Medical hypnosis can be beneficial in all the fields of medicine. In obstetrics, it is being used for pain relief of labor and delivery. Hypnosis is a focused form of concentration. Self-hypnosis is one form of hypnosis in which a certified practitioner or therapist teaches an individual to induce his or her own state of altered consciousness. When used for childbirth pain, the primary aim of self-hypnosis is to help the woman maintain control by managing anxiety and discomfort though inducing a focused state of relaxation(1). Meta-analysis of 18 studies on the effectiveness of hypnosis in pain management revealed a moderate to large hypnoanalgesic effect, supporting the efficacy of hypnotic techniques for pain management. The results also indicated that hypnotic suggestion was equally effective in reducing both clinical and experimental pain. The overall results suggest broader application of hypnoanalgesic techniques with pain patients(2).
In order to examine the benefits resulting from the use of hypnosis in obstetrics, 21 infants delivered with the help of this technic were studied clinically and biochemically and compared with infants born under various types of analgesia and anesthesia. Of the 21 babies, 20 were in excellent clinical condition at birth. This was not significantly different from the incidence found in a regional anesthesia group. Biochemical analysis of cord blood samples were also similar in most groups and consistent with mild to moderate asphyxia present in all the infants. However, serial determinations of the acid-base status during the first hour of life showed a significantly greater ability of the hypnosis group of babies to recover from the asphyxia of birth, as compared to the non-hypnosis infants including a non-medicated regional anesthesia group(3).
A study on the effects of hypnotherapy on the first and second stages of labour in a large group of pregnant women showed that “the mean lengths of the first stage of labour in the primigravid women was 6.4 h after hypnosis and 9.3 h in the control group (P
Hypnosis reduces distress and duration of an invasive medical procedure for children with urinary tract abnormalities undergoing voiding cystourethrography (VCUG)(5).
Hypnotic intervention also can accelerate postoperative wound healing as cited in the study on the site-specific effects on physical healing per se. In this randomized controlled trial, the relative efficacy of an adjunctive hypnotic intervention, supportive attention, and usual care only on early post-surgical wound healing were compared. Eighteen healthy women presenting consecutively for medically recommended reduction mammaplasty at an ambulatory surgery practice underwent the same surgical protocol and postoperative care following preoperative randomization (n = 6 each) to one of the three treatment conditions: usual care, 8 adjunctive supportive attention sessions, or 8 adjunctive hypnosis sessions targeting accelerated wound healing(6).
Orthopedic hand-surgery patients experience severe pain postoperatively, yet they must engage in painful exercises and wound care shortly after surgery; poor patient involvement may result in loss of function and disfigurement. This study tested a hypnosis intervention designed to reduce pain perception, enhance postsurgical recovery, and facilitate rehabilitation. Using a quasi-experimental research design, 60 hand-surgery patients received either usual treatment or usual treatment plus hypnosis. After controlling for gender, race, and pretreatment scores, the hypnosis group showed significant decreases in measures of perceived pain intensity (PPI), perceived pain affect (PPA), and state anxiety. In addition, physician’s ratings of progress were significantly higher for experimental subjects than for controls, and the experimental group had significantly fewer medical complications. These results suggest that a brief hypnosis intervention may reduce orthopedic hand-surgery patients’ postsurgical PPI, PPA, and anxiety; decrease comorbidity; and enhance postsurgical recovery and rehabilitation. However, true experimental research designs with other types of controls must be employed to determine more fully the contribution of hypnosis to improved outcome(7).
Medical hypnosis is also being used by patients with cancer. This is a clinical report relating the experience gained in 24 months of study of 27 children using contemporary medical hypnosis in combating some aspects of malignancies. The afflicted children, aged 4 to 20, were trained at Children’s Hospital in Denver in group trance sessions to induce trance in themselves. Varying degrees of success are recorded, from poor to excellent. The anxiety which was the common experience of all concerned is recognized; its alleviation through denial is discussed. Obtained with the trance state were more rest, easier and longer sleep, more adequate food and fluid intake and retention, and greater tolerance for and manageability during diagnostic and therapeutic procedures. Fear, anxiety, depression, overdetermined response to discomfort, and anticipatory vomiting prior to treatment were diminished. A net positive opinion of the value of this adjunctive treatment is shared by the authors(8).
Another study explored using hypnosis for pain and anxiety management in 6 colonoscopy patients (5 men, 1 woman), who received a hypnotic induction and instruction in self-hypnosis on the day of their colonoscopy. Patients’ levels of anxiety were obtained before and after the hypnotic induction using Visual Analogue Scales (VAS). Following colonoscopy, VASs were used to assess anxiety and pain during colonoscopy, perceived effectiveness of hypnosis, and patient satisfaction with medical care. Hypnotizability was assessed at a separate appointment. The authors also obtained data (time for procedure, number of vasovagal events, and recovery time) for 10 consecutive patients who received standard care. Results suggest that hypnosis appears to be a feasible method to manage anxiety and pain associated with colonoscopy, reduces the need for sedation, and may have other benefits such as reduced vasovagal events and recovery time(9).
Hypnosis is an alternative or complementary therapy that has been used since ancient times to treat medical and dermatologic problems. A MEDLINE search was conducted from January 1966 through December 1998 on key words related to hypnosis and skin disorders. Results showed a wide spectrum of dermatologic disorders may be improved or cured using hypnosis as an alternative or complementary therapy, including acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hence, appropriately trained clinicians may successfully use hypnosis in selected patients as alternative or complementary therapy for many dermatologic disorders (10).
By: Eleen Gumpal, MD
1. MCN, American Journal of Maternal Child Nursing:
November/December 2002 – Volume 27 – Issue 6 – pp 335-340
2. International Journal of Clinical and Experimental Hypnosis
Volume 48, Issue 2, 2000
3. Frank Moya, M.D.; L. Stanley James, M.B Medical Hypnosis for Obstetrics, Clinical and Biochemical Evidence Indicates That Cautious and Competent Administration Is Required; JAMA. 1960;174(16):2026-2032. doi: 10.1001/jama.1960.03030160012004
4. Mary W. Jenkins Medical Hypnotherapist, Hypnosis: practical applications and theoretical considerations in normal labour, BJOG: An International Journal of Obstetrics & Gynaecology, Volume 100, Issue 3, pages 221–226, March 1993
5. PEDIATRICS Vol. 115 No. 1 January 1, 2005 ,pp. e77 -e85 ‘(doi: 10.1542/peds.2004-0818) Copyright © 2005 by the American Academy of Pediatrics
6. C Ginandes, P Brooks,et al 2003 – Taylor & Francis Online, American Journal of Clinical Hypnosis,Volume 45, Issue 4, 2003
7. MH Mauer, KF Burnett, et al. Medical hypnosis and orthopedic hand surgery: Pain perception, postoperative recovery, and therapeutic comfort, International Journal of Clinical and Experimental Hypnosis,Volume 47, Issue 2, 1999
8. W LaBaw, C Holton, K Tewell,et al.The Use of Self-Hypnosis by Children with Cancer, American Journal of Clinical Hypnosis,Volume 17, Issue 4, 1975, Taylor & Francis Online
9. G Elkins, et al, Hypnosis to Manage Anxiety and Pain Associated with Colonoscopy for Colorectal Cancer Screening: Case Studies and Possible Benefits, International Journal of Clinical and Experimental Hypnosis, Volume 54, Issue 4, 2006
10. Philip D. Shenefelt, MD, MS, Hypnosis in Dermatology, Arch Dermatol. 2000;136:393-399.