Publisher: Natural Health
But it can help alleviate physical pain as well as phobia induced stress and anxiety.
For most of her adult life, Terri Shifrin was crippled by a peculiar kind of agoraphobia - the fear of being trapped. Airplanes and elevators petrified her. She stopped driving on freeways, worried she'd get caught in a traffic jam and not be able to get out.
Over the years Shifrin went to one therapist after another, trying biofeedback, talk therapy, and desensitization therapy. Nothing relieved her anxiety. So she learned to work around it. For 20 years she never traveled more than10 miles from her Palo Alto, Calif., home. "I wanted to go out and do things but I just felt stuck," says Shifrin, 51, a former kindergarten teacher.
Two years ago, anticipating her son's graduations form college 400 miles away in Southern California, she decided to try something new: hypnosis. Shifrin went to the Stanford Center for Integrative Medicine, where she met with psychiatrist David Spiegel, M.D., co-author with his father, Herbert Spiegel, M.D., of the 1978 book Trance and Treatment (American Psychiatric Publishing, 2004), which remains a standard textbook on the clinical uses of hypnosis. Using a combination of directed hypnosis and self-hypnosis, Spiegel helped Shifrin regain a sense of control. Once she was in a hypnotic state, he would have her imagine a place that made her feel relaxed - she chose a waterfall in Hawaii she had visited as a teenager. Then he would have her imagine a situation that frightened her, such as driving on a congested freeway at rush hour. He directed her to look back and forth between the two scenes as they were projected side by side on a movie screen. Over time, she came to use the calming waterfall as an emotional touchstone in moments of panic.
After more than a dozen appointments with Spiegel and countless self-hypnosis sessions on her own at home, Shifrin and her parents climbed into her car for the drive to the graduation. The first hour and a half of the ride were tough, her knuckles white as she gripped the steering wheel. But eventually she began to relax. "I got to the pint where I could look at the scenery and enjoy the conversation with my parents." The next day, as her son walked across the stage to accept his diploma, Shifrin beamed with pride - in her son and in herself.
Hypnosis, or hypnotherapy, is becoming more common in medical clinics like the one at Stanford and in hospitals, where doctors are using it to sedate patients before surgery, ease the pain of burn victims, and prepare women for childbirth. Evidence is mounting that hypnosis is useful in treating not only psychological conditions like anxiety, addiction, and phobias but also distinctly physical ailments like broken bones and surgical wounds.
When it works, hypnosis can be surprisingly effective, taking a person form physical agony, for example, to a pain-free state in minutes. But it doesn't work for everyone. "About two-thirds of adults can be hypnotized," Spiegel says. But even those who cant' be hypnotized may benefit form hypnosis sessions, which generally induce relaxation and ease stress, if nothing else. Whether hypnosis is successful may depend on the skill and training of the person who is directing it as well as the recipient's motivation, readiness, and rapport with the therapist.
Spiegel and other experts are quick to point out that hypnosis is not about therapists exerting power over their clients: it's about people taking control of their own minds and bodies. Practitioners achieve this by putting you into a hypnotic trance, which Spiegel describes as a state of focused concentration. "This helps put other concerns out of your consciousness." Practitioners have several ways to induce hypnosis. Most begin by making you comfortable, often in a plush recliner, and directing you to close your eyes and relax. The hypnotherapist will then guide you into a trance, usually by counting backwards and directing you to feel parts of your body become heavy. Once you're in a hypnotic state, the therapist may offer gentle suggestions ("imagine your body floating somewhere safe and comfortable, like a warm bath") or visualization techniques that help you imagine malfunctioning organs working properly or pained areas going numb. Practitioners typically teach these skills to you and sometimes provide audiotapes or CDs so directed sessions can be reinforced with self-hypnosis.
Not long after David Patterson, Ph.D., started working as a psychologist at the Harborview Medical Center in Seattle, he met with a 60-year-old burn patient who complained of excruciating pain. "He was taking morphine, Valium, and laughing gas and still said he'd rather die than go through his next dressing change," Patterson recalls. The doctor consulted a colleague, who suggested hypnosis.
Patterson had studied hypnosis in school and was familiar with the basic technique. After hypnotizing the patient, he suggested that when a nurse touched him on the shoulder he would become relaxed and free of pain. The doctor left the ward for a couple of hours. When he returned, the floor was abuzz: A nurse, he learned, had come to change the man's dressing; when she touched his shoulder, he instantly fell asleep.
Hypnosis seldom works that dramatically, admits Patterson. And yet for many sufferers, it offers significant relief from both chronic and acute pain. In a 2003 review of clinical trials on hypnosis for pain, Patterson and colleague Mark Jensen, Ph.D., found that hypnosis was associated with significant reductions in ratings of pain, the need or painkillers or sedation, nausea and vomiting, and length of stay in hospitals.
A handful of hospitals are even using hypnosis as an alternative or adjunct to anesthesia for medical procedures. The most notable example is Beth Israel Deaconess Hospital in Boston, where radiologist Elvira Lang, M.D., offers hypnosis to patients before invasive procedures. In a study published in The Lancet in 2000, Lang and colleagues studied 241 people who underwent interventional radiology procedures to open clogged arteries and veins, relieve blockages in the kidney drainage system, or block blood vessels feeding tumors. The patients who had hypnosis had more stable vital signs during the operation, left the operating room sooner and needed less pain medication than patients who received standard medical care.
No one completely understands how hypnosis works on pain, but brain-imaging studies have shown that people have a distinctly different pattern of brain activity when they are hypnotized. Activity is reduced in areas of the pain network, including the primary sensory cortex, which is responsible for the perception of pain. "These changes suggest that hypnosis blocks the pain signal form getting to the parts of the brain that perceive pain," says Sebastian Schulz-Stubner, M.D., Ph.D., and assistant professor in the University of Iowa Department of Anesthesia.
Hypnosis is slowly gaining favor as a way to ease the pain of childbirth. According to Grantly Dick-Read, M.D., the English obstetrician who wrote Childbirth Without Fear in 1933, hypnosis during labor helped women break the "fear-tension-pain syndrome." In a 2006 study, Australian researchers compared childbirth experiences of 77 women who were taught self-hypnosis in preparation for childbirth to those of 3,249 controls. The women who used hypnosis were less likely than other to need an epidural.
In a 1999 study at Harvard Medical School, health psychologist Carol Ginandes, Ph.D., divided 12 people with ankle fractures into two groups. Everyone received casts and standard orthopedic care, but six also underwent a series of hypnotherapy sessions, which included suggestions meant to target their particular stage of healing. Researchers reinforced the sessions by sending patients home with hypnotherapy audiotapes. Six weeks after they broke their ankles, the hypnotized patients had healed to an extent that would normally take eight and a half weeks.
Ginandes and colleague Patricia Brooks followed up with a study in 2003 on incision healing. They divided 18 women who underwent breast-reduction surgery into three groups of six. One received only standard postoperative care. The second group had eight sessions with a psychologist who offered emotional support but no hypnosis. The third group received eight hypnotherapy sessions. Nurses who examined the surgical wounds for seven weeks after the surgery found that the group receiving hypnosis healed fastest, followed by those who had had psychological support; the standard-care group healed most slowly.
"After a single session of self-hypnosis, half the people will stop smoking right away," says Spiegel, "and of those, half will not touch a cigarette for two years." Unfortunately, there's little evidence hypnosis can help people break other bad habits. Weight-loss studies haven't been impressive, and there's even less evidence of effectiveness in the treatment of drug addiction. "Drugs mess with the brain," says Spiegel, "making it hard to use hypnosis."
A series of studies has shown hypnosis to be an effective treatment for most of the physical symptoms of irritable bowel syndrome (IBS) as well as the anxiety and depression that often accompany them. Most studies reported success rates of between 70 percent and 95 percent - impressive results for a condition that doesn't respond well to medical treatment.
Hypnosis has long been used to treat phobias, anxiety, and post-traumatic stress disorder, and recent studies have shown it to be highly effective. But despite her successes, Terri Shifrin is the first to say hypnosis is not a cure. "I still have agoraphobia," she says. "I battle anxiety every day."
However, in the two years since she started hypnosis treatment, Shifrin has widened her comfort zone. Now she's working on the phobia of airplanes: She wants to return someday to that waterfall in Hawaii, the one she visualizes whenever she feels the panic begin to rise.