The American journal of clinical hypnosis
-
The mechanisms underlying pain modulation by hypnosis and the contribution of hypnotic induction to the efficacy of suggestions being still under debate, our study aimed, (1) to assess the effects of identical hypoalgesia suggestions given with and without hypnotic induction, (2) to compare hypnotic hypoalgesia to distraction hypoalgesia and (3) to evaluate whether hypnotic suggestions of increased and decreased pain share common psychophysiological mechanisms. To this end, pain ratings, nociceptive flexion reflex amplitude, autonomic responses and electroencephalographic activity were measured in response to noxious electrical stimulation of the sural nerve in 20 healthy participants, who were subjected to four conditions: suggestions of hypoalgesia delivered with and without hypnosis induction (i.e. hypnotic-hypoalgesia and suggested-hypoalgesia), distraction by a mental calculation task and hypnotic suggestions of hyperalgesia. As a result, pain ratings decreased in distraction, suggested-hypoalgesia and hypnotic-hypoalgesia, while it increased in hypnotic-hyperalgesia. ⋯ The absence of a significant difference between the hypnotic hypoalgesia and hyperalgesia conditions suggests that brain processes as evidenced by evoked potentials are not invariably related to pain modulation. Time-frequency analysis of electroencephalographic activity showed a significant differentiation between distraction and hypnotic hypoalgesia in the theta domain. These results highlight the diversity of neurophysiological processes underlying pain modulation through different psychological interventions.
-
The use of hypnosis to promote hypnoanalgesia has a long history and has been written about anecdotally as well as having been researched in the last several decades. Research has been both clinical in nature and, in the laboratory, trying to understand the brain physiology and processes involved. This article is not about a review of the research. ⋯ Due to the restraints of limited space, I can only discuss the various techniques briefly. I will describe a philosophical perspective that has served me well and driven my approach to treatment. I will discuss the concept of self-regulation training along the dimensions of Sensation, Affect, Cognition, and Behavior and share how hypnosis has been incorporated in working within each of those aspects of experiencing.
-
Case Reports
Case Study: Cognitive Restructuring Hypnosis for Chronic Pain in a Quadriplegic Patient.
This case study reports on a 28-year-old male with spinal cord injury (SCI), quadriplegia, and chronic pain with neuropathic characteristics. The treatment had to be adapted to address the patient's needs, as he was on a respirator and paralyzed from the chin down. The intervention consisted of eight 90-minute sessions. ⋯ Such therapy helps patients by teaching them effective coping strategies that they can use on their own to manage pain and its effects. In addition, it is important to note that this therapy provided benefits to someone who had not experienced any benefits from numerous medications he had tried before treatment. Therefore, the findings support continued efforts to make this treatment more accessible to patients who could benefit from this approach.
-
In response to Wickramasekera II's description of his empathic involvement theory of hypnosis in "Mysteries of hypnosis and the self are revealed by the psychology and neuroscience of empathy" (Wickramasekera II, 2015), Henning offers further reflections on what empathy might be and what it allows therapists to do, particularly in conditions of hypnotic trance. She defines her intersubjective view of hypnotic trance as an experience in which client and therapist mutually engage in a shared state of consciousness, and a mutual bidirectional or multidirectional exchange of verbal and nonverbal, as well as conscious and unconscious, material occurs, and which may include shared taking on of roles and expectations in each party, as suggested by the other, particularly when both client and therapist are highly hypnotizable. ⋯ Concepts from other disciplines and traditions, including quantum physics, transpersonal psychology, contemplative Christianity, and shamanistic practices and trance in other cultures are then offered to clarify the processes of intersubjectivity, and perspectives about empathy and hypnotic co-trance are offered from the context of the author's own clinical work as a trauma therapist. Finally, suggestions are provided for future research approaches and methods to further explore and understand these phenomena.
-
Placebo and nocebo effects have recently emerged as an interesting model to understand some of the intricate underpinnings of the mind-body interaction. A variety of psychological mechanisms, such as expectation, conditioning, anxiety modulation, and reward, have been identified, and a number of neurochemical networks have been characterized across different conditions, such as pain and motor disorders. ⋯ Furthermore, the mechanisms activated by placebos and nocebos have been found to be the same as those activated by drugs, which suggests a cognitive/affective interference with drug action. Overall, these findings highlight the important role of therapeutic rituals in the overall therapeutic outcome, including hypnosis, which may have profound implications both in routine medical practice and in the clinical trials setting.