CBT-Hypnotherapy

Braid in 1846 defined hypnosis. Hypnosis has been defined as an altered state of consciousness or an increased state of awareness that heightens suggestibility or responsiveness to ideas that is induced by expectation, focused attention, and suggestion.

Multiple physiological mechanisms play role in hypnosis reduction of pain

• Individuals engaged in successful hypnotic analgesia invoke physiological inhibitory processes in the brain
• Suggestions for sensory reductions in pain show corresponding changes in activity in the somatosensory cortex, whereas suggestions for affective pain reduction are reflected in the part of the brain that corresponds to processing emotional information.
• Successful inhibition of pain through hypnosis may also occur, at least in part, through descending spinal inhibitory mechanisms

CNS activity during hypnotic analgesia

• Activity of brain during hypnosis can be explored with neuroimaging techniques such as regional cerebral blood flow (rCBF), positron emission tomography (PET), single photon emission computer tomography (SPECT), and functional Magnetic Resonance Imaging (fMRI).
• Data suggest hypnosis may involve enhanced cognitive effort (increased blood flow and metabolism in brain tissue).
• Effect of suggestion on brain showed effects on pain neuromatrix i.e. anterior cingulate cortex (ACC), insular cortex, thalamus and sensorimotor cortex and these are well described.
• According to PET studies, hypnotic analgesia can produce both an inhibition of afferent nociceptive signals arriving at the somatosensory cortex and a modulation of pain affect by producing changes in limbic system (e.g. anterior cingulate cortex).

In combining cognitive-behavioral therapy (CBT) with hypnosis for the treatment of posttraumatic stress disorder (PTSD), one study found a 70% greater improvement in clients’ symptoms of distress, as opposed to those that just received CBT.

Procedure involves identifying the patient’s cognitive style and his or her thoughts about pain or his/her underlying illness and problem and then targeting hypnotic suggestions to alter these cognitions should facilitate analgesia or freedom from such thoughts.

CBT-hypnotherapy increases body awareness, achieve an overall relaxed state and decreased arousal, and allow the patient to gain confidence regarding physiological control. It minimizes the reactive component through the acquisition of skills that increase the patient’s ability to cope with the disorder/pain and to reduce disease and pain-related distress. These can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions. Advantages of using hypnotherapy is its relative simplicity, low cost and absence of side effects.

In one study, the patients with refractory fibromyalgia were given a 1-hr session of CBT-hypnotherapy (supplemented by a self-hypnosis home practice) over a 3-month period had larger improvements when compared with 12 to 24 hr of physical therapy (massage and muscle relaxation training) for 12 weeks, with follow-up at 24 weeks. In another study, hypnosis was given in six or more sessions over the course of 1 year and patients are asked to practice self-hypnosis daily (without the assistance of an audiotape) and to give self-suggestions for relaxation, ego strengthening, decreased tension, and aversion of pain attacks.

There are significant studies in a variety of areas within psychological research that include the positive effects of hypnosis for:

• Treatment of anxiety and phobias
• Posttraumatic stress disorder
• Addictive issues such as smoking cessation
• Weight loss
• Gastrointestinal disorders
• Nausea
• Irritable bowel syndrome
• Asthma

Hypnosis for the treatment of Chronic pain has multiple roles:

• To decrease depression;
• To reduce medication and opioid use;
• To improve sleep, social and family relations and quality of life;
• To increase in range of motions and activity level; and
• To return to work

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