Headache, Hypnosis And Stress, A Case History
By Dr. Larry Deutsch, Thu Dec 8th
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Now, more that ever, concerned physicians are beginning to askabout and understand the role of non-drug therapies to assistpatients with headache. These therapies, alone or in combinationwith medications can significantly impact on headache treatment.
This pleases me. As a Family Physician and Clinical Hypnotistwith thirty years experience in the field, I applaud this trend.Certainly, a capable and compassionate physician will struggleto assist his/her patient find headache relief by whatevermethods, complimentary, traditional or both. Much can be gainedif we look at hypnosis as a helpful tool in the battle forheadache relief.
As our understanding of how the brain works and which compoundsor "neurotransmitters" control our pain response develops, webegin to suspect that relaxation therapies including hypnosis,may alter in a positive and fundamental way our brain chemistrysuch that pain relief is more likely. An interesting study wasperformed with patients who learned relaxation skills. Theresearchers checked the subjects' monoamine oxidase levels-sincemonoamine oxidase is what metabolizes serotonin, a pain reliefchemical, and found changes in those levels consistent with whatyou would expect with preventive drug therapy! The studysuggests that it is not just a matter of feeling relaxed that'simportant but actually learning via these relaxation therapiesto turn off and on certain pain pathways in the nervous systemby changing monoamine oxidase levels and consequently serotoninlevels.
In this paper, I would like to introduce you to hypnosis andself-hypnosis as a modality of pain relief for patients whosuffer from headache. Hypnosis is fun, effective, relaxing andhas no side effects. What is this thing they call hypnosis? No,Virginia, it is NOT clucking like a chicken, barking like a dogor being " put under", helpless, and at the control of themaster. Rather for most people, most of the time, it is afocused state of attention or harmony. It is easily achieved byvisiting a professional skilled in hypnosis. This pleasant statehas two fascinating and useful properties:
1) It is profoundly relaxing. In our stressful lives what personwould not enjoy a few minutes of deep relaxation in the middleof the day from hell!
2) The mind becomes open to positive and therapeuticsuggestions. Only suggestions given with your permission and foryour own benefit are accepted. No one can be forced or coercedinto doing something they do not wish to do.
Hence, when I help patients use hypnosis for headache andstress, I offer them headache specific suggestions as well asrelaxation and stress reduction instructions. I find thisprocess fun and creative. I get to know my patient not just asMr. Jones with a headache, but also as a real person in astressful situation. This stressor in combination with his orher biological predisposition to headache is creating more pain.
Let's take a look at a case history and see how it all fitstogether. Mr. X, a hard driving chief financial officer of ahigh tech company is known as the "firing man" and isresponsible for downsizing a company whose expenses exceed itsrevenues, and whose market share is declining. His neurologisthas referred him to me for help with his chronic daily headachethat has not responded well to numerous medications. Hisexecutive decisions in the short run will result in layoffs andsuffering for many. However, with his expertise, talent,intelligence and hard work, he may "turn the company around" andin the long run, his efforts will benefit far more people thanthose who will suffer in the short term. He is not well liked byhis co-workers and worries a lot about his health and finances.
He is a pleasant man, rather intense and self confident to thepoint of arrogance. At this time, he is wiling to considernon-drug therapies to diminish the pain and discomfort of hisdaily headaches.
As I get to know him, I will develop for him the three elementsessential to our success. First, in order to benefit from thetherapy he must be motivated. Motivated
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to want to use hypnosisfor his purposes, not mine, and motivated to put aside tenminutes each day to develop via hypnosis relaxation sufficientto impact on the pain chemicals in his brain.
Second, I must establish with him a positive and supportiverapport. Trust is an essential element of the hypnotic process.For this gentleman who is used to firing people and always beingin control in a "one up one down" situation, I must simply behis assistant. Without this rapport, hypnosis will not beeffective.
Third, I must make sure he has sufficient hypnotizablity. Mostof us can experience hypnosis without difficulty. Probably, onlyabout 10 percent of us will not be able to enjoy the hypnoticprocess. I have little to worry about with this patient. Mosthigh functioning individuals in our society have good hypnoticskills, as hypnotizability is associated with creativity,intelligence and imagination.
After a brief explanation of hypnosis and after gaining hispermission, Mr. X was hypnotized to enjoy some deep relaxation.Of course, like many patients he had expected to be 'put under"as he had seen on the stage. Prior to his hypnosis, he wasinformed that this would not happen but nonetheless, in spite ofhis level of awareness, the relaxation and ability to acceptsuggestion would be pleasing to him.
With this mixture of trust, motivation (based on correctinformation) and hypnotizablity, I was not at all surprised thatMr. X achieved some initial success at relaxation using hypnosisand self-hypnosis.
Mr. X was pleased and agreed to return for further sessions. Notsurprisingly, he canceled most of them because he was too busyat work! Nonetheless, he was very positive about the hypnosisthat we did. He reported that the relaxation lessened the painfrom his headache.
It is a principal of hypnosis that all suggestions requirereinforcement. Additionally, practice and repetition arerequired to develop these skills so they can produce both abiologically medicated pain relief (via altered brain chemicals)and a psychological harmony that helps the patient deal moreeasily with daily stress.
As with most of my patients, I asked Mr. X to set aside tenminutes daily (preferably at work and without interruption) tolisten to an audiocassette that I created for him to recapturethe relaxed feeling and increased suggestibility that heexperienced in my office. With some practice on his part, I wasconfident that these daily and pleasant practice sessions wouldreinforce positive suggestions relating to his particularheadache and attitude toward work.
Results have been very satisfactory so far. Mr. X has notreturned for further work. When last I inquired he reported animprovement in the severity of his daily headache. Once again,he said he had little time for therapy but he was enjoying theten minute practice sessions via his personalized audiocassette.
This particular case history will illustrate to the reader thevalue of using non-drug therapies to assist in pain control.Human beings are complex creatures who may have many different"triggers" for headache. Some of these triggers are stress andpsychologically mediated. By dealing effectively with these"triggers" we may assist in pain control with less or no drugs.
To summarize, hypnosis is effective and fun and provides apowerful complimentary or stand-alone therapy to those whosuffer from headache. Stress reduction and relaxation techniqueshave an important role to play in the treatment in one of themore vexing problems physicians face in practice, the patientwith headache. A recent paper, New Treatment Options In Migraineby neurologists Drs. Brandes, Edvinson, Marcus, and Rapoportrates relaxation therapies as "effective" as a non-drug therapyfor migraine.
About the author:Dr. Larry Deutsch is a practicing family physician andhypnotherapist. His proven self-help and programshave helped thousands of people achieve happier and healthierlives. As a Family Doctor, he is able to amplify sound medicalcounseling with a unique and artistic style of self hypnosisaccompanied by beautiful and relaxing music. http://www.drlarry.com
Learn hypnosis by reviewing these other articles on hypnotherapy and self-hypnosis:
