The purpose of this article is to explain what clinical hypnosis is, how it may benefit people living with arthritis, rheumatism, gout and other related disorders, in particular in managing pain, and in procuring and maintaining lifestyle changes.
What is clinical hypnosis?
Historically, hypnosis has been used in religious ceremonies, and has been associated with magic, the occult and the supernatural. Hypnosis still has these associations today. It is no wonder then that the general public, including many professionals, view hypnosis with bemusement, scepticism, suspicion and fear. Some people may also have images of swinging pendulums and stage hypnotism, with volunteers on stage clucking or mooing, when hypnosis is mentioned.
This view of hypnosis is now changing. Due to the encouraging results of numerous scientific studies and research on hypnosis conducted from the 18th century and which continue to date, hypnosis has now found its way into mainstream medical and clinical settings. Clinical hypnosis is being used for, inter alia, fractures, cancer, burns, pain relief, gastrointestinal disorders, phobias, childbirth and dentistry. Many hospitals, especially in the United States of America and the United Kingdom, are now staffed with clinical hypnotherapists.
Although there is no singular and universally accepted definition of clinical hypnosis, a widely accepted definition is the one offered by the American Psychological Association’s hypnosis division (Yapko, 2003) –
“Hypnosis is a procedure during which a health professional or researcher suggests that a client, patient or subject experience changes in sensations, perceptions, thoughts and behaviour.”
How Can Clinical Hypnosis Help?
The most notable symptom of arthritis, rheumatism and/or gout is chronic pain. Hypnosis can be used, as part of a patient’s treatment program, to reduce sensitivity to pain.
Well-controlled experiments have been carried out to test the effectiveness of including hypnosis as part of treatment programs for the relief and control of pain. They have shown hypnosis to be an effective tool.
One such study conducted by David Spiegel, MD, et al, and published in the April 29, 2000, issue of The Lancet, concluded that hypnosis reduced pain, anxiety, and blood pressure complications in patients undergoing invasive medical procedures.
A more recent study (published in the November-December 2004 issue of Regional Anesthesia and Pain Medicine) by researchers at the University of Iowa, IU Carver College of Medicine and the Technical University of Aachen, Germany, used functional magnetic resonance imaging (fMRI) to find out if hypnosis alters brain activity in a way which may explain pain reduction.
They found a distinctly different pattern of brain activity in volunteers experiencing painful heat under hypnosis than when not under hypnosis. There was reduced brain activity in top levels of the pain network, and increased activity in the left anterior cingulated cortex and the basal ganglia. The researchers speculate that this increased activity in these two regions of the brain may be part of an inhibition pathway which blocks the pain signal from reaching the higher cortical structures responsible for pain perception.
Faulty and negative thought patterns
Painful arthritis attacks can also have a psychological impact on patients. Patients may often have feelings of helplessness, sadness and loss, due to a realization that they have lost their good health, mobility and/or independence. There may also be feelings of stress, anxiety and low self-esteem. Such negative emotions may further aggravate the pain, and a vicious circle of pain and negative emotions may develop. Therefore, it is desirable for a pain management to be comprehensive, which includes challenging faulty and negative thought patterns.
Hypnosis can be used to challenge these thought patterns as it includes relaxation techniques to minimize stress and anxiety, positive ego-strengthening suggestions to restore confidence, raise self-esteem and motivation, and other techniques to shift negative thoughts towards a more balanced thought pattern. Patients are also taught self-hypnosis so that they can maintain a more positive outlook, as well as to manage their pain autonomously, after leaving the therapy room.
Motivation for Change in Lifestyle
Hypnosis may also be used to motivate patients towards adopting and maintaining a healthier lifestyle, by encouraging them to incorporate exercise and to adopt a healthier diet as part of their treatment plan.
What to Expect in a Hypnosis Session
The first session will involve taking a thorough case history of the patient, discussing his/her concerns and identifying a concern which the patient would first like to address. A personalized treatment plan will be presented and hypnosis will also be explained to the patient, to dispel any misconceptions. If hypnosis is used, it would include relaxation, pain reframe and ego-strengthening suggestions. Typically, a first session lasts 1½ hours.
In the second session the patient may be taught pain control techniques and self-hypnosis, which will be reinforced under hypnosis. Typically, a second session lasts 1 hour. Ego-strengthening and motivational suggestions will also be given to the patient under hypnosis to boost his confidence and shift his mind set positively. The patient is encouraged to practise self-hypnosis on a daily basis, so that he/she may gain control and autonomy over his/her concerns.
The third session also typically lasts an hour. In this session the patient may give feedback on his/her progress and reinforcements through hypnosis may be given if required.
Subsequent sessions may or may not be required depending on the patient’s progress.
Patients should inform their medical doctors or specialists of their intention to see a qualified clinical hypnotherapist, before they do so. This is because clinical hypnosis is a complementary treatment, to be incorporated in a patient’s medical treatment plan, and is not an alternate therapy.
Yapko, Michael D., Trancework : an introduction to the practice of clinical hypnosis (3rd Edition) (2003) NewYork & Hove, Brunner-Routledge
Hypnosis for Pain (2001). In WebMD, Inc. Retrieved October 28, 2010 from http://www.webmd.com/balance/features/hypnosis-for-pain
University of Iowa (2005). Brain Imaging Studies Investigate Pain Reduction By Hypnosis. In ScienceDaily. Retrieved October 28, 2010, from http://www.sciencedaily.com/releases/2005/03/050326100346.htm
Ng Yi-Ching, D.Hyp, PDCHyp, MBSCH, is a clinical hypnotherapist and practices at Global Doctors Specialist Centre (Hospital), 18 Jalan Kiara, Mont’ Kiara, 50480 Kuala Lumpur (+603-62030999). She holds a Diploma and a Practitioner Diploma in Clinical Hypnosis and trained with the London College of Clinical Hypnosis (Asia). She is also a Full Member of the British Society of Clinical Hypnosis in the United Kingdom.