Hypnosis and Pain Control

Abstract

Hypnosis, begun as a therapeutic discipline in the eighteenth century, was the first Western conception of a psychotherapy. It is a powerful analgesic, and there is compelling clinical documentation of its effectiveness as far back as the mid-nineteenth century. The British surgeon James Esdaile reported that 80 % of subjects obtained anesthesia with hypnosis during major surgical procedures such as amputations. Hypnosis has been proven effective in treating pain and anxiety in the medical setting using randomized prospective trial methodology among both adults and children. Hypnosis is a state of highly focused attention coupled with a suspension of peripheral awareness. This ability to attend intensely while reducing awareness of context allows one to alter the associational network linking perception and cognition. The hypnotic narrowing of the focus of attention is analogous to looking through a telephoto lens rather than a wide-angle lens – one is aware of content more than context. This can also facilitate reduced awareness of unwanted stimuli, such as pain, or of problematic cognitions, such as depressive hopelessness, that can amplify pain. Such a mental state enhances openness to input from others – often called suggestibility – and can increase receptivity to therapeutic instruction. Yet despite much clinical and neurobiological evidence, hypnosis is rarely used as an analgesic for adults or children.