International Handbook of Clinical Hypnosis - E-Lib FK UWKS

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International Handbook of Clinical Hypnosis. Edited by G. D. Burrows, R. O. Stanley, P. B. Bloom
Copyright # 2001 John Wiley & Sons Ltd
ISBNs: 0-471-97009-3 Hardback); 0-470-84640-2 Electronic)
Hypnosis in Chronic Pain
Management
FREDERICK J. EVANS
Path®nders, Consultants in Human Behavior, Lawrenceville, NJ, USA
HYPNOSIS AND CHRONIC PAIN: A BRIEF REVIEW
The Scottish physician, Esdaile 1850/1957) may have been the ®rst to document
the use of hypnosis to control pain. Just prior to the development of chemical
anesthesia, Esdaile successfully used hypnosis widely in India as the only form of
anesthesia for amputations, tumor removals and complex surgical procedures.
Overlooked in Esdaile's reports was the fact that most of his patients survived
surgeryÐa rare event in those days because of hemorrhage, shock, and postsurgical
infection. In addition to controlling surgical and post-operative pain,
hypnosis may have had autonomic and/or immunological effects that minimized
the usual complications of surgical procedures.
Clinical reports document that hypnosis has been used to reduce chronic pain
Sacerdote, 1970), to reduce the pain and severity of debridement procedures in
burn patients Ewin, 1976; see also chapter 19 in this volume), and to assist in the
management of pain in the terminally ill cancer) patient Domangue & Margolis,
1983). There are relatively few well-controlled empirical studies of the clinical
ef®cacy of hypnosis in the management of acute or chronic pain Turner &
Chapman, 1982). The evidence suggests that about 50% of terminal cancer patients
Hilgard & Hilgard, 1975) and 95% of dental patients J. Barber, 1977) can be
helped with some pain control by the adjunctive use of hypnotic techniques.
Recently, a powerful policy statement was issued by the National Institutes of
Health Technology Conference 1995) on `The Integration of Behavioral and
Relaxation Approaches into the Treatment of Chronic Pain and Insomnia', ®nding
that `hypnosis is effective in alleviating chronic pain associated with various
cancers ...[and] irritable bowel syndrome, in¯ammatory conditions of the mouth,
temporomandibular disorders, and tension headaches'. Most of the studies which
led to this conclusion have been reviewed by Large 1994) and Holroyd 1996).
Studying mixed groups of chronic pain patients, Melzack & Perry 1975) found
that a combination of hypnosis and biofeedback was more effective in alleviating
International Handbook of Clinical Hypnosis. Edited by G. D. Burrows, R. O. Stanley and P. B. Bloom
# 2001 John Wiley & Sons, Ltd