Published in the Association for Solution Focused Hypnotherapists’ Blog, November 2020.

Linda’s story

Linda learnt to manage her chronic back pain with Solution Focused Hypnotherapy. And there’s plenty of clinical evidence that endorses her experience.

Regular listening to a relaxation recording every evening, together with a series of 6 tailored Solution Focused Hypnotherapy sessions helped Linda change the way she experienced pain. As a result, Linda was able to access physical therapy to help the underlying cause of her back pain.

“I was sceptical about hypnotherapy,” Linda explained, “My back pain was caused by a sporting injury many years ago. It seemed to be getting worse. Pain medication wasn’t working very well. Solution Focused Hypnotherapy with Jane has made a real difference. I had been taking many more tablets than I should. Now I only take them occasionally. I am in control of my medication, I get out more, I am more connected to friends and family, and I do more exercise. I am less depressed, isolated and irritable too. In six weeks, my quality of life improved dramatically.”

Linda’s pain didn’t miraculously disappear. It subsided to manageable levels. She was able to engage more in everyday activities which created a virtuous circle of thought and action which reduced the experience of pain, and often enabled her to

What causes Chronic Pain?

Pain is sending a message to the brain that we need to take action, for example taking our hand out of the fire, or rubbing our nettle sting with dock leaves!

Chronic pain however has no such useful biological function. When pain becomes persistent it becomes more complex. Pain research indicates that there are psychological, physical, emotional and neurological elements to pain.

Our understanding of pain

Chronic pain falls under anaesthetists for historical reasons. In reality, medical science doesn’t fully understand the pathways of pain, and cannot completely resolve the issue with medication. In other words, conventional medicine is not always helpful for chronic pain.

The brain and the nerves inside the spine make up the central nervous system. The brain receives messages from the spinal nerves. Receptors in the brain (nociceptors) send pain sensations to the spinal cord through nerve fibres.

A fibres and C fibres

Short, sharp and well localised pain is known as acute pain, which is transferred to the brain via A-Fibres.

When pain is persistent and not localised, for example the experience of burning, aching or throbbing sensations, we refer to it as chronic pain. Chronic pain signals are transmitted via C-Fibres.

In short: A-fibres are fast transmitters and take precedence over C-Fibres, so acute pain overrides chronic pain. We may have chronic terrible back pain but if we burn our hand, the intense localised pain overwhelms the chronic persistent pain.

The Pain Gate Control theory

The Pain Gate Control theory hypothesises that some C-Fibres transmit signals from the brain down the spinal column. When inhibitory neurons are excited by neurotransmitters (e.g. serotonin and noradrenaline) they can produce endorphins and enkephalins which act as a ‘pain gate’.

So Pain Gate Theory looks to ‘close a gate’ on the pain signal. A relaxed positive state of mind encourages the production of serotonin, the naturally produced chemical that helps us cope with life. Serotonin can, in turn, interrupt pain signals received in the brain.

How Does Hypnotherapy Reduce Pain?

Simply, pain pathways can be blocked to ‘close the gate’ on pain.

Hypnotherapy, and the Solution Focused practice that works alongside it, helps to create the steady flow of chemicals that help block pain. Many medications, including some anti-depressants work in a similar way. Only with hypnotherapy, there are no side effects or potential harms.

Supporting the parasympathetic nervous system

The sympathetic nervous system influences whether pain signals are sent back up the spinal cord to the brain. Neurotransmitters linked to stress hormones can increase the experience of pain. Any therapies that support the parasympathetic nervous system help to counter the activity of these neurotransmitters. That might include massage, reiki, medication, mindfulness and of course, hypnotherapy. In short, it’s important to stay relaxed and to manage your stress.

Changing the way pain is experienced

Solution Focused Hypnotherapy focuses on calming, relaxation techniques that change the way pain is experienced and perceived. Solution Focused Brief Therapy focus the mind on the positive elements of the present and future. Rather than convince you your pain doesn’t exist – it undoubtedly does – Solution Focused thinking helps you focus on habits and behaviours that will ease pain, reduce stress and relax the nervous system to reduce awareness of the sensations.

All hypnotherapy helps to create a steady flow of serotonin which helps to interrupt pain signals received by the brain.

Hypnotherapy can train the brain to refocus attention on more pleasant scenes and experiences that produce the right chemical responses that help to ease the pain.

For Linda, the sound of the ocean, the feel of sand, the warmth of the sun were all soothing experiences that took her away from her pain. Regular sessions and listening to a relaxation recording all helped her reduce her experience of pain.

Clinical Evidence on Hypnosis for Pain Management

Solution Focused Hypnotherapy, and other forms of hypnotherapy, even self-hypnosis, have been proven to be a viable therapy for pain management. 

Early studies

The earliest case reports describing hypnotic strategies for chronic pain management were published in 1950s; biofeedback technology was also helping to create similar physiologic states that reduced pain. A number of studies followed looking at hypnosis for chronic pelvic pain, fibromyalgia, headaches, irritable bowel syndrome and chronic conditions such as multiple sclerosis which confirmed those findings.

Hypnosis is also shown to improve sleep and reduce stress; two factors that can exacerbate the experience of pain.

An alternative to opioids

Some pain management medication for chronic pain has become contentious, concerns related to effectiveness and safety have evolved over decades, the medical professional is seeking effective alternatives.

More Recent Research

Research conducted by the University of Utah* explored three different therapeutic interventions (meditation, hypnosis and pain coping education) over a year. 244 patients who had reported experiencing unmanageable pain as the result of illness, disease or surgical procedures took part.

A measurable reduction in pain

Those who received a hypnotic suggestion intervention experienced an average 29% reduction in pain, even though sessions were short (15 minutes) and couldn’t be tailored to the patient. This clinically significant level of pain relief is roughly equivalent to the pain relief produced by 5 milligrams of a drug called oxycodone. In this study, mindfulness resulted in a 23% reduction in the experience of pain, and the education intervention just 9%.

Results from a study by the University of Greenwich* support those findings. Although some patients are more responsive to hypnosis than others, researchers found that therapeutic benefits exist across groups. Researchers’ findings detailed that pain levels fell by over 40% for patients who were described as being highly responsive to hypnosis and by 29% for those who were considered as only moderately responsive.

Reviewing the research

Gary Elkins, Marp P Jensen and David R Patterson in their article Hypnotherapy for the Management of Chronic Pain* reviewed controlled prospective trials of hypnosis for the treatment of chronic pain.

The Researchers explained, “The findings indicate that hypnosis interventions consistently produce significant decreases in pain associated with a variety of chronic-pain problems. Also, hypnosis was generally found to be more effective than non-hypnotic interventions such as attention, physical therapy, and education.”

Why Choose Solution Focused Hypnotherapy?

Solution Focused Hypnotherapy provides the benefits of hypnotherapy, proven through scientific evidence to reduce the experience of chronic pain. In addition, the Solution Focused questions that keep clients focused on what is good, better or improving every week, also moves people towards managing their own general wellbeing and finding new solutions to reduce stress, increase activity and enjoy activities more.

Retaining personal agency

With Solution Focused Hypnotherapy you retain your personal agency – that is you are in control. You are in a light to medium trance but you are not completely ‘out of it’ or out of control. If you want to find out more about how it works in practice do text or email me.

Jane Pendry
Sense-Ability Hypnotherapy & Coaching
www.sense-ability.co.uk
jane@sense-ability.co.uk
07843  813 883

NB: in this article, Linda was happy to share her experience but wished to remain anonymous. Linda is not her real name

*References:

Medical issues should always be directed to a fully qualified doctor and people with chronic conditions and any on-going type of pain should, if they haven’t already done so, see their GP in the first instance.

Hypnosis, even when conducted by a trained accredited practitioner, isn’t for everyone. Some people are resistant to the idea, others object on the grounds of personal belief or have serious psychological disorders. It’s important, in the case of chronic complex illnesses that practitioners contact the relevant medical professional to ensure that any complementary treatment is appropriate. Where hypnosis is not advised, clients may like to consider the biofeedback, meditation or mindfulness.

Hypnotherapy for the Management of Chronic Pain, Gary Elkins, Mark P. Jensen, and David R. Patterson

University of Utah Research

University of Greenwich Research summary from the Nursing Times

Opioids and the Treatment of Chronic Pain: Controversies, Current Status, and Future Directions by Andrew Rosenblum, Lisa A. Marsch, Herman Joseph, and Russell K. Portenoy details issues, controversies and benefits related to pain management.

Nursing Times article on the pain mechanism.