The International Journal of Clinical and Experimental Hypnosis
Volume 46, Number 1 - January 1998 - English
The folly of effort: Ironic effects in the mental control of pain.
Eastwood,-John-D.; Gaskovski,-Peter; Bowers,-Kenneth-S.
During exposure to pain, 49 college students who were engaged in hypnotic analgesia or stress inoculation provided pain reports every 5 sec and 45 sec, respectively. It was found that the frequency of pain reporting had a significant effect on Ss' level of experienced pain. This finding is discussed in the context of important methodological implications for laboratory investigations of analgesia. Furthermore, preliminary evidence was obtained suggesting that high hypnotizables in hypnotic analgesia remained relatively undisrupted by frequent pain reporting. Based on D. M. Wegner's (1994) ironic process theory, it is argued that this pattern of results is inconsistent with theories of hypnosis that propose that hypnotized individuals intentionally engender responses while remaining unaware of their sustained, deliberate effort. The obtained pattern of results, however, was predicted from the dissociated control model of hypnosis (Bowers, 1990,1992).
Hypnotic pain control: Some theoretical and practical issues.
Pain management programs assist patients to use their behavioral and cognitive skills for the purpose of rendering their experience of pain as more tolerable in some way. Hypnotic procedures may be included in this perspective. Thus, hypnosis may be best conceived as a set of skills to be deployed by the individual rather than as a state. The authors contend that such an emphasis is more compatible with the approaches of some pain management practitioners who have been generally slow to acknowledge the value of hypnosis and to incorporate hypnosis in their range of treatment skills. In this article, the authors present a minimal and atheoretical definition of hypnosis, and they list the basic properties of hypnosis that may be used in the treatment of pain. For a number of reasons, it is suggested that undertaking hypnosis as though the individual were indeed being placed into a special trance state may in some cases promote an effective outcome. However, it should be acknowledged that there may be instances when the relevant skills may be more effectively engaged at the expense of a strict special trance state by targeting the specific skills that are to be used for therapeutic benefit. Case illustrations are presented.
Cognitive aspects of pain and pain control.
Reviews some of the theoretical and experimental bases of cognitive approaches to pain control, as well as examples of the techniques used. Special emphasis is given to self-efficacy, perceived control, and stress inoculation therapy. There is also discussion of some of the limitations of the cognitive approach. The overall conclusion is that the cognitive approach is a powerful and effective one for pain control despite its limitations.
The mysterious persistence of hypnotic analgesia.
Hypnotic treatment of pain has a long history and, among hypnotic phenomena, pain relief is a relatively commonplace focus for intervention, yet we lack a conceptual explanation for this treatment. Hilgard's neodissociation theory accounts for the phenomenon of acute hypnotic analgesia, but not of persistent pain relief. How does a clinician effect persistent hypnotic analgesia? In exploring this question, the author illustrates and further elaborates on the nature of hypnotic responding in a clinical setting; briefly summarizes what we can learn from the laboratory investigation of hypnotic suggestion; proposes 2 hypotheses of how hypnotic suggestion in a clinical setting might operate; and describes various methods used to treat recurring pain.
Hypnotic analgesia: A constructivist framework.
Reviews a few historically dominant and contemporary models of pain and points out the limitations of such models. The authors also propose a new constructivist framework for understanding pain processing that emphasizes how the brain constructs the content of consciousness (i.e., painful experience) from dynamically distributed processing in large-scale neurocognitive networks that operate in parallel. Finally, they consider implications of the new framework for pain and hypnotic analgesia research.