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
Every time someone goes into hypnosis they have the opportunity of disconnecting and becoming free of past struggles, worries and concerns. It amazes me how quickly most clients experience the positive change they’re looking for.
What also surprises me is how most of the clients I see have absolutely no experience with hypnosis but still manage to succeed with their goals. They routinely have an expression of wonder at the conclusion of their first session. They look around the room trying to figure out what is different until they realize their perspective is what has changed.
This feeling of positive change becomes rooted with repetition. By pressing play once a day their inner thoughts become conditioned to stay on course with success. This process of repetition also creates unexpected freedom, clarity, and relief in areas of their life completely unrelated to the problem than one fix.
By: Paul Gustafson RN CH
As a Registered Nurse, my focus has always leaned more to the medical side of hypnosis. I prefer helping individuals with chronic anxiety, stress, and pain conditions which is why I decided to become an irritable bowel syndrome specialist. IBS is a chronic gastro-intestinal condition (GI) with no known cause or cure.
Symptoms include any one or a combination of the following: diarrhea, constipation, cramping, gas, pain, or bloating. Symptoms usually run in cycles lasting for days, months, or years. IBS making its victims feel like prisoners in their own home.
IBS affects 35 million Americans, 4 of 5 are women, and it is more prevalent than asthma, diabetes, acid reflux and depression combined. There are likely millions who never pursue treatment due to embarrassment. 10% of all primary care physician visits are IBS related. It is the 2nd leading cause for employee absenteeism and costs the US 8 billion dollars/year.
Diagnosing IBS is a process of exclusion which means a physician needs to rule out conditions such as lactose intolerance, Chron’s disease, bacterial infections, parasites, dumping syndrome, ulcerative colitis, inflammatory bowel disease, celiac and gallbladder disease before a diagnosis of IBS can be determined.
The onset of symptoms ranges between the ages of 20-29 in adults and 9-11 in children. Onset of symptoms can sometimes be traced back to a traumatic event, illness, injury, or accident. Some clients just begin having symptoms early in life for no apparent reason at all. IBS is also known to be familial. Many IBS sufferers go through life with no idea of what normal gastro-intestinal function is like.
Symptoms can also be aggravated by stress, chocolate, caffeine, alcohol, foods high in animal or vegetable fat, beverages containing dyes, artificial sweeteners, food or medication sensitivities or hormone fluctuation but none are the cause.
Traditional medical intervention includes high fiber diets, antispasmodics to relieve cramping and spasms; antidepressants to relieve the emotional burden and antidiarrhea medication. Research indicates that this approach offers symptom relief to only 25%. Because IBS is not life threatening, is not a precursor to acute illness and is undetectable with diagnostic equipment, sufferers are usually told they have to live with it.
Hypnosis stands alone as the most significant long-term symptom solution for IBS which is why I chose to specialize in it. IBS hypnosis has been researched for over 20 years and the results are consistently positive. The success rate of hypnosis relieving IBS symptoms ranges from 70-95% and relief is at least two years in duration.
The largest study to date followed 250 IBS clients who were treated with 12 hypnosis sessions over a three month period and they also listened to recorded sessions at home. The conclusions showed dramatic improvement in all IBS symptoms. The average reduction in symptoms was more than 50% as well as increased quality of life and relief from anxiety and depression. (Gonsalkorale, WM., 2002)
Another study compared 25 severe IBS clients treated with hypnosis to 25 patients with similar symptom severity treated with other methods. The hypnosis group showed that in addition to significant IBS symptom improvement participants had fewer MD visits, lost less work time, and rated an improved quality of life. Hypnosis clients unable to work before treatment went back to work afterwards. The study shows the economic benefits and improved health-related quality of life. (Houghton, LA., 1996)
My IBS program involves four gut-specific hypnosis sessions spread out over the course of a three month time period. My clients daily rate all of their symptoms on a scale of one to ten, so we can objectively track their progress. To give you an idea of how effective IBS hypnosis is the average combined symptom rating at the beginning of treatment is 8/10, after 6 sessions it is 3/10
Most IBS clients have suffered with their symptoms for decades, but after a few short months they learn to create peaceful comfort from within. With the help of hypnosis they are able to replace anticipatory anxiety with the expectation of relief. When an individual knows they can control how they feel with their thoughts all bets are off in terms of how long lasting the relief can last.
By: Paul Gustafson RN CH
