Hypnotherapy can be quite effective in the treatment of chronic pain. The goal is not merely trance induction to decrease stress, but to actually use the trance state to tap into the ability of the unconscious mind to reduce pain. Hypnotherapy for chronic pain patients is taught to the patient as self hypnosis. This is done in three to four sessions. The mistake of much hypnosis used for pain control is to be indirect with the pain. Our approach is to take the pain on and to use pain control images and paradoxes to reduce the pain.

Hypnosis is a common state of mind experienced by all people. This is explained to all patients to take the mystery out of hypnotherapy. It is also important to note that self-hypnosis is learned behavior that most often improves with increased practice.

During the first session a trance is induced and several pain reduction images are taught, while the patient is in trance. The objective of the first session is to teach the patient a fairly easy way to induce self hypnosis and to use the pain reduction techniques between the first and second session. The patient is asked to practice this two times daily. Post hypnotic suggestion is used to sustain any pain control developed during the first session. The second session is scheduled in two to three weeks.

The second session begins with a review of the practice between sessions. Patients are discouraged from using tapes, because the technique of self hypnosis is something that will need to be used when no tapes are available. Once progress from the first session is determined, another trance induction technique is used to add to the patient's choices for trance induction. Again the induction is an uncomplicated technique that is easy to adapt to self-hypnosis. New pain reduction techniques are used in trance and the patient is given post hypnotic suggestions for their use after the session. The patient is encouraged to be creative with pain control techniques and use the ones currently taught as springboards for developing more personally meaningful images.

If the patient is showing poor progress at the third session, reasons for treatment failure are explored. Often the patient is falling asleep after trance is self induced or they are using trance to relax, but are not using pain control techniques. Sometimes patients do not feel comfortable with the first two trance inductions and may respond well to more mechanical techniques such as tensing and relaxing muscle groups (autogenic training) or geometric breathing. For these patients the third session is used to reinforce the need to use pain reduction images and to find better self-hypnotic inductions.

For those who have progressed more comfortably and have been able to use self-hypnotic images to reduce pain, the final session is used to teach rapid 20 to 30 second trance inductions to be used throughout the day to reduce stress and control pain. These rapid induction techniques can be used in public situations, without detection by others.

This technique can be taught on tape, but the tape should caution the patient to use the tape in a stepwise fashion and not move onto the next phase until mastering the current techniques. We feel it is most appropriate for patients to be evaluated for past trauma and for PTSD before using hypnotherapy in person or with hypnotic tapes as hypnosis may precipitate an abreaction in these patients.

As with all other approaches to treating chronic pain, self-hypnosis should be seen as part of a larger armamentarium. No technique, including hypnosis works under all circumstances. Patients who practice diligently and use the trance to actively diminish their pain will have the best results.