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Hypnotic Treatment of Chronic Pain

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.

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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.

    PubMed  Article  CAS  Google Scholar 

  • *Andreychuk, T., and Skriver, C. (1975). Hypnosis and biofeedback in the treatment of migraine headache. Int. J. Clin. Exp. Hypn. 23: 172–183.

    PubMed  Article  CAS  Google Scholar 

  • Benson, H. (1975). The Relaxation Response, Avon, New York.

    Google Scholar 

  • Blumstein, H., and Gorevic, P. D. (2005). Rheumatologic illnesses: Treatment strategies for older adults. Geriatrics 60: 28–35.

    PubMed  Google Scholar 

  • Campbell, D. T., and Stanley, J. C. (1966). Experimental and Quasi-Experimental Designs for Research, Rand McNally, Chicago.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    PubMed  Article  CAS  Google Scholar 

  • Cohen, J. (1988). Statistical Power Analyses for the Behavioral Sciences, 2nd ed., Lawrence Erlbaum, Hillsdale, New Jersey.

    Google Scholar 

  • 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.

    PubMed  Article  CAS  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • *Edelson, J., and Fitzpatrick, J. L. (1989). A comparison of cognitive-behavioral and hypnotic treatments of chronic pain. J. Clin. Psychol. 45: 316–323.

    PubMed  Article  CAS  Google Scholar 

  • 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.

    PubMed  CAS  Google Scholar 

  • Friedman, H., and Taub, H. A. (1984). Brief psychological training procedures in migraine treatment. Am. J. Clin. Hypn. 26: 187–200.

    PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Gruzelier, J. (1999). Hypnosis from a neurobiological perspective: A review of evidence and applications to improve immune function. Anales de Psicologia 15: 111–132.

    Google Scholar 

  • Gruzelier, J. (1998). A working model of the neurophysiology of hypnosis: A review of evidence. Contemp. Hypn. 15: 3–21.

    Article  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Hilgard, E. R., and Hilgard, J. R. (1994). Hypnosis in the Relief of Pain, Brunner/Mazel, New York.

    Google Scholar 

  • Holroyd, J. (1996). Hypnosis treatment of clinical pain: Understanding why hypnosis is useful. Int. J. Clin. Exp. Hypn. 44: 33–51.

    PubMed  Article  CAS  Google Scholar 

  • Jensen, M. P., and Barber, J. (2000). Hypnotic analgesia of spinal cord injury pain. Aust. J. Clin. Exp. Hypn. 28: 150–168.

    Google Scholar 

  • 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.

    PubMed  Article  Google Scholar 

  • 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.

    PubMed  Article  Google Scholar 

  • Kirsch, I. (1985). Response expectancy as a determinant of experience and behavior. Am. Psychol. 40: 1189–1202.

    Article  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • Miller, M. E., and Bowers, K. S. (1993). Hypnotic analgesia: Dissociated experience or dissociated control? J. Abnorm. Psychol. 102: 29–38.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    PubMed  Article  CAS  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Patterson, D. R., and Jensen, M. P. (2003). Hypnosis and clinical pain. Psychol. Bull. 129: 495–521.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    PubMed  CAS  Google Scholar 

  • 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.

    CAS  Google Scholar 

  • Spiegel, D., and Bloom, J. R. (1983). Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosom. Med. 45: 333–339.

    PubMed  CAS  Google Scholar 

  • Spiegel, H., and Spiegel, D. (2004). Trance and Treatment, American Psychiatric Publishers, Washington, DC.

    Google Scholar 

  • *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.

    PubMed  Google Scholar 

  • *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.

    Article  PubMed  CAS  Google Scholar 

  • *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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • *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.

    Google Scholar 

  • Yapko, M. D. (2003). Trancework: An Introduction to the Practice of Clinical Hypnosis, 3rd ed., Brunner-Routledge, New York.

    Google Scholar 

  • *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.

    Article  PubMed  CAS  Google Scholar 

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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

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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

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KEY WORDS:

  • hypnosis
  • chronic pain
  • clinical trials
  • control groups