This Treatment May Make Hypnosis More Effective for Chronic Pain

Man in blue shirt works with woman in hypnosis session.
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  • New research from a team at Stanford University’s School of Medicine have found a way to increase your hypnotizability.
  • Hypnosis is increasingly being explored as a way to treat psychological conditions as well as pain disorders.
  • The study indicates that transcranial deep brain stimulation does tangibly increase hypnotizability, but more research is needed in this emerging area.

A team of researchers from Stanford University are hopeful that their new findings could pay dividends for those in chronic pain.

The article, published this week in Nature Mental Health, is focused on how transcranial magnetic stimulation (TMS) can increase hypnotizability for a short time.

How to improve hypnosis

The research was conducted as a double-blind randomized controlled trial with 80 individuals. Half of the participants were given the treatment while the other half were given a version of transcranial magnetic stimulation that is not strong enough to penetrate the skull, but follows the same procedure. 

In general an estimated 15% of people are considered highly hypnotizable and on the 10-point measure of hypnotizability, they would be expected to score a 9 or 10.

Previous studies have found that hypnosis-based intervention can aid in psychological therapies as well as with those experiencing chronic pain. For their study, the researchers used a technique known as Stanford Hypnosis Integrated with Functional Connectivity Targeted Transcranial Stimulation (SHIFT).

The study involved participants being scanned via both a standard MRI and a functional MRI These scans allowed the researchers not just to observe brain activity that is connected to someone’s hypnotizability, but also to know where best to apply the magnetic coil that is used during transcranial magnetic stimulation. Having already undergone a test to see what their hypnotizability score was prior to the procedure to establish a baseline, those involved were tested again afterwards. 

Those who had the neurostimulation were found to have a significant increase in hypnotizability meaning they scored one point higher on the 10-point measure of hypnotizability. Those who did not get the neurostimulation had no increase.

Lead author, and postdoctoral fellow at Stanford, Dr. Afik Faerman (PhD) says that he’s optimistic that this proof of concept study will allow hypnosis-based therapies to be better utilized in the future, particularly for those with chronic pain conditions. 

“We know that individuals that are experiencing pain are automatically good candidates for hypnosis-based treatment, because we know hypnosis works for pain. And the benefit that hypnosis has on the first line of treatment is that it’s drug free.”

All of the participants included had fibromyalgia, a chronic pain condition that was chosen because of how it manifests in the body.

Dr. Jean-Philippe Langevin, director of restorative neurosurgery at Pacific Neuroscience Institute who also is a faculty member in the department of neurosurgery at UCLA, says that he sees promise in what Faerman and his team have found. 

Langevin wasn’t involved in the study.

“There’s always this thought that perhaps neuromodulation can be used not only to correct problems like mental health issues… but perhaps it could also be used in the future to enhance some capabilities of humans,” Langevin said.

How hypnosis is used in medicine

Hypnosis is far from a new phenomenon in research circles, but Dr. David Spiegel, professor of medicine at Stanford University and a co-supervisor on the study, says that it has, at times, fallen out of favor. 

“Hypnosis is actually the oldest Western conception of psychotherapy… [It’s sometimes] sort of pushed to the side as either a stage show trick or something dangerous or irrelevant.”

According to the study, and previous research done by Spiegel and his colleagues, hypnotizability is determined by a combination of how two different cortexes in the brain interact, what Faerman calls a “…Fine-grained pathway that these structures have that we are trying to target.” 

One of the aspects of this study that makes it different from other interventions is that it is non-invasive. Langevin says that transcranial magnetic stimulation, and the use of an fMRI during the treatment process, could have significant implications for the field in conjunction with or beyond hypnosis, particularly when it comes to more common treatments.

“I do research in post traumatic stress disorder. So that’s one active field where neurostimulation through transcranial magnetic stimulation is also being used,” Langevin said. “If we find partial results, or perhaps partial benefits, in those patients who are more severe, we can go back and implant a permanent [stimulator] to replicate the results.”

How hypnosis can help with chronic issues

Spiegel says that, fundamentally, this approach is challenging dominant narratives in medicine and offers patients an alternative option for treatment.

“The standard in modern medicine is incision, ingestion or injection. Do something physical, treat the body like it’s a broken car and replace the parts and fix it,” Spiegel said. “And in fact, people can learn to do this [modulate pain sensations] extremely well with techniques like hypnosis. And in this case, augmented with transcranial magnetic stimulation.”

In the future, Faerman would like to see a process like this conducted with a wide variety of patients and that doing so will lead to time and cost savings. 

“My vision…as a clinical psychologist and in general, is that patients will come to see their psychologist or psychiatrist for psychotherapy and before they walk into their therapy appointment, they’re going to have a brief stimulation session, and hopefully, it is going to increase the effectiveness of the treatment that you’re getting,” Faerman said.

Takeaway

Researchers say they may have found a non-invasive way to increase hypnotizability for a short period of time. Hypnosis can help treat certain conditions including issues with chronic pain.

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