Article from National Institute of Health (NIH) Clinical Center October 2002

Hypnosis helps patients cope with pain and anxiety

Handel coaches patients in therapeutic hypnosis

The 14-year old boy was terminally ill and in severe pain. A brain tumor was causing blinding headaches and he suffered multiple fractures of his ribs because of the metastases spreading throughout his side. At night, he clutched a stuffed teddy bear to keep from crying out.

He could have remained at the hospital and received constant attention, but he wanted to return to his home and family. With a regimen of medicines and just a few training sessions in clinical therapeutic hypnosis, he was able to do that.

"It was a transformative experience for me and, I think for him and his family," said Dr. Daniel Handel, the man who trained the young patient and who now describes himself as the "new kid on the block" in the Pain and Palliative Care Department. "To see what people can do when they have a strong motivation to help themselves and to work with the tools-I'm constantly amazed at what we, as humans are capable of."

Handel came to the Clinical Center in January, bringing with him more than a decade of skills in pain management and a strong interest in therapeutic hypnosis. Originally from Minnesota, he spent the last 13 years at Harris Medical Hospital in Fort Worth, Tx., where he worked with critically ill patients.

"I'm very impressed with hypnosis as an effective adjunctive clinical tool," he said. "I think of it as a natural, God-given state of mind that we can tap into." What he's learned, he said, is that people can have significant control over their bodily functions and sensations-far more than most people can imagine. And because he's asked others to do it, he's taken great care to practice what he preaches.

Years ago in medical school, he had two wisdom teeth removed, an experience he described as grueling. Impacted, the teeth were removed with some difficulty, leaving Handel with a great deal of swelling and in considerable pain. " The doctor said to come back when I was ready and we'd do the other two," he recalls. " So ten years later, I was ready."

This time a friend, who also was a colleague, trained him using self-hypnosis. But Handel was nervous. His wisdom teeth had become even more impacted in the ensuing years. To his surprise, after the procedure there was no swelling or pain. He used his hypnotic training steadily and after three days used only two tablets of ibuprofen.

" Most of us have this ability," he said, " and it's important to realize it isn't something one person does to another, but is something we do for ourselves following appropriate training. It's not magic."

Of course, people have varying degrees of ability to be hypnotized and it's not always easy to determine who will be most susceptible. Far from what many think, he said, you never surrender control under hypnosis and you can bring yourself out of it at any time. "It's simply an altered state of consciousness through which we can accomplish phenomena that we may not otherwise feel capable of accomplishing."

According to Handel, a hypnotic trance is simply concentration or focusing—very similar to what a driver might experience on a long straight road or highway. " If someone jumped out in front of your car, you would react, but otherwise you might find yourself wondering where the last 60 minutes went." Outside of clinical uses, hypnosis can be used as a means of relaxation or preparation for study.

Clinically, hypnosis has been used effectively not only for pain, but anxiety, control of nausea-induced vomiting and for sleep disorders. It can be used by itself or as an adjunct to other therapies. For an enduring effect, it requires motivation, work and practice, which he admits are not easy. Still, the results can border the incredible. Handel has seen hypnosis used in surgery instead of anesthesia for operations on bone. But it's the day-to-day successes that impress him the most.

" This is something that has been closely studied in a clinical setting for 35 years," he said. " It's well researched and proven, yet we still don't know some of the underlying mechanisms of how it works."

Recent studies have shown that subjects given Positron Emission Tomography brain scans while actually looking at a flower can be put into a hypnotic trance later and be induced to " look" at it again through hypnotic hallucination. PET scans at that time reveal activation of the same brain sites as in the original visualizing event. But if the subjects were asked simply to recall the plant from memory, without hypnosis, different sites involving visual memory would be activated.

Such research fascinates Handel. "As the new kid on our team, I'm equally as impressed, and proud, that so many healing disciplines are used at the Clinical Center in assisting our patients toward wellness and comfort."

For further information on clinical therapeutic hypnosis, visit the website of the American Society of Clinical Hypnosis at http://www.asch.net.