by: Judy Koch CCH
 

To begin a discussion about the uses of Hypnotherapy in Pain Management, first we need to understand pain. What is it? How does it work? All of us can describe pain in varying degrees and by using some very powerful and sometimes colorful words. Pain can be hot or cold, pulsing or continuous. Pain can be deep or shallow, all consuming or not.

Pain has been used as a very effective tool during war to interrogate a prisoner. Some would go to any lengths to avoid pain. Even to the point of taking their own lives. Yet there are others who live with physical pain day in and day out for their entire lives. It can control every aspect of their life, and every decision they make-from choosing to get out of bed in the morning, to brushing their teeth.

What is the nature of pain? We understand that it is a signal the body sends to the brain. Recent medical research by Candice Pert of the National Institute of Mental Health has found a substance called neuropeptides. These along with their receptors are considered to be a network of signals for emotions, and behavior as well as our autonomic, endocrine and immune systems. Dr. Pert and others are now calling these informational substances, (Rossi & Cheek, 1988 pg. 207-208) a biochemical signal for pain.

One of the theories about pain is the gate control theory that was formulated by psychologist Ronald Melzak and a biologist Patrick Wall in 1965. They state that pain impulses pass through a pan of the spinal cord called the substantial gelatinosa; they call this a gate for impulses. The secretion of endorphins stimulates the closing of the pain gate.

These hormones are the body's own opiates. (Sdorow, Lester 1993 pg. 220-221). The ANS Inhibition Theory suggests that with the use of hypnosis the parasympathetic or relaxation side can control the sympathetic branch of our autonomic nervous system. In other words, the relaxation response can inhibit or ameliorate pain stimuli. With deep relaxation pain can be interpreted as pressure by the mind.

Medical hypnosis was approved by the American Medical Association in 1958 as a form of treatment in all areas of medicine and surgery (Pizza, Sam. I997, Medical Hypnosis). "In 1955, the British Medical Association approved the use of hypnosis for the treatment of psychoneurosis and for anesthesia during surgery for childbirth. In 1961 the American Medical Association gave further approval for the use of clinical hypnotherapy by recommending a minimum of 144 hours of training hypnotherapy for student physicians and medical doctors" (Longacre, R. D 1995 l~g. 8).

"Though the initial accounts of Hypnoanesthesia demonstrated its potential and promised a role in medicine, the lack of a scientific method or model for understanding hypnotic phenomena contributed to its limited application m medicine. Without a credible scientific model, hypnotic methods remained largely in the hands of entertainers and lay healers. Medical practitioners who did use these methods were limited to a few pioneers" (Barber, Joseph. 1996 pg. 217).

Hypnosis has a wide range of uses. These methods can be used for group and family therapy, behavior therapy, and cognitive therapies as well, Hypnosis be used to control anxiety, reduce or eliminate phobias. "Hypnosis is not a treatment for severe mental disorders such as schizophrenia and major depression, but it has been used for almost everything else from phobias to sexual problems and psychosomatic illnesses, to bed-wetting and nail biting in children. One of its best established therapeutic uses is in the control of pain both acute and chronic (Harvard Mental Health Letter. Vol. 7 No. 10).

"It is estimated that up to 10% of the population could undergo major procedures with Hypno-anesthesia. Patient selection appears to be very important. While probably only a small percentage of patients can negotiate major surgery using the hypnotic trance as the sole anesthetic, a far more important percentage can benefit from the "'softer" more subtle therapeutic influence of hypnosis, as it is applied in an integrated fashion through the continuum of the hospitalization sequence" (Sunnen, Gerard; Medical Hypnosis).

Hypnosis can be used in childbirth without any sensation of pain. Another practical use for hypnosis would be during medical procedures where tubes need to be inserted while the patient is conscious. Relaxing the muscles around the inserted tube could reduce any discomfort the patient may feel. Using guided imagery hypnosis to help relieve anxiety of medical procedures could be a valuable tool in hospitals today.

"Therapeutic hypnosis has been proven to be effective in the treatment of alleviation of problems associated with psychosomatic cardiovascular disorders and coronary disease. The efficacy of hypnotherapy has also been demonstrated in the treatment of gastrointestinal disorders, arthritis. metabolic diseases, obesity, hyperthyroidism, anorexia nervosa, alcoholism, respiratory disorders, bronchial asthma and a variety of allergies that may or may not have a psychogenic component.

Hypnosis can provide analgesia for general surgery, dental surgery and a variety of invasive diagnostic procedures. Hypnotherapy can also benefit oncology, orthopedic, rehabilitation, intensive care and pediatric patients (Longacre, R.D. 1995 pg. 3)

2004

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