What is the most effective hypnotic suggestion for pain reduction in highly susceptible subjects?

From the Guidelines

The most effective type of hypnotic suggestion for reducing pain in highly susceptible subjects is focused analgesia. This technique involves directing the subject's attention specifically to altering their perception of pain in a targeted area of the body. With focused analgesia, highly hypnotizable individuals can achieve significant pain reduction by mentally blocking or transforming pain sensations. The technique works by engaging the brain's natural pain modulation systems, particularly in the prefrontal cortex and anterior cingulate cortex, which can inhibit pain signals at the spinal cord level before they reach conscious awareness.

Key Points

• Focused analgesia is a highly effective technique for pain management in highly susceptible individuals, as it directly targets the pain processing mechanisms 1.
• Dissociated imagery and deep relaxation are also beneficial hypnotic approaches for pain management, but they may not produce the same level of pain reduction as focused analgesia in highly susceptible individuals.
• Hypnosis has been shown to be effective in reducing pain in various studies, including a study that found a 44% mean pain reduction in patients with distal sensory polyneuropathy (HIV-DSP) who received hypnosis 1.
• The use of hypnosis for pain management is supported by guidelines, including the 2017 HIVMA of IDSA clinical practice guideline for the management of chronic pain in patients living with HIV, which recommends hypnosis for neuropathic pain (strong, low) 1.

Considerations

• The effectiveness of focused analgesia and other hypnotic suggestions may vary depending on the individual's level of susceptibility and the specific pain condition being treated.
• More research is needed to fully understand the mechanisms by which hypnosis affects pain perception and to determine the long-term benefits of hypnosis for pain management.
• Clinicians should consider individual patient preferences and values when selecting a pain management approach, and may want to combine hypnosis with other therapies, such as cognitive behavioral therapy or physical therapy, for optimal results 1.

From the Research

Hypnotic Suggestions for Pain Reduction

The most effective type of hypnotic suggestion for reducing pain in highly susceptible subjects is a topic of interest in the field of hypnosis and pain management.

• Focused analgesia, dissociated imagery, and deep relaxation are all hypnotic suggestions that have been studied for their effectiveness in reducing pain.
• According to a study published in 1999 2, high hypnotizable subjects displayed significant reductions in pain and distress levels during dissociated imagery, focused analgesia, and deep relaxation.
• The study found that focused analgesia was particularly effective in highly susceptible subjects, with significant increases in sensory and pain thresholds and significant reductions in P3 peak amplitudes.
• Another study published in 2009 3 reviewed the literature on hypnotic analgesia and found that hypnosis consistently results in greater decreases in pain outcomes compared to no treatment or standard care.
• The study also found that hypnosis frequently out-performs non-hypnotic interventions, such as education and supportive therapy, in terms of reductions in pain-related outcomes.
• A study published in 2007 4 compared the effects of analgesia suggestions and relaxation suggestions on clinical pain in patients with fibromyalgia, and found that hypnosis followed by analgesia suggestions had a greater effect on pain intensity and sensory dimension of pain than hypnosis followed by relaxation suggestions.
• Overall, the evidence suggests that focused analgesia, dissociated imagery, and deep relaxation are all effective hypnotic suggestions for reducing pain in highly susceptible subjects, with focused analgesia being particularly effective.

Comparison of Hypnotic Suggestions

• The studies suggest that different hypnotic suggestions may be more or less effective depending on the individual and the specific pain condition being treated.
• For example, a study published in 1994 5 found that high hypnotizable subjects displayed significant reductions in reported pain during conditions of neutral hypnosis, relaxation, dissociated imagery, and focused analgesia.
• The study also found that high hypnotizable subjects showed significant reductions in amplitudes of painful laser-induced brain potentials during focused analgesia.
• Another study published in 2006 6 found that hypnotic susceptibility could be increased using techniques such as EEG neurofeedback, progressive muscle relaxation, and self-hypnosis.
• The study found that all three techniques successfully enhanced hypnotic susceptibility in over half of the participants, with the majority of increases occurring in the more susceptible subjects.

Effectiveness of Hypnotic Suggestions

• The evidence suggests that hypnotic suggestions can be an effective tool for reducing pain in highly susceptible subjects.
• A study published in 1999 2 found that highly susceptible subjects reported the highest number of omitted responses and the shortest reaction times during focused analgesia.
• The study also found that highly susceptible subjects showed faster habituation of skin conductance responses during focused analgesia and dissociated imagery.
• Overall, the evidence suggests that hypnotic suggestions, particularly focused analgesia, can be a useful adjunct to other pain management techniques for highly susceptible subjects.