Medical Hypnosis and Physiology

Source: Tracework by Yapko, 2005. Traditional medicine has long recognized the "placebo effect". In some instances, a patient's positive belief that he or she is getting an active drug when she is really getting no drug at all, only a sugar pill resembling a drug, will generate the same level of therapeutic effect as if the patient has been given an active drug. Conversely, a negative expectation can foster a "nocebo" effect, a negative therapeutic effect. A person's expectation and attitudes can obviously have profound effects on mental and physical experience. With this growing recognition of the influence of client's expectancy on both physical and psychological treatments, there is a growing use of hypnosis and hypnosis-related techniques. Psychologist Irving Kirsch, Ph.D., has evolved a specific socio-cognitive model of hypnosis, known as the response set theory, which heavily emphasizes the role of expectancy in treatment (1985, 2000). In fact, Kirsch detailed considerable evidence that much of the positive effects of hypnosis is due to positive expectations on the part of the client, and Kirsch has even come to refer to hypnosis as a "non-deceptive placebo", unlike the sugar pill clients are fooled into believing are active drugs (1994). There is a considerable body of empirical evidence attesting to the power of expectations in both psychological and medical conditions ( Harrington, 1997). Given a foundation for appreciating how expectancy can influence physiology and behavioral responses, is hypnosis only a placebo? Certainly there is some truth in that perspective, if that's all hypnosis was, it would still be worthy of intensive study. After all, the need to engage clients in their treatment is vital to enhancing treatment effects and minimizing a sense of victimization and even depression when such reactions delay or even prevent recovery (Lynch, 1999; Yapko, 2001). In general, hypnosis can be useful adjunct to more traditional medical treatments for several reasons, the first of which relates to the mind and body relationship and the role of the mind (attitudes and related emotions) in medical disorders. "Miracle cures" that defy current medical understanding, which have evolved out of the patient's refusal to give up, are not uncommon in literature. Pragmatically speaking, why not encourage ---or at least permit "miracles"? Why place limitations on the patient that he or she would not place on him or herself? A second reason for making use of hypnosis in the medical context is because of its emphasis, by its very nature, on the responsibility of each person for his own health and well-being. Use of hypnosis gives people a direct experience of having control over internal experiences, whether pain or distress. Finding resources of comfort or the ability to shift perceptions of their body within themselves is a dramatic experience, and allows a new and higher level of responsibility for patient's own well being. Specific applications of hypnosis in medical contexts are greatly varied, but can generally be described as a way of attaining a significant degree of control over physical process. One possibility is the reduction or elimination of pain without the use of medication (Chaves, 1993; Montgomery, DuHamel, & Redd, 2000). Pain management is one of the more sophisticated uses of medical hypnosis, and is applicable to the patient in both chronic and acute pain. Hypnosis is commonly used in the treatment of anxiety and stress disorders, and is considered to be the most effective treatment ( Schoenberger, 2000). Teaching the medical patient techniques for preventing negative stress whenever possible, techniques for identifying stress well before it reaches a level where it is likely to cause debilitating symptoms, and techniques for relaxing and managing stress positively are all elements in teaching a hypertensive patient to manage his or her condition positively and responsibly. Hypnosis in the treatment of serious diseases, as an adjunct, not a replacement, for more traditional approaches, has demonstrated the necessity of addressing the emotional needs while using the mental resources of the patient as a part of the treatment....Hypnosis doesn't replace other treatments, it adds to them. .