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A Brief History of Using Hypnosis for Pain Management

 

Back in May 2018, I had the pleasure of presenting a talk within a workshop about hypnosis and pain management at The British Pain Society ASM. As some of you know I have a keen interest in the history of medicine, so was delighted to talk about the history of hypnosis in pain management. Of course, with time pressures of a presentation, I can only offer my interpretation of who I think the key influencers were and are, so no doubt I have omitted some, but perhaps that’s for another blog. So here is a summary of my presentation….

Many people have the misconception that hypnosis is the stuff of entertainers and magic shows, perhaps having seen them on TV or on stage whilst on holiday. Hypnosis is a very powerful tool in healthcare when used properly. I aim to show you the history of hypnotism, which will help you understand that it always has been about relieving pain and suffering; healing the physically, mentally and emotionally wounded.

Through the ages, hypnosis has been thought to have, and proven to hold supreme power. There are many accounts both written and verbal which testify that hypnosis has alleviated the suffering from Egyptian times and changed the lives men on the battlefields of every major war in history. Doctors around the globe have harnessed the effectiveness of hypnosis to reduce the pain and misery and suffering of millions and bring healing.

Ancient Egyptians

Ancient Egyptians used hypnosis for both religious and medical purposes, although often in ancient cultures the hypnotic trance state for healing wasn’t always called hypnosis. The earliest recorded documentation of hypnosis was found in an Egyptian tomb dating back to 1500BC. It documented how the sick would visit ‘sleep temples or ‘dream temples’ to be cured of various ailments. Whilst they the Priest-physician would repeat positive suggestions whilst having their patients fix their gaze on metal discs to enter a trance, not unlike the stereotypical pocket watch we may see today to encourage people into a trance.

Interestingly, even though the origins of hypnosis go back to Ancient Egypt, the methods used are very similar to the techniques that western medicine and psychology use today.

Shamanism

Shamanism is the oldest and most widespread method of healing in the world. Archaeological evidence suggests that Shamans and their use of hypnosis, hypnotic techniques, including dancing, fasting, séance and ritual are at least 20,000 years old. The Western world often has a stereotypical view of the shaman as someone in a head dress with a bone through his nose dancing and waving things around the campfire. However, the rest of the world, is more enlightened and sees Shaman as powerful healers who move in a spirit world that can’t be accessed without them and their magic powers. Although Shamanic practices focus on the spiritual and the spirit world, hypnosis is still the vehicle they use to heal their patients. However, unlike today’s practitioners, The Shaman prepared themselves by putting themselves into a focussed state before seeing a patient to heal them.

1800’s, The Age of Reason

For many historians, the turning point in the history of hypnosis was in the 18th Century along with the Enlightenment and the Age of Reason. This was because during this period that doctors, psychologists and psychiatrists began to be aware of the trance state and start using it successfully in their practices, hence studying it scientifically.

Some key movers and shakers

Franz Anton Mesmer, was a German doctor who mixed the dramatic and medical aspects of hypnosis perfectly – he wore a cloak and acted like a mystical figure whilst still being part of the medical community.  He theorised that there was a natural energetic transference that occurred between all animated and inanimate objects that he called animal magnetism, sometimes later referred to as mesmerism. The theory attracted a wide following between about 1780 and 1850, it continued to have some influence until the end of the century.

James Braid, his reputation firmly rests upon his experiments and studies, which established hypnosis as a subject for scientific research and persuaded the medical establishment that it was a valid clinical technique. In that sense, he can be thought of as the first “hypnotherapist”.

His publication ‘Neurypnology’ contains descriptions of twenty-five cases. Braid used hypnotism to successfully treat a wide variety of conditions, such as that of a 45 year old man who had suffered four years of limited mobility in his upper body following a spinal injury. Braid used hypnosis to alleviate pain in the spinal cord and arms, and after two months of daily treatment, the man was able to return to work. Braid also worked with stroke victims, cases of paralysis and chronic rheumatoid conditions, as well as headaches, skin complaints and sensory impairment. It’s also a testament to his humility and professionalism that he included examples of cases where hypnosis didn’t work.

Braid identified many key features of the trance state itself, such as the greater sensory awareness that subjects display. He estimated, for instance, that hearing in the trance state is about twelve times more acute than in everyday consciousness, since the ticking of a watch that could not be heard more than three feet away was audible from thirty-five feet when the subject was in trance. This was an important finding, distinguishing hypnotic trance from ordinary sleep. He also observed that autonomic bodily processes, such as heart rate and blood circulation, can be controlled to a remarkable degree whilst in trance.

John Elliotson – He initially used mesmerism as a treatment for nervous disease and is famous for his studies on the Oakley sisters. His methods were considered flamboyant, perhaps they could be compared to current day stage hypnosis. He lost his reputation with the medical establishment and resigned from UCL. However,he went on to open The London Mesmeric Infirmary in 1849 and pioneered the use of hypnosis in anaesthesia and pain control in surgery which is confirmed by his records.

James Esdaile – he performed over 300 major and 1000 minor operations using only hypnotic anaesthesia. In his book ‘Mesmerism In India, and its Practical Application in Surgery and Medicine’, Esdaile gives a summary of the 73 painless surgical operations he performed in the last eight months of his stay in India. These include arm, breast and, alarmingly, penis amputations, dental surgery and the removal of tumours. In addition, he used hypnosis to cure 18 nervous and medical complaints, including headaches, tics and convulsions, sciatica, inflammation of various body parts and a “feeling of insects crawling over the body.

Émile Coué in Europe, saw hypnosis become part of the self-help movement. As a pharmacologist, Coué (1857-1926) observed that patients tended to respond better to medication when he emphasized its efficiency. From this he developed the concept of autosuggestion – the idea that unconscious responses can be consciously modified, through the imagination. He is best remembered for the phrase “every day, in every way, I’m getting better and better”. Coué’s ideas influenced the rise in popularity of self-hypnosis.

Milton Erikson was a psychiatrist and psychologist who specialised in medical hypnosis and family therapy. He is best known for his approach to the unconscious mind as creative and solution generating. He frequently drew on his own personal experiences of ill health to provide examples of the power of the unconscious mind, and identified many of his early experiences as hypnotic or autohypnotic

Dave Elman, unlike many influencers in hypnosis, Dave Elman was not a doctor or psychologist, he was a performer, in spite of his lack of medical credentials, he was often billed as The world’s youngest and fastest hypnotist’.  He was very fast and direct in his approach as he had learned the rapid inductions used by stage hypnotists and applied them to the therapeutic world. He demonstrated these techniques and knowledge of pain control to his Doctor friends, who were suitably impressed and wanted to know more. As a result, he was asked to provide training to doctors and dentists. Best known for his technique the Elman induction which is based on eye closure, similar to that demonstrated way back by James Braid.

Ernest Hilgard established the Hypnosis Lab at Stanford University. Working with his wife and other colleagues, began experimenting and collecting data on hypnosis as a means of, among other things, treating pain. One of the interesting aspects of Hilgard’s research into hypnosis is the concept of what he calls the “hidden observer.” Ostensibly, a person undergoing hypnosis to manage pain, for example, feels no conscious pain. That does not mean the pain is not there, however; nor does it mean that the patient’s subconscious is not registering the pain. In one experiment conducted by the Hilgard’s, subjects were hypnotized and told they would feel no pain or discomfort when an arm was placed in ice water, or when a tourniquet was tied at the elbow to restrict blood flow to the arm. The subjects reported no pain or discomfort during these procedures. When their “hidden observers” were tapped into, however (usually by a prearranged sign or suggestion from the experimenter), there were reports of pain and discomfort (although not necessarily as severe as would be expected). In subjects particularly susceptible to hypnotic suggestion—those who could be rendered hypnotically deaf or blind, for example—the “hidden observer” could recall “heard” or “seen” objects.

Hypnosis now and in the future

Bringing hypnosis back up to date, in 2016 Jiang, White, Greicius et al used fMRI to scan people brains whilst they experienced a guided hypnosis session. They found that distinct sections of the brain have altered activity and connectivity whilst the person is experiencing hypnosis. The areas which showed changes were areas involved in focussed attention, the control of the body’s functioning and the awareness of both internal and external environments.

In 2017, Jensen and colleagues published an article summarising key advances in hypnotic research over the past two decades, highlighting different areas of the brain working when responding in a trance and clinical research supports the efficacy of hypnosis in treating various conditions such as pain and or anxiety. They suggest that future research continues to look at the role of the central nervous system in maintaining illness and how hypnosis can help. Another topic for research is that of hypnotic suggestibility. As we can see the future of hypnosis is bright.