Clinical hypnosis for procedures, pain and hot flushes
A brief hypnosis session before breast surgery or a biopsy reduces pain, nausea and anxiety afterwards, and a course of hypnosis roughly halved hot flushes in one randomised trial. It is a skill some psychologists offer, not a stage act.
Overview
Clinical hypnosis uses focused attention and suggestion to change the experience of pain, anxiety and autonomic symptoms. In a randomised trial of 200 women undergoing excisional breast biopsy or lumpectomy (Montgomery et al., JNCI 2007), a 15-minute presurgical hypnosis session reduced post-operative pain, nausea, fatigue and discomfort and shortened time in the operating room compared with attention control. In 60 breast cancer survivors (Elkins et al., JCO 2008), five weekly hypnosis sessions reduced hot flush scores by about two thirds compared with no treatment. The 2022 SIO-ASCO pain guideline says hypnosis may be offered for procedural pain, and the SIO breast guideline lists it for hot flushes. Trials are small, and no-treatment controls in the hot flush studies leave a large placebo component unaccounted for.
How it works
Suggestion under focused attention alters expectation and the cortical processing of pain and autonomic signals; effects are largest for acute, procedural symptoms.
- Brief, cheap, no drug interactions
- Randomised trials with objective outcomes for procedures
- Included in SIO-ASCO pain guidance
- Few trained providers
- Hot flush trials lacked sham or attention controls
- Effect varies with hypnotisability
Latest papers
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