Self-hypnosis has also been used by patients instead of general or local anaesthetics in operations in the past, including in the
Hypno-anaesthesia is gaining popularity both due to its clinical track record, and because physical pain inflicts stress and suffering, while the drugs that reduce pain can be harmful. In fact, the leading cause of death during surgery is complications due to chemical anaesthesia. For sufferers of chronic pain, using narcotics can lead to impaired mental functioning, other bad side effects, and even addiction.
The terrific news is that hypnosis can almost always reduce—and sometimes eliminate—physical pain, with no dangerous side effects whatsoever. Hypno-anaesthesia is one use of hypnotherapy that the scientific community has proved beyond any doubt.
"Though often denigrated as fakery or wishful thinking, hypnosis has been shown to be a real phenomenon with a variety of therapeutic uses—especially in controlling pain," Scientific American reports. "Sceptics have argued that this effect results from either simple relaxation or a placebo response. But a number of experiments have ruled out these explanations."
Today many clients rely on hypnotherapy to increase their comfort and safety during surgery. Meanwhile, the most common - and likewise well-proven - use of hypno-anaesthesia is to help chronic-pain sufferers experience chemical-free relief.
Hypno-anaesthesia works to some degree for virtually everyone; very well for the majority of clients; and for highly hypnotizable subjects, it can be 100% as effective as chemical anaesthesia.
While by now numerous studies have documented that hypno-anaesthesia works amazingly well, researchers continue to investigate exactly how it does so. The studies indicate that hypno-anaesthesia blocks our higher brain centres from registering painful signals sent up through the spinal column.
Hypno-anaesthesia "definitely does something to reduce the pain signal input into the cortical structure," said Sebastian Schulz-Stubner, M.D., Ph.D., and co-author of the first study to use fMRI to investigate hypno-anaesthesia. Additional brain-imaging research has confirmed this finding.
There is also evidence that hypno-anaesthesia stimulates the brain to release endorphins (natural pain-reducing neuro-chemicals) and regulates the neurotransmitters serotonin and dopamine in a manner that lowers pain. This also may help explain why hypnotherapy clients report feeling so much better mentally and emotionally, as well as physically.
Two theories of pain control by hypnosis currently exist: 1. Socio-cognitive model - patient actively copes with noxious stimulus. Hypnotic analgesia should be like cognitive techniques like stress inoculation training. It requires deliberate effort. 2. Dissociative control model - pain reduction requires little cognitive effort.
This article reviews recent research findings, expanding an evolving neuropsychophysiological model of hypnosis (Crawford, 1989; Crawford & Gruzelier, 1992), that support the view that highly hypnotizable persons (highs) possess stronger attentional filtering abilities than do low hypnotizable persons, and that these differences are reflected in underlying brain dynamics. Behavioral, cognitive, and neurophysiological evidence is reviewed that suggests that highs can both better focus and sustain their attention as well as better ignore irrelevant stimuli in the environment. It is proposed that hypnosis is a state of enhanced attention that activates an interplay between cortical and subcortical brain dynamics during hypnotic phenomena, such as hypnotic analgesia. A body of research is reviewed that suggests that both attentional and disattentional processes, among others, are important in the experiencing of hypnosis and hypnotic phenomena. Findings from studies of electrocortical activity, event-related potentials, and regional cerebral blood flow during waking and hypnosis are presented to suggest that these attentional differences are reflected in underlying neurophysiological differences in the far fronto-limbic attentional system.
Hilgard once said we should study what is going on inside the skull when we study hypnotic behavior. Theta EEG was studied, in 3.5 and 5.5-7.5 band widths, based on Crawford's research (no differences between high and low hypnotizables in low range but significant differences in waking state, eyes closed condition).
Presents point of view of a private practice anesthesiologist in
He began by saying that he is opposed to using hypnosis for surgery, though he favors a theory of how hypnosis effects physiological change, and cites T. X. Barber's classic "Changing Unchanging Bodily Processes."
The author stated that his research and the few other studies of cardiac surgery patients do not support idea that cardiac surgery patients benefit from hypnosis and suggestion.
"Surgical patients can absorb information while they're knocked out, and even learn tips that help with recovery, researchers reported Friday at a symposium on memory and anesthesia.
Bowers' dissociated control adaptation of Hilgard's neodissociation theory of hypnosis posits that higher control systems are not used if lower systems are activated.
Patients ages 19-55 were accepted into the study and they were paid for participation. (Older patients were excluded to guard against memory or hearing problems.) Other criteria for exclusion were: ASA physical status 4 or 5 indicating significant systemic disease, visual or hearing problems, middle ear disease (because it increases probability of nausea and vomiting), if their condition might require heavy sedation, if they were currently taking medication that interferes with memory (e.g. benzodiazepines, if there were intolerance to opioids, or if there were a likelihood of using postoperative pain treatment other than opioids.
Sensory and pain thresholds to laser stimulation were determined, and the laser-pain evoked brain potentials were measured for 8 highly hypnotizable (Harvard Scores 10-11) student volunteers in 3 conditions: (1) waking, (2) suggestion of hyperaesthesia during hypnosis, (3) suggestion of analgesia during hypnosis.
Postoperative course was evaluated by 5 variables: pain, nausea and vomiting, evaluation by nursing staff, subjective well-being, and duration of postoperative hospital stay. From the chart they used amount of postoperative analgesia, volume of nasogastric suction or drainage and fluid lost through vomiting over 6 days post-operatively; duration of postoperative hospital stay was registered after discharge. See p. 699 for details, including wording of questions. They cite their own earlier study that got positive results, and explain the difference as possibly due to use of only male voices on tapes, lack of difference in the sounds on tapes in this study, insensitivity of outcome measures (patients stayed longer in first study than in this one), and sample too small in this study (106).
52 female patients having gynecological surgery as day cases received either a short preoperative hypnotic induction or a brief discussion of equal length. Hypnotized patients who underwent vaginal termination of pregnancy required significantly less methohexitone for induction of anesthesia and were significantly more relaxed as judged by their visual analogue scores for anxiety. Less than half the patients were satisfied with their knowledge about the operative procedure even after discussions with the surgeon and anesthetist. A significant correlation was found between anxiety and perceived knowledge of procedures. Results suggest that preoperative hypnosis can provide a quick and effective way to reduce preoperative patient anxiety and anesthetic requirements for gynecological daycase surgery.
This article is a reply to Wagstaff's (1984) critique of the McGlashan, Evans & Orne (1969) article which was entitled "The nature of hypnotic analgesia and the placebo response to experimental pain," published in Psychosomatic Medicine, 31, 227-246. The paper to which the authors are replying is Wagstaff, G. F. (1984). Is hypnotherapy a placebo? Paper given at the First Annual Conference of the British Society of Experimental and Clinical Hypnosis,
Reported a series of experiments: 1. Under atropine, we did not get an orienting response to things having to do with the operation, but did get an orienting response to jokes, dogs barking, and the name of a polite anesthetist. 2. Replicated the research by Bennett and didn't get ear pulling response. 3. Studied cardiac patients. Gave subjects a pre-anesthesia speech of importance [of hearing under anesthesia? Notes here are not clear.] and a chin touch suggestion that was successful. 7 of 30 subjects gave reports of recall - usually recalled something of particular interest to them. These 7 subjects appeared more anxious postoperatively than previously. 4. Recognition study: Pre-op "IQ" test. Gave subjects answers to the questions while they were under anesthesia, and postoperatively they had better performance than previously. 5. Recall study, double blind. Interviewer learned something about the patient, and told them something about what was learned about the patient during anesthesia e.g., You have a lovely garden. After surgery they were hypnotized by someone who did not know what information was given, and then recall for information "heard" under anesthesia was tested. 6. 10 female patients who were good hypnotic subjects, all received the same statement under anesthesia, that they would believe for a moment that they had green hair. During the interview, one said she was fascinated by green things, one wanted to go home and wash her hair.
The author writes of the "domain of hypnosis" as within the larger domain of social psychology (because it is usually interpersonal); cognitive psychology (because of alterations in perception, imagination, memory, and thought); developmental and personality psychology (because of individual differences); and physiological psychology (because of neurophysiological aspects).
"In this experiment, we attempted to apply the distinction between memory and awareness of memory to the question of whether adequately anesthetized and apparently unconscious patients can register and retain what is said in their presence during surgery. Prior research relating to this question has focused, for the most part, on the ability of postoperative patients to recall or recognize a specific item....The inference need not be drawn, however, that 'patients in so-called surgical planes of anesthesia cannot hear' (15, p. 89) or that anesthetized patients cannot encode and store in memory events that transpire during their surgery. The possibility remains that even though the effects of memory for intraoperative events may not--and probably cannot--be revealed in postoperative tests of retention that require remembering to be deliberate or intentional, such effects might be evident in the performance of tests that do not demand awareness of remembering.
This study compared effectiveness of direct hypnosis and indirect hypnosis (Rapid Induction Analgesia, developed by Joseph Barber) in reducing experimental and clinical pain in spinal cord injured patients. The 30 male paraplegic patients who had chronic benign pain volunteered for the study. They were administered three tests: the Pain Estimate Scale (Sternbach, 1974), Ischemic Muscle Pain Test (IMPT), and the Stanford Profile Hypnotic Susceptibility Scale, Form II -- SPHSS -- (Weitzenhoffer and Hilgard, 1967). Each patient experienced three sessions: (1) Baseline Control, (2) Direct Hypnosis, and (3) Indirect Hypnosis. Patients were randomly assigned to Sessions (2) and (3). The results indicated no significant statistical difference in the effectiveness of direct versus indirect hypnotic analgesia in these chronic pain patients. Direct and indirect hypnosis were equally effective; hypnotizability was not associated with outcome. Furthermore, there was no interaction between treatment effects and pretreatment pain level. The results were similar for both clinical and experimental pain.
Nitrous oxide-oxygen produces a state of consciousness in the patient that is reported to be similar to the hypnotic state. In this investigation, the authors test the hypothesis that nitrous oxide-oxygen heightens a patient's responsiveness.
Several cases are described and observations made about the interplay of forces between staff, patient, and therapist, as well as the expectations of the patients to assess how these factors influenced the use of hypnosis. Hypnosis appears to be a particularly useful means for reaching isolated and depressed children with burns and for improving the morale of the staff team working with these children. The results may be along specific lines in terms of pain tolerance and improved eating, or in general improvement of cooperativeness and mood on the part of the child. (PsycINFO Database Record (c) 2002 APA, all rights reserved)
Attar, A.; Muftic, M. (1964). Narcohypnosis in abdominal surgery. British Journal of Medical Hypnotism, 16 (1), 29-32.
Although a review of relevant literature turned up little in the way of statistical studies, some case studies were located in which unintended or unexpected results of hypnosis were observed. The authors located 15 cases in which the symptoms that developed subsequent to symptom removal using hypnosis were more disturbing than the original symptom. This type of response occurred in patients with extensive psychiatric history, prior to the hypnosis experience. However, it could not be determined whether the undesired response was due to hypnosis or to the psychotherapy that was provided to these patients.
"Summary and Conclusions
Author describes a case highly resistant both to anesthesia and dentistry. Although very responsive to hypnosis, she continued moaning and moving from side to side (later determined to be her way of preventing dental work even though anesthetized). Ultimately a combination of hypnosis and multiple anesthetics was needed, including nembutal, sodium pentothal, nitrous oxide and novocain. In the author's experience, most other patients require only hypnosis or hypnosis plus novocaine.