Hypnosis in the management of
intractable pain is a valuable but frequently overlooked tool for the practicing physician. Two cases are presented which illustrate some of the benefits and limitations of
hypnosis in
pain management.
Hypnosis is most effective when the patient is motivated, and
pain is a strong motivating force. Secondary gain from the
pain and underlying
psychiatric illness must be considered when seemingly routine
pain problems do not respond to
hypnosis.
Hypnosis may be equally effective for
pain of organic or psychogenic origin. Ancillary benefits from
hypnosis may include a diminution of secondary anxiety and depression. The technic is impractical for some patients because of the time requirements, but proper patient selection can obviate much of this objection.
Self-hypnosis and/or the supervised use of a relative as a substitute for the physician enhances effectiveness. Training in
hypnosis for adjunctive use in the management of
pain is available to primary care physicians.