Imagining yourself free of pain


When Mike Muller had nine-hour cancer surgery two years ago, he was fishing with his father -- or at least he thought he was.

Muller, 64, prepared for the operation with a hypnosis session from Dr. Eleanor D. Laser, a clinical psychotherapist in Chicago specializing in medical hypnosis, hypnotherapy and hypnoanesthesiology.

Thanks to hypnosis, Muller says, his recovery time was accelerated, he needed less medication, and his post-surgery pain was more manageable.

"People think it's voodoo medicine, and it's not," says the Chicago resident. "I had to take all my old prejudices and cast them away."

Muller isn't the only one who's trashing his hocus-pocus notions of hypnosis; many doctors are, too, as more evidence surfaces about the power of psychological interventions to help solve physical problems.

The medical community is beginning to make room for people like Laser, who use hypnosis to manage medical and other health-related conditions.

The American Society of Clinical Hypnosis in Chicago, which has 2,400 members, and the Society for Clinical and Experimental Hypnosis in Washington state, with nearly 1,000 members, are among the most respected institutions in the field.

Dr. Arreed Barabasz, president of the Washington state-based organization, which offers training and certification programs, describes hypnosis as "attention plus concentration, which leads to controlled imagination."

The technique is used in everything from dermatology to dentistry and may be administered before or during surgery as a complement or even a substitute for anesthesia. Or it may be used as a method to deal with chronic pain. Some doctors use simple relaxation techniques, while others take patients as deep into the hypnotic state as they can.

"When hypnosis works, it can really create some dramatic effects," says Dr. David Patterson, a professor of psychology in the department of rehabilitation medicine at the University of Washington's Harborview Medical Center. "You're not relying on drugs; there are no side effects."

A study in the Lancet journal of medicine in April reported that hypnosis reduced levels of pain and anxiety for recipients of minimally invasive surgeries. And beyond physical benefits, the Lancet study says hypnosis has financial perks.

Dr. Elvira Lang, an associate professor of radiology and medicine at Harvard Medical School, who led the study, says the cost of surgery was reduced by about $130 when hypnosis was used. The amount of time in the operating room was significantly shortened and less medication was required, she explains.

Another study by Dr. David Spiegel, professor and associate chair of psychiatry and behavioral sciences at Stanford University, found that breast cancer patients receiving hypnosis in addition to their regular weekly treatments, lived significantly longer than a control group lacking hypnosis.

Dr. Francisco Tausk, an associate professor of dermatology at Johns Hopkins University, experimented with the effects of hypnosis and relaxation on psoriasis sufferers and discovered that symptoms significantly improved in highly hypnotizable sufferers.

Tausk says hypnosis works best for conditions where stress plays a major role, such as psoriasis, and he agrees that it's effective in pain relief. But he's not ready to promote the powers of hypnosis in much else.

"Most of it is bunk," Tausk believes. "It has been used for everything, but not many [things] that you really have scientific support for."

Lisa Hansen, who went to Harborview's Patterson two years ago, has no doubts about hypnosis. The 38-year-old sought help to mentally prepare herself for brain surgery and says hypnosis had a definite impact on her recovery.

The day after surgery, Hansen says, her nurse was surprised that she had hardly used her painkillers. Instead, Hansen was using relaxation techniques and self-hypnosis to deal with the pain.

"It's really fascinating," she says. "I'm so glad I did it."

No one is certain why hypnosis and pain relief are such a good match. But the dissociative nature of hypnosis seems to offer clues.

"You have to pay attention to pain," Spiegel says. "You shift your attention and actually change what you feel." Spiegel says hypnosis works on the brain's primary sensory mechanisms, influencing a person's perception.

The medical application of hypnosis can be traced back more than 200 years to the Austrian physician Anton Mesmer, considered by many at the time to be a practitioner of black magic.

Some of the shady overtones associated with hypnosis still exist. When many people hear the word hypnosis, they think of stage shows where unsuspecting volunteers in hypnotic states bark like dogs and hop on one foot. And inadequately trained hypnotists promising instant relief for everything from overeating to smoking have also contributed to the stigma.

But doctors stress that hypnotism isn't magic and say the concepts behind it are simple.

"It's like getting absorbed in a book or a good movie," says Lang. "There may be people throwing popcorn on you," but you don't seem to notice it as much, if at all.

In terms of physiology, there is controversy regarding whether hypnosis actually changes brain wave patterns. Patterson says recent research using sophisticated brain imaging equipment has shown that parts of the brain are stimulated in the hypnotic state.

The more obvious benefits of hypnosis -- relaxation, reduction of tension and stress -- can make all the difference in how a patient experiences surgery, Lang says.

While adhering to a basic framework, practitioners can structure their method of hypnosis in various ways.

"There is no way to standardize these things," says Dr. Jerry Steiner, a Baltimore County dentist who has been using hypnosis on some of his patients since 1953.

"I tailor it to what I feel each patient would respond to best," he says.

To induce and deepen hypnosis, Steiner may suggest that the person is taking an escalator from a top floor. Other therapists use scripts, which could range from Steiner's method to having the patient mentally walk down a flight of stairs or count backward. The days of the swinging pocket watch and "You're feeling very sleepy" may be gone, but the focus is still on getting patients to breathe deeply and relax.

When Patterson was hypnotizing Hansen, she recalls it feeling like "he was talking to my body, not to me. He has you think of a serene spot. He gradually guided me to it." Visualization is a common technique. For example, Laser encourages patients to visit a "vacation spot."

After a hypnotic state has been achieved, the hypnotist may then offer suggestions. In Tausk's case, the suggestion can be as simple as telling psoriasis patients that the treatment they are receiving is working.

To deal with such behaviors as overeating and smoking, Laser takes the patient back to the experience that may have triggered the behavior, and shifts it. The behavior then "takes on a new meaning," she says, and the need to smoke or overeat may be eliminated.

According to Patterson, who uses hypnosis to ease the pain of people with major burns, about 10 percent to 15 percent of the population is highly hypnotizable. The same number are difficult or impossible to hypnotize.

Barabasz of the American Society for Clinical and Experimental Hypnosis says highly hypnotizable people tend to be more prone to fantasizing and are more trusting -- the type to get deeply absorbed in things. It has nothing to do with intelligence, he says.

Hypnosis is not a cure-all, doctors agree, but a way of tapping into strengths and potential that are already there.

"All we do is help the patients help themselves," Lang says.

Want to know more?

Learn more about the medical uses of hypnosis at:

The American Society for Clinical Hypnosis

33 West Grand Ave.

Suite 402, Chicago, Ill. 60610

Phone: 312-645-9810


The Society for Clinical and Experimental Hypnosis

2201 Haeder Road

Pullman, Wash. 99163

Phone: 509-332-7555


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