Living with chronic pain significantly impacts quality of life, often leading individuals on a relentless search for effective and safe treatment options. Clinical hypnosis has been a well-established treatment for chronic pain that sadly keeps getting “rediscovered” rather than remaining in the discussion among clinicians.

With its roots in the power of suggestion and focused attention, clinical hypnosis offers a unique and holistic therapeutic avenue that goes beyond traditional medical interventions. This article explores the application of clinical hypnosis as a complementary approach to chronic pain management, delving into the evidence supporting its efficacy, underlying mechanisms, and the potential benefits it can provide to individuals seeking relief from persistent pain.

Defining Chronic Pain

Simply defined, chronic pain is any pain that you have for three months or more, or that lasts beyond the expected healing time.

Types of Pain

When we talk about types of pain we break them into three categories: nociceptive, neuropathic, and neuroplastic. The first two types are commonly accepted, while neuroplastic, although having a long documented history, is not discussed as frequently in the medical community. A big part of our work is getting that conversation going.

Nociceptive pain refers to the type of pain that arises from the activation of specialized nerve fibers called nociceptors. These nerve fibers are sensitive to potentially damaging or noxious stimuli, such as heat, cold, pressure, or chemical irritants. Nociceptive pain is usually a response to tissue damage or inflammation and serves as a warning signal to protect the body from further harm.

Examples of nociceptive pain:

• Acute pain from an injury (sharp, localized, and short-lived)
• Inflammatory pain (arthritis, tendonitis, and bursitis can cause chronic inflammatory pain)
• Visceral pain (originates from the internal organs / kidney stones, gallbladder inflammation, and appendicitis can cause visceral pain)

Neuropathic pain is a type of pain that results from damage or dysfunction in the nervous system itself. It arises when there is abnormal processing or signaling of pain messages by the nerves, even in the absence of any ongoing tissue damage or inflammation. Neuropathic pain is often described as a shooting, burning, or electric shock-like sensation that can be chronic and debilitating.

Examples of neuropathic pain:

• Diabetic neuropathy – diabetes can cause damage to the nerves over time, leading to a condition called diabetic neuropathy. It commonly affects the feet and legs but can also involve the hands and other parts of the body. People with diabetic neuropathy often experience symptoms such as tingling, numbness, burning pain, or sharp shooting pains.
• Postherpetic neuralgia – postherpetic neuralgia is a complication that can occur after a person has had shingles (herpes zoster). It is characterized by persistent pain that continues in the area previously affected by the shingles rash. The pain is often described as a deep, aching or burning sensation and can be quite severe, lasting for months or even years after the initial shingles outbreak.

Neuroplastic pain is pain that is neither nociceptive or neuropathic. In most cases a neuroplastic pain diagnosis comes after both nociceptive and neuropathic pain have been ruled out.

There are several indicators that the pain may be neuroplastic, including:

• Pain originating without injury
• Pain originating during a time of stress
• Pain that is inconsistent (e.g., back hurts while standing but not while running)
• Pain that spreads or moves around the body
• History of a wide range of symptoms (e.g., stomach pain, migraine, knee pain, etc.)
• Childhood adversity or trauma history
• Personality tendencies toward anxiety, hypervigilance, and perfectionism

Clinical Hypnosis

We’ve found that clinical hypnosis is an extremely effective way to treat neuroplastic chronic pain. Hypnosis is a method of teaching people how to deliberately go into a state of consciousness called trance.

Trance is a natural state of consciousness that is happening all the time. Hypnosis is just a method to enter that state deliberately versus accidently. You can learn to enter that state deliberately utilizing a combination of focused attention and imagination.

Often relaxation is a byproduct of trance, but it is not required. People can be in active trances when they are running or working. Trance is important because we have found that people can learn certain things in trance that they aren’t able to learn in their normal state of consciousness. For example, learning how to alter pain perception is something people can learn to do in trance.

During a hypnosis session, a clinician trained in clinical hypnosis guides the individual into a state of deep trance. In this state, the individual becomes more open and receptive to suggestions that are given by the hypnotherapist. These suggestions can be used to explore and address underlying issues, change negative thought patterns, or promote specific desired outcomes.

Treating Chronic Pain with Clinical Hypnosis

Clinical hypnosis can be used as an adjunctive therapy to help manage and alleviate chronic pain. Although the exact mechanisms are not fully understood, we know  that hypnotic suggestions can influence pain perception and modify the brain’s response to pain signals.

Here are a few ways in which clinical hypnosis may help in the treatment of chronic pain:

• Altered pain perception: Clinical hypnosis can help individuals alter their perception of pain. By inducing a state of deep relaxation and focused attention, hypnosis can reduce the perception of pain intensity or alter the way pain is experienced. It can help individuals dissociate from the pain, creating a sense of distance or numbness, making the pain more manageable.
• Stress and anxiety reduction: Chronic pain often leads to increased stress and anxiety, which can exacerbate the pain experience. Clinical hypnosis can help individuals achieve a state of deep relaxation, which can alleviate stress and anxiety. By reducing overall tension and promoting relaxation, clinical hypnosis can indirectly help in managing chronic pain.
• Cognitive restructuring: Clinical hypnosis can be used to change negative thought patterns and beliefs related to pain. By addressing subconscious beliefs about pain and shifting focus towards more positive or helpful thoughts, individuals can experience a reduction in pain intensity or improved coping strategies. Clinical hypnosis can also help individuals develop new perspectives and attitudes towards their pain, empowering them to take an active role in managing it.
• Behavioral change: Clinical hypnosis can facilitate behavioral changes that contribute to pain management. For example, a hypnotherapist may provide suggestions for engaging in relaxation techniques, visualizations, or self-hypnosis exercises that can be used as coping mechanisms for pain. This can help individuals develop effective strategies for self-regulation and pain control.

Evidence for Clinical Hypnosis for Chronic Pain

Clinical hypnosis has been recognized as an effective therapeutic approach for chronic pain management for decades. Here is just a small sampling of the evidence, which demonstrates the efficacy of clinical hypnosis for chronic pain.

A meta-analysis published in 2018 examined 85 studies and found that hypnosis was effective in reducing pain intensity and improving pain-related outcomes in individuals with chronic pain. (1)

A randomized controlled trial published in 2007 evaluated the effectiveness of hypnosis for fibromyalgia, a condition characterized by chronic widespread pain. The study found that hypnosis significantly reduced pain intensity and improved quality of life compared to the control group. (2)

Over 30 years of research and 35 studies in the published empirical literature show hypnotherapy as an effective treatment for gastrointestinal (GI) disorders. (3)

GI Psychology

Dr. Navidi is a licensed clinical psychologist, one of the founders of GI Psychology, and one of the founders of the Northern Virginia Society of Clinical Hypnosis (NVSCH). Dr. Navidi has been helping patients with GI disorders, chronic pain and complex medical issues for over twelve years.

GI Psychology is a team of clinical experts specially trained to facilitate relief in patients experiencing GI disorders, chronic pain, and other medical conditions. GI Psychology recruits therapists that are highly experienced in treating common psychological conditions and then provide rigorous training in GI and health psychology.