Hypnosis for Pain Control Newport & Cardiff
Pain is an unpleasant sensory or emotional experience which is linked with actual or potential tissue damage or is described in terms of such damage. Pain behaviour is the extent to which people will behave as if the pain is still there even after the tissue damage has healed.
Pain is a relative concept. One person’s pain is another person’s inconvenience. For example, some people have such a fear of the amount of pain they will experience at the dentist that they have even been known to pull a tooth out at home in a much more painful way. Clearly then it is the context that is important here rather than the amount of pain. An individual’s previous experience, personality, pain behaviours, coping strategies and social environment are all important in determining how pain is experienced and reported. Thus to assess fully the extent of pain experienced not only physiological factors should be considered but also psychosocial and behaviourial expressions of pain.
The main psychological factors which have been emphasised as playing an important part in pain experience are personality, inappropriate behaviours and incorrect cognitive processing. The personality factor may be that some people are pain prone because there is a benefit to be gained, such as time off work, or they may be paid attention to, etc.
Back pain is often not down to a specific physical cause. It has been found that up to 41% of patients presenting with non-specific back pain have some psychiatric reason. In a study of patients with chronic back pain they were diagnosed as having at least one psychiatric disorder. The most common diagnoses were depression and anxiety disorder. It must be admitted, however, that feeling chronic back pain could lead to depression and anxiety which could persist even after the physical cause seems to be gone.
In the genetic approach to pain the theory is that people may be born with different levels of pain thresholds. So this means that some people have a low threshold to pain and some a high threshold in which case those with a low threshold feel pain more easily and intensely than those with a high threshold to pain. Having said that it is still the case that the control of pain is a major technique that can be useful to people whether they have a high or a low threshold to pain. This is because the control of pain is a psychological and physical event which results from the interaction between the psychological and physiological events.
Hypnosis too is used for relaxation and reducing or even eliminating pain. However, for it to work the patient has to be suggestible and to believe in the technique. The way a session of pain control hypnosis in Newport or Cardiff works, besides through the power of suggestion, is to reduce the pain by half through the deep relaxation that some patients experience when they undergo it.
Techniques for pain control management
The theory is that certain types of thoughts and feelings can help to reduce or stop pain while other feelings and thoughts may actually work to amplify or increase the pain. The aim then is to teach the person what thoughts and feelings which will reduce or stop pain.
It is an accepted idea now that the person who has the pain is also the one who controls it. This gets away from the idea that the person is just a victim of the pain and enables the feeling of empowerment. This relates too to the idea of locus of control. With an internal locus of control the person feels it is up to them to deal with the problem/pain although initially they would need to be taught the appropriate methods. With an external locus of control the person feels they need treatment, but take a passive approach that the doctor or therapist is the one who is responsible for how it goes and they do not need to make any or little effort themselves.
There are a number of techniques to control pain such as relaxation, hypnotherapy, visualisation, etc and these are discussed below.
The aim of hypnotherapy and relaxation is to give the feeling that there are a number of ways the person can control their pain. Some will work very well for them and others are in-between and others won’t work. Since it is a very individual thing then it is necessary to find out what would suit the particular person. There are a number of very powerful methods to deal with pain using the power of the mind through thoughts and visualisation.
Methods of pain control
Before explaining the methods it is important to make one proviso. Although it may be possible to remove the pain entirely this is often not advisable. What is recommended is that it is reduced to a level where the person is still aware of some of the pain so that if it needs urgent attention then it would be given. Broken bones are a classic example of this as it would be unwise not to be able to feel any pain
if the bones are still mending and the person needs to take care that no damage is done during that process.
Pain inoculation training involves preparing in advance for the onset of pain. It is to remember coping techniques when the pain starts to mount and to feed oneself encouraging, but realistic, thoughts. After the pain has come in then the coping techniques are used such as controlled breathing, relaxing the muscles, encouraging self-talk, distracting oneself. Essentially this is the same method as when self-hypnosis is done. When the pain has subsided then the person gives him/herself credit for handling it so well.
Hypnotic anaesthesia: Cold and warm methods
It is easier to induce numbness in the hand as opposed to the trunk of the body or the head. For this reason hypnotherapists often use the hand as an instrument to induce anaesthesia in the trunk of the body or the head. The procedure, if say a swelling needs to reduced or the pain is a burning pain, is to anaesthetise the hand by suggesting that it is in a bucket of ice and that as the person visualises this and feels the hand becoming colder and colder then all sensation will be lost in the hand. This can be tested by pinching the skin of the back of the hand or by pricking it with a sterilised needle. The next step is to put the hand on the part of the body and suggest that the anaesthetising cold will go from the hand into that part of the body. When the hand is again normal temperature then the part should be either pain free (if it is safe to do that) or the pain is reduced.
If the pain is from muscular tension and knotting up then it is better to use warmth to deal with it. The person then is asked to imagine that their hands are in a bowl of comfortably hot water warming up until they feel the same temperature as the water. Then if it is pain from knotted neck muscles or a tension headache coming from a knotting of muscles in the neck then the hands can be laid on the scalp with the warmth going from the hands into the neck easing the muscles and unknotting them. As this happens then if a head ache is linked with the knotting of the muscle then the headache would go too. If it is not due to knotting of the muscles then the procedure would be the same but to put the warm hands on the scalp and suggest that as the warmth seeps from the hands into the head that the headache will reduce and even disappear.
Distraction or attention diversion
This method involves refocusing the attention onto something else rather than focus on the pain. When it involves external distraction then it includes focussing on an external focus point. When it involves internal distraction then imagination and imagery are used mentally such as removing oneself to a favourite place where one can feel comfortable and safe. Pain displacement involves imagining a similar or different sensation in a part of one’s body where it would be less painful or distressing. Using guided imagery for this can be very effective.
This involves making say a burning pain into something less painful such as a dull heavy pain. Again guided imagery facilitates this.
Diaphragmatic breathing (seven/eleven technique)
This involves breathing in to the count of seven and breathing out to the count of eleven. By breathing out more slowly than breathing in the relaxation response is strengthened over the arousal response.
Pain relief imagery
The imagined cause of the pain can be interpreted and imaginatively transformed into something else which would feel less painful and more benign. The different forms of this are described below.
- Symptom alteration imagery involves images of shrinking or expanding the pain, changing the colour of the pain from say an angry red to a calm blue. If pain had a taste changing it from astringent to a smooth, pleasant taste. The same could be done for other senses and pain such as smell, touch, texture…
- Healing lights: A healing coloured light stream that neutralises pain and physical hurt. This goes well with the use of colour in the relaxation part of hypnosis.
- The switch or the dial: The switch is a metaphor for being able to switch the pain on and off. The dial metaphor allows the pain to be turned down from say a 10 when it is very painful to say a 4 which is much more controllable.
- Nature images: This goes well with the imagery part of hypnosis to imagine oneself in a very relaxing, calming, enjoyable and warming scene.
These approaches to pain see the environment and behaviour as being important factors. But a purely behaviourial approach is not favoured now. Most psychologists favour the CBT (cognitive- behaviourial therapy) approach where the individual’s beliefs, thoughts and their interpretation of the world are thought to be important. For example, in the control of pain through hypnosis it is important that the person believe the hypnosis will be effective.
Another important factor mentioned above is whether people have an internal or external locus of control. Those with an internal locus of control feel it is possible to do something to lessen their pain. Those with an external locus of control would think that it depends more on outside factors over which they have little or no control. For example, it has been found that people with chronic back pain who think it will never get better actually do have a poorer prognosis than those who believe that it will get better. A patient’s belief in the negative consequences of back pain will determine their attitude to how far their future activities will be restricted. for example:
A bad back should be exercised.
A bad back must be rested.
Once a patient’s beliefs about back pain have been ascertained then counselling and advice on coping can be given. Pain management used to mean prescribing, medication and rest, but now the importance of psychological intervention for both chronic and acute pain is being realised. An example would be back pain again. It has been found that there is no correlation between increased activity and an increase in pain; in fact, some back pain sufferers continue to be active in sports activities. It is possible to exercise without causing further damage indeed the rehabilitation of the chronic back pain patient will often involve increasing their “up time”, i.e., increasing their activity levels.
Does hypnosis work for pain control?
A wide range of methods to control pain has been given because for it to work hypnosis has to be done in an individual way in conjunction with the method to suit a particular person. I will only treat pain with hypnosis in Newport or Cardiff when the cause of the pain has been determined by a doctor and suitable treatment given.
It is important to remember that pain is not just a physical thing but involves the person’s previous experience, pain behaviours, personality, coping strategies, and social environment. To put it another way it is physical, psychological, social, behaviourial. It is important too that the pain should not go away entirely as it does have the useful function of warning the person to be careful with that part of the body until most of the healing has taken place.