Case of the Month #29: Using Hypnosis in Pain Management by Dr Sue Peacock

What is hypnosis?

If you ask several people what is hypnosis? you will probably get different answers, so it is probably more helpful to consider it as a model.
Focussed attention + belief + expectation + imagination = hypnosis (British Society for Clinical and Academic Hypnosis)
According to Heap (2012) hypnosis can be seen as ‘a waking state of awareness, (or consciousness), in which a person’s attention is detached from his or her immediate environment and is absorbed by inner experiences such as feelings, cognition and imagery’. 
When applied to pain management, hypnosis aims to alter the perception of the individual’s pain, enhance coping strategies, and promote overall well-being.

Brief overview of the current evidence base of hypnosis and pain management

Over time, supported by research, hypnosis has emerged as a promising option for chronic or persistent pain.
One of the primary advantages of hypnosis in chronic or persistent/ persistent pain management is the ability to reduce pain perception. Many studies have found that hypnosis can significantly decrease both the intensity and subjective experience of the pain (Langlois et al, 2022; Ruan & Chen, 2022; Patterson & Jensen, 2003).

Chronic or persistent pain often leads to psychological distress, including anxiety and depression and can result in a decreased quality of life. Tan et al (2009) study found that hypnosis can reduce anxiety, depression, catastrophizing thoughts, whilst improving overall mood and quality of life.

Chronic or persistent pain often disrupts sleep patterns leading to poor sleep and further pain exacerbation. The relationship between sleep and pain is bi-directional so it is important to address sleep issues. Research examining the effects of hypnosis on sleep in people with chronic or persistent pain indicated that hypnotic interventions lead to significant improvements in sleep duration, sleep quality and decreased sleep disturbances, hence contributing to pain reduction and improving quality of life (Jensen & Patterson, 2014)

In the vein of supported pain self-management, hypnosis can promote individuals to take a more active role in their pain management and promote self-efficacy. Through hypnosis, people with pain can learn relaxation techniques, visualisation exercises and self-hypnosis strategies to manage their pain independently. Giving people with pain back this sense of control can enhance self-management skills and decrease feelings of helplessness (Lynch.1999).

A notable benefit of hypnosis in chronic or persistent pain management is the potential to reduce medication use. Long term use of pain medications can lead to various side effects and potentially dependency issues. A systematic review found that hypnotic interventions resulted in reduced use of medication in chronic or persistent pain patients (Thompson et al, 2019)