Researchers from Neuroscience Research Australia (NeuRA) and UNSW Sydney have reviewed how clinical hypnosis has moved from a new hope to emerging standard in a new paper published in Pain.
Postdoctoral Research Fellow at NeuRA and UNSW Sydney, Dr Rodrigo Rizzo, was first author on the paper and said as our understanding of pain increases, so does exploration of non-pharmacological treatments.
“For a long time, pain was often thought of as a simple signal travelling from the body to the brain, but research over the past few decades has shown it is far more complex,” Dr Rizzo said.
“We have learned the brain is not a passive receiver of messages from body, rather it actively processes signals from the body and the environment. In chronic pain, the brain may have gradually changed how it processes information from the body, activating even when signals from the body or situation are no longer harmful.
“Hypnosis is one of the earliest non-invasive procedures developed to help people reduce pain and discomfort, through guiding individuals to change how their brain processes sensations, perceptions, and other information coming from the body.
“We found growing evidence base demonstrating the effectiveness of hypnosis for chronic pain. While current evidence supports its recommendations for some chronic pain conditions, stronger evidence is needed to support recommendations for others.”
Understanding clinical hypnosis
“Hypnosis is an experience of focused attention and reduced peripheral awareness, during which some individuals show increased responsiveness to suggestions,” Dr Rizzo said.
“Through history, hypnosis has experienced periods of enthusiasm and neglect, and it has often been portrayed as entertainment at parties. However, our understanding has evolved and a body of evidence suggests it can be a practical clinical approach for managing a range of chronic pain conditions, alone or in combination with other treatments.”
Clinical hypnosis is typically delivered over four to eight sessions, spaced a few days to several weeks apart. They may also include self-hypnosis training.
The review identified 11 meta-analyses published since 2009, including studies focusing on people living with chronic pain. Taken together, these analyses suggest that clinical hypnosis can reduce pain, with benefits lasting several weeks or even a few months.
It also highlighted that some clinical practice guidelines have begun recommending clinical hypnosis for conditions such as irritable bowel syndrome (IBS), fibromyalgia, and cancer-related pain in adults, as well as IBS in children. In addition, new high-quality clinical trials are investigating its potential benefits for other conditions, including chronic back pain.
Steps to becoming a recommended treatment
So, what needs to happen for clinical hypnosis to become a recommended treatment for patients?
“For clinical hypnosis to be a treatment recommendation in clinical practice guidelines, we need high-quality systematic reviews or randomised-controlled trials and demonstrate that it can be easily incorporated into existing chronic pain management,” Dr Rizzo said.
“This includes understanding which patients benefit the most, how hypnosis can be delivered in real-world clinical settings, and how clinicians can be trained to use it safely and effectively.”
The research team also considered the availability of appropriately trained practitioners, noting that persistent misinformation, stigma, and uncertainty about professional qualifications could limit implementation.
The NeuRA team is currently conducting a large government-funded clinical trial investigating the effectiveness and implementation of clinical hypnosis delivered via a mobile device for people with chronic back pain. If proven effective, this approach could become a “prescribable” intervention that clinicians can offer to support patients throughout their care journey.
You can read the full paper here.
