Hypnosis has become a common TV trope because of its mysterious nature. When I hear the term, my mind immediately turns to a cartoonish villain dangling a watch in front of someone’s face like a pendulum, repeating “you are getting veeerrry sleeepy” before brainwashing the hero. However, this version is a complete myth. The American Psychological Association describes it as a “therapeutic technique in which clinicians make suggestions to individuals who have undergone a procedure designed to relax them and focus their minds”¹. In other words, participation from both parties is necessary for the process to work. Make sure the Hypnotist is also a certified psychologist, as the field of hypnosis on its own is not very well regulated³. It is good practice to always ask to see a psychologist’s credentials before the first session, and report any complaints you have to the College of Alberta Psychologists (CAP).

Chair and Dangling Pocket-watch
Image Source: unsplash.com, taken by MK Hamilton

Hypnosis has two phases, an induction phase and a suggestibility phase². Unlike the movies, the induction phase cannot be forced because the patient must direct their focus towards the hypnotist’s voice. Induction is a trance-like, heightened state of awareness similar to guided meditation. Once the induction phase has lowered your guard against your pesky critical thinking skills, phase two begins.

The second phase, the suggestion phase, is where they guide you through a familiar scene based on details you’ve provided them, if you’re in a personal session. It can vary from a personal memory, or a more general scene. The more realistic it is, the more susceptible the patients are to suggestion because there are less conflicting details to overlook. However, the hypnotist may change the ending of the or try to repaint the mood of the scene to something more comfortable. The goal is to train your mind to dissociate, or disconnect, from the feelings of chronic pain².

Hypnotherapy is a complementary (addition to other treatments) therapy rather than an alternative medicine practice (alternative to other treatments²). Beware of any sources telling you to quit your current routine in favour of hypnosis, as they may not be reliable. 

It is of note that hypnotism does not cure, or even reduce chronic pain. The goal of hypnotism is simply to reduce the impact of the pain, allowing the brain to turn down its volume². The theory behind this asserts pain is psychological. Neuropathic pain connects to the emotional part of the brain as well as the memory. Practices focusing on how the brain processes information and memory such as hypnotherapy have been shown to cause physical changes in that area of the brain, providing relief to chronic pain sufferers².

Does it work?

The studies are in and experts have found that the results are… insufficient. A meta-analysis (a review of reviews) of 85 studies showed an improvement of pain tolerance of up to 42%³. This sounds incredible, right? Well… the review shows all of the studies have a bias. Structural flaws included missing or useless control groups, conflicts of interests, as well as small sample sizes. The review concludes that while hypnotized patients have better results placebo or no therapy. Better structured studies need to be conducted to determine the extent of the benefits of hypnosis.

Things to consider before trying hypnotherapy

Hypnotherapy is not a mainstream health practice, meaning a certificate in hypnotherapy on its own may be unreliable. Be sure to find a licensed therapist, and always talk to your doctor before trying a new treatment.

Some people resist hypnosis

  • Most people can be hypnotized, but how effective it is varies from person to person. Some people aren’t receptive to the induction phase, while others may be less responsive to the suggestive phase, making the results unknown before trying. A professional leading the session in a quiet, comfortable environment greatly increases the chance of success, but there’s no guarantee. 

Hypnotism can affect your memory

  • Hypnotists have the ability to alter your memory, both purposefully and inadvertently through suggestion¹. This makes it great for anxiety-related disorders, but sufferers of psychosis are advised against it because of their fragile perception of reality. Always talk to your doctor before adding a new treatment, even if it doesn’t require a prescription.

Hypnosis can be expensive

  • Treatment can cost as much as several hundred dollars per visit and require anywhere from 2 or 3 to an unlimited number of visits. On average, the recommended amount of guided sessions are 4-10³, which you will (likely) have permission to record and replicate at home, but be sure to ask first! Alberta has some restrictions around recording private conversations without permission.
  • You should have enough material to practice at home after the 4-5 recorded sessions. You may even be able to structure and record your own sessions.

Hypnosis is a continuous practice

  • Hypnotism is time consuming when done correctly. It takes anywhere from a few minutes to hours a session, 1-7 days a week. Think about it like an exercise routine for the memory, if you don’t keep at it, you don’t benefit. Likely for chronic pain it’ll be in the range of 30 minute-1 hour sessions, 2 to 4 days per week

Hypnosis isn’t a primary treatment

  • Hypnosis could be another tool in your self-management plan.  No one technique will make your pain go away, but several tools working together can make a noticeable impact.
  • Therapy can complement other treatments and self-management techniques.  One advantage hypnosis can tout is it has the potential to be structured to your needs.

My personal experience

My personal experience with a professional hypnotist is limited and unrelated to chronic pain, but I can give a general idea of how the process is structured. I didn’t follow through with the practice because of finances ($190/1hr session), however, if you have coverage for psychotherapy, you may have coverage for this as long as the practitioner has a valid license. I also believe my sessions were on the pricier side due to her experience, with the average practitioner charging  $150/session.

Myself, I attended a total of three sessions. The first appointment was much like a regular consultation where the therapist asked about my life, my roadblocks, specific situations etc. Afterwards, she described a scene she wanted to create based on those experiences. She asked if I had any objections, any important details to add or corrections to make. At the end of the session, she recommended I return in one week, at which time she would have a script ready.

The second session was the first time I was actually hypnotized. I was required to sign a form allowing her to hypnotize me, and confirming she stepped through the process with me.

The Induction Phase

“Close your eyes. Fall into the most comfortable position, whatever that may be” My therapist ordered in a soft, soothing voice. “Are you comfortable?”

I shifted in my chair to find a place where my arms could rest comfortably and relaxed the muscles in my back. 

“Yes,” I responded.

“Good, now relax your arms further into the armrests” she continued in that same soothing voice. She waited for a few seconds to give me time to complete the action “Now focus on how good that feels”.

It did, it felt nice. I originally thought I was as comfortable as I could get, but the light sensation in my arms made me aware of just how much tension I was carrying in my arms.

“Let everything but the sound of my voice just float away as if a gentle breeze has come to sweep them up”, she told me. “Let all the sounds of traffic become distant, because nothing else matters. Don’t try to push them away, just let them drift away into the sky and focus on my voice.”

I imagined a soft breeze taking all of the distractions away. From the ever-present anxiety I held, to the sound of the clock on the wall. The only thing left was the pleasant sound of her voice, which resembled a yoga instructor. I felt some tension leave my temples.

“Focus on how good that feels”.

We continued on in this way, gradually releasing the tension from all parts of my body. When I relaxed the muscles my neck couldn’t support my head anymore and fell onto my shoulders. We even went through the muscles on my face. As the process continued, I felt a small smile creep up to my face. She told me to let it happen, to let the body do as it wants.

The whole first phase took about 10 minutes. It was a pleasant, serene experience. I would definitely recommend this for sleep, it was tempting to drift off right there.

Next came the suggestive phase. In the same calm voice she described the scene she created,  intimate and familiar, yet not at the same time. Though things felt a bit “off”, I felt a goofy smile float to my face, occasionally I felt my arms float up a bit. I was told to simply let them.

I struggled to connect to the scene, but I retained the state of relaxation. The session lasted 45 minutes, and I felt genuine regret at letting go. We discussed which parts of the session worked, as well as the ones that didn’t. As we did, she took notes to help compose the next script. I made a third session  and gathered up the recording to use at home. 

At home, I had problems getting into the practice of hypnotherapy, particularly finding a time and a place for it in my day and home. I used it before bed a few times and was able to fall asleep, and it gave me pleasant dreams. I was hypnotized again at the next session with the adjusted script, but the induction phase was the same. The adjustments helped and I left with the script. I had the same issues at home.

Conclusion

Hypnotism can be a good idea for chronic pain sufferers who are looking to add to their toolbox, but whether it’s effective or not is still up for discussion. I can’t make a recommendation either way in good faith, but if it’s an avenue you want to pursue, go into it with eyes wide open. Doctor Fredrick Mau – a professional hypnotist who works with clients experiencing chronic pain – believes neuropathic pain sufferers make ideal patients because of how they experience pain. However, do further research and talk with your doctor before making a commitment.  Ask the therapist whether or not you have permission to record the session before meeting.

References

1) American Psychological Association
https://www.apa.org/topics/hypnosis

2) Hypnotism for Pain Management, Dr. Fredric Mau
https://us02web.zoom.us/rec/play/VurMZjjGxHy3a8NUYs6pa_DEeo2NOxWRiAQQDrnhootjbEvokGblCXyksBIKfwCs07R8fEIOVqfY8Mg9._yLwsG17KIPL9QHt?continueMode=true&_x_zm_rtaid=w9Lvf3hrTOG3hF5Fimzomw.1620960952141.297910617b269bc92d76b37e6ba55d7a&_x_zm_rhtaid=956

3) The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials
https://www.sciencedirect.com/science/article/pii/S0149763418304913

4) The effective use of hypnosis in schizophrenia: structure and strategy
https://pubmed.ncbi.nlm.nih.gov/23957260/

5) Hypnotherapy for the Management of Chronic Pain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752362

Additional Reading

The Hypnotic Analgesia Suggestion Mitigated the Effect of the Transcranial Direct Current Stimulation on the Descending Pain Modulatory System: A Proof of Concept Study
https://pubmed.ncbi.nlm.nih.gov/32982393/

The Role of Suggestions in Hypnosis for Chronic Pain: A Review of the Literature
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113537/

The College of Alberta Psychologists
https://www.cap.ab.ca/concerns-about-br-a-psychologist

#67 Hypnosis for Neuropathic Pain
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