Hypnosis is now an accepted treatment method for pain alleviation. Nurses have a special opportunity to reduce the patient’s apprehension about upcoming tests and surgeries. Hypnosis is an effective tool for those patients who agree to undergo the process. The goal is not to replace medication, but to augment the pain relief afforded by medication. The nurse can perform hypnosis, under supervision, to decrease pain, thereby lowering the anxiety that creates an increased perception of pain.
This article examines empirical data on the use of hypnosis for pain management. The many medications for pain may have side effects when used by some patients. Some are not only addictive, but may result in unpleasant side effects. Hypnotherapy is non-addictive and has no negative side effects. National Institutes of Health (NIH) Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia, concluded that hypnosis has a moderate effect on pain and is possibly advantageous on a long-term basis.
The use of hypnosis is contraindicated as treatment for those who are psychotic or suffering from other conditions that render them incapable of understanding what is real and what is not (Eliopoulos, 1999). Clinicians can offer hypnosis as an alternative to medication. Some patients will ask for it specifically, and others will ask for a substitute for medication without naming hypnosis. The nurse can explain how the hypnotic trance is brought about, and what it will do for the patient. For example, the feeling of pain can be altered. In other words, the pain remains the same, but the patient does not perceive the pain in the same way. His focus is on something other than awareness of pain. Another feeling can replace the perception in the patient’s thoughts or he can achieve amnesia of the pain itself.
Candidates for hypnosis are those who find that medication provides minimal relief and maximum side effects. They are looking for a replacement that will not negatively affect their ability to think clearly. The nurse, or other health-care worker can do a pre-hypnosis interview to find out what activities bring pleasant thoughts to the patient. She can then provide a clear explanation of the process of hypnosis and the desired goal. Any words relating to pain should be avoided during the hypnosis session. Even skeptical patients find hypnosis to be beneficial in reducing the pain they feel.
The general sequence of events leading to sessions of hypnosis are:
• Pain assessment
• Patient assessment
• Educating the patient
• Conducting the actual session
Hypnosis was found to reduce pain, provide relaxation and do so without negative side effects. A nurse is close by when a patient prepares for a procedure that causes anxiety and pain. Visualization of a pleasant place or situation can displace the anxiety and reduce the apprehension that may intensify the perception of pain.
Pain is a major health-care concern. In 1995, partial or full disability affected more than 50 million Americans (Foley, 1995, Genuis, 1995) as the result of chronic pain. Additionally, 26 million people in the US have back pain and 50% of surgical patients feel their post-surgery pain relief is inadequate. Pain affects more than 50% of psychiatric patients as well.
Researchers and members of the medical community have evaluated the use of hypnosis as a treatment for pain. The culmination of these evaluations is the endorsement of hypnosis as a viable treatment option when used for pain relief. These conclusions are based on self-reports by the patients who utilized it.
Researchers will continue to compile examples favoring hypnosis for pain alleviation as a valid method, both in conjunction with medication or alone. Nurses, physicians, psychotherapists and other health care workers can be trained in the application in medical settings. This education is the next important step towards facilitating the management of acute and chronic pain in the patient population through the competent application of hypnotherapy.
Eliopoulos, C. (1999). Complementary and alternative therapies in longterm care. Primary Care Practice, 3, 194-203.
Foley, K.M. (1995). Pain, physician-assisted dying and euthanasia. Pain Forum, 4, 163-178.
Genuis, M.L. (1995). The use of hypnosis in helping cancer patients control anxiety, pain, and emesis. A review of recent empirical studies. American Journal of Clinical Hypnosis, 37, 316- 325.
Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. NIH Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia. (1996). Journal of the American Medical Association, 276, 313-318.
Filed under: Pain