January 4, 2010
Author: Philip D Shenefelt, MD, MS,
Introduction
Hypnosis is the intentional induction, deepening, maintenance, and termination of the natural trance state for a specific purpose. For the much maligned stage hypnosis, the purpose is entertainment. For medical hypnotherapy, the purpose is to reduce suffering, to promote healing, or to help the person alter a destructive behavior. The hypnotic phenomenon has been used since antiquity to assist in healing.
All individuals enter spontaneous mild trances daily while absorbed in watching television or a movie, in reading a book or a magazine, or in another activity or meditation. With appropriate training, an individual may intensify this trance state in himself or herself or in another individual and use this heightened focus to induce mind-body interactions that help to alleviate suffering or to promote healing. The trance state may be induced by using guided imagery, relaxation, deep breathing, meditation techniques, self-hypnosis, or hypnosis induction techniques. Individuals vary in their ability to enter the trance state, but most can obtain some benefit from hypnosis.
In dermatology, hypnosis may help decrease pain and pruritus in the skin; intervene in psychosomatic aspects of skin diseases; and lead to the resolution of some skin diseases, including verruca vulgaris. Suggestion without formal trance induction may be effective in some cases. Sulzberger and Wolf1 reported on the use of suggestion to treat verrucae.
Precisely defining hypnosis has proven to be challenging. Marmer2 described hypnosis as a psychophysiological tetrad of altered consciousness consisting of narrowed awareness, restricted and focused attentiveness, selective wakefulness, and heightened suggestibility. For a more detailed discussion of the definitions of hypnosis, see the texts by Crasilneck and Hall 3 or Barabasz and Watkins.4 Many myths exist about hypnosis that overrate, underrate, or distort the true capabilities of hypnosis.
Hypnosis can regulate blood flow and other autonomic functions that are not usually under conscious control. The relaxation response that occurs with hypnosis also affects the neurohormonal systems that regulate many body functions. Studies on the influence of hypnosis on immediate immune responses have shown the ability of hypnotized volunteers to significantly decrease the flare reaction to the histamine prick test. Similarly, in one study, the effect of hypnotic suggestion on delayed cellular immune responses has shown significant effect on the size of erythema and on palpable induration but no significant effect in other studies.
A report by Braun 5 on different allergic responses; dermatologic reactions; and effects on seizure disorders, pain control, and healing in the same individual with multiple personality disorder (now called dissociative identity disorder) shows how much influence the mind can have on physiologic reactions and disease processes, depending on the personality present. The report also described the differences in physiologic responses and disease conditions for selected individuals under hypnosis compared with their normal waking state.
