a tomato plant just flourishes each day, just a day at a time. I like to think the tomato plant can know the fullness of comfort each day. You know, Joe, just one day at a time for the tomato plant. That’s the way for all tomato plants.”
While this pain state was an extreme one, the story highlights Erickson’s method of conversational and ‘gentle’ hypnosis- no swinging watches, no orders or demands, just gentle suggestions and invitations to feel at peace, to feel comfortable.
Professor Jensen suggested during Explain Pain3 that hypnosis could be used in this way for pain, but also combined with an Explain Pain education approach to make the new ideas more “sticky” – there are some key ideas of his in a previous post summarising Day 3 of ep3.
It would be great to hear from any therapists or practitioners out there using hypnosis to help people in pain – how you use it, your experiences, successes or otherwise. I’m also interested in what others think of the place of hypnosis in the treatment of pain – should it be left just for dentists, psychiatrists and psychologists?
Explain Pain 2nd Ed, the Graded Motor Imagery Handbook and all noigroup courses are all bursting at the seams with the latest and greatest neuroscience nuggets and educational excellence; click on the links to get your hands on a copy or to find a course near you.