Approaches
Using three psychological approaches — Clinical Hypnosis, Guided Imagery, and Cognitive Behavioral Therapy — we can provide you with new ways to manage your pain.
Clinical Hypnosis
Hypnosis is a word that will often bring rolled-back eyes and disdain to the faces of many. For clinicians beginning to incorporate clinical hypnosis into their practice, substantial time will be spent educating potential referral sources and patients. At Pain Management Bay Area, we expected to be challenged with questions and uncertainties from the start. Actually, we welcome the questions, as each answer provides us a way to offer well-documented and researched information about this remarkable clinical tool.
Many of you probably are unaware that as a psychological intervention, hypnosis is one of the earliest procedures used by trained professionals. However, what is well-known is that Clinical Hypnosis has bounced in and out of favor for nearly two centuries. As we enter the 21st Century, it is particularly exciting for us to see Clinical Hypnosis gain a solid footing – a recognition - an acceptance - firmly set in the bedrock of good science.
Speaking of the science, here is an example of the application of hypnosis in the management of pain. One of the more provocative theories regarding hypnosis suggests that it might alleviate pain by decreasing the activity of brain areas involved in the experience of suffering. Scientists, using highly specialized brain scan imaging found that hypnosis reduced activity in an area known to be involved with suffering, but did not affect activity in the area where actual sensations of pain are processed. Imagine that a man had fractured his arm and although it was healing as medically expected, he experienced “life suffering” discomfort – he couldn’t drive or write, and was becoming depressed and withdrawn because of these limitations. If clinical hypnosis could aid in reducing his suffering over the current limitations, the fact that it may not actually affect the sensation of pain seems to diminish in importance.
At Pain Management Bay Area, we see individuals who report changes in how their lives have been negatively impacted by pain. With hypnosis, these clients report a reduction in “life suffering,” while the actual sensations of pain may or may not show the same improvement. However, what is striking is that with more effective management of their “life suffering,” clients appear to have an improved tolerance of their physical pain – findings now being confirmed in research studies.
One of the treatment approaches we offer at Pain Management Bay Area is Clinical Hypnosis. We provide our patients with education in its use through guidance and the acquisition of skills which then can be self-applied to more effectively manage their pain.
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Guided Imagery
Guided imagery is a powerful tool for decreasing anxiety, lifting a mood, or managing physical pain. There is much research that shows that thoughts have a direct influence on feelings and behaviors. A negative thought can produce sadness and frustration just as easily as a positive thought can produce a sensation of calm, happiness, and relaxation.
Guided imagery works in part because the mind does not know that you are creating the experience of an image, rather than the experience of a real situation. If you see a situation with your eyes open, your body produces a particular response. If you then closed your eyes and imagined the same situation, your body’s responses will be the same or similar to when you actually experiencing the event. These are some of the reasons how we chose guided imagery as a pain management tool.
Here is how it works: Typically, a therapist will lead you through a pleasant experience, such as a walk in your favorite nature environment. The therapist will invite you to experience the sights, sounds, and other sensory experiences of your image. You imagine your footsteps on the dirt path, and hear the crunching of yellow, orange and brown leaves. The environment is safe, and the sounds soothe you in some way, and you find yourself taking a deep breath. As you exhale, you see a slight shadow of your breath reminding you of the cold, and you are grateful your thick blue flannel jacket is keeping you warm as you pull the jacket closer to your body.
Get the picture? Usually guided imageries are recorded so you can take them home and listen to them when you need or want to calm down, relax or alleviate some of your physical pain.
There are many guided imagery CD’s available for pain management, and while they can be effective, a guided imagery experience that is tailored to your experience and abilities is often the most powerful and effective. Please give us a call; we can help you develop this tool for your pain management toolpack.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) has been around for a while. It did not reach fame in psychotherapy circles until scientific research demonstrated its effectiveness. Its effectiveness includes pain management, as well as anxiety, depression and other distressing emotional conditions. We work with medical professionals to facilitate the patient’s capacity for pain management. CBT can also work well in conjunction with Physical Therapy and Clinical Hypnosis.
It is easy for any of us to distort our thoughts—and thus our perspective—on certain challenging events in our lives. Often this distortion comes from a feeling of helplessness. Any of us may perceive chronic joint pain or headaches, for example, as hopeless. The afflicted person may have one or more of the following thoughts:
- “I will never feel good.”
- “Nothing can help.”
- “There is no fun in my life because of my pain.”
- “I must have done something really awful to deserve this pain.”
- “Even if I do feel better, the pain will come right back again.”
- “My life is totally awful now. There is nothing good in my life because of this pain.”
And so on.
Cognition is another name for thought, and thoughts have impact on a person’s emotional state. Thoughts also direct behaviors. In Cognitive Behavioral Therapy (CBT), therefore, considerable emphasis is placed upon the important role thinking plays in how we feel and how we behave. How a person responds emotionally to illness or pain can have a powerful influence on the experience and extent of his or her suffering. From a Cognitive Behavioral Therapy perspective, the thoughts listed above are distortions of reality. Such distortions can be unlearned and replaced by functional thoughts. CBT helps people to think differently about their pain. The CBT therapist and the client work closely together, as partners, to establish realistic positive beliefs about the client’s life with the pain. When these beliefs are consistently realistic for the client, the door to successful pain management has been opened.
Since thoughts and perceptions generate emotions and behavior, taking action is also a part of CBT. Relevant “homework” is assigned to the client. Completion of homework is crucial since it facilitates embodiment and solidification of the new perspective. Effective pain management can then take its rightful place in the person’s life.
