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An exploration of the utility of hypnosis in pain management among rural pain patients

Published online by Cambridge University Press:  22 May 2007

THOMAS THORNBERRY
Affiliation:
The Pain Treatment Center of the Bluegrass, Lexington, Kentucky
JENNIFER SCHAEFFER
Affiliation:
The Pain Treatment Center of the Bluegrass, Lexington, Kentucky
PETER D. WRIGHT
Affiliation:
The Pain Treatment Center of the Bluegrass, Lexington, Kentucky
MINDI C. HALEY
Affiliation:
Pharmacy Practice and Science, University of Kentucky, Lexington, Kentucky
KENNETH L. KIRSH
Affiliation:
The Pain Treatment Center of the Bluegrass, Lexington, Kentucky Pharmacy Practice and Science, University of Kentucky, Lexington, Kentucky

Abstract

Objective: Hypnosis is an adjunctive, noninvasive treatment with few side effects that can be useful in the management of chronic pain. However, it has fallen into disfavor in recent years and is often perceived by physicians as simple charlatanism. We evaluated the efficacy of this treatment as used clinically in a large, mostly rural, pain management center.

Methods: We conducted a chart review of 300 pain patients from the Pain Treatment Center of the Bluegrass who had undergone hypnosis for their pain concerns. A chart audit tool was developed consisting of basic demographics, pre- and posthypnosis pain ratings, a rating of relaxation achieved posthypnosis, and scores on the Beck Depression Inventory, Perceived Disability Scale, and the Pain Anxiety Symptom Scale.

Results: The sample consisted of 79 men (26.3%) and 221 women (73.7%) with a mean age of 46.3 years (SD = 9.9, range = 19–78). Pain levels recorded pre- and posthypnosis revealed significant improvement as a result of the intervention (mean difference = 2.5, t(1,298) = 25.9, p < .001). Patients reported an average of 49.8% improvement in relaxation level posthypnosis (SD = 24.2%) and had a mean score of 19.0 on the Beck Depression Inventory (SD = 9.9), indicating moderate levels of depression. Also, patients saw themselves as severely disabled regarding their ability to engage in physical (8.3/10) or job-related (7.7/10) activities. Attempts to identify predictors of hypnosis success were not fruitful with one exception. “Poor” responders to hypnosis reported greater levels of perceived dysfunction in their sexual functioning compared to the “good” responders, F(1,187) = 7.2, p < .01.

Significance of results: Hypnosis appears to be a viable adjunct for pain management patients, including those from rural and relatively disadvantaged backgrounds. Prospective trials are needed to examine the utility of this modality in end-of-life and palliative care patients.

Type
Research Article
Copyright
© 2007 Cambridge University Press

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References

REFERENCES

American Medical Association (1958). Council on mental health: Medical use of hypnosis. Journal of the American Medical Association, 168, 186189.Google Scholar
Anderson, E., Frischholz, E.J., & Trentalange, M.J. (1988). Hypnotic and nonhypnotic control of ventilation. American Journal of Clinical Hypnosis, 31, 118128.Google Scholar
Appel, P.R. & Bleiberg, J. (2006). Pain reduction is related to hypnotizability but not to relaxation or to reduction in suffering: A preliminary investigation. American Journal of Clinical Hypnosis, 48, 153161.Google Scholar
Barrett, D. (2001). The power of hypnosis. Psychology Today. Available at: http://www.psychologytoday.com/articles/pto-20010101-000034.html, accessed October 24, 2006.Google Scholar
Barrett, D. (2006). Hypnosis in film and television. American Journal of Clinical Hypnosis, 49, 1330.Google Scholar
Beck, A.T., Rial, W.Y., & Rickets, K. (1974). Short form of depression inventory: Cross-validation. Psychological Reports, 34, 11841186.Google Scholar
Beck, A.T. & Steer, R.A. (1984). Internal consistencies of the original and revised Beck Depression Inventory. Journal of Clinical Psychology, 40, 13651367.Google Scholar
Ernst, W. (2004). Colonial psychiatry, magic and religion. The case of mesmerism in British India. History of Psychiatry, 15, 5771.Google Scholar
Ewin, D.M. (1992a). Hypnotherapy for warts (Verruca vulgaris): Forty-one consecutive cases with 33 cures. American Journal of Clinical Hypnosis, 35, 110.Google Scholar
Ewin, D.M. (1992b). The use of hypnosis in the treatment of burn patients. Psychiatric Medicine, 10, 7987.Google Scholar
Freeman, R., Barabasz, A., Barabasz, M., et al. (2000). Hypnosis and distraction differ in their effects in cold pressor pain. American Journal of Clinical Hypnosis, 43, 28.Google Scholar
Gallagher, D., Nies, G., & Thompson, L.W. (1982). Reliability of the Beck Depression Inventory with older adults. Journal of Consulting and Clinical Psychology, 50, 152153.Google Scholar
Jensen, M.P., McArthur, K.D., Barber, J., et al. (2006). Satisfaction with, and the beneficial side effects of, hypnotic analgesia. International Journal of Clinical Experimental Hypnosis, 54, 432447.Google Scholar
Lu, D.P., Lu, G.P., & Kleinman, L. (2001). Acupuncture and clinical hypnosis for facial and head and neck pain: A single crossover comparison. American Journal of Clinical Hypnosis, 44, 141148.Google Scholar
Meston, C.M., Levin, R.J., Sipski, M.L., et al. (2004). Women's orgasm. Annual Review of Sexual Research, 15, 173257.Google Scholar
Osman, A., Barrios, F.X., Osman, J.R., et al. (1994). The pain anxiety symptoms scale: Psychometric properties in a community sample. Journal of Behavioral Medicine, 17, 511522.Google Scholar
Paice, J.A. & Cohen, F.L. (1997). Validity of a verbally administered numeric rating scale to measure cancer pain intensity. Cancer Nursing, 20, 8893.Google Scholar
Patterson, D.R. & Ptacek, J.T. (1997). Baseline pain as a moderator of hypnotic analgesia for burn injury treatment. Journal of Consulting and Clinical Psychology, 65, 6067.Google Scholar
Scogin, F., Beutler, L., Corbishley, A., et al. (1988). Reliability and validity of the short form Beck Depression Inventory with older adults. Journal of Clinical Psychology, 44, 853857.Google Scholar
Shenefeldt, P.D. (2003). Hypnosis-facilitated relaxation using self-guided imagery during dermatologic procedures. American Journal of Clinical Hypnosis, 45, 225232.Google Scholar
Siegel, E.F. (1979). Control of phantom limb pain by hypnosis. American Journal of Clinical Hypnosis, 21, 285286.Google Scholar
Strahl, C., Kleinknecht, R.A., & Dinnel, D.L. (2000). The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning. Behavior Research and Therapy, 38, 863873.Google Scholar
Tan, G., Hammond, D.C., & Gurrala, J. (2005). Hypnosis and irritable bowel syndrome: A review of the efficacy and mechanism of action. American Journal of Clinical Hypnosis, 47, 161170.Google Scholar
Upshaw, W.N. (2006). Hypnosis: Medicine's dirty word. American Journal of Clinical Hypnosis, 49, 113122.Google Scholar
Weber, C.J. (2002). The perceived disability scale: Normative development and clinical utility. ProQuest Dissertation Abstracts, Illinois Institute of Technology, 2002, 55 pages; AAT 3051408.
Zarren, J.I. & Eimer, B.N. (2002). Brief Cognitive Hypnosis: Facilitating the Change of Dysfunctional Behavior. New York: Springer Publishing Company.