Hypnosis for Pain Management
Hypnosis is a modified state of consciousness that connects the conscious and the unconscious. In the context of chronic pain, hypnosis helps to control the intensity of pain, manage the pain and emotions that accompany it, and help the patient find resources to mobilize become active in the care.
To care by hypnosis is also to treat a being in relation to himself and with his surroundings.1 The description of this technique goes beyond the aim of this article centered on a practical approach. However, some essential elements will be mentioned as an introduction before presenting an overview of the literature and the clinical work done with patients suffering from chronic pain.
What is Hypnosis
Hypnosis is a modified state of consciousness where the patient is aware of everything that is said and everything that happens around him. It is not a state of sleep as some patients think. Research has shown that electroencephalogram and functional MRI changes observed in the state of hypnosis do not correspond to a state of sleep.2,3 Hypnosis allows to link the conscious and the unconscious and thus to seek resources within oneself. This approach is thus active and consenting.4 It is a complementary tool to other medicinal and non-drug therapies (physiotherapy, massage for example) that benefits the patient. In a state of hypnotic trance, the therapist will use suggestions, metaphors (for example visualization and felt of a glove around the hand to reduce unpleasant sensations among others), in order to propose to the patient to modify his relationship with the pain. , with other symptoms or more widely with its environment.
Signs specific to the state of hypnotic trance make it possible to evaluate the suggestibility of a patient, such as, for example, the fixity of the gaze, the decrease in blinking of the eyelids, a change in the coloration of the skin of the face.
Any patient can benefit from learning self-hypnosis, consisting of learning the techniques to do hypnosis alone at home: learning induction, job suggestions and metaphors developed with the therapist and exit hypnosis. The goal of this learning is to be able to use this state constructively and therapeutically. In contrast, hypnotic management in non-psychologically stabilized patients is contraindicated.
Approach in chronic pain
According to the International Association for the Study of Pain (IASP), pain is, let us recall, an unpleasant sensory and emotional experience related to an existing or potential tissue injury or described in terms of such an injury. It is therefore a complex experience including sensory, emotional, cognitive and motivational characteristics. The pain is further influenced by the patient’s representations, his experience in the broad sense (lived in relation to other pains he has known, in relation to his life events).
Hypnosis, in the context of chronic pain, can be useful to control the level of pain intensity, to manage pain and / or emotions that accompany it, to help the patient regain quality acceptable life.
Hypnosis allows the patient to discover and develop new personal tools for managing the different components of pain. The patient suffering from chronic pain is often invaded by these and has difficulty decentering. Hypnosis allows you to broaden your field of vision, taking a step back not only in relation to pain but also in relation to your situation. Through her suggestions during the hypnosis session, the therapist allows the patient to focus on other things than pain, reframing the situation and having them discover their own resources for pain management.
Hypnotherapy allows to act on several levels: the sensory level (intensity for example), the management of the pain (to decrease a negative anticipation for example), the cognitive level (to make links between the pain and negative thoughts), the emotional level (in connection with unfulfilled grief for example), and the motivational level (helping him to find resources to mobilize himself, to become active in the care).
The hypnotic tools used to modulate pain are multiple, such as distraction, mental imagery, learning to manage emotions, especially anxiety and stress, and techniques that allow the patient to stay away from a painful binary thought or total absence of pain. All these techniques