Hypnotherapy pain relief – peer-reviewed research

Modern hypnosis has its origin in medical research. One of its first uses was hypnotherapy pain relief. However there is still considerable resistance in medical circles to accepting hypnotherapy as a valid technique.

Hypnotherapy pain relief is beginning to be accepted a valid therapy more and more in mainstream medicine. A recent research study at the University of Queensland goes some way towards showing that the benefits of hypnotherapy for pain relief are very real.

The University of Queensland's Child Health Research Centre carried out an investigation into the effect of hypnotherapy on anxiety, pain and stress. The research objective was to test whether hypnotherapy had a measurable effect on the distress of burns patients.

The trial

The patients were children with extensive burns, who had to have their dressings changed frequently. Changing burns dressings is often very painful. Children who know that their dressings are going to be changed soon often show raised levels of anxiety and stress.

There is some evidence to suggest that the pain and anxiety can manifest itself in later life as PTSD and other psychological problems. Anything that can reduce the stress and anxiety of the hospital treatment can have long-term benefits.

The study involved 62 burns patients aged between four and 16 years old. Half the group had hypnotherapy, half the group had standard burns care. Anxiety, pain, stress and wound healing were measured at each change of dressing.

The results

The results were very clear. At the second change of dressing, children in the hypnotherapy group reported a reduction of 70% in their pain levels compared with children in the standard group. The hypnotherapy group also had only one third of the stress levels of the other group. At the third change of dressing the results were even more dramatic. The hypnotherapy children had a 90% reduction in pain, and 84% less anxiety.

The pain and stress levels were estimated by asking the child how they felt. But this was backed up by heart rate monitors. The hypnotherapy children has significantly lower pulse rates before and after the third dressing. Pulse rate gives an objective method of measuring pain and stress.

Hypnotherapy has been used on adult burns patients before. Children and teenagers usually show much stronger responses to hypnosis. This research has confirmed that.

The medical benefits of hypnotherapy could be used in other areas of children's medicine. Children get very anxious when treated for asthma and fractures, and when approached with a needle. Hypnotherapy might prove very effective in all these areas.

Source: Chester et al. 2016 Trials 17:233

DOI: 10.1186/s13063-016-1346-9

The mystery of dysthymia

Discovering dysthymia

Today I was talking with one of my students and she asked me "How are you today?" I said what I usually say "Average." She said "Well, that's not very good." And I said "doesn't everyone feel average every day? Isn't that what average means?" So she said "shouldn't you try to appear cheerful all the time?"

I said "I have never believed in pretending that I'm something I'm not. Sometimes I am up, sometimes I am down, but most of the time I'm just average." And then she said to me "Unless you tell yourself that you're feeling great you are going to stay that way all day." So I asked her why she felt that she had to try to boost how she feels all day. She said "Well, I woke up this morning feeling very grumpy, I really don't want to feel like that all day."

And I asked her if she felt grumpy a lot. She agreed that she felt grumpy sometimes. I asked her how well she slept. She told me that she sleeps badly. My psychology training began to get interested. I asked "would you say your mind was always busy?"

"Oh yes, always".

"Do you often get irritated with other people? Like when they don't do things you think they should do."

"Oh yes, too much. In fact my sisters were telling me at the weekend that I'm always snapping at them. They think I'm just bad tempered all the time. I don't think there's anything wrong with me."

Discussing the symptoms

At this point I realised I was talking to someone with a form of depression, who was totally unaware that she had it. I asked a few more questions and every one of them built up a picture of someone who sleeps badly, eats badly, can't concentrate, has a busy mind, gets down a lot and somehow just can't get around to doing her studies. I explained to her, gently, and I thought she actually has a form of depression. We discussed the symptoms of dysthymia back-and-forth and once she had got over the initial shock, she seemed to accept it. In fact she seemed quite relieved. It was as if that at last she had found something which explained all the different aspects of her behaviour.

We talked about dysthymia and its effect on day-to-day life for most people. She very rapidly realised that she in fact had all the symptoms. And not only that, she could identify them clearly in a niece of hers. And then she named several other relatives who also had odd behaviour that could be explained by this.

Finding out more

I got her to look it up on Google. I even had to spell it for her. And there it was, laid out in great detail, the classic symptoms. She was both appalled and delighted. Now she knew exactly what was going on, and what to do about it.

I have no doubt that she will follow the advice and gradually get rid of her long-term anxiety. I was very pleased to be able to help her. The tragedy is, that so many people have it, and don't realise. Dysthymia is an unnecessary drag on people's lives and happiness. And it is easily cured.

Perhaps there should be a public awareness campaign to bring it into the public consciousness. The mystery of dysthymia is why something has not been done up till now.

Boredom and creativity, or not

Recent research has suggested that boredom is something you need to go through before you can be creative. Yet everywhere I look people are doing everything they can to avoid it. Last week I was managing a series of presentations at the University.
The presenters were all new and inexperienced so I wanted to make sure that the audience was paying attention to them. I told everyone to shut their laptops and focus on the presenter. Everyone duly shut their laptops, except for one student who had to be forcibly assisted.
When the presentations got underway, I noticed about 1/3 of the students were actually now using their cell phones under the desk. Other students were showing withdrawal symptoms. It would seem that almost everyone nowadays seeks to be constantly stimulated. They appeared to be almost terrified of having one moment of boredom.

Research into boredom

In one recent study researchers asked their subject to do something either boring or something interesting. Then they asked the subjects to do something creative. One group copied numbers out of the telephone book and the other group watched a television show. Both groups were then asked to think up something creative to do with cups. The boredom group came up with more and better creative things to do with the cups.

In a second test subjects came up with more answers to an associative word test after they'd been forced to watch a boring screensaver for a while.
It has been known for centuries that being bored leads to daydreaming. And daydreaming leads to creativity. So how it works is not a mystery.

The scientist are now asking themselves that if everyone is overstimulated and never gets bored, what will happen to the nation's creativity?

For therapists the question is quite different. Most of our clients keep themselves constantly busy, have the TV on all the time, or listen to headphones in bed in order to avoid what happens to them when they're not stimulated. In that case what they get is fears and anxieties coming out. They don't get creativity, they get frightened.

Perhaps psychologists will begin to look into that?

Prevent heart attacks with hypnosis

Recent research suggests that hypnosis has a role to play as a front line treatment to prevent heart attacks. Doctors have known for a long time that stress is associated with increased risk of heart attack. However there was only a correlation, and no direct proof that stress caused heart attacks. It was just as likely that the factors that lead to heart attacks also lead to stress.

Two new studies show that stress actually has a direct effect on the brain. The brain responds as if to a threat. It orders the body to produce new white cells. The increased blood cells then cause inflammation in the walls of the blood vessels. And this leads to narrowing of the arteries and a higher chance of being blocked by blood clots. Blockages lead to heart attacks, angina and strokes. According to the study, this is the first time that a direct link between stress and cardiovascular disease has been proved.

Using hypnosis to prevent heart attacks

What the study shows is that stress is just as important as diet and smoking. Hypnotherapists have an excellent record on stopping people smoking, and also help people to lose weight. These two outcomes both reduce the risk of heart problems. It seems that we can now play another role in keeping people healthy.

Hypnosis and relaxation therapy are very good ways of reducing stress. It now appears that teaching our clients how to relax, or how to go into self hypnosis, can have direct effects on their cardiovascular health.

This is something that hypnotherapists should develop. Perhaps we should emphasis stress reduction in advertising and when talking to clients. Perhaps one day we will have clients coming to hypnosis as the treatment of choice to deal with their general feelings of stress.

Source:

Tawakol, A., et al. (2017) Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study. The Lancet

Ending compulsive gambling

Gambling is reaching epidemic proportions in Australia. There are pokey machines (slot machines) everywhere. It is becoming a major social problem. There is a constant need for ending compulsive gambling.
I saw a client today who feels that her gambling is out of control. Even on the way to my office she passed the local pub and thought to herself "I wonder if it's open", so that she could go in and play the pokey machine. Last week she put the entire household shopping budget, over $400, into a pokey machine.
When we started talking about it, she told me that the noise, the lights, the high she gets just puts her into a zone. As long as she has money, she just keeps putting it in to stay in the zone. She said that she feels she is spiralling out of control.

Source of the compulsive gambling

In my experience gambling is always an aspect of anxiety.
I started asking her what it was that she was trying to avoid by gambling, and she told me that she was having troubles with her job, her marriage, and felt that she was failing her daughter. I asked her if she had always been anxious. She told me that since she was 11 she has been pulling her eyelashes, and goes through periods of trichotillomania. And to my surprise, took off her hat, to show that she was near bald.

She was clearly unhappy. So I asked her about her childhood. She told me that she grew up on a farm. She said that she had a very happy childhood. When someone tells me that a happy childhood, my heart fails, because usually they are deluding themselves. They would not be sitting in my chair if they had had a happy childhood.

I started asking about growing up, and it turned out that for her mother she was never good enough. Her mother was a perfectionist, her father was always working. Her sister was always academically bright. So she never felt good enough.
When she was 15 years old her father lost his job, and that was when the anxiety started.

To me the suggested that her mother had anxiety, and her father had some sort of need to be always busy. I asked her she had ever been diagnosed with depression and she said she'd been on pills for 20 years.
Digging deeper revealed a history of failed relationships, single mom, unsuitable relationships with married men. All of these suggested to me that her basic problem was insecurity.

I think that her gambling puts her into the zone where she can forget all her worries. Her unconscious mind is driving her to do that because it doesn't have any other way of dealing with her overwhelming feeling of not being good enough.
Her gambling binge had only been going on for six months.

Six months ago, she and her husband went to a bar, for no particular reason put some money into a pokey machine, and won $900. This was a godsend and got them out of a financial problem. In her unconscious mind, she associated ending her problems with winning on the pokies. She started using them occasionally, and then continuously.

The solution to compulsive gambling

The solution was to deal with the anxiety. I asked her to relax, and breathe deeply. Then I got her to focus on her own feelings of insecurity, anxiety, and inadequacy. It was immediately obvious that she had found the feeling so I began to develop it as a metaphor. I helped her to develop it into an object. It was a grey object like a brain. I encouraged her to think about how it might change, and gave her suggestions as to how to do that.

She transformed into a very small green thing that she felt good about. I got her to take that somewhere outside where it could grow and flourish. Then I got her to fill the space where the brain thing had been with something nice. She chose her daughters smile to fill it with.
I use that feeling to fill the whole of her mind with a feeling of contentment. Then I use that new feeling to go fishing for the anxiety deep inside. I suggested that her mind had found the source of the anxiety, lifted it out of where it had been hiding, and destroyed it.
I then brought her back to the present.
She said to me that she felt as though she had been asleep for hours. She said she felt such a relief. And she was now ready to go back and get her life back on track.

Fear of earthquakes

I live in an earthquake zone, but up until today I had never actually had a client with a fear of earthquakes. My client was a young mother who had lived in New Zealand all her life. Earthquakes are a monthly occurrence here. But since the last big earthquake she had been getting more and more fearful. Her anxiety was now becoming a serious problem. To the extent that she was seriously considering moving her family to Australia to avoid earthquakes. Strangely, it was not the earthquake itself she was afraid of, it was not being able cope with the aftermath.

Not an irrational fear

She was very embarrassed about having such an irrational fear. She asked her husband if anyone else where he works was afraid of the next earthquake, and he said no. It was well is the fear is suffering from acute embarrassment.

I said that it seems to me like a simple phobia. She told me that her mother had also been terrified of earthquakes, and as a child, he had been disturbed by her mother's distress. It seemed to me that this might be a case of phobia by proxy.

I told her that as far as I was concerned, her fear of earthquakes was not irrational, although it was unusual. I told her that it wasn't irrational because it was actually based on a childhood fear that had never been dealt with. Something in the last earthquake had triggered that childhood fear, possibly about an earthquake, possibly about something else. And now, every time she thought about it, that childhood fear was triggered back into action. The way to treat her fear of earthquakes was to treat the childhood fear.

Treating her fear of earthquakes

She was easily distressed just by talking about it and so I explained about Gestalt metaphor technique. I talked her through feeling the fear and got her to feel it in her body. I developed it as an object. She told me that she felt something oblong in her stomach. It was black and wobbly and soft and cold like jelly. I asked what she wanted to do with it. She told me she wanted a stamp on it. Gradually, I got her to change the object until it became like a teardrop, but she could not change it any further.

I asked her if she had ever done any baking. I talked about rolling, spreading, flattening, twisting, to seed the idea in her mind. This worked and she said that it had now become like a balloon. I got her to expand it and expand it, until it popped. She then put it down the sink disposal unit.

Then I got her to think about the place where it used to be. I encouraged her to fill it with something nice, like a flower, or a candle, or a child's smile, or something else that she liked. He decided to fill it with the view from her new house.

Replacing the fear of earthquakes

I then deepened her into a safe place, where she had everything she needed, and felt safe and comfortable. I suggested that her baby was there with her. Together they were surrounded, protected, and loved. In that place they were not affected by what happened outside.

Then I added some personal resources for her. I suggested that she was the type of woman who shines in an emergency. The type of woman who takes control, the type of woman who is in charge of herself and everything else. I suggested that she was ready, and in control, and a survivor. That she was the type of person that other people rely on.

Then I allowed her to bring herself back to the present.

That she felt very tired, but now thought of earthquakes quite differently.

I guess we shall just have to wait for the Next Big One to find out.

Drinking addiction?

Addicted to drinking

Yesterday a man came to see me about drinking. I saw him about eight years previously to stop smoking, and he hadn't touched a cigarette since. He said that he was addicted to drinking and wanted me to help him the same way I'd helped him stop smoking.

I asked him why he thought he was addicted to drinking. He told me that almost every night he had a few drinks, and more than a few at the weekend. He had't had a weekend without drinking since he was a teenager. I asked him why he drank. He said he drank because he was bored. Also he thought that stress played a role.

He runs a small business with seven employees. His business is outdoors, weather dependent. So there's a lot of downtime, a lot of explaining to clients why he can't get the job done on time, and then he feels bad because he wasn't doing what he said he was going to do. He said he hated being late, for anything.

Drinking through boredom

Now this got me thinking. The word "bored" generally means that the client has anxiety. I was also interested to find out whether it was the having to explain to the clients, or the not living up to what he promised, that was causing the stress.

I pursued the idea of drinking, and asked him to detail when he drank. He actually didn't drink every night, and he had no problem with not drinking. I asked him how he knew when to have a drink. A told me he usually drank at night, when the boredom set in. And really that was the key to his problem.

When people say they do something when they are bored, but they really saying is that they do something when they have a lack of stimulation. In this case, when he got home after a hard day, he would start to think about the jobs, what he hadn't got done, and how he might have to deal with it. This caused anxiety and he drank for something to do to take away the feeling. This was exactly what he had done when he was smoking. When he felt anxious previously it just went outside for another cigarette. Now he was having a drink when he feels stressed. Basically he is self-medicating with alcohol.

No drinking addiction

So he doesn't have an addiction to alcohol. He just doesn't have a way of dealing with stress. We explored this for a while, and confirmed that he had suspected for a long time that he might have depression. We discussed his drinking cycle. When he gets anxious, he does not know what to do, so he takes a drink. That drink leads to another drink, and leads to another, until he has too much. Then he wakes up in the morning feeling bad, feeling guilty, and that adds to his anxiety. And of course the worry about the job hasn't gone away. Alcohol is a depressant, so his drinking is actually making his depression worse. And his depression is making his drinking worse. He is on a downward spiral.

The solution

The answer is to change his lifestyle. We talked for the rest of the session about how you can get more exercise into his life. I taught him self hypnosis to reduce his anxiety. We then talked about is drinking at weekends. He said that if he was on his own he would not drink. But every weekend there was a big family gathering at somebody's house. Everyone drinks at the BBQ, and everyone is expected to drink. Social pressure means he just couldn't not drink.

So I got him to think about how he could keep onside with his family but not join in the drinking culture. This is something he had never thought about. He is now happy that he does not have an addiction to alcohol. What he does have is a lack of ways of dealing with stress, and a family that pressures him to drink with them.

Those are things he can do something about.

Chinese Restaurant Phobia

I saw a client today with Chinese Restaurant phobia. This is one of the more unusual phobias I have come across. My client went to a Thai restaurant about two weeks ago and was enjoying the meal. But something in the ingredients set off an extreme allergic reaction. He ended up being stretchered out of the restaurant barely breathing and into hospital dangerously ill.

He was discharged two days later and swore to avoid Thai restaurants in future. However this week, when he went into a Chinese restaurant he immediately felt dizzy and frightened and had to go outside again. After ten minutes we went back in to join his friends. But again he was seized with an overwhelming fear and actually vomited when he ran outside.

It is interesting to see so clearly the process of how a phobia forms. His unconscious mind has identified something in the Thai restaurant as being associated with the sudden onset of a dangerous illness. It is therefore primed to protect him by forcing him out of any place where he might get harmed. It is now in the process of broadening out the possible indicators to include other types of Asian 'things'. Over time, if left untreated, his unconscious will start to include an ever wider range of possible indicators. It may eventually end up as a full size fear of any restaurant, or even of food.

Treating the phobia

I like to treat phobias by going directly for the feeling. I ask the client to think about the feared situation and feel the fear. If they can get the fear as a feeling in their body I can clear it immediately using Gestalt Metaphor Therapy.

In this case the client could not summon up the feeling, probably because it has not had time to create a strong repeatable feeling.

So I put him into trance and tested to make sure he was under. Then I suggested he think about the Thai restaurant and the Chinese restaurant and the feeling that he got there. The client turned to be one of these people who go corpse-like in trance, and give no indication of what is going on inside. I therefore could not do a question and answer session with him.

All I could do then was assume he had the feeling and try to remodel it without feedback. I suggested that the feeling could become an object, that it had a shape, a size, a color and so on. Then in several different ways I suggested that the object was changing, shrinking, changing color and transforming itself in ways it wanted to. I really had no idea what was going in his mind or whether he was experiencing anything at all.

I brought him out of trance and asked, a bit nervously, what object had looked like. "Oh, a big concrete square," he said, "and I crushed it".

Looks like the job got done.

Loose Bowels and stress

In hypnotherapy you never know what you are going to meet next. Today I had a case of loose bowels. The client was a lovely woman with a terrible secret. She has to go to the toilet every time she has to meet with another person. Her job involved constant meetings and briefings, so this really is a major problem.

She gets the squitters with stress. I dug into the cause of the stress and discovered it was really about the fear that she would have to leave the other person alone. In her mind this is unforgivably rude. If she was called away or something then the other person would be thinking bad thoughts about her due to her behavior. She had no problem with three people. She could meet three people, because if she had to leave then there would still be two people to talk to each other, and they would not condemn her for being rude.
I discussed this with her looking for the source. She said she had a great childhood. There was no reason for the anxiety.

Therapy

When dealing with a specific stress like this my normal approach is relax the client. Then I get her to imagine the exact situation and feel the feeling she gets. The idea is to use the feelings as a bridge to the original event that was causing the stress. She tried but could not get the feeling without being there.

I therefor put her into trance. I did a general exploration of her subconscious using the Leaky Shoes script and she started crying. Crying is always an an indication of an emotion coming to the surface. She was now in the feeling that she said she could not find.

I got her to express the feeling as a metaphor. The feeling transformed into a brown ball full of moving clouds of black. I worked on changing this and got her to shrink it. It gradually got smaller and when it was a golf ball size she stopped. She couldn't shrink it any more. This kind of halt is common in metaphor therapy. So I asked her if she had ever sliced a tomato and that did it, the image of the tomato allowed her to start cutting into the ball. Then I got her to think of dicing something and she got rid of the thing completely.

Outcome

Whatever the source of her stress was, it was now gone. I brought her out of trance and talked about what she had just done in her mind. The result was that she started talking about her upbringing. Somehow it was now something she could talk about. It turned that she in fact had not had a good childhood.
She had been bought up with an adopted older brother, her mother expected perfection, and there were constant arguments that she escaped by joining a girls' organisation and spending as much time as possible out of the house. Somewhere in all that mess was the source of her unique fear.

Do you have second hand anxiety?

I had a client who came to me for anxiety: it turned out to be second hand anxiety. The cause of her anxiety is direct result of her upbringing, which was a direct result of events.
Her father was Polish, and was conscripted into the army early in WWII. His unit was captured by the Germans. He was imprisoned in a labour camp. Thousands died through brutality, starvation and disease.

The Russians over ran the camp but instead of liberating them all, he was conscripted into their tank battalion. As part of that battalion he endured the horrors of fighting on the Eastern Front right up to the end. Eventually they let him go due to pneumonia.

The result of his privations and captivity was that he had lung disease for the rest of his life. He also had survivors' guilt, night terrors and PTSD. So she was brought up in a household where her father was constantly in and out of hospital, he was often absent or lying sick in his room, there was never enough money, and constant worry about the future.

My client had a lifetime of caring for him, not having a real dad, and not having a settled home life. She became anxious and constantly stressed. Most likely this triggered her own life long anxiety. It also led to her becoming a professional nurse.
What is notable about all this is that my client is in her late sixties, and still suffering from something that happened in the 1930's, long before she was born. The evils of the second world war are still with us today.
It is quite remarkable how long historical events can reach into daily life. And if my client's children are in turn affected by her behavior then they, in their old age, will still be suffering for what happened over a century before.

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