Hypnosis as a surgical tool

The editorial of the Journal of the National Cancer Institute discusses a recent study that found that hypnosis can be successfully used in breast cancer surgery to reduce pain, nausea, painkiller use, tiredness and emotional impact of the surgical procedure.

The study was a randomized controlled trial of patients who were undergoing breast surgery either to treat a cancer or to test a lump to see if it was cancerous.

Patients were randomly assigned to either a brief 15-minute hypnosis condition, or to another where the patient discussed their concerns with an empathic psychologist (to make sure the effects weren’t just due to having someone their to ‘calm their nerves’).

The study found that patients given hypnosis needed less painkilling medication, were less nauseous, less emotionally upset, and experienced less pain intensity than the patients in the ’empathic listening’ condition.

The editorial notes that the results suggest hypnosis is a powerful tool for helping patients, discusses why it isn’t being used more widely, and what we know about how it affects the brain:

Thus, the study in this issue contributes to an impressive body of research using randomized prospective methodology in sizeable patient populations to demonstrate that adjunctive hypnosis substantially reduces pain and anxiety during surgical procedures while decreasing medication use, procedure time, and cost. If a drug were to do that, everyone would by now be using it.

So why don’t they? For one thing, there is no mediating industry to sell the product‚Äîdangling watches are out of fashion for hypnotic inductions. Plus, there is still lingering suspicion that hypnosis reeks of stage show trickery. After all, the magic wand originated with Mesmer’s use of a magnetic stick to presumably alter magnetic fields in patients’ bodies. Yet hypnosis is the oldest Western form of psychotherapy. Hypnosis is a state of highly focused attention, with a constriction in peripheral awareness and a heightened responsiveness to social cues. It is most similar to the everyday state of becoming so absorbed in a good movie or a novel that one enters the imagined world and suspends awareness of the usual one, a condition playwrights refer to as the “suspension of disbelief.” This state can exert powerful influence on mind and body.

Altering perception using hypnosis results in brain changes that literally reduce pain perception [rather than merely altering the response to pain]. Indeed, simply changing the wording of the hypnotic instruction from “you will feel cool, tingling numbness more than pain” to “the pain will not bother you” alters the brain location of the analgesia from the somatosensory cortex to the anterior cingulate gyrus. Hypnotic alteration of color perception results in bidirectional changes in blood flow in the portions of the visual cortex that process color vision‚Äîblood flow in this region increases when color is imagined rather than seen and decreases when color is hypnotically drained from a colorful stimulus. Thus, there is good neurophysiologic reason to believe that hypnosis is potentially a powerful tool to alter perception of pain and associated anxiety.

If you’re interested in volunteering for research into the neuropsychology of hypnosis in London (which doesn’t involve anything painful!), we’re still recruiting participants for sessions at 2pm on Saturday 17th and 24th November.

There’s more information at our study web page.

Link to Journal of the National Cancer Institute editorial on hypnosis.
Link to abstract of RCT study.
Link to information on our neuropsychology of hypnosis study.

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