Hypnoanalgesia for procedural and chronic pain

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Mark P. Jensen, David R. Patterson, Elvira Lang · 2000 · University of Washington

What it is

Clinical hypnosis for pain is a structured interaction in which the patient, after an induction that focuses attention and usually produces relaxation, is offered suggestions to change how pain is perceived (its intensity, its unpleasantness, its sensory quality, how much attention it receives) and…

Format

• Phase 0. Medical clearance and screening (before session 1). Goal: confirm the pain has been medically assessed, that no red-flag or untreated condition is being bypassed, and that the patient is suitable for (group or individual) hypnosis. In the Vanderbilt group protocol, the referring provider…
• Phase 1. Education and expectation setting (session 1, often longer). Goal: explain hypnosis as focused attention and suggestion, correct misconceptions, set realistic hope (some patients gain lasting relief, some short relief lasting hours, most gain something such as better sleep or calm; no…

Who practises it, and how they are trained or regulated

• How Jensen's Therapist Guide orders the work (from the publisher's table of contents, description and chapter abstracts; the chapter text itself is not summarised here). The publisher describes the book as distilling trial-tested techniques into research findings on pain, what hypnosis can do for pain, and step-by-step instructions for inductions and suggestions. Part I covers the biology and psychology of pain;…
• Further published formats. UW/VA Chronic Pain Skills Study (veterans): self-hypnosis training as one of three group treatments, eight weekly sessions of about 90 minutes, homework between sessions, pain and comfort rated before and after every session, a workbook plus audio recordings for participants treated by mail, group leaders drawn from existing credentialed clinic staff (e.g. psychologists, nurse…
• Before the day: whole-team training. In the Comfort Talk model, all staff (reception, technologists, nurses, physicians) learn advanced rapport, expectation-shaping and comforting language; a core group of licensed professionals learns to guide self-hypnotic relaxation. The MRI trial protocol used 2 × 8-hour live modules plus a 4-hour e-module, with an observed structured exam of staff behaviour (including counting…

Evidence status, as the guide reports it

• How change is thought to happen (as the authors frame it). Suggestions can target separate pain dimensions (sensory intensity, unpleasantness, threat value, the ability to screen out discomfort and let in comfort), which imaging studies link to different brain areas, so wording is tailored to the…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• catalepsy suggestions near painful limbs (avoid).
• none specific; keep silence short with anxious patients.
• suggestions that encourage overriding medical activity limits.
• sedating medications and daytime sleepiness; coordinate with prescriber.
• relaxation-induced anxiety (A5). Working when: lower muscle tension and arousal.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.