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 lpg. 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 in 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 can 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.
