International Handbook of Clinical Hypnosis - E-Lib FK UWKS

268 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
dosages of antidepressants up to 300 mg per day of amitriptyline), other psychotropic
agents and analgesics prescribed by previous practitioners.
This successful case, however, raises a cautionary noteÐ6 months after discharge
she collapsed in the street with total paraplegia and was eventually found,
after further investigation, to be suffering from a high dorsal spinal meningeal
tumour. When this was successfully removed she became permanently asymptomatic.
IMAGERY TECHNIQUES AND CHRONIC PAINÐA
PRACTICAL PRIMER
SPECIFIC PAIN CONTROL TECHNIQUES
1. Suggestions of deep relaxation in themselves may reduce the anxiety that
often accompanies pain. These suggestions can be enhanced by providing
imagery under pleasant environmental conditions, with as much visual and
sensory imagery as possible. For example, asking patients to imagine that
they are in a mountain cabin in the snow can be therapeutic in itself or it can
lead to the production of `glove anaesthesia'. This may occur when patients
are asked to imagine going for a walk in the snow, picking up a handful of
snow, holding it to the pain area and then transferring the cold and numbness
to replace the pain.
2. Direct suggestions of pain relief. Simply telling patients under hypnosis that
the pain will disappear and will not return when the patient is in the normal
waking state may lead to an apparent reduction in pain.
3. The hypnotic transfer of pain from one part of the body to another, where it is
less disabling, may bene®t patients who have a psychological need for the
pain to continue whether for sympathy or to get a greater ®nancial settlement.
For example, such patients may be able to transfer their pain from their
abdomen to a ®nger.
4. Hypnosis can be used to change pain sensations into more easily tolerated
sensations. It can be suggested that the pain will be experienced as a pleasant
`buzzing' or `warmth'sensation rather than an acute or deep sensation.
5. Pain may be controlled by suggesting an area of numbness produced by
asking patients to imagine that a local anaesthetic has been administered.
Another method previously mentioned is `glove anaesthesia' which can be
transferred to the pain area. For example, in dentistry, an anaesthetic gel can
be used on a child's ®nger. The child is then told that he or she has a `magic'
®nger which can remove all the discomfort experienced during the procedure.
The anaesthetic thus reinforces the therapist's suggestions.
Dissociation can be used to separate patients from their pain. If patients are
well trained and motivated, it is possible for them to dissociate all or part of