This article reviews controlled trials of hypnotic treatment for chronic pain in terms of: (1) analyses comparing the effects of hypnotic treatment to six types of control conditions; (2) component analyses; and (3) predictor analyses. The findings indicate that hypnotic analgesia produces significantly greater decreases in pain relative to no-treatment and to some non-hypnotic interventions such as medication management, physical therapy, and education/advice. However, the effects of self-hypnosis training on chronic pain tend to be similar, on average, to progressive muscle relaxation and autogenic training, both of which often include hypnotic-like suggestions. None of the published studies have compared hypnosis to an equally credible placebo or minimally effective pain treatment, therefore conclusions cannot yet be made about whether hypnotic analgesia treatment is specifically effective over and above its effects on patient expectancy. Component analyses indicate that labeling versus not labeling hypnosis treatment as hypnosis, or including versus not including hand-warming suggestions, have relatively little short-term impact on outcome, although the hypnosis label may have a long-term benefit. Predictor analyses suggest that global hypnotic responsivity and ability to experience vivid images are associated with treatment outcome in hypnosis, progressive relaxation, and autogenic training treatments. The paper concludes with a discussion of the implications of the findings for future hypnosis research and for the clinical applications of hypnotic analgesia.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
References marked with an asterisk indicate studies included in the review.
*Anderson, J. A., Basker, M. A., and Dalton, R. (1975). Migraine and hypnotherapy. Int. J. Clin. Exp. Hypn. 23: 48–58.
*Andreychuk, T., and Skriver, C. (1975). Hypnosis and biofeedback in the treatment of migraine headache. Int. J. Clin. Exp. Hypn. 23: 172–183.
Benson, H. (1975). The Relaxation Response, Avon, New York.
Blumstein, H., and Gorevic, P. D. (2005). Rheumatologic illnesses: Treatment strategies for older adults. Geriatrics 60: 28–35.
Campbell, D. T., and Stanley, J. C. (1966). Experimental and Quasi-Experimental Designs for Research, Rand McNally, Chicago.
Chaves, J. F. (1993). Hypnosis in pain management. In Rhue, J. W., Lynn, S. J., and Kirsch, I. (Eds.), Handbook of Clinical Hypnosis, American Psychological Association, Washington, DC.
Chaves, J. E., and Dworkin, S. F. (1997). Hypnotic control of pain: Historical perspectives and future prospects. Int. J. Clin. Exp. Hypn. 45: 356–376.
Cohen, J. (1988). Statistical Power Analyses for the Behavioral Sciences, 2nd ed., Lawrence Erlbaum, Hillsdale, New Jersey.
Dinges, D. F., Whitehouse, W. G., Orne, E. C., Bloom, P. B., Carlin, M. M., Bauer, N. K., Gillen, K. A., Shapiro, B. S., Ohene-Frempong, K., Dampier, C., and Orne, M. T. (1997). Self-hypnosis training as an adjunctive treatment in the management of pain associated with sickle cell disease. Int. J. Clin. Exp. Hypn. 45: 417–432.
Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., Kerns, R. D., Stucki, G., Allen, R. R., Bellamy, N., Carr, D. B., Chandler, J., Cowan, P., Dionne, R., Galer, B. S., Hertz, S., Jadad, A. R., Kramer, L. D., Manning, D. C., Martin, S., McCormick, C. G., McDermott, M. P., McGrath, P., Quessy, S., Rappaport, B. A., Robbins, W., Robinson, J. P., Rothman, M., Royal, M. A., Simon, L., Stauffer, J. W., Stein, W., Tollett, J., Wernicke, J., and Witter, J. (2005). Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 113: 9–19.
*Edelson, J., and Fitzpatrick, J. L. (1989). A comparison of cognitive-behavioral and hypnotic treatments of chronic pain. J. Clin. Psychol. 45: 316–323.
Edmonston, W. E., Jr. (1991). Anesis. In Lynn, S. J., and Rhue, J. W. (Eds.), Theories of Hypnosis: Current Models and Perspectives, Guilford Press, New York, pp. 197–237.
Freeman, R., Barabasz, A., Barabasz, M., and Warner, D. (2000). Hypnosis and distraction differ in their effects on cold pressor pain. Am. J. Clin. Hypn. 43: 137–148.
Friedman, H., and Taub, H. A. (1984). Brief psychological training procedures in migraine treatment. Am. J. Clin. Hypn. 26: 187–200.
Gay, M., Philipport, P., and Luminet, O. (2002). Differential effectiveness of psychological interventions for reducing osteoarthritis pain: A comparison of Erikson hypnosis and Jacobson relaxation. Eur. J. Pain 6: 1–16.
Green, J. P., Barabasz, A. F., Barrett, D., and Montgomery, G. H. (2005). Forging ahead: The 2003 APA Division 30 definition of hypnosis. Int. J. Clin. Exp. Hypn. 53: 259–264.
Gruzelier, J. (1999). Hypnosis from a neurobiological perspective: A review of evidence and applications to improve immune function. Anales de Psicologia 15: 111–132.
Gruzelier, J. (1998). A working model of the neurophysiology of hypnosis: A review of evidence. Contemp. Hypn. 15: 3–21.
Hannen, H. C., Hoenderdos, H. T., van Romunde, L. K., Hop, W. C., Mallee, C., Terwiel, J. P., and Hekster, G. B. (1991). Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia. J. Rheumatol. 18: 72–75.
Hilgard, E. R., and Hilgard, J. R. (1994). Hypnosis in the Relief of Pain, Brunner/Mazel, New York.
Holroyd, J. (1996). Hypnosis treatment of clinical pain: Understanding why hypnosis is useful. Int. J. Clin. Exp. Hypn. 44: 33–51.
Jensen, M. P., and Barber, J. (2000). Hypnotic analgesia of spinal cord injury pain. Aust. J. Clin. Exp. Hypn. 28: 150–168.
Jensen, M. P., Hanley, M. A., Engel, J. M., Romano, J. M., Barber, J. B., Cardenas, D. D., Kraft, G. H., Hoffman, A. J., and Patterson, D. R. (2005). Hypnotic analgesia for chronic pain in persons with disabilities: A case series. Int. J. Clin. Exp. Hypn. 53: 198–228.
Jensen, M. P., and Patterson, D. R. (2005). Control conditions in hypnotic-analgesia clinical trials: Challenges and recommendations. Int. J. Clin. Exp. Hypn. 53: 170–197.
Kirsch, I. (1985). Response expectancy as a determinant of experience and behavior. Am. Psychol. 40: 1189–1202.
Kirsch, I., Montgomery, G., and Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: A meta-analysis. J. Consult. Clin. Psychol. 63: 214–220.
Lang, E. V., Benotsch, E. G., Fick, L. J., Lutgendorf, S., Berbaum, M. L., Berbaum, K. S., Logan, H., and Spiegel, D. (2000). Adjunctive non-pharmacological analgesia for invasive medical procedures: A randomized trial. Lancet 355: 1486–1490.
Lynn, S. J., and Rhue, J. W. (1991). Theories of hypnosis: An introduction. In Lynn, S. J., and Rhue, J. W. (Eds.), Theories of Hypnosis: Current Models and Perspectives, Guilford Press, New York, pp. 1–15.
McCauley, J. D., Thelen, M. H., Frank, R. G., Willard, R. R., and Callen, K. E. (1983). Hypnosis compared to relaxation in the outpatient management of chronic low back pain. Arch. Phys. Med. Rehabil. 64: 548–552.
Melis, P. M., Rooimans, W., Spierings, E. L., and Hoogduin, C. A. (1991). Treatment of chronic tension-type headache with hypnotherapy: A single-blind time controlled study. Headache 31: 686–689.
Melzack, R., and Perry, C. (1975). Self-regulation of pain: The use of alpha-feedback and hypnotic training for the control of chronic pain. Exp. Neurol. 46: 452–469.
Miller, M. E., and Bowers, K. S. (1993). Hypnotic analgesia: Dissociated experience or dissociated control? J. Abnorm. Psychol. 102: 29–38.
Montgomery, G. H., DuHamel, K. N., and Redd, W. H. (2000). A meta-analysis of hypnotically induced analgesia: How effective is hypnosis? Int. J. Clin. Exp. Hypn. 48: 138–153.
Nash, M. R. (2005). The importance of being earnest when crafting definitions: Science and scientism are not the same thing. Int. J. Clin. Exp. Hypn. 53: 265–280.
Patterson, D. R., and Jensen, M. P. (2003). Hypnosis and clinical pain. Psychol. Bull. 129: 495–521.
Patterson, D. R., and Ptacek, J. T. (1997). Baseline pain as a moderator of hypnotic analgesia for burn injury treatment. J. Consult. Clin. Psychol. 65: 60–67.
Rainville, P., Duncan, G. H., Price, D. D., Carrier, B., and Bushnell, M. C. (1997). Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science 277: 968–971.
Ruoff, G. E., Rosenthal, N., Jordan, D., Karim, R., Kamin, M., and Protocol CAPSS-112 Study Group (2003). Tramadol/acetaminophen combination tablets for the treatment of chronic lower back pain: A multicenter, randomized, double-blind, placebo-controlled outpatients study. Clin. Ther. 25: 1123–1141.
Schlutter, L. C., Golden, C. J., and Blume, H. G. (1980). A comparison of treatments for prefrontal muscle contraction headache. Br. J. Med. Psychol. 53: 47–52.
Simon, E. P., and Lewis, D. M. (2000). Medical hypnosis for temporomandibular disorders: Treatment efficacy and medical utilization outcome. Oral. Surg. Oral. Med. Oral. Pathol. 90: 54–63.
Spiegel, D., and Bloom, J. R. (1983). Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosom. Med. 45: 333–339.
Spiegel, H., and Spiegel, D. (2004). Trance and Treatment, American Psychiatric Publishers, Washington, DC.
*Spinhoven, P., and Linssen, A. C. G. (1989). Education and self-hypnosis in the management of low back pain: A component analysis. Br. J. Clin. Psychol. 28: 145–153.
*Spinhoven, P., Linssen, A. C. G., Van Dyck, R., and Zitman, F. G. (1992). Autogenic training and self-hypnosis in the control of tension headache. Gen. Hosp. Psychiatry 14: 408–415.
*ter Kuile, M. M., Spinhoven, P., Linssen, A. C., Zitman, F. G., Van Dyck, R., and Rooijmans, H. G. (1994). Autogenic training and cognitive self-hypnosis for the treatment of recurrent headaches in three different subject groups. Pain 58: 331–340.
Thimineur, M. A., Kravitz, E., Vodapally, M. S. (2004). Intrathecal opioid treatment for chronic non-malignant pain: A 3-year prospective study. Pain 109: 242–249.
Turner, J. A., and Clancy, S. (1988). Comparison of operant behavioral and cognitive-behavioral group treatment for chronic low back pain. J. Consult. Clin. Psychol. 56: 261–266.
Van den Hout, J. H. C., Vlaeyen, J. W., Heuts, P. H. T. G., Zijlema, J. H. L., and Wijnen, J. A. G. (2003). Secondary prevention of work-related disability in nonspecific low back pain: Does problem-solving therapy help? A randomized clinical trial. Clin. J. Pain 19: 87–96.
*Winocur, E., Gavish, A., Emodi-Perlman, A., Halachmi, M., and Eli, I. (2002). Hypnorelaxation as treatment for myofascial pain disorder: A comparative study. Oral. Surg. Oral. Med. Oral. Pathol. 93: 429–434.
Yapko, M. D. (2003). Trancework: An Introduction to the Practice of Clinical Hypnosis, 3rd ed., Brunner-Routledge, New York.
*Zitman, F. G., Van Dyck, R., Spinhoven, P., and Linssen, A. C. (1992). Hypnosis and autogenic training in the treatment of tension headaches: A two-phase constructive design study with follow-up. J. Psychosom. Res. 36: 219–228.
ACKNOWLEDGMENTS
This work was supported by the National Institutes of Health (grant no. R01 GM42725-09A1) and by the National Institutes of Health, National Institute of Child Health and Human Development, National Center for Medical Rehabilitation Research (grant no. P01 HD33988). The authors would like to express their thanks to two anonymous reviewers of a previous version of this manuscript for their careful review and suggestions
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jensen, M., Patterson, D.R. Hypnotic Treatment of Chronic Pain. J Behav Med 29, 95–124 (2006). https://doi.org/10.1007/s10865-005-9031-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-005-9031-6