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 and Pain
LEONARD ROSE
Melbourne Pain Management Clinic, Australia
Many factors in¯uence a patient's response to pain, and these are as important as
the extent of the physical damage causing it. They include personality, cultural
background, previous experience, the signi®cance of the organ involved, and
®nancial implications. Thorough assessment by history and physical examination
must be considered with an evaluation of the social issues. Treating the physical
component of pain without considering the psychological and emotional consequences
of pain will result in less than optimal pain relief.
A problem when dealing with pain is its measurement, both for diagnosis and for
assessing the success of treatment. The simplest measure is the Visual Analogue
Scale or VAS, a horizontal or vertical line with the ends ®xed by the statement `no
pain' or `the worst pain experienced'. The McGill Pain Questionnaire MPQ)
Melzack, 1975) has been well studied and validated. The MPQ consists of groups
of pain descriptors forming three main categories which can be compared to the
three higher centres described originally by Melzack. These include the following
categories: sensory throbbing, burning, cramping, etc.); affective sickening,
terrifying and blinding, etc.); evaluative annoying, miserable and unbearable, etc.).
Multiple studies have con®rmed that the words chosen by the pain patient to
describe their pain are important as a measure of severity, affective words being
among the more important.
Thus cues to the appropriate utilization of hypnotic approaches to treat pain are
often given in the very terminology patients use to describe their pain. Even the
adjectives used to describe pain may have an important role in forming the
diagnosis. Pain from nerve damage is often described as shooting, jabbing, or like
lightning; such conditions as causalgia, re¯ex sympathetic dystrophy RSD), and
post-herpetic neuralgia are described as `cold ®re', or `burning ice' Merskey &
Bogduk, 1994). Conditions where the pain is described as having a burning quality
may respond well to the use of hypnotic suggestions of a cooling nature. In glove
anaesthesia suggestions are made with imagery of cooling the affected area with
snow or a cool breeze. Painful areas associated with sensations of cold or in
situations where vaso-constriction has actually occurred may respond to suggestion
of warmth such as `imagine you are now holding the affected area) to the warmth
International Handbook of Clinical Hypnosis. Edited by G. D. Burrows, R. O. Stanley and P. B. Bloom
# 2001 John Wiley & Sons, Ltd