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.
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
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.
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.
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.
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.
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
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.