What is Hypnosis?
There are many myths and misconceptions about hypnosis. For some of you, your only experience or introduction to hypnosis may have been at the state fair, which is very different from hypnosis as it is used in a therapeutic setting. We do not swing a watch back and forth in front of you. You will not be asked to stand up and cluck like a chicken or do anything you do not want to do. That is not how hypnosis works when we are talking about hypnosis for pain control.
Steps of Hypnosis
Rapport. Hypnosis is a partnership between the therapist and the client or the patient. It is not a situation where somebody is doing something for you. It is not mind control. For hypnosis to work, you really need to be comfortable and relaxed with the therapist you are working with. For this reason, rarely will you do hypnosis in the very first session with the therapist. (See more under “Finding a qualified therapist.”)
Deep breathing and relaxation. A key component of hypnosis, relaxation helps to focus your attention and let go of defenses.
Deepening. You tune out everything around you. Deepening is an altered state of consciousness that helps you relax, let go of defenses or inhibitions and really focus your attention on what the therapist is saying. This is where the crucial work of hypnosis takes place.
Suggestions for change. The state of deep relaxation and focus of attention makes you more open to suggestions for change or new ideas. Again, the things the therapist is going to suggest to you are just that, suggestions. They are not demands, and they are not things that you do not want to do. You are still in control.
Alerting. During this time, the therapist guides you to gradually bring your focus of attention back to the environment around you, open your eyes and become alert.
Can anyone be hypnotized?
Hypnotizability—or how easily someone can be hypnotized—varies a great deal from person to person and can actually be measured by a clinical psychologist. While under hypnosis, a person is given 12 tasks to complete. The tasks are very non-threatening, such as smelling something that may not be there. The psychologist scores the person based on his or her ability to complete those 12 tasks while under hypnosis. The person who completes all the tasks scores a 12, which is considered highly hypnotizable. A score of zero indicates low hypnotizability. A majority of the population falls between two and six—the moderate range of hypnotizability. Studies have shown that people in the mild to moderate range can still benefit from hypnosis.
Research on hypnosis for pain management
Hypnosis is no longer seen as a fringe or alternative type of therapy; rather, the scientific community is studying and taking it seriously. Images of the brain can now show us that changes in activation areas in the brain
occur when a person is under hypnosis. A lot of exciting new research is going on in this area, both for acute and chronic pain.
Lang and others compared a group of patients receiving an outpatient surgical procedure using only standard sedation to a similar group using standard sedation plus hypnosis. They found that the costs associated with this medical procedure were cut in half for the group that received hypnosis along with the standard sedation. This kind of research demonstrating cost savings may eventually lead to expanded coverage by insurance companies.
Rarely does hypnosis completely take the place of standard sedation or medication. On the burn unit at Harborview Medical Center, we do not usually replace standard narcotics with hypnosis, we supplement, and we are finding that the need for the standard narcotics actually decreases if hypnosis is added.
Researchers at Harborview have studied the use of hypnosis during burn debridement, the excruciatingly painful removal of dead tissue that burns patients must endure once or twice a day to promote healing and avoid infection. Standard narcotics often are not enough to make the pain manageable during debridement, but we cannot put them under anesthesia once or twice a day either. Dr. David Patterson, the UW clinical psychologist in the Department of Rehabilitation Medicine, saw hypnosis as a possible way to help people facing this excruciating pain on a daily basis and began studying its effectiveness in the 1990s.
In one of his studies of patients with high pain (8 on a 10-point scale), those who received hypnosis dropped on average to a pain score of about four, whereas the control comparison group’s pain dropped only slightly, to about seven. Repeating this study later again found that those who received the hypnosis had a larger drop in pain than those who did not.
Patterson also reported on the successful use of hypnosis alone in place of opiates in a burn patient who could not use opiates because of an adverse reaction. Luckily, for this patient hypnosis worked very, very well and he was able to go through his entire burn treatment with hypnosis only.