Implications for Hypnotherapy, Neuroplasticity, and Pain Control

woman experiences back pain and puts hand on lower back

We provide a brief review of the significance of hypnosis with respect to applications and physiological processes in hypnotherapy. Our review concludes that hypnosis is a promising method to manage acute and chronic pain. In addition, we discuss indications pointing toward the view that hypnosis can induce changes in neuroplasticity, possibly involving epigenetic mechanisms.

Introduction

Hypnosis has been used to manage diverse types of pain since centuries and across different cultures (Pintar and Lynn, 2008). Although hypnosis has been controversial, there is increasing evidence that hypnosis can indeed be an effective non-pharmacological and cost-effective method for the treatment of various health conditions like pain, anxiety, mood disorders, sleep problems, stress associated with medical and surgical procedures, cancer treatment-related side effects or irritable bowel syndrome (Anbar and Slothower, 2006; McCann and Landes, 2010; Coelho et al., 2008; Schnur et al., 2008; Lindfors et al., 2013; Kravits, 2013; Yeh et al., 2014).

While a uniform definition of hypnosis still not exists, hypnosis can be considered to be an altered state of consciousness (i.e. a trance-like state) resembling sleep induced by another person. It allows to recall memories or to be guided to change a specific behavior (Wagstaff, 2013). Although the neurophysiological mechanisms underlying hypnosis are far from sufficiently understood, neuroimaging studies revealed that subjective changes in response to hypnotic suggestion are associated with corresponding changes in brain areas related to the specific psychological function (Demertzi et al., 2011, 2015; Jensen et al., 2017). Furthermore, neuroimaging studies found that altered functional connectivity is associated with hypnosis (Schulz-Stübner et al., 2004; Jiang et al., 2017; Pyka et al., 2011). In addition, hypnotherapy may also be associated with hypnosis-induced epigenetic changes (Sawni and Breuner, 2017; Cozzolino et al., 2021; Rossi, 2005).

Here we review the relevant literature and explain why we conclude that hypnosis is a promising method to manage acute and chronic pain. In addition, it is also proposed that hypnosis could induce changes in neuroplasticity and that epigenetic mechanisms may underlie these changes of synaptic plasticity.

Hypnotisability

Hypnotisability refers to the degree to which individuals follow suggestions during hypnosis. Standardized tests like the “Stanford Hypnotic Susceptibility Scale, Form C” (SHSS:C; Weitzenhoffer and Hilgard, 1962) and the “Harvard Group Scale of Hypnotic Susceptibility scale, Form A” (HGSHS:A; Shor and Orne, 1962) have been developed to measure and predict hypnotic suggestibility (Gamsa, 2003).

Hypnotherapy for various health conditions

Numerous studies have shown that hypnosis can be an effective and safe approach for the treatment of pain, wound healing, emotional stress, haemorrhage, depression, anxiety, sleeping disorders, or stressful events like surgical procedures or tooth extraction. Furthermore, hypnosis has been applied in the context of bone marrow aspiration, colonoscopy, and for psychotherapy (Chester et al., 2016; Rogovik and Goldman, 2007; Evans et al., 2008; Iserson, 2014; Schnur et al., 2008; Fuhr et al., 2017}

Hypnotherapy and acute pain

Feeling pain is stressful and often induces anxiety. The stress is sufficient to trigger the perception of pain (Rome and Rome, 2000). Our nervous system controls how we process and feel pain, although there is no single “pain center” in the body that is responsible for the processing of pain. Pain perception is associated with interactions between various regions of the peripheral and central nervous systems that contribute to the overall experience of pain. Pain by itself is a complex,

Hypnotherapy and chronic pain

Although most of the earlier researchers focused on acute pain reduction by hypnotic analgesia induced in laboratory settings or pain associated with medical procedures, there is a constantly growing interest in applying the efficacy of hypnosis for chronic pain conditions. Chronic pain affects hundreds of millions of people worldwide, resulting in great personal suffering and social burden in terms of lost productivity and financial cost. A survey of developed and developing countries revealed Brain activity and functional connectivity associated with hypnosis The human brain is an extremely complex system that can be represented as a structurally interconnected and functionally synchronized network, which provide the segregation and integration of information processing. The human brain is topologically arranged into spatially distributed and functionally specific networks. The most extensively studied networks are the DMN, executive-control network (ECN) and SN since they have essential roles in cognitive functions (Liang et al., 2016). However, Genetic and epigenetics aspects of hypnosis Epigenetics is a discipline that studies heritable and reversible changes in gene expression that do not involve altering the DNA sequence. Most essential epigenetic mechanisms are DNA methylation, histone post-translational modifications (methylation, acetylation, phosphorylation, and ubiquitination), and regulatory non-coding RNAs (ncRNAs), such as micro-RNA (miRNA), Piwi-interacting RNA (piRNA) and long noncoding RNA (lncRNA), and chromatin organization (Clark et al., 2016; Zhang et al., 2019 Epigenetic mechanisms underlie neural plasticity and long-term memory Neuroplasticity (also termed “neural plasticity”) refers to the brain's ability to change its activity in response to extrinsic or intrinsic stimuli through dynamically reorganizing its structure, functions or connections (Mateos-Aparicio and Rodríguez-Moreno, 2019). While it was first thought that neural plasticity is limited to a phase when the nervous system is developing, the current knowledge is that neural plasticity is not restricted to infancy but retained by the individual throughout

Summary and conclusions

According to Gandhi and Oakley (2005), “Despite its intrinsic interest, its potential as an adjunctive procedure in therapy and more than 200 years of scientific investigation, hypnosis has remained an elusive concept for science and on the periphery of mainstream psychology.” As we reviewed, there are numerous and interconnected hypnotisability factors that play elementary roles in the contradictions in diverse experiments regarding to neural correlates of hypnosis, hypnotisability and hipnotic Declaration of Competing Interest The authors report no conflicts of interest. The authors alone are responsible for all the content presented in this review.

Acknowledgements

The author, István Bókkon, gratefully acknowledges the assistance of SXM ExperiMental Ltd, Hungary, Budapest. References (173) • S.K. Abdeshahi et al.