Chronic pain can be treated by combining hypnosis with brief psychotherapy. Hypnosis alone, though useful for acute pain, is seldom effective in relieving chronic pain because it does not address the significant psychologic components in the patient's illness. Treatment using self-hypnosis in conjunction with brief psychotherapy, however, can enable the patient to recognize these components, to change from a passive to an active role in achieving relief, and to modify his attitude toward the pain.
The International Journal of Clinical and Experimental Hypnosis
The aim of the present study was (a) to investigate the relative efficacy of autogenic training and future oriented hypnotic imagery in the treatment of tension headache and (b) to explore the extent to which therapy factors such as relaxation, imagery skills, and hypnotizability mediate therapy outcome. Patients were randomly assigned to the 2 therapy conditions and therapists. 55 patients (28 in the autogenic therapy condition and 27 in the future oriented hypnotic imagery condition) completed the 4 therapy sessions and 2 assessment sessions.
The clinical utility of hypnosis for controlling pain during burn wound debridement was investigated. Thirty hospitalized burn patients and their nurses submitted visual analog scales (VAS) for pain during 2 consecutive daily wound debridements. On the 1st day, patients and nurses submitted baseline VAS ratings. Before the next day's would debridement, Ss received hypnosis, attention and information, or no treatment. Only hypnotized Ss reported significant pain reductions relative to pretreatment baseline. This result was corroborated by nurse VAS ratings.
Thirty-two patients hospitalized for the care of major burns were randomly assigned to groups that received hypnosis, lorazepam, hypnosis with lorazepam, or placebo controls as adjuncts to opioids for the control of pain during dressing changes. Analysis of scores on the Visual Analogue Scale indicated that although pain during dressing changes decreased over consecutive days, assignment to the various treatment groups did not have a differential effect.
In this paper I examine the clinical use of hypnosis for pain management from a cognitive-behavioral perspective. This perspective emphasizes the multifaceted nature of hypnotic interventions and the importance of patients' attitudes, expectations, and beliefs in modulating the pain experience. Special attention is given to identifying ways of combining cognitive and contextual variables to maximize clinical outcomes.
Burn pain is almost always acute, and treatment strategies are often on the opposite end of the spectrum from chronic pain. However, many of the techniques developed for chronic pain can be useful for burn pain, particularly when the problem involves characteristics of both. The cognitive styles that patients bring to burn care and the manner in which they interpret nociception provide a rich source of intervention strategies.
Complementary therapies have found increasing vogue in the management of patients with cancer, although little formal evaluation has been undertaken. We report on our experience of offering hynotherapy to palliative care outpatients in a hospice day care setting. During 2 1/2 years, 256 patients had hypnotherapy, all singly; two-thirds (n = 104) were women. Only 13% (n = 21) had four or more treatment sessions. At the time of survey, the 52 patients still alive were mailed an evaluation sheet, of whom 41 responded. 61% reported improved coping with their illness.
OBJECTIVE: Burn injuries produce severe wound care pain that is ideally controlled on intensive burn care units with high-dosage intravenous opioid medications. We report a case illustrating the use of hypnosis for pain management when one opioid medication was ineffective. SETTING: Intensive burn care unit at a regional trauma center. PATIENT: A 55-year-old man with an extensive burn suffered from significant respiratory depression from a low dosage of opioid during wound care and also experienced uncontrolled pain. INTERVENTION: Rapid induction hypnotic analgesia.