Hypnotic Effects

After reconstructive breast cancer surgery, Joni Holland, 58, of Tarzana, California, was left in unbearable pain for days. When she learned she’d need another operation, she was petrified about having all that pain again. So when a mutual friend referred her to Janet Montgomery, a certified hypnotherapist in Woodland Hills, California, she was all ears.

During their single session, Montgomery hypnotized Holland, who described the session as very relaxing. Holland left with a 30-minute CD of their interaction and used it for the month leading up to her next surgery.

“Listening to the CD, I’d go back to that same comfortable place in my mind. Because of Janet, I went into surgery feeling much calmer,” Holland says. “It went well, and I had no pain afterwards. I really believe a better attitude helped.”

Hypnosis can be traced back to ancient Egypt, as well as Greek mythology. Now modern medicine is adapting the approach to help cancer patients through surgery, biopsy, radiation and chemotherapy.

Recognized as a valid medical procedure for patients since 1958 by both the American Medical Association and the American Psychological Association, hypnotherapy also gained credibility when the National Institutes of Health recommended it for chronic pain relief in 1995.

Since then, dozens of studies have suggested that medical hypnosis can decrease cancer-related anxiety, fatigue, pain, and depression. And new research is exploring other potential benefits, such as possible reduction of radiation-induced skin redness or itching.

Despite its legitimacy, hypnotherapy remains mysterious to some, but to psychiatrist David Spiegel, MD, medical director of Stanford University’s Center for Integrative Medicine, hypnotherapy is “a genuine mental state, in which the mind, like a telephoto lens, zooms in on a single, specific subject, and perception itself can change.”

“It’s not a treatment—it’s a level of concentration,” says the medical hypnosis pioneer. “Under hypnosis, the brain can learn to alter what it sees and feels.”

Hypnotic intervention begins with therapist and patient agreeing to participate in “talking therapy,” a psychotherapeutic technique, explains psychologist Guy Montgomery, PhD, director of the Integrative Behavioral Medicine in the Department of Oncological Sciences at Mount Sinai School of Medicine in New York City. The hypnotist makes suggestions for changes in perception, sensation, cognition, affect, mood, or behavior; the patient’s willingness allows acceptance of these suggestions.

“Hypnosis is one of the most effective tools available to help people cope with cancer and its treatment,” says Montgomery.

Since the late 1970s, when Spiegel theorized that “strain and pain lie mainly in the brain,” he has treated thousands of cancer patients with medical hypnosis. He says it works because, “pain hijacks our attention. Two-thirds of metastatic patients have some kind of pain, often substantial during chemotherapy.” By teaching the brain to transform or change its awareness, hypnosis treatment frequently reduces even drug-resistant pain, he says.

The Lancet

In his landmark study published in in 2000, Spiegel and colleagues reported that hypnosis could ease pain for patients undergoing invasive medical procedures. Of 241 total subjects, those randomized to hypnosis had half the reported pain and were less anxious than those who had standard care. They also used significantly less pain medication. “These [research subjects] are not suffering in silence—they are able to change their perception of pain,” Spiegel wrote.

In addition to pain, fatigue is one of the most reported side effects of cancer, during and after treatment. With patients undergoing radiation, fatigue can be especially distressing. In Montgomery’s recent study on fatigue and breast cancer radiation, 22 subjects, who met weekly with a trained psychotherapist throughout their radiation treatment, reported no increase of fatigue over the course of radiation. For the 20 patients in the control group who did not meet with a psychotherapist, fatigue increased linearly.

Hypnosis not only reduces physical symptoms, but can also impact patients’ emotional status. Studies have shown patients who undergo hypnosis before surgery reduces pain, but also anxiety.

Journal of the National Cancer Institute

Montgomery’s randomized clinical trial with 200 breast cancer patients, which was reported in 2007 in the , provided 15 minutes of pre-surgery hypnosis to the intervention group. On average, the hypnosis group had ten minutes less operating room time and approximately 30 percent less anesthesia when compared with the control group. The researchers believe the cause was the subjects’ calmer state. After surgery, patients reported about half the level of post-surgery discomfort.

In a smaller study, Montgomery’s team found that patients who received hypnosis self-reported more positive moods and fewer episodes of negative feelings compared with the control group.

“By lowering patient distress and changing expectations, hypnosis improves outcomes. For over a century, the success of hypnosis for improving postsurgical recovery has been documented,” Montgomery adds.

How can you find a well-qualified hypnotherapist to help with anxiety, pain, depression, fatigue, or other difficulties due to your cancer? Some cancer centers offer the approach or can make referrals. Also, check to see if your insurance covers hypnotherapy.

You can also seek a nearby hypnotherapist through the Society for Clinical and Experimental Hypnosis (www.sceh.us), American Society of Clinical Hypnosis (www.asch.net), The American Association of Professional Hypnotherapists (www.aaph.org) or American Psychological Association (www.apa.org).

Find a hypnotherapist who is a licensed, trained health professional. “Choose someone with 40 or 50 hours of additional hypnotherapy training,” Spiegel advises.

Make sure the hypnotherapist has worked specifically with cancer patients. A successful session requires a skilled practitioner, plus the patient’s trust and willingness. “Hypnosis facilitates a primary treatment strategy. It helps separate psychological from physical stress, to better manage pain and anxiety. It’s much safer than any medication,” Spiegel assures.

Often, patients can benefit from a single session. “As little as 15 minutes pre-surgery can be effective,” says Montgomery.