Hypnosis – does it really work?
At last, it’s official. Hypnotism really does work – and it has an impact on the brain which can be measured scientifically, according to one of America’s leading psychiatrists.
David Spiegel, from Stanford University, told the prestigious American Association for the Advancement of Science that he had scanned the brains of volunteers who were told they were looking at coloured objects when, in fact, they were black and white.
A scan showing areas of the brain used to register colour highlighted increased blood flow, indicating that the volunteers genuinely ‘saw’ colours, as they had been told they would.
‘This is scientific evidence that something happens in the brain when people are hypnotized that doesn’t happen ordinarily,’ Mr Spiegel told delegates.
He added that there were ‘tremendous medical implications’ and envisaged people being able to manage their own pain and anxiety.
Hypnosis beneficial for breast surgeries
A Randomized Clinical Trial of a Brief Hypnosis Intervention to Control Side Effects in Breast Surgery Patients. In a randomized study of 200 women undergoing surgery for breast cancer, those who received a brief hypnosis session before entering the operating room required less anesthesia and pain medication during surgery, and reported less pain, nausea, fatigue, and discomfort after surgery than women who did not receive hypnosis. The overall cost of surgery was also significantly less for women undergoing hypnosis.
Reference: Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH. Department of Oncological Sciences, Mount Sinai School of Medicine, NY. Journal of the National Cancer Institute, 2007 Sep; 99(17):1304-12.
Hypnosis: A Powerful Tool in Complementary Cancer Care
Complementary therapies, while not given the attention that more traditional cancer therapies may receive, are perhaps equally important while undergoing treatment for certain types of cancer. Patients diagnosed with difficult to treat malignancies will often use these types of therapies in conjunction with traditional surgical, chemotherapeutic, or radiology techniques to form a more comprehensive and effective treatment regimen. Among the most important and effective alternative therapies utilized by those diagnosed with cancer is hypnotherapy.
Hypnotherapy has been used for many years in clinical settings. Hypnotherapy’s role in cancer management however, is relatively new and indications are that its utilization has not been fully maximized yet. Effective cancer treatment often depends on the patient’s ability to not only defeat the cancer through treatments but also to maintain their health and mental spirit throughout the painful side effects of cancer treatments such as chemotherapy and radiation.
Often, the symptoms and effects of the cancer itself on the body are negligible compared to the pain and other side effects of chemotherapy and radiation. This is where acupuncture has been said to be most effective. Cancers such as mesothelioma, which are often unable to be removed by surgical means, are often treated with some combination of chemotherapy and radiation. While these potent therapies can be effective in eliminating some of the tumor mass and growth, they also profoundly affect the health of the surrounding tissue. Symptoms of these effects including fever, nausea, and general pain have been dramatically reduced through the utilization of hypnosis. Patients, who are able to withstand these symptoms and recover quickly, will often be able to be more aggressively treated, increasing the efficacy of the treatment regimen as a whole. Some specific hypnotherapy techniques utilized in pain management include altering the neurophysical configuration of pain, control of anticipatory anxiety, and targeted imagery.
Hypnotherapy techniques may not be appropriate for all patient’s pain and individual symptoms but it’s certainly worth exploring as it can do very little harm in experimenting with integrative therapies. The goal with alternative therapies, as with traditional mesothelioma treatments, is always to increase the effectiveness of treatment as a whole. If hypnotherapy can assist in any way in helping patients recover or manage symptoms of chemotherapy or radiation, then it will have contributed to the treatment regimens overall efficacy and should certainly be utilized.
References: Erickson MH: Hypnosis in painful terminal illness, in Haley J (ed): Advanced Techniques of Hypnosis and Therapy: Selected Papers of Milton Erickson, MD. New York, Crune & Stratton, 1967.
Sunnen, Gerard M.D., Hypnotic Approaches in the Cancer Patient Ozonics International, LLC
Hypnosis and Cancer
Spiegel and Bloom (1983) reported that a study of women with metastatic breast cancer showed that patients who received group therapy with training in hypnosis over a one-year period were able to reduce their pain experience by 50% when compared to a control group.
Reference: Spiegel, D. & Bloom, J. R. (1983). Group Therapy and Hypnosis Reduce Metastatic Breast Carcinoma Pain. Psychosomatic Medicine, 45, 333-339.
In addition, at a 10-year follow-up of these same women, the hypnosis treatment group had a mean survival rate of 36.6 months compared to 18.9 months for the controls. This suggests that the intervention may be both important quantitative and important qualitative effects (Spiegel 1989).
Reference: Spiegel, D., Bloom, J. R., Kraemer, H. C. & Gottheil, E. (1989). Effect of Psychosocial Treatment on Survival of Patients with Metatastic Breast Cancer. Lancet pp. 888-891.
Both adolescent and adult cancer patients undergoing chemotherapy were reported by Cotanch (1985) and by Zeltzer (1984), in separate research, to have fewer symptoms of anticipatory nausea and vomiting following hypnotic interventions.
Reference: Cotanch, P., Hockenberry, M. & Herman, S. (1985). Self-Hypnosis Antiemetic Therapy in Children Receiving Chemotherapy. Oncology Nursing Forum, 12, 41-46.
Reference: Zeltzer, L., LeBaron, S. & Zeltzer, P. M. (1984). The Effectiveness of Behavioral Intervention for Reduction of Nausea and Vomiting in Children and Adolescents Receiving Chemotherapy. Journal of Clinical Oncology, 2, 683-690.
Preoperative Guided Imagery Improves Cardiac Surgery Outcomes
Effect of guided imagery on length of stay, pain and anxiety in cardiac surgery patients. “Cardiac surgery patients who listened to a pre-op guided imagery surgical tape had significantly less pain, anxiety, and two days shorter hospital stay.”
Reference: Tutsek, D. L., Cwynar, R., and Cosgrove, D.M., Cleveland Clinic, Ohio, Journal of Cardiovascular Management 10; 2: 22-8 1999
General Cardiovascular Conditions
In research by Bernardi (1982), hypertensive patients showed themselves to be significantly more effective at controlling cardiovascular responses to stressors in hypnosis than they were in the normal waking state. This was particularly true for subjects with more marked hypnotic ability.
Reference: Bernardi, L., Galezaai, L. & Bardelli, R. (1982). Hypnotic Responsivity of Cold Pressor Test in Normal and Hypertensive Subjects. Paper presented at the International Society of Hypnosis, 9th International Congress of Hypnosis and Psychosomatic Medicine, Glasgow, Scotland.
In a study by Sletvold (1986), normotensive subjects were shown able to either increase or decrease their blood pressure significantly with hypnosis.
Reference: Sletvold, H., Jensen, G. M. & Gotestam, K. G. (1986). Blood Pressure Responses to Hypnotic and Non-Hypnotic Suggestions in Normotensive Subjects. Pavlovian Journal of Biological Science, 21, 32-35.
In a 1979 research study by Jackson, subjects with hypnotic ability were shown to improve their aerobic performance significantly in response to post-hypnotic suggestion. In addition, subjects with high hypnotic susceptibility significantly improved their performance in physical exercise using post-hypnotic suggestion.
Reference: Jackson, J. A., Gass, G. C. & Camp, E. M. (1979). The Relationship Between Post-Hypnotic Suggestion and Endurance in Physically Trained Subjects. International Journal of Clinical and Experimental Hypnosis, 27, 278-293.
In 1963, Schwartz reported on a study in which hypnotherapy was used successfully to prolong pregnancy and prevent premature delivery.
Reference: Schwartz, M. (1963). The Cessation of Labor Using Hypnotic Techniques. American Journal of Clinical Hypnosis, 5, 211-213.
Omer (1986a, 1986b, 1987a) found that frequency of physical complaints and the general level of anxiety were correlated with premature labor and premature contractions. A brief technique emphasizing the use of self-hypnosis was employed as an adjunct to pharmacological treatment. The prolongation of pregnancy was significantly higher for this group than for the medication-alone control group, and infant weight was also significantly greater.
Reference: Omer H., Elizur Y., Barnea T., Friedlander D. & Palti Z. (1986a). Psychological Variables and Premature Labor: A Possible Solution for Some Methodological Problems. Journal of Psychosomatic Research, 30, 559-565.
Reference: Omer H., Friedlander D. & Palti Z. (1986b). Hypnotic Relaxation in the Treatment of Premature Labor. Psychosomatic Medicine, 48, 351-361.
Reference: Omer H. (1987). A Hypnotic Relaxation Technique for the Treatment of Premature Labor. American Journal of Clinical Hypnosis, 29, 206-213.
Hypnosis slows impacts of dementia and improves quality of life. Forensic psychologist, Dr. Simon Duff, (Univ. of Liverpool) compared the effects of hypnosis therapy with those of mainstream therapies for people suffering from dementia, and group therapy in which participants were encouraged to discuss news and current affairs. Working in partnership with Dr. Dan Nightingale over a 9-month period, Duff established that people living with dementia who had been given hypnosis therapy exhibited improved concentration, memory and socialization compared to the other two treatment groups. Relaxation, motivation and daily living activities also improved with the use of hypnosis.
Reference: University of Liverpool Research Intelligence (http://www.liv.ac.uk/researchintelligence/issue36/hypnosis.htm)
Hypnosis improves or cures dermatologic disorders
Hypnosis in Dermatology. A comprehensive review of dermatology studies spanning 32 years that involved hypnosis concluded: “A wide spectrum of dermatologic disorders may be improved or cured using hypnosis as an alternative or complimentary therapy, including acne exoriee, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo.
Reference: Schenefelt PD, Department of Internal Medicine, College of Medicine, University of South Florida, Tampa, Arch Dermatol. 2000 Mar; 136(3):393-9.
Hypnosis Shows 77% Success Rate for Drug Addiction
Utilizing Hypnosis in the Treatment of Substance Abuse Disorders. In a measure of 18 clients over the 7 years, hypnosis showed a 77% success rate for at least a 1-year follow-up. (15 for alcoholism or alcohol abuse, 2 cocaine addiction, and 1 for marijuana addiction).
Reference: Potter, Greg, American Journal of Clinical Hypnosis, Jul. 2004.
Hypnotherapy is More Effective than Psychotherapy for Addicts
In a comparative study of hypnotherapy and psychotherapy in the treatment of methadone addicts, significantly more methadone addicts quit with hypnosis. At six-month follow-up, 94% of the subjects who received hypnosis remained narcotic-free.
Reference: Manganiello A.J. American Journal of Clinical Hypnosis 1984; 26(4): 273-9.
Controlled Trial of Hypnotherapy in the Treatment of Refractory Fibromyalgia. In a controlled study, 40 patients with refractory fibromyalgia were randomly allocated to treatment with either hypnotherapy or physical therapy for 12 weeks with follow up at 24 weeks. Compared with the patients in the physical therapy group, the patients in the hypnotherapy group showed a significantly better outcome.
Reference: Haanen H.C.M.; Hoenderdos H.T.W; Van Romunde L.K.J.; Hop W.C.J.; Mallee C.; Terwiel J.P.; Hekster G.B. Sint Antonius Ziekenhuis, dept. rheumatology, Nieuwegein 3430 EM, Netherlands. Journal of Rheumatology 1991, vol. 18, no. 1, pp. 72-75.
Research performed at Washington State University in Pullman found that hypnosis strengthens two different types of immune cells that fight off disease. Sixty-five students participated in the study. Thirty-three participants were highly hypnotizable and responded well to hypnotherapy induction. Thirty-two participants had difficulty achieving a hypnotic state.
All 65 participants were randomly assigned into 3 separate groups. One group received hypnosis, one group received relaxation therapy, and one group served as the control group and received no form of therapy or treatment. Results showed that the participants who received hypnosis displayed a jump in 2 important types of white blood cells. Those who were highly hypnotizable and received hypnosis showed the greatest increase. This shows that hypnosis can help people boost their white blood cell count and thus boost their immune system and better enable themselves to fight off disease (Ruzyla-Smith).
Researchers from Ohio State University have determined that hypnotherapy can prevent the immune system from weakening due to stress. Hypnosis helps strengthen the immune system through relaxation. For people who worry a lot, are anxious, or are easily distracted, hypnosis helps them calm down so that their immune system does not weaken due to the stress. When hypnosis is induced in a person, relaxation techniques are used. Stress is a main contributor to a weakened immune system. Hypnosis acts to increase positive thinking through suggestion while using relaxation techniques to decrease stress (Holland).
It is important to keep your immune system strong so that you are able to fight off disease and viruses. Using hypnosis and eating healthy foods can help you keep your immune system strong through this pandemic. Reducing stress and increasing your white blood cells can greatly increase your odds of not getting the flu this season.
Reference: Holland, E. (2001). Hypnosis may prevent weakened immune status, improve health. Retrieved on October 30, 2009 from http://researchnews.osu.edu/archive/hypnosis.htm
Ruzyla-Smith, Patricia et al. (1993). As reported at the annual meeting of the American Psychological Association.
Hypnotherapy for incontinence caused by the unstable detrusor. Fifty incontinent women with proved detrusor instability completed 12 sessions of hypnosis (symptom removal by direct suggestion and “ego strengthening”) over one month. At the end of the 12 sessions, 29 patients were entirely symptom free, 14 improved, and 7 unchanged. Three months later cystometry in 44 of the patients showed conversion of the cystometrogram to stability in 22 and a significant improvement in a further 16; only 6 showed no objective improvement…” “It is concluded that psychological factors are very important in “idiopathic” detrusor instability and that hypnotherapy is effective for incontinence due to this disorder.”
Reference: R M Freeman and K Baxby; Br Med J (Clin Res Ed). 1982 June 19; 284 (6332): 1831-1834.
Irritable Bowel Syndrome
The Treatment of Irritable Bowel Syndrome (IBS) with Hypnotherapy. Previous research from the United Kingdom has shown hypnotherapy to be effective in the treatment of irritable bowel syndrome (IBS). The current study provides a systematic replication of this work in the United States.
Reference: Galovski TE, Blanchard EB, University of Albany, State University of New York, New York, Appl Psychophysiol Biofeedback. 1998 Dec; 23(4):219-32.
Male Sexual Dysfunction
Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction. A study comprised 79 men in whom clinical and laboratory examinations revealed no organic cause for their impotence were treated with testosterone (20 men), trazodone (21 men), hypnosis (20 men), or a placebo (18 men), all of comparable age groupings. Their reported results by interview at 4, 6, and 8 weeks after treatment were verified by interviewing their partners. Conclusion: “The only treatment superior to placebo seemed to be hypnosis.”
Reference: Aydin S, Odabas O, Ercan M, Kara H, Agargun MY. Department of Urology, Medical School of Yuzuncu Yil University, Van, Turkey. Br J Urol. 1996 Feb; 77 (2): 256-60.
The Use of Hypnosis in the Treatment of Burn Patients. “Hypnosis has a part to play in nearly every aspect of burn care, from the initial visit through tubbing and grafting, and finally to rehabilitation. Early hypnosis attenuates the inflammatory response to the injury, limiting the usual progression of the burn from first degree to second degree, or from second to third. Procedural pain can be controlled. Guilt or anger about the accident need to be alleviated, caloric intake can be increased, and active participation in physical therapy can be enhanced.”
Reference: Dabney M. Edwin, Tulane University, LA, USA, International Handbook of Clinical Hypnosis, Online ISBN: 9780470846407; DOI = 10. 1002/0470846402.ch19
Whorwell (1984) reported successful treatment of irritable bowel syndrome using hypnosis in a controlled study of a group of patients who had a severe chronic form of the disorder and had not responded to conventional therapies. Patients were randomly allocated to either psychotherapy or hypnotherapy groups. The psychotherapy patients showed a significant improvement in measures of pain, distension and in general well-being despite a lack of change in bowel habit. In contrast, the hypnotherapy patients showed a dramatic improvement in all measures which persisted at a two-year follow-up. (Whorwell, 1987). Hypnotherapy, including suggestions for improved gastrointestinal function and pain reduction, was significantly better than hypnosis for simple deep muscle relaxation.
Reference: Whorwell, P. J., Prior, A. & Faragher, E. B. (1984). Controlled Trial of Hypnotherapy in the Treatment of Severe Refractory Irritable Bowel Syndrome. Lancet, pp. 1232-1234.
Reference: Whorwell, P. J., Prior, A. & Colgan, S. M. (1987). Hypnotherapy in Severe Irritable Bowel Syndrome: Further Experience. Gut, 28, 423-425.
Harvey (1989) reported a similar improvement following hypnotherapy in 20 of the 33 patients with refractory irritable bowel syndrome at three-month follow-up.
Reference: Harvey, R. F., Hinton, R. A., Gunary, R. M. & Barry, R. E. (1989). Individual and Group Hypnotherapy in Treatment of Refractory Irritable Bowel Syndrome. Lancet, pp. 424-425.
A review study of over a hundred clinical studies of hypnosis for medical procedures documents that hypnosis is beneficial for allergy, anesthesia for pain, anesthesia for surgery, warts, dermatitis, irritable bowel syndrome, peptic ulcers, abdominal surgery, healing from injury or surgery, hemophilia, hypertension, headaches, childbirth, asthma, smoking cessation, fibromyalgia, impotence, and urinary incontinence.
“Many important trials reviewed here have helped to establish the role of hypnosis in contemporary medicine. These trials have established the utility and efficacy of hypnosis for several medical conditions, either alone or as part of the treatment regimen,” writes Stewart, JH, Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Jacksonville, FL, Mayo Clinic Proceedings 2005; 80: 511-524.
Hypnosis with Conscious Sedation Instead of General Anesthesia? Applications in Cervical Endocrine Surgery. 197 thyroidectomies and 21 cervical explorations for hyperparathyroidism were performed under hypno-sedation and compared to a closely matched population of patients operated on under general anesthesia. All patients having hypno-sedation reported a very pleasant experience, had significantly less postoperative pain, significantly reduced analgesic use, significantly shorter hospital stay, providing a substantial reduction of the medical care costs. Their postoperative convalescence was shortened.
Reference: Meurisse M, Defechereux T, Hamoir E, Maweja S, Marchettini P, Golloglly L, Degauque C, Joris J, Faymonville ME. Dept. Surgery, University of Liege, Belgium, Acta Chir Belg. 1999 Aug; 99 (4): 151-8.
Medical Hypnosis Underutilized
Medical Hypnosis: An Underutilized Treatment Approach. Five case histories demonstrate the dramatic and sometimes unexpected beneficial outcomes of medical hypnosis. “Hypnosis is suitable for patients with the following medical conditions: chronic headache, chronic back pain, psychogenic weakness or paralysis, chronic constipation, irritable bowel syndrome, panic attacks and phobias,” writes Alman, B., Permanente Journal, Fall 2001/Vol. 5, No. 4.
Mind/body suggestions control blood flow during surgery
Preoperative Instruction for Decreased Bleeding During Spine Surgery
In a trial with 93 spinal surgery patients at the University of California (Davis) Medical Center, those who received specific instructions about blood flow lost about half as much blood compared to the controls and a third group taught relaxation techniques.
Reference: Bennett, HL et al., Center for the Advancement of Perioperative Health, Yale University School of Medicine, New Haven, CT Anesthesiology. 1986; 65:A245.
Swirsky-Saccetti (1986) reported on research with hemophiliacs. Over an eighteen-week follow-up, a group of hemophiliac patients who were taught self-hypnosis significantly reduced both their level of self-reported distress and the amount of the factor concentrate they required to control bleeding when compared with a control group of patients who did not undergo hypnosis.
Reference: Swirsky-Saccetti, T. & Margolis, C. G. (1986). The Effects of a Comprehensive Self-Hypnosis Training Program on the Use of Factor VIII in Severe Hemophilia. International Journal of Clinical and Experimental Hypnosis, 34, 71-83.
A 30-month follow-up by LaBaw (1975) with hemophiliac patients demonstrated the effectiveness of group procedures for self-hypnosis in reducing distress and the amount of blood products required when compared to control groups in patients ranging from five to forty-eight years of age.
Reference: LaBaw, W. L., (1975). Auto-Hypnosis in Hemophilia. Printed in the Journal Haematologia, 9, 103-110.
Preoperative suggestions improve abdominal surgery outcomes
Effect of Preoperative Suggestion on Postoperative Gastrointestinal Motility. Single-blind trial of abdominal surgery patients, to whom a 5 minute script was read preoperatively suggesting increased gastrointestinal motility after surgery. Suggestion group had significantly shorter ileus time (disruption of bowel movement) and was discharged two days earlier, with an estimated savings of $1200.
Reference: Disbrow, E.A., Bennett, H.L., and Owings, J.T. Department of Anesthesiology, University of California, Davis School of Medicine, Sacramento, 1993 West J Med 158; 5:488-92.
Using hypnosis to accelerate the healing of bone fractures: a randomized controlled pilot study. In a study at Mass. General’s Dept. of Bone and Joint Disease in Boston, 12 adults with bone fractures were followed for 12 weeks, to measure how hypnosis accelerated their healing. Radiographic results showed dramatically improved healing at 6 weeks in the hypnosis patients. Orthopedic assessments of mobility, strength and need for analgesics showed greater improvement in the hypnosis patients at weeks 1, 3 and 9. The hypnotic intervention included audio taped suggestions to reduce swelling, stimulate tissue growth, and fusion at the injury site, and counteract pain and stress; and imagery rehearsals of greater mobility, enhanced bone strength and recovery of normal activities.
Reference: Ginandes CS, Rosenthal DI. Using hypnosis to accelerate the healing of bone fractures: a randomized controlled pilot study. Alter Ther Health Med. 1999 Mar; 5(2):67-75.
Using hypnosis to accelerate the healing of bone fractures
Data suggest that hypnosis may be capable of enhancing both anatomical and functional fracture healing.
Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical Trial. In a randomized, controlled trial, 18 healthy women were randomized to one of the three treatments after breast reduction surgery: usual care, additional supportive attention, or additional hypnosis sessions targeting accelerated wound healing. The hypnosis group’s objectively observed wound healing (digital imagery and staff blind to groups) was significantly greater than the other two groups, indicating that use of a targeted hypnotic intervention can accelerate postoperative wound healing.
Reference: Ginandes C, Brooks P, Sando W, Jones C, Aker J. Am J Clin Hypn. 2003 Apr; 45(4):333-51.
Other Medical Conditions
In a careful single-case controlled study of a patient with Raynaud’s disease, Conn (1984) showed a rapid and dramatic vasodilation in response to hypnotic suggestion.
Reference: Conn L & Mott T. (1984). Plethysmographic Demonstration of Rapid Vasodilation by Direct Suggestion: A Case of Raynaud’s Disease Treated by Hypnosis. American Journal of Clinical Hypnosis, 26, 166-170.
In research reported by Spanos (1988), a pair of randomized, carefully designed studies were conducted with a group of people who had warts. Subjects who were given hypnotic or non-hypnotic suggestions were significantly more likely to achieve wart regression than placebo or no-treatment groups.
Reference: Spanos, N.P., Stenstrom, R.J. & Johnston, J.C. (1988). Hypnosis, Placebo and Suggestion in the Treatment of Warts. Psychosomatic Medicine, 50, 245-260.
In a report by David Spiegel in the Harvard Mental Health Letter, the following research was cited: a) Several controlled experiments have shown that hypnosis can be effectively used to eliminate warts; and b) Studies have been done on persons suffering from pseudoseizures, in which they lose consciousness or motor control and make jerking movements typical of epilepsy (but without the associated brain damage). Such patients have been taught to limit or eliminate these symptoms by using hypnosis.
Reference: Spiegel, David, author. Report in the Harvard Mental Health Letter, September 1998, vol. 15, p. 5-6.
Hypnosis re-routes pain stimulation away from brain “pain center”
fMRI used to investigate brain activity under hypnosis for pain suppression. When hot plates were applied to volunteers substantial pain was induced and the live brain scan showed the signal routed to the pain center. Under hypnosis little or no pain was experienced and the brain scans revealed that the signal was routed to other parts of the brain and not the pain center. “It helps to dispel prejudice about hypnosis as a technique to manage pain because we can show an objective, measurable change in brain activity linked to a reduced perception of pain.”
Reference: Sebastian Schulz-Stubner, MD, PhD. University of Iowa Roy J and Lucille A Carver College of Medicine. Also on team: Timo Krings MD, Ingo Meister MD, Stefen Rex MD, Armin Thron MD, PhD, and Rolf Rossaint MD, PhD, from the Technical University of Aachen, Germany. November-December 2004 issue of Regional Anesthesia and Pain Medicine
Ernest Hilgard (1977) and coworkers: in extensive investigations, using experimental paradigms to induce pain (typically either a tourniquet cutting off the circulation to a limb or plunging the limb into cold water), they have demonstrated that various types of pain can be reduced by hypnotically induced analgesia. In these studies, 66% of the high susceptibility group, but only 13% of the lower and 17% of the medium susceptibility groups, were able to reduce their pain by 1/3 or more. Twenty-six percent of the high, 57% of the medium, and 31% of the low susceptibility groups were able to reduce their pain by 10-32% when compared to controls. Experimentally induced pain, while undeniably noxious, is different from the experience of patients in the clinical setting. Whereas experimental pain is brief, undergone voluntarily, and can be terminated at any time by the subject, in the clinical setting, pain is often long-term, comes against the wishes of the individual and is usually experienced as being outside of personal control. Moreover, it is a part of a disease process that directly alters both physical and mental functioning.
Reference: Hilgard, E. R. (1977). Divided Consciousness: Multiple Controls in Human Thought and Action. NY: John Wiley. 1977.
In a neurochemical study of hypnotic control of pain conducted by Domangue (1985), patients suffering from arthritic pain showed a correlation among levels of pain, anxiety and depression. Anxiety and depression were inversely related to plasma norepinephrine levels. Depression was correlated with dopamine levels and negatively correlated with levels of serotonin and beta endorphin. Following hypnotherapy, there were clinically and statistically significant decreases in depression, anxiety and pain, and increases in beta endorphin-like substances.
Reference: Domangue, B. B., Margolis, C. G., Lieberman, D. & Kaji, H. (1985). Biochemical Correlates of Hypnoanalgesia in Arthritic Pain Patient. Journal of Clinical Psychiatry, 46, 235-238.
The relationship between pain and endorphins is a complicated one. In his study, Guerra (1982) found that only particular forms of the beta endorphins found in peripheral blood during painful experience are associated with the hypnotic response.
Reference: Guerra, G. & Guantieri, G. (1982). Hypnosis and Plasmatic B-Endorphins, Paper presented at the International Society of Hypnosis, 9th International Congress of Hypnosis and Psychosomatic Medicine, Glasgow, Scotland.
Hilgard (1982) studied children with cancer. He found hypnosis to be effective in reducing the pain and discomfort associated with repeated unpleasant medical inventions.
Reference: Hilgard, E. R. (1982). Hypnotic Susceptibility and Implications for Measurement. International Journal of Clinical and Experimental Hypnosis, 30, 394-403.
Stam (1986) reports that patients with chronic facial pain show a greater responsiveness to suggestions as measured by the Carleton University Responsiveness to Suggestion Scale (CURSS) than do normal controls. These patients had higher hypnotic susceptibility scores than did controls, showing a high susceptibility score to be a good predictor of response to hypnotic treatment among such patients.
Reference: Stam, H. J., McGrath, P. A., Brooke, R. I. & Cosier, F. (1986). Hypnotizability and the Treatment of Chronic Facial Pain. International Journal of Clinical and Experimental Hypnosis, 34, 182-191.
Domangue (1985) conducted a study of 19 patients with a variety of musculoskeletal disorders. He reported significant reductions of pain and dysphoria following hypnosis. The reductions were associated with significant increases in plasma beta endorphin.
Reference: Domangue, B. B., Margolis, C. G., Lieberman, D. & Kaji, H. (1985). Biochemical Correlates of Hypnoanalgesia in Arthritic Pain Patient. Journal of Clinical Psychiatry, 46, 235-238.
Barabasz and Barabasz (1989) studied a sample of 20 patients with a variety of chronic pain syndromes. They utilized an hypnotic technique known as Restricted Environmental Stimulation Therapy (REST). All of the patients were initially rated as having low hypnotic susceptibility on the Stanford Hypnotic Susceptibility Scale (SHSS). Following exposure to the training technique, the subjects demonstrated significant increases in both SHSS scores and in pain reduction when compared to controls.
Reference: Barabasz, A. J. & Barabasz, M. (1989). Effects of Restricted Environmental Stimulation: Enhancement of Hypnotizability for Experimental and Chronic Pain Control. International Journal of Clinical and Experimental Hypnosis, 37, 217-231.
Hypnosis and Headache Pain
Evidence accumulated to date suggests that a number of hypnotherapeutic approaches are highly effective in the treatment of patients with chronic migraine headaches. Although no one hypnotherapeutic technique has been demonstrated to be most effective, all the methods appear to be superior to a standard treatment relying on pharmacological approaches alone.
In a study conducted by Anderson (1975), migraine patients treated with hypnosis had a significant reduction in the number of attacks and in their severity compared to a control group who were treated with traditional medications. The difference did not become statistically significant until the second six-month follow-up period. In addition, at the end of one year, the number of patients in the hypnosis group who had experienced no headaches for over three months was significantly higher.
Reference: Anderson, J. A., Basker, M. A. & Dalton, R. (1975). Migraine and Hypnotherapy. International Journal of Clinical and Experimental Hypnosis, 23, 48-58.
In a controlled trial conducted by Olness (1987), self-hypnosis was shown to be significantly more effective than either propranolol or placebo in reducing the frequency of migraine headaches in children between the ages of six and twelve years of age.
Reference: Olness, K., MacDonald, J. T. & Uden, D. L. (1987). Comparison of Self-Hypnosis and Propranolol in the Treatment of Juvenile Classic Migraine. Pediatrics, 79, 593-597.
In a research conducted by Schlutter (1980), hypnosis was also found effective in dealing with the relief of tension headache.
Reference: Schlutter, L. C., Golden, C. J. & Blume, H. G. (1980). A Comparison of Treatments for Prefrontal Muscle Contraction Headache. British Journal of Medical Psychology, 53, 47-52.
Alladin (1988) reviewed the literature on hypnosis, identifying fully a dozen different hypnotic techniques that have been used in the treatment of chronic migraine headaches. Of these, hypnotic training emphasizing relaxation, hand warming (which, according to Anderson, 1975 seems the simplest method of establishing increased voluntary control of the sensitive vasomotor system) and direct hypnotic suggestions of symptom removal have all been shown to be effective in reducing the duration, intensity and frequency of migraine attacks during a ten-week treatment course and at thirteen-month follow-up when compared to controls.
Reference: Alladin, A. (1988). Hypnosis in the Treatment of Severe Chronic Migraine. In M. Heap (ed.), Hypnosis: Current Clinical, Experimental and Forensic Practices. London: Croom Helm. pp. 159-166.
A study (Gutfeld, G. and Rao, L., 1992) was conducted on 42 patients suffering from chronic headaches. These patients, all of whom had responded poorly to conventional treatments, were split into two groups. One received hypnotherapy to relieve their daily headaches; the rest acted as a comparison group. The hypnotherapy group experienced reduced frequency and duration of headaches, cutting the intensity by about 30%. “These results are impressive in such a difficult, hard-to-treat group of patients,” commented Egilius Spierings, M.D., Ph.D. director of the headache section, division of neurology at Brigham and Women’s Hospital.
Reference: Gutfeld, G. and Rao, L. (1992). Use of Hypnosis with Patients Suffering from Chronic Headaches, Seriously Resistant to Other Treatment, as reported in Prevention, 44, 24-25.
In studies by Maher-Loughnan (1962, 1970), hypnosis was shown to alleviate the subjective distress of patients with asthma. This change was measured either by the number of attacks or the amount of medication that was needed when compared to supportive therapy.
Reference: Maher-Loughnan, G. P., MacDonald, N., Mason, A. A. & Fry, L. (1962). Controlled Trial of Hypnosis in the Symptomatic Treatment of Asthma. British Medical Journal, 2, 371-376.
In further study by Maher-Loughnan (1970) asthmatic subjects were randomly assigned to either hypnosis or relaxation therapy. The results showed both treatment modalities of benefit to the patients, but the improvement in the hypnotherapy group was significantly greater. There was a peak of improvement between the seventh and twelfth weeks of treatment. In addition, only the hypnotic subjects showed improvement in physiologic measures of respiration (forced expiratory volume).
Reference: Maher-Loughnan, G. P. (1970). Hypnosis and Auto-Hypnosis for the Treatment of Asthma. International Journal of Clinical and Experimental Hypnosis, 18, 1-14.
Ewer and Stewart (1986) reported a randomized control trial of hypnosis in patients with moderate asthma. Patients with a high hypnotic susceptibility showed a 74.9% improvement in bronchial hyper-responsiveness (to methacholine challenge), a 5.5% increase in peak expiratory flow rate, a 26.2% decrease in the use of bronchodilator and a 41% improvement in daily ratings outside of the clinic. Twelve patients with a high hypnotic susceptibility score showed a 75% improvement. However, a control group of 17 patients and a second group of 10 patients with a low level of hypnotic susceptibility showed no change in either objective or subjective measures.
Reference: Ewer, T. C. & Stewart, D. E. (1986). Improvement in Bronchial Hyper-Responsiveness in Patients with Moderate Asthma after Treatment with a Hypnotic Technique: A Randomized Controlled Trial. British Medical Journal, 293, 1129-1132.
A study by Olness (1985) showed that children trained in self-hypnosis could significantly alter their tissue levels of oxygen as measured by transcutaneous PO2 measures.
Reference: Olness, K. & Conroy, M. (1985). A Pilot Study of Voluntary Control of Transcutaneous PO2 by Children. International Journal of Clinical and Experimental Hypnosis, 33, 1-5.
Hypnosis is the most effective way of giving up smoking, according to the largest ever scientific comparison of ways of breaking the habit. A meta-analysis, statistically combining results of more than 600 studies of 72,000 people from America and Europe to compare various methods on quitting. On average, hypnosis was over three times as effective as nicotine replacement methods and 15 times as effective as trying to quit alone.
Reference: University of Iowa, Journal of Applied Psychology, How One in Five Give Up Smoking. October 1992.
Stress and Anxiety
In a report by David Spiegel in the Harvard Mental Health Letter, the research was cited that hypnosis methods have been used successfully for anxiety associated with medical procedures. Two hundred forty-one patients who were undergoing percutaneous vascular and renal procedures were randomly tested on three testing regimens, one of which was hypnosis. Patients rated their pain and anxiety on 1-10 scales before, every 15 minutes during, and after the procedures. Pain remained flat over the duration of procedure time in the hypnosis group; pain increased linearly with procedure time in both other groups. Anxiety decreased over time in all three groups; the sharpest decrease was in the group that was hypnotized. Procedure times were significantly shorter in the hypnosis group. In addition, hypnosis showed itself to be superior in improving hemodynamic stability.
Reference: Spiegel, David, author. Report in the Harvard Mental Health Letter, September 1998, vol. 15, p. 5-6.
Hypertension and Stress
Kuttner (1988) found that a hypnotic approach emphasizing storytelling and imagery was significantly more effective than behavioral techniques or standard medical practice in alleviating distress during bone marrow aspirations in young children with leukemia.
Reference: Kuttner, L. (1988). Favorite Stories: A Hypnotic Pain-Reduction Technique for Children in Acute Pain. American Journal of Clinical Hypnosis, 30, 289-295.
Hypertensive subjects were found to have characteristic patterns of increased cerebral blood flow that were most marked in the left hemisphere. During hypnosis, they could reduce cerebral blood flow more dramatically than could normotensive controls. The changes noted in this research by Galeazzi (1982) were associated with decreases in vascular resistance and diastolic blood pressure in the rest of the body.
Reference: Galeazzi, L. & Bernardi, L. (1982). Cerebral Rheographic Variations by Hypnosis. Paper presented at the International Society of Hypnosis, 9th International Congress of Hypnosis and Psychosomatic Medicine, Glasgow, Scotland.
Friedman and Taub (1977, 1978) reported the results of a trial comparing hypnosis with biofeedback or a combination of both in essential hypertension. At the end of four weeks of treatment, all groups showed a significant reduction in blood pressure. But at six-month follow-up only the patients receiving hypnosis had maintained the reduction.
Reference: Friedman, H. & Taub, H. (1977). The Use of Hypnosis and Biofeedback Procedures for Essential Hypertension. International Journal of Clinical and Experimental Hypnosis, 25, 335-347.
Reference: Friedman, H. & Taub, H. (1978). A Six-Month Follow-Up of the Use of Hypnosis and Biofeedback Procedures in Essential Hypertension. American Journal of Clinical Hypnosis, 20, 184-188.
Generally speaking, literature review supports the value of hypnosis in analgesia and stress reduction in a number of disorders, whether following the dissociative formulation (Miller, 1986) or a social psychology approach (Nolan, 1987).
Reference: Miller, M. E. & Bowers, K. S. (1986). Hypnotic Analgesia and Stress Inoculation in the Reduction of Pain. Journal of Abnormal Psychology, 95, 6-14.
Reference: Nolan, R. P. & Spanos, N. P. (1987). Hypnotic Analgesia and Stress Inoculation: A Critical Reexamination of Miller and Bowers. Psychological Reports, 61, 95-102.
In a report by David Spiegel in the Harvard Mental Health Letter, the following research was cited: One seven-year study showed that 50% of patients afraid of flying were improved or cured after hypnosis treatment for a fear of flying.
Reference: Spiegel, David, author. Report in the Harvard Mental Health Letter, September 1998, vol. 15, p. 5-6.
Patients undergoing head and neck surgery who were trained with preoperative hypnosis had significantly shorter postoperative hospitalizations than did matched controls (Rapkin, 1988).
Reference: Rapkin, DA, Straubing, M, Singh, A & Holroyd, JC (1988). Guided Imagery and Hypnosis: Effect on Acute Recovery from Head and Neck Cancer Surgery. Paper presented at the Annual Meeting of the Society for Clinical and Experimental Hypnosis, Asheville, NC.
Swedish researchers studied 50 women prior to surgery. Twenty-five of the women were assigned to the experimental group who were briefly hypnotized each day for several days before their scheduled operations. Twenty-five were assigned to control groups who were not hypnotized. While in a hypnotic state, the women in the experimental group heard suggestions to relax and feel hungry. After surgery only 10 had nausea (15 experienced no nausea), compared to 17 on the no-hypnosis control group (8 experienced no nausea).
Hypnosis Subjects Lost More Weight Than 90% of others and Kept it Off
Hypnosis as an adjunct to cognitive-behavioral psychotherapy for obesity: a meta-analytical reappraisal. Researchers analyzed 18 studies comparing a cognitive behavioral therapy such as relaxation training, guided imagery, self-monitoring, or goal setting with the same therapy supplemented by hypnosis. Those who received the hypnosis lost more weight than 90 percent of those not receiving hypnosis and maintained the weight loss two years after treatment ended.
Reference: University of Connecticut, Storrs Allison DB, Faith MS. J Consult Clin Psychol. 1996;64(3):513-516.