Can Hypnosis Improve the Quality of Life for Individuals with Chronic Illnesses?
Hypnosis has been used as a psychological treatment for a variety of illnesses with apparent success. While it is unlikely that hypnotic suggestions are capable of curing physical disease, they can be used to enhance relaxation and alleviate pain and other physical discomforts, and therefore they may make a positive contribution to the overall quality of care and of life. For example, several controlled studies have shown that hypnotic suggestions administered to patients who suffer from asthma can reduce both bronchodilator use and attacks of "wheezing", as well as increase peak expiratory flow rates. Hypnosis has also been used effectively in the treatment of irritable bowel syndrome, hyperemesis gravidarum (persistent nausea and vomiting) in pregnant women, and anticipatory nausea experienced by cancer patients who receive chemotherapy. Hypnotic suggestions have been observed to stimulate and inhibit allergic responses, and may also speed the healing of burns and wounds, but these issues require further carefully controlled study.
Even though the use of hypnosis may be associated with positive therapeutic outcomes, it is not clear that hypnosis itself is responsible for the effects observed. The active ingredient in some treatments labeled "hypnosis" might be mere relaxation, or a kind of placebo effect attributable to the use of a hypnotic ritual. It is well known, for example, that the "relaxation response" meditation technique introduced by Benson can alter blood pressure, heart rate, oxygen consumption, and the levels of certain neurotransmitters. The relaxation response is not the same as hypnosis, but hypnotic techniques may achieve some of their effects by virtue of the high levels of relaxation commonly associated with them. In the case of asthma, however, hypnosis seems to have a specific effect over and above relaxation.
The professional and popular literature contains occasional reports of clinical improvements and even cures of cancer in patients who have been treated with hypnosis or related techniques, such a relaxation and imagery. However, these apparent successes are typically poorly documented, and in the final analysis it is difficult to distinguish such "miracle cures" from spontaneous remissions which sometimes occur in these conditions. The most appropriate use of hypnosis in cancer treatment is as a complement to traditional medical treatments, such as chemotherapy, with the goal of enhancing the patient's quality of life while treatment is in progress.
Can Hypnosis be used in Pain Reduction?
Hypnosis has been employed in the clinic for both medical and psychotherapeutic purposes. By far the most successful and best documented of these has been hypnotic analgesia for the relief of pain. Clinical studies indicate that hypnosis can effectively relieve pain in patients suffering pain from burns, cancer and leukemia (e.g., bone marrow aspirations), childbirth, and dental procedures. In such circumstances, as many as half of an unselected patient population can obtain significant, if not total, pain relief from hypnosis. Hypnosis may be especially useful in cases of chronic pain, where chemical analgesics such as morphine pose risks of tolerance and addiction. Hypnosis has also been used, somewhat heroically perhaps, as the sole analgesic agent in abdominal, breast, cardiac, and genitourinary surgery, and in orthopedic situations, although it seems unlikely that more than about 10% of patients can tolerate major medical procedures with hypnosis alone.
A comparative study of experimental pain found that, among hypnotizable people, hypnotic analgesia was superior to morphine, diazepam, aspirin, acupuncture, and biofeedback (Click on to the figure at the right to see an enlarged view). Hypnotic analgesia relieves both sensory pain and suffering. It is not a matter of simple relaxation or self-distraction. It does not appear to be mediated by endorphins or other endogenous opiates. There is a placebo component to all active analgesic agents, and hypnosis is no exception; however, hypnotizable people receive benefits from hypnotic suggestion that outweigh those of plausible placebos.
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