The International Journal of Clinical and Experimental Hypnosis
Volume 45, Number 4 - October 1997 - English
Internal and external distraction in the control of cold-pressor pain as a function of hypnotizability.
Farthing,-G.-William; Venturino,-Michael; Brown,-Scott-W.; Lazar,-Joel-D.
Compared the effectiveness of different pain-distraction tasks as a function of level of hypnotizability, using the cold-pressor pain-testing procedure. Selected high, medium, or low hypnotizable undergraduates first underwent a 1-min baseline immersion of a hand in ice water, with periodic pain ratings. Independent groups were then given 4-min test immersions under 1 of 5 conditions. Analgesia suggestion and guided imagery were conceived to be internal distractors, whereas word memory and pursuit-rotor tasks were external distractors. Placebo-control groups were given permission to let their minds wander. All 4 experimental treatments reduced pain significantly for highly hypnotizable Ss, compared to control Ss, whereas none of the experimental treatments were effective for low hypnotizable Ss. The different treatment instructions did not produce different preimmersion anxiety state ratings, so the treatment effects on pain ratings could not be explained in terms of their effects on anxiety. It appears that high hypnotizable Ss are more effective than low hypnotizable Ss at diverting attention to control pain, regardless of whether internal or external distractor tasks are used.
Self-hypnosis training as an adjunctive treatment in the management of pain associated with sickle cell disease.
Dinges,-David-F.; Whitehouse,-Wayne-G.; Orne,-Emily-Carota; Bloom,-Peter-B.; Carlin,-Michele-M.; Bauer,-Nancy-K.; Gillen,-Kelly-A.; Shapiro,-Barbara-S.; Ohene-Frempong,-Kwaku; Dampier,-Carlton; Orne,-Martin-T.
Examined the efficacy of a supplemental cognitive-behavioral pain management program centering on self-hypnosis (SFH) among 37 patients with sickle cell disease (aged 5-51 yrs) who reported experiencing 3 or more episodes of vaso-occlusive pain the preceding year. Frequency of SFH group training sessions were once per week for the first 6 mo, biweekly for the next 6 mo, and once every 3rd wk for the final 6 mo. SFH intervention was associated with a significant reduction in pain days. Both the proportion of "bad sleep" nights and the use of pain medications also decreased significantly during the SFH treatment phase. However, Ss continued to report disturbed sleep and to require medications on those days during which they did experience pain. Results suggest that overall reduction in pain frequency was due to elimination of less severe pain episodes, and that nonspecific factors may have contributed to treatment efficacy. Nevertheless, results show that an adjunctive behavioral treatment for sickle cell pain, involving patient self-management and regular contact with a medical SFH team, can be beneficial in reducing recurrent, unpredictable episodes of pain in a patient population for whom few safe, cost-effective medical alternatives exist.
Cognitive-behavioral therapy for clinical pain control: A 15-year update and its relationship to hypnosis.
Updates S. Y. Tan's (1982) review of cognitive and cognitive-behavioral methods for pain control and extends this review to include discussion of the relationship between hypnosis and cognitive-behavrioal therapy in this area. In the 15 yrs since the publication of Tan's (1982) review, significant advances have been made in cognitive-behavioral therapy for pain. The scientific evidence for its efficacy for clinical pain attenuation is now much more substantial and is briefly reviewed. In particular, cognitive-behavioral therapy for chronic pain was recently listed as one of 25 empirically validated or supported psychological treatments available for various disorders. A number of emerging issues are further discussed in light of recent developments and research findings. The relationship of cognitive-behavioral therapy to hypnosis for pain control is addressed, with suggestions for integrating hypnotic and cognitive-behavioral techniques.
Factors predicting hypnotic analgesia in clinical burn pain.
Patterson,-David-R.; Adcock,-Rebecca-J.; Bombardier,-Charles-H.
The use of hypnosis for treating pain from severe burn injuries has received strong anecdotal support from case reports. Controlled studies provide less dramatic but empirically sound support for the use of hypnosis with this problem. The mechanisms behind hypnotic analgesia for burn pain are poorly understood with this patient population, as they are with pain in general. It is likely that, whatever the mechanisms are behind hypnotic pain analgesia, patients with burn injuries are more receptive to hypnosis than the general population. This article postulates some variables that may account for this enhanced receptivity, including motivation, hypnotizability, dissociation, and regression.
Hypnotic control of pain: Historical perspectives and future prospects.
Discusses the history and professional acceptance of hypnotic analgesia (HPA). HPA emerged early in the 19th century when effective clinical techniques for pain management (PMT) had not yet developed, and the relief of pain and suffering had not even become a well-defined social goal. Acceptance of HPA was complicated by political struggles surrounding the humanitarian transformation of medicine and a redefinition of the physician-patient relationship. The initial struggle for professional acceptance was won only when the debate became localized within the professional community. Acceptance of hypnosis by professional organizations has been followed by alternating periods of interest and indifference. While evidence for effects of suggestion and related variables has been observed and reported in nonhypnotic contexts, their relationship to hypnotic phenomena has often not been appreciated. Since the mid-20th century, scientific information about HPA has grown substantially and has had significant influence on strategies for acute and chronic PMT. It is argued that if recent calls for wider application of HPA in PMT are to succeed, additional data from clinical populations and a balanced and scientifically prudent approach by its advocates are required.