Hypnotically induced analgesia is truly one of the most remarkable capacities human beings have. The potential to reduce pain to a manageable level or even eliminate it altogether is one of the most meaningful applications of clinical hypnosis. Given the large number of people suffering with chronic and debilitating pain, and the potential for any of us to suffer pain from injuries and medical conditions, the value of any tool for managing pain effectively is obvious. Consequently, pain relief through hypnosis may well be the most intensively studied of all the hypnotic phenomena, and may also be the most empirically well-supported application of hypnosis. In a recent meta-analysis evaluating the merits of hypnotically induced analgesia conducted by Montgomery, DuHamel, and Redd (2000), hypnosis provided significant pain relief for about 75% of the population. Further analysis indicates that hypnosis appears to be at least as effective as other nonphysical approaches, such as cognitive-behavorial pain management approaches. There is evidence that when hypnosis is added to standard patient-controlled sedation, hypnosis affords significantly greater pain relief than does concise sedation alone. Hypnosis is not addictive; it is empowering to the patient, and it encourages a healthy proactive role in managing pain.
Hypnosis has been used successfully in the treatment of all kinds of painful conditions, including headache, dental conditions, irritable bowel syndrome and many, many other conditions. The use of hypnosis in pain management necessarily involves eliciting hypnotic analgesia or anesthesia. Unlike chemical anesthesia, hypnosis involves a perceptual, and therefore mental, component. How exactly hypnotic analgesia works continues to be a mystery. It does not appear to be either placebo or mere stress inoculation, nor does it seem to involve the brain's natural opiate receptors, endorphins.
Working with clients in pain requires a broad base of understanding of hypnotic principles, human physiology, psychological motivations, human information processing, and interpersonal dynamics. Clients in pain are, in some ways, easier to work with because of their high level of motivation. In other ways, however, such clients are exceptionally difficult to work with because of the intensity and pervasiveness of the negative impact of the pain on their lives. Therefore, approaching the person in pain must be done sensitively, with an appreciation that the pain is usually more than only pain. It is also a source of anxiety, feelings of helplessness and depression, increased dependency and restricted social contact. Even pain emanating from clearly organic causes has psychological components to it, particularly how the suffering person experiences the pain and its consequences. it is the psychological dimension of the pain that is most overtly affected by hypnosis for a variety of reasons that all seem to stem from the greater self-mastery hypnosis affords. Fear and anxiety, feelings of helplessness, and negative expectations can all be reduced with the use of hypnosis. The physical components of the pain are also addressed by the use of hypnosis.
Hypnotic analgesia is one of the classical hypnotic phenomena that people react to with the most skepticism, asking, "If a person is in pain from cancer or some other physical cause, how can something psychological make a difference?" Most people even go a step further and hold the misconception that if the person's pain is reduced or eliminated through hypnosis, "then it must have been all in his or her head in the first place." Nothing is further from the truth. First, hypnosis and the various hypnotic phenomena are evident, at least in part, in everyday experiences. Second, as was pointed out earlier, pain that is primarily physical in origin also has very real psychological components. The relationship between pain and anxiety and/or depression is an intense, circular one. Pain causes anxiety and/or depression, which intensifies the pain, which intensifies the anxiety and/or depression, and so on. By merely facilitating the relaxation hypnosis affords, one can interrupt the cycle.
Consider routine experiences that closely approximate the experience of hypnotic analgesia. You can probably recall a time when you were very involved in an activity and only after the activity's completion did you notice you had cut or bruised yourself - and only then did it begin to hurt! Your awareness was distracted away from noticing genuine physical damage, the essence of hypnotic analgesia. The injury was real, but how much you noticed it and how much it affected you varied with your focus either on or away from it. Employing hypnosis to facilitate analgesia can give one at least partial control over the experience of pain through a deliberate procedure, rather than such useful distraction being only a seemingly random event. The fact that pain is modifiable through hypnosis is not indicative that the person's pain is psychogenic. Instead, it is indicative that our experience of our bodies is malleable and even negotiable.
Using hypnosis in the management of pain is advantageous for some very important reasons. First, and foremost in my opinion, is the opportunity for greater self-control and therefore, greater personal responsibility for one's level of well-being. Feeling victimized, whether by pain, circumstances, or other people, puts one in a helpless position from which it is difficult to do any real healing. Having some degree of self-control is extremely important to the person in pain, and hypnosis facilitates its acquisition. Second, because the ability to experience hypnosis is a natural one existing within the person, pain medications may be reduced or even eliminated. Hypnosis has no negative side effects, nor is it addictive, Pain is reduced in differing degrees in different people, but whatever the quality of result, it is obtained safely and naturally. Third, hypnosis permits a higher level of functioning and enhances the healing process in persons who utilize hypnotic patterns. Remaining as active as one's condition allows is important at all levels, and can make a significant difference in its course. The expectation of wellness, the experience of comfort, and the diminished anxiety and fear can all be important factors in facilitating recovery at most, or retarding decline, at least.
In summary, hypnosis can offer physical relief and an emotional wellspring of positive possibilities to the person in pain. Over time and with practice, such persons can benefit greatly from the increased self-control and self-reliance hypnosis may afford.