Andrea was a 32 year old professional woman who was referred to me by her primary physician. She had back surgery one year ago to free up a restricted nerve which was causing her a lot of discomfort. Her surgery was successful although she continued to have pain. Although her pain was less than before but she said it still interfered with her sleep and limited her extremely active lifestyle.
Andrea described her job as constant motion; she was a sales rep and did a lot of traveling and was on call 24/7. The financial rewards were enormous but over the last few years she liked it less. Further into our initial conversation I learned that Andrea was brought up in an athletic family; her father was a high school track coach who instilled his militaristic views on fitness to his family. When she wasn’t working she was a long distance competitive runner. In addition to all of this stress, she recently went through a divorce.
We talked a lot about her lifestyle, the surgery and how things are marginally better now compared to before surgery. I then asked her if she was happy. She didn’t understand what that would have to do with the pain so I explained that what we think about most on a day-to-day basis has a significant affect on how we feel physically, emotionally and even the types of situations we attract into our lives. I also added that apparently there was a physical component to her pain which surgery seemed to improve but that there also could be an emotional component still in need of attention.
I told her about a sixteen year old boy, Jeff (not his real name), who had come to me for IBS. He was not progressing as well as I thought he should, so during a session I asked him to look forward in time and see himself free of IBS, after the session he said he couldn’t envision such a scenario. He said everyone knew him as the kid battling IBS. He said it was part of who he was.
In a subsequent session in which we dialoged back and forth I asked him if the healthy Jeff would be able to help the IBS Jeff through this transition, to which he agreed. I then asked IBS Jeff if he thought it was a good idea to take a rest and let healthy Jeff lead the way, which also got a positive response. This is called parts therapy and can be an extremely powerful tool to free up inner conflict creating resolution, freedom and relief. After this session Jeff quickly began experience relief from his IBS symptoms.
Andrea was intrigued and excited to pursue hypnosis. In her first session I helped her learn how to deeply relax and to also stimulate the flow of endorphins which can be extremely comforting. When she came back in two weeks for her next session she was smiling and experiencing some relief but still had some discomfort. She agreed to try dialoging during this session as had I described doing with Jeff.
In hypnosis, I asked Andrea what she thought the source of her remaining discomfort might and she was quick to respond. She said she hated her job and always had. Her father had a sales job and he pushed her into doing the same. She also hated running and maintaining her family’s ridiculous fitness standards. I asked her what changes she might make that could help her with her discomfort and she said her first move was to search out a job that she was passionate about and also starting to listen to her body more rather than punishing it with endless exercise. She also said that because hypnosis has brought her such clarity she would continue practicing self-hypnosis.
At the conclusion of the session Andrea was very emotional. She had been driven for so long by values she couldn’t live with and to experience such immediate and complete freedom from the weight of such a burden can be an amazing experience. So many times I see clients who think they know what their problem is only to learn it was something completely different.
Andrea came back for a couple of more visits. Her pain was gone and she was excited about her future. She, of course, still wasn’t sure what path she might take but she certainly knew that positive healthy change was coming and was very open to consider all possibilities.
By: Paul Gustafson RN CH
Although hypnosis has been shown to reduce pain perception, it is not clear how the technique works. Identifying a sound, scientific explanation for hypnosis’ effect might increase acceptance and use of this safe pain-reduction option in clinical settings.
Researchers at the University of Iowa Roy J.and Lucille A. 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 that might explain pain reduction. The results are reported in the November-December 2004 issue of Regional Anesthesia and Pain Medicine.
The researchers found that volunteers under hypnosis experienced significant pain reduction in response to painful heat. They also had a distinctly different pattern of brain activity compared to when they were not hypnotized and experienced the painful heat. The changes in brain activity suggest that hypnosis somehow blocks the pain signal from getting to the parts of the brain that perceive pain.
“The major finding from our study, which used fMRI for the first time to investigate brain activity under hypnosis for pain suppression, is that we see reduced activity in areas of the pain network and increased activity in other areas of the brain under hypnosis,” said Sebastian Schulz-Stubner, M.D., Ph.D., UI assistant professor (clinical) of anesthesia and first author of the study. “The increased activity might be specific for hypnosis or might be non-specific, but it definitely does something to reduce the pain signal input into the cortical structure.”
The pain network functions like a relay system with an input pain signal from a peripheral nerve going to the spinal cord where the information is processed and passed on to the brain stem. From there the signal goes to the mid-brain region and finally into the cortical brain region that deals with conscious perception of external stimuli like pain.
Processing of the pain signal through the lower parts of the pain network looked the same in the brain images for both hypnotized and non-hypnotized trials, but activity in the top level of the network, which would be responsible for “feeling” the pain, was reduced under hypnosis.
Initially, 12 volunteers at the Technical University of Aachen had a heating device placed on their skin to determine the temperature that each volunteer considered painful (8 out of 10 on a 0 to 10 pain scale). The volunteers were then split into two groups. One group was hypnotized, placed in the fMRI machine and their brain activity scanned while the painful thermal stimuli was applied.
Then the hypnotic state was broken and a second fMRI scan was performed without hypnosis while the same painful heat was again applied to the volunteer’s skin. The second group underwent their first fMRI scan without hypnosis followed by a second scan under hypnosis.
Hypnosis was successful in reducing pain perception for all 12 participants. Hypnotized volunteers reported either no pain or significantly reduced pain (less than 3 on the 0-10 pain scale) in response to the painful heat.
Under hypnosis, fMRI showed that brain activity was reduced in areas of the pain network, including the primary sensory cortex, which is responsible for pain perception. The imaging studies also showed increased activation in two other brain structures — the left anterior cingulate cortex and the basal ganglia.
The researchers speculate that increased activity in these two regions may be part of an inhibition pathway that blocks the pain signal from reaching the higher cortical structures responsible for pain perception. However, Schulz-Stubner noted that more detailed fMRI images are needed to definitively identify the exact areas involved in hypnosis-induced pain reduction, and he hoped that the newer generation of fMRI machines would be capable of providing more answers.
“Imaging studies like this one improve our understanding of what might be going on and help researchers ask even more specific questions aimed at identifying the underlying mechanism,” Schulz-Stubner said. “It is one piece of the puzzle that moves us a little closer to a final answer for how hypnosis really works.
“More practically, for clinical use, it helps to dispel prejudice about hypnosis as a technique to manage pain because we can show an objective, measurable change in brain activity linked to a reduced perception of pain,” he added.
In addition to Schulz-Stubner, the research team included Timo Krings, M.D., Ingo Meister, M.D., Stefen Rex, M.D., Armin Thron, M.D., Ph.D. and Rolf Rossaint, M.D., Ph.D., from the Technical University of Aachen, Germany.
University of Iowa Health Caredescribes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at www.uihealthcare.com.
STORY SOURCE:University of Iowa Health Science Relations, 5135 Westlawn,Iowa City,Iowa52242-1178
Tania Lapointe is the happy mother of three young children. But when she recalls giving birth to her two boys, 5-year-old Guille and 2-year-old Philip, she is not exactly overcome by a warm, maternal glow of remembrance.
“I was in extreme pain — the kind of pain where I was almost convulsing, screaming ‘give me drugs, give me drugs,'” Lapointe said. For her baby Chole, born one month ago, Lapointe was determined it was going to be different, and it was. During labor, without any medication at all, she was calm, quiet, and peaceful, surrounded by her husband, her mid-wife and Maureen Saba, the woman who taught her how to perform self-hypnosis.
Saba, a hypno-birthing practitioner, has taught Lapointe and dozens of other women how to be self-hypnotized during birthing. The women use positive images and relaxation exercises to ease the pain of childbirth, and for many, the results have been outstanding, advocates say.
Summoning Serenity During Labor
“They are so focused, they are in such control. It’s incredible,” Saba said. Though self-hypnosis is not a new idea, it is a rising trend in natural childbirth. Many people think a hypnotist as someone waving a pocket watch in front of a person’s eyes to make them do things they would not normally do. But when it comes to clinical applications, hypnosis is nothing like what you may have seen on stage, or in movies.
Women are encouraged to think of birth pains as surges or pressure rather than “contractions.” They are asked to picture themselves in a serene location, such as the beach. The hypno-birthing practitioner encourages them to feel waves of relaxation moving through their body.
Some 1,000 instructors are certified through the HypnoBirthing Institute, based in Epsom, N.H. — and the demand for the instructors certainly exists. Lapointe cannot imagine giving birth without one.
“This was like heaven compared to the other two,” Lapointe said. Pregnant mothers or patients who choose to learn self-hypnosis as a way to ease pain during pregnancy or surgical procedures use a combination of techniques to achieve a state of hypnosis. “Some of the basics are learning how to breathe properly how to let the muscles completely relax,” Saba said. “It really must be practiced at home, self-hypnosis gets better with practice,” she said.
Saba has her students attend five classes of self-hypnosis instruction. When they’re done with the classes, they continue to practice at home using tapes and the techniques they learned in class.
Breezing Through Kidney Operation
Hypnosis is not just for the labor room. Robert Scott used hypnosis when he had his second kidney removed at Boston’s Beth Israel Deaconess Medical Center.
His doctor, Elivira Lang, says hypnosis reduces the need for pain medication, which often leaves the patient confused and weakened. It worked for Scott, who said that with just a tiny bit of medication and hypnosis, his second kidney removal was a breeze compared to the last.
“This one I’m much more alert afterwards, much more awake,” Scott said. His experience is not unusual. Dr. Lang has published the results of a study with 241 patients who have undergone hypnosis while having radiological procedures. “We found three things: the procedures are more comfortable, safer and faster,” Lang said. ” I think it’s just a state of focused concentration like you’re watching TV, you’re reading a book.” Doctors in other disciplines also believe in the power of focused concentration.
Taking Sting Out of Burns
Toronto dentist Dr. Victor Rausch uses hypnosis in his practice, and when had his own molar extracted by a colleague, he hypnotized himself, and used no anesthesia. Clinicians have also used hypnosis to help patients through one of the most painful procedures in all of medicine — removing the bandages from a burn victim.
David Patterson, a professor of rehabilitation medicine at the University of Washington, used hypnosis to help electrical technician Ladd Richter, who suffered burns over 20 percent of his body after an electrical explosion. The process helped Richter through the twice-a-day ordeal of treating his wounds, and he felt energized when the hypnosis was done.
“I feel like a million bucks,” Richter said. “When you get up, you feel like you just slept. Like you had a good power nap. Full of energy.” And whether it’s a devastating experience like burns, or a joyous experience like giving birth, the benefits of hypnosis continue into recovery. “The huge difference was my recovery,” Lapointe said. “I was alert after the birth … and this time I was on my feet, right after the birth I was on my feet.”
Courtesy of ABC News
