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Hypnosis for pain

Hypnosis is a strategy that can be used for pain management.

Question

Should I try hypnosis for pain?

B.L.U.F

Hypnosis is a trance-like state produced from a heightened sense of focus and concentration. Like other mind-body strategies, hypnosis can sometimes provide temporary pain relief for many pain conditions. Learn more about what hypnosis is, the research on what pain conditions it can help, things to be aware of, and its relevance to the military in HPRC's InfoReveal on hypnosis.

InfoReveal

According to the American Psychological Association (APA), "hypnosis is a set of techniques designed to enhance concentration, minimize one's usual distractions, and heighten responsiveness." This focus, like meditation, can help some people change thoughts, feelings, behavior, and/or physiological state. Contrary to popular myths, hypnosis is not about suggestibility or becoming under someone else's control. Rather, it is the development of mental skills to highly focus one’s attention. Hypnosis is not a type of psychotherapy and is not stand-alone treatment. It is used to supplement other types of pain therapies and treatments.

Hypnosis usually is done by a hypnotic induction, which is a series of suggestions or instructions. Hypnotherapists usually do hypnotic inductions, but some people learn to do them by themselves, called self-hypnosis. People under hypnotic trances are not asleep. Similar to other mind-body techniques, hypnosis brings about a hyper-focus or state of extreme concentration. In a hypnotic state, people become less aware of pain, which may provide temporary pain relief. They also can become more relaxed, providing stress reduction, which may also contribute to pain relief.

What we know

Hypnosis is not a specific treatment. That is, it can work for many different types of pain and may be used with other pain treatments. The APA states that hypnosis is “likely to be effective for most people” in managing different kinds of pain. It also might help reduce stress and improve quality of life, which are important in people with chronic pain.

Multiple reviews1,2, show that hypnosis may be helpful in pain management for:

  • cancer pain, jaw pain, fibromyalgia, and mixed chronic pain syndromes3;
  • breast cancer pain4;
  • headache, cancer pain, and chronic pain5;
  • abdominal pain and irritable bowel syndrome, fibromyalgia, non-heart related chest pain, pain from multiple sclerosis, and painful health procedures like OB/GYN procedures, needle sticks, and burn and wound healing6; and
    • fibromyalgia (hypnosis also may improve sleep in this condition).7

Additional studies are looking at combining hypnosis with virtual reality as a new way of delivering hypnosis and for combat-related issues.8,9 For example, one case study details how hypnosis may be helpful for controlling pain related to combat related spinal cord injuries10, and another suggests that hypnosis may work better than biofeedback for spinal cord injury pain.11 The reviews cited above also suggest that hypnosis may not work well for low back pain.

Cautions

The APA describes how hypnosis is not a type of psychotherapy and “is not a treatment in and of itself; rather, it is a procedure that can be used to facilitate other types of therapies and treatments.” It is important for hypnosis to be conducted by a trained/certified hypnotherapist. However, everyone's experience with hypnosis is different, which means that individuals differ in how they respond and whether hypnosis works for them.

Minor side effects include dizziness, headache, and anxiety or distress. People with certain health concerns (for example, epilepsy, personality disorders, or mental illness that involves separation from reality) probably should not use hypnosis. Lastly, hypnosis is not a replacement for traditional treatments for pain management, though it can be used in addition to standard treatments.

Debrief (Military Relevance)

The military has used hypnosis for the treatment of various health conditions since the World Wars.12 Currently, DoD and VHA have approved the use of hypnosis for pain after surgeries (see “Clinical Practice Guideline” for more information). For more military-specific findings in pain management treatments, check out the Defense & Veterans Center for Integrative Pain Management's website.

Note: This InfoReveal is an educational overview that describes the use of hypnosis as a strategy for pain management; it is not a comprehensive review of the current state of the research.

This InfoReveal was created in collaboration with the Defense & Veterans Center for Integrative Pain Management.

References

  1. Adachi T, Fujino H, Nakae A, Mashimo T, et al. A meta-analysis of hypnosis for chronic pain problems: a comparison between hypnosis, standard care, and other psychological interventions. The International journal of clinical and experimental hypnosis. 2014;62(1):1-28.
  2. Patterson DR, Jensen MP. Hypnosis and clinical pain. Psychological bulletin. 2003;129(4):495-521.
  3. Elkins G, Jensen MP, Patterson DR. Hypnotherapy for the management of chronic pain. The International journal of clinical and experimental hypnosis. 2007;55(3):275-87.
  4. Montgomery GH, Bovbjerg DH, Schnur JB, David D, et al. A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. Journal of the National Cancer Institute. 2007;99(17):1304-12.
  5. Jensen M, Patterson DR. Hypnotic treatment of chronic pain. Journal of behavioral medicine. 2006;29(1):95-124.
  6. Stoelb BL, Molton IR, Jensen MP, Patterson DR. The Efficacy of Hypnotic Analgesia in Adults: A Review of the Literature. Contemporary hypnosis : the journal of the British Society of Experimental and Clinical Hypnosis. 2009;26(1):24-39.
  7. Picard P, Jusseaume C, Boutet M, Duale C, et al. Hypnosis for management of fibromyalgia. The International journal of clinical and experimental hypnosis. 2013;61(1):111-23.
  8. Askay SW, Patterson DR, Sharar SR. Virtual Reality Hypnosis. Contemporary hypnosis : the journal of the British Society of Experimental and Clinical Hypnosis. 2009;26(1):40-7.
  9. Patterson DR, Jensen MP, Wiechman SA, Sharar SR. Virtual reality hypnosis for pain associated with recovery from physical trauma. The International journal of clinical and experimental hypnosis. 2010;58(3):288-300.
  10. Stoelb BL, Jensen MP, Tackett MJ. Hypnotic analgesia for combat-related spinal cord injury pain: a case study. The American journal of clinical hypnosis. 2009;51(3):273-80.
  11. Jensen MP, Barber J, Romano JM, Hanley MA, et al. Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal-cord injury. The International journal of clinical and experimental hypnosis. 2009;57(3):239-68.
  12. Colosimo CP. Use of hypnosis in the military. Psychiatric medicine. 1992;10(1):149-67.