Hypnotherapy reveals how functional
pain may come from the brain

A joint British-American research project to investigate unexplained pain has shown the cause may begin in the brain.

Evidence for this came from work carried out by University College London and the University of Pittsburgh Medical Center using hypnotised volunteers. Many types of functional pain - such as chronic low back pain - have presented a long-term puzzle because there was no obvious source of the problem.

Millions of people in Britain are suffer from such pain - sometimes suspected of malingering. Using hypnotised volunteers, the UK-US study has shown that, in some cases, the origins of such pain come from the patients' brains not their bodies

Dr David Oakley

Dr Stuart Derbyshire

 

The researchers discovered that volunteers who felt pain following hypnotic suggestion displayed strikingly similar brain activity to those subjected to physical pain via pulses of heat at 49 degrees Celsius.

This indicated some forms of pain which cannot be traced to a physical problem may have a neurological basis.

They also found when the volunteers were asked to simply imagine, that they felt the same pain, but had significantly different brain activity than under hypnotised and physical pain conditions.

Volunteers were chosen using the Harvard Group Scale of Hypnotic Susceptibility and were hypnotised with a simple imagery induction such as going down stairs or descending in a lift.

Details of the study are published in the journal NeuroImage under the joint authorship of Dr. David Oakley, Director of UCL's Hypnosis Unit and Dr Stuart Derbyshire, assistant professor of anaesthesiology and radiology at Pittsburgh University.

As part of the study eight volunteers were placed a magnetic resonance brain scanner and pictures of their brain function taken while they were hypnotised.

They experienced periods of rest, periods of noxious heat delivered to the hand and periods when they were told the heat was coming but none was actually delivered. During this third period all the volunteers reported still experiencing heat and most of these non-stimuli were experienced as painful. None reported believing the probe was switched off - though it was,

Dr. Derbyshire explained: "Thus we were able to present images of the brain during an experience of pain based on actual delivery of a noxious stimulus and during a hypnotically induced experience of pain when no stimulus was actually delivered."

He claimed the study provided direct evidence of the brain generating pain in the absence of any actual noxious input. "That is significant because many functional disorders, such as fibromyalgia, might rely upon similar mechanisms."

Dr Oakley commented: "The fact that hypnosis was able to induce a genuine painful experience suggests that some pain really can begin in our minds. People reporting this type of pain are not simply imagining it."

He added:"A lot of people have been dismissed as malingerers. But the research findings should reassure people suffering these types of pain that they were not imagined É You shouldn't treat the patient as if the pain is just imagined.

"If this pain has an origin in the brain it suggests that you can use other therapies, such as hypnosis, to alleviate the pain."

Dr Oakley recognised though there would inevitably be cases of people making up symptoms, for example to avoid going back to work.

He believes studies such as this, published in reputable scientific journals, offer evidence that hypnosis has moved "out of the Dark Ages" to become a valuable research tool.

"Hypnosis offers a safe way of altering a person's experience of themselves or of the world around them," he added.

Posted August 2004
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